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  1. #1
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    Post Gastric Bypass Surgery Nutrition / Hydration Question

    I had gastric bypass surgery 1 month ago. This weekend I went on my first bike rides in 6 months, and BOY have I missed my bike.

    A brief explanation of gastric bypass as it is at the root of my question. My stomach was divided. At the end of my espohagus is the smaller stomach which I still use. It is currently about 2-3oz, and will likely stretch to 4-6oz. in a year. The ramifications of this are: I MUST emphasize protein and vegetables, and can't waste precious pouch space on empty carbs (bread, potatos, etc.). Bariatric patients who do not eat enough protein experience heart damage and hair loss. I also am restricted in fluid intake, and am not supposed to drink 1/2 hour before and 1 hour after eating.

    Before this AM's bike ride I ate 6 ounces of sugar-free pudding. The starch provides some carbohydrates, and this is essentially a liquid as it goes through my stomach quickly. I used a traditional water bottle.

    As I increase my distance, I'm thinking I'll have to drink gatorade to provide a stream of carbs and liquids. Furthermore, I'm thinking a camelback hydration will be better, as it will allow me to take frequent small sips instead of huge gulps every 15 minutes.

    Are there any other bariatric patients out there with experience on these issues? Any suggestions?

  2. #2
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    I don't know how much weight you have to loose. Two woman at work had the surgery. They didn't start exercising until they had lost over 100 pounds each. Just taking a stab in the dark, but you'll probably only be riding short distances at first. If you are only riding 5-10 miles, I don't think you need any special water or food requirements. The camelback seems like a good idea. I only use Gatorade when I'm on a multiple day event or doing interval training. You may want to look up threads about people at BF on the Atkin's Diet.

  3. #3
    Look Ma, NO hands!
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    My wife is just under 2 weeks out from the same surgery, i assume you had RNY, and she is doing great. I have gone through all the littiture and meetings with her. My only question with the Gatoraid plan. Will it cause you to have "dumping"? High energy liquids are one of the things this surgery is susposed to protect you from consuming. You may be better off mixing your own sports drink with salt and KCl. From what I understand about dumping you may also be able to avoid this by paying special attention to the osmolarity of the solution you are consuming, thus avoiding fluid rushing to your small bowel. You may try some of the many bariatric support groups on line and ask these same questions.

  4. #4
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    Quote Originally Posted by outashape
    I don't know how much weight you have to loose. Two woman at work had the surgery. They didn't start exercising until they had lost over 100 pounds each. Just taking a stab in the dark, but you'll probably only be riding short distances at first. If you are only riding 5-10 miles, I don't think you need any special water or food requirements. The camelback seems like a good idea. I only use Gatorade when I'm on a multiple day event or doing interval training. You may want to look up threads about people at BF on the Atkin's Diet.
    I got the surgery so I could exercise. I started in December at 298, lost to 280 to have surgery on Feb 20th. I am currently 245, dropping about 5 lbs per week. I ride bikes and play softball. My weight caused me to tear the PCL in my right knee, and then I got plantar fasciitis. I am 41 years old, have a blood pressure of 130/78 (pre surgery, it's likely fallen some) who weighs too much, but I am reasonably healthy due to my exercise level.

    With respect to dumping, I don't think I am susceptible. I had a bit of ice cream with apple cobbler (total about 3 oz!) with no ill effects. I can eat a whole banana in about 20 minutes. I'll try the gatorade and see what happens.

  5. #5
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    A long term follow up in case anyne needs to know. I dropped to about 200lbs. I could be lighter, but that is not my priority. I eat well, and have no food specific sensitibvities. I do not dump, and can hydrate just fine. I'm riding more now, as I have been too busy.

    For some reason my bikes don't break as much as they used to. Go figure.

    If anyone you know is considering the surgery feel free to contact me with specific questions.

  6. #6
    The Question Man
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    just curious, but why did you decide to have surgery?
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  7. #7
    Stuck in winter hell :( Jimmy_Thing's Avatar
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    just curious, but why did you decide to have surgery?
    Admittedly I am curious as well. At 298 it seems that is not really heavy enough to justify such a life changing surgery. I wish you well and am glad to hear it worked out for you.

  8. #8
    The Question Man
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    Quote Originally Posted by Jimmy_Thing
    Admittedly I am curious as well. At 298 it seems that is not really heavy enough to justify such a life changing surgery. I wish you well and am glad to hear it worked out for you.
    frankly I'm so against the surgery, I wouldn't think it was justified for anyone under 400 pounds. I mean, take a look at some of the posts in the Weight Loss thread. Those guys are simply amazing.
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  9. #9
    Look Ma, NO hands!
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    As I posted earlier in this thread, my wife had this surgery over a year ago. She has lost over 100 pounds, feels great, and is more active than she has been in her whole life.
    There are some side effects to the procedure, but nothing like being so obease. BTW the need for the procedure is long and drawn out. It is based more on your BMI and other "comorbid" conditions than just you gross weight.
    Now on the Bikeforums may be a weird place to talke about weight loss surgery, but let's face it, some people are never gonna be exersize freeks, like some of us. Another good thing that has happened because of the surgery for my wife, is that she had to quit smoking before the surgery, and has remained smoke free since! YEA!
    I have a very strong personality, just ask anyone who knows me, I quit smoking 2 years before she did, lost 60 pounds, and begain exersizing, then riding a bike! Now I am 5 MPH faster than 3 years ago, ride centuries, time trials, and commute some (more since the price of gas has gone through the roof)! Now I have a hard time explaning to her why I need to drive 45 miles, with the bike, to ride 100 miles with a group, and drive home. Some of us have the mind set to do anything we set our minds to, others need another solution. Weight loss surgery is it for some. It would be all too easy for me to sit back and say " If I can do it, anyone can!", the fact is that some poeple can't do it.

  10. #10
    sweet but not innocent wretchedheathen's Avatar
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    I rode 9.2 miles last saturday, which was 11 days post op and it was 1.2 miles too far. wiped me out for two days. I absolutely can not tolerate anything but water on my ride. wow. nothing with sweeteners in them or I get horrible dumping. I did take 1 ounce portions of pork loin and that gave me a lot of energy for the trip. it was for my husband death defyingly slow, but 10 mph for me was a hard work out considering, my staples had only been out for 2 days. he got on the stationary at home and rode a heart pounding 50 miles and was much happier. I am now doing 2 miles a day every other day on the stationary, it is just too hot and I dehydrate too fast outside.
    Katherine
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  11. #11
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    Whey protein powder dude!

    http://www.wheyoflife.org for all
    the details on health benefits.

    If you put about 3 giant scoops of
    whey protein powder in a 4 to 6 oz
    glass of half and half and mixed it
    good in a blender you would have
    all the energy to ride for a couple
    of hours and not think about food
    again til lunch. In addition, you could
    add glutamine, creatine and such to
    it for performance enhancement and
    not increase the carb content at all.

    Whey protein is 80 to 90 percent pure
    amino acid protein source, they highest
    source of protein you can get in any
    food (particularly in small dosages) and
    its performance and metabolic characteristics
    are such that it promotes lean muscle mass,
    glucose management (if diebetes is an issue)
    and weight loss.

    I cannot recommend anything more
    highly. I used it to lose my weight (90 lbs)
    and have continued to use it in maintenance.

    I am sure you get similar supplement
    drinks through your doctor, but check
    this out. 3 scoops of that stuff as indicated
    above would keep you rev'n dude!

    And my doctor is f'n amazed at how
    healthy, lean and fit I got on this diet.

    Cheapest place on the Internet I have
    found to buy it (and yes, I buy the 44 lb
    bag) is at: http://www.supplementdirect.com/?con...oduct_id=10805

    You can check with your Dr, but I bet
    if he knows what the f*ck he is talking
    about, he'd agree this stuff would do
    you wonders.

    Good Luck!
    Ned Goudy, Glendora, CA USA
    Lightning Thunderbolt, Easy Racer EZ1, Rhoades Car
    http://www.rhoadescar.com/4w1p-j.jpg

  12. #12
    Dirt-riding heretic DrPete's Avatar
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    Quote Originally Posted by cheebahmunkey
    frankly I'm so against the surgery, I wouldn't think it was justified for anyone under 400 pounds. I mean, take a look at some of the posts in the Weight Loss thread. Those guys are simply amazing.
    Well, the NIH consensus criteria that most institutions use for bariatric surgery are a Body Mass Index of 40, or 35 with comorbid conditions directly related to obesity (sleep apnea, arthritis, diabetes, hypertension, the list goes on). In addition to meeting the BMI requirements, patients undergo psych, nutrition, and endocrine screening, and have to have failed on multiple (5 or more) diet/exercise programs.

    For the longest time I thought it was all an issue of willpower too, but now that I've seen more patients who get a HUGE benefit from the surgery, I'm becoming a believer. So I wouldn't criticize the OP for his choice--most people don't embark on it lightly and the vast majority of the patient's I've taken care of truly view surgery as a last resort.

    As far as the original post goes--If you don't dump you're in pretty good shape. The key is to eat something that's a relatively small volume and has a good mix of simple and complex carbs. The first thing that comes to mind is GU, which is more complex-carb oriented than other gels. It's a small portion and shouldn't fill you up too much.

    As far as hydration goes, I think you're absolutely right on in the camelbak idea. Your GI tract is inherently malabsorbing, and if you don't keep a steady stream of water going you'll find yourself feeling like crap in a hurry. Anything that lets you sip on some H2O for the whole ride is a great idea.

    The key in your long-term training, IMHO, is to improve your aerobic base, and not to do too much of the high-intensity stuff just yet. A heart monitor would probably be a great investment. Do lots of long, low-intensity riding and two things will happen: 1. You won't die because your body won't need as much carbohydrate (which you can have a hard time getting enough of) and 2. Your anaerobic threshold with slowly rise, meaning your aerobic metabolism will pick up more and more of the slack, even with higher intensity work.

    Congratulations on your gastric bypass! I would also mention to your nutritionist (patients at our hospital all get one--If you don't it might be a good idea) that you're cycling, and he/she may have some good ideas for keeping your energy up. Endurance sports change the ballgame quite a bit when it comes to dieting. Take it from someone who sucked some serious wind while trying to ride on the south beach diet.

    See you on the road!
    DrPete

  13. #13
    Dirt-riding heretic DrPete's Avatar
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    Quote Originally Posted by wretchedheathen
    I rode 9.2 miles last saturday, which was 11 days post op and it was 1.2 miles too far. wiped me out for two days. I absolutely can not tolerate anything but water on my ride. wow. nothing with sweeteners in them or I get horrible dumping. I did take 1 ounce portions of pork loin and that gave me a lot of energy for the trip. it was for my husband death defyingly slow, but 10 mph for me was a hard work out considering, my staples had only been out for 2 days. he got on the stationary at home and rode a heart pounding 50 miles and was much happier. I am now doing 2 miles a day every other day on the stationary, it is just too hot and I dehydrate too fast outside.
    You're totally doing the right thing. Carbs are the main fuel for higher-intensity efforts, so you should definitely keep the intensity low. If you're 11 days postop I can't imagine you were doing a whole lot in the way of intense aerobic activity before, so it'll just take time.

    Keep with it, and I would consider buying a heart monitor to prevent overtraining or overshooting your heart rate... Keep it in the low-intensity aerobic zone and tell your hubby to be patient. Just having the surgery won't cause you to be miraculously in shape, but it will pave the way...

    Congrats!
    DrPete

  14. #14
    Senior Member john bono's Avatar
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    I've been about 2 1/2 years post op(lap band). My starting weight was 450 at 5'10"(currently 290-something), so I have some experience here, and I'll relate what I did. YMMV.

    The first thing that I needed to tackle was the idea that I was *really* out of shape. So, the first month to or so of exercise I focused mainly just on improving my aerobic capacity, and nothing else. The first two weeks I did 1/2 hour of medium-light intensity workout on a recumbent stationary bike, then switched to daily. Recumbents are easier to use if you are obese. The idea here is not to just get exercise, but to get in shape to get in better shape--improve your baseline so you can really hammer it later. When there is no aerobic capacity at all, even anaerobic exercise is taxing. Once I got past that point, I added weightlifting and an abdominal workout to my routine. Initially, I lifted every MWF, doing all muscle groups at once. Once I reached a level of comfort in my lifting, I changed to lifting every day, doing a different muscle group each day(chest monday, bicep tuesday, shoulder wednesday, legs thursday, etc) Nonetheless, I still did 1/2 hour on the bike each day(including playing the air drums using an Ipod ).

    Around when I reached 350 lbs, I saw someone discarding an old Raleigh road bike. I picked it up, and started using it to ride to and from the gym instead of using the recumbent. I started to build up in distance, finishing that summer by riding about 30 or so miles/week, with an occasional 20 mile ride. Last summer, I purchased a used Schwinn Caliente for $80, and rode that about 4-5 days a week for about 50 or so miles/week, and finished that summer with a 45 mile ride around Candlewood(At the time I was about 310). I still lifted weights during that time as well.

    This past March, I bit the bullet and bought a brand new Spec. Sequoia Elite ($1100 at the LBS). Since March, I've done 2 half centuries, a metric century, and two full centuries. I use the bike to commute, to ride to the gym, and to get groceries.

    Right now, I'm focusing the most part of my training on the bike to improving my hill climbing. I discovered during the Hat city Cyclefest that my hill climbing just plain sucked esp. on those little dippy hills that were all over the first 50 or so miles of the course.

    Finally, to those who think the surgery is a panacea, it isn't. It's just a way to get started. If I didn't do the physical activity I do, even with the surgery, I'd still be a lardbutted couch potato, just a smaller lardbutted couch potato. Personally, I think failing to exercise soon after surgery will only prolong the time until you achieve your goal, and your energy level will still be far lower than it should be.

  15. #15
    Senior Member john bono's Avatar
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    Quote Originally Posted by wretchedheathen
    I rode 9.2 miles last saturday, which was 11 days post op and it was 1.2 miles too far. wiped me out for two days. I absolutely can not tolerate anything but water on my ride. wow. nothing with sweeteners in them or I get horrible dumping. I did take 1 ounce portions of pork loin and that gave me a lot of energy for the trip. it was for my husband death defyingly slow, but 10 mph for me was a hard work out considering, my staples had only been out for 2 days. he got on the stationary at home and rode a heart pounding 50 miles and was much happier. I am now doing 2 miles a day every other day on the stationary, it is just too hot and I dehydrate too fast outside.
    How much time are you spending on the stationary bike? If you are only riding 2 miles on the stationary bike, you might not be putting enough time to give yourself a workout. At 10mph 2 miles is only 12 minutes of aerobic exercise. Aerobic exercise starts paying off after 15 minutes. You need to put in 30 minutes each time you ride the stationary bike, and you will need to build up to being able to do that daily. Notice I didn't mention distance, but time. If you pedaling at a decent clip for yourself, it really doesn't matter what it says on the odometer, only what it says on the clock.

    If you are able to do 1/2 hour on the stationary bike, every day, for about a month or so, that would be a good time to switch to riding outside, 1/2 hour, fifteen minutes out, fifteen minutes back, every other day, for a couple of weeks, then switch to riding 1/2 hour daily.

  16. #16
    sweet but not innocent wretchedheathen's Avatar
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    on the stationary bike I am getting much more than the outside bike. since I am not dealing with road resistance, wind, and whatnot, I can go 18 mph, I go through two cycles of the 'trainer' keeping my heart rate at 139 and it takes me about 20 minutes before I crash to the floor and wonder if my heart will ever stop pounding.

    I alternate the indoor bike when I can not got out door in the wild. for instance this week it has rained 7 days and 7 nights and will continue, so I am not risking it, one slip on the pavement and my 20 day old tummy could take a direct hit. the second challenge is that hydration issue, when it is blistering hot, and I can barely get 64 ounces in a day, it is just not worth it to take on the heat/humidity until I am further out and have more 'room' to hydrate with. our last adventure, we did stop and sip every mile. it was good for the kids as well (4 and 6).
    Katherine
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  17. #17
    Ain't Easy Being Cheesy CheeseLouise's Avatar
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    Kat!

    Hello from Minnesota to Texas!!!

    Nice to hear you are out and about on the bike! Keep it up! For me right now I am backing off as I am on a 10 day pre-op liquid diet and not a lot of energy right now. I did get out for a couple of 25 mile rides this week but I was feeling the lack of energy Not much fuel in Carnation Instant Breakfast and chicken broth.

    Some really good information has been posted here and then there is some that is posted out of lack of knowledge of Gastric Bypass Patients. Thank you to those who have been brave and open enough to share your knowledge and experience.

    I am scheduled for surgery on June 30th, 2006. Next Friday!!! I have been up and down the scale my whole life, mainly up. Granted most obese people are not physically active, some of us are Kat, for one and myself. I currently ride from 100-200 miles per week at an average speed of 16 mph. I am 5'5" tall and weigh 242#. I have a BMI of 38.8. I am a type II diabetic and looking forward to losing all the weight and climbing hills faster and better than ever.

    Kat, there are people who cycle after Gastric Bypass and do quite well at it. I like the camelback idea.

    For some of you who mayb einterested I have a blog and more info at www.bikenaked.net

    TAke care Kat and keep up the cycling, just remember "Rubber Side Down"
    "Bike First"
    "Work Later"

    2006 Specialized Ruby Comp
    www.bikenaked.net

  18. #18
    sweet but not innocent wretchedheathen's Avatar
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    Congratulations on gettin a "Date", Each week, as I drop, I mentally drop the years, rolling back to what I weighted, when. (currently, I am back to 1997) and as my pouch size increases, I am able to get more water in and the more I am confident that I am hydrated, the better I feel about 'real' biking in the Texas heat as opposed to 'pseudo' biking inside. I was getting over heated last night during my 'ride' (increased to 3.5 miles) but maintained my heart rate at 135 the whole 13 minutes.

    I tried a Propel yesterday, and was able to tolerate it well. 4 grams of carbs just gives me the willies. I prefer to keep my carbs under 1 to 2 at most. been this way for 110 days and it has been working for me.
    each day I get stronger and better. today is a 2 hour walk through a nature preserve. no cardio, but exersize just the same.
    Katherine
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  19. #19
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    Bariatric patient

    Hi, I just found this forum. I will be 4 years out from my gastric bypass and lost 181 lbs. I am cycling and in no way shape or form am I good. I understand our not eatting and drinking together. TO be totally honest it does not bother me at all on the ride. I usually have a whol grain tortilla with p-nut butter and sugar free jelly and some bananna. It is really yummy to me. The furthest ride I have done is 100 miles and I did bonk. I associated it to dehydration. I was really dry and I was drinking. I spoke with one of the guys at my local bike shop. We discussed nutrition at length. We need to eat and drink secondary to or small ability to intake food and fluid. I drink all the time water that is. I also have started to use mototabs . They work better for me than gatorade. Gatorade works for me when I run but not when I ride. I did not give you all that you wanted but these are some of the things that I do.
    Liz

  20. #20
    Galveston County Texas 10 Wheels's Avatar
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    Welcome to BF Liz,
    I rode 100 miles last week twice. Thursday and Friday.
    I drink 7 bottles of fluid on 100 mi rides.

    Do you have a road bike?
    [SIZE=1][B]What I like about Texas[/B]
    http://www.youtube.com/watch?v=PGukLuXzH1E

    Set F1re To The Ra1n ( NY Night Rain Ride)
    http://www.youtube.com/watch?v=W7jfcWEkSrI

  21. #21
    sweet but not innocent wretchedheathen's Avatar
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    I have a mountain bike with hybrid tires and I am seriously a lightweight when it comes to riding. My most recent ride I had a 15 lb still camera in my backpack and 4 bottles of fluids and made it 22 miles before I thought I was going to die. ;-) heehee

    my average speed is 9 mph and my top speed is 12 mph. I was at 3300ft elevation, so the air was thinner, but overall in general, I just do not have the stamina for a 50 - 100 mile ride. I am seriously proud of myself if I get out and go 7 - 14 miles.

    that being said.. at this point.. I am not focusing on my carbs when I ride.. on my 22 mile ride, I had two 20 gram Cliff protein bars and some cheese sticks to keep me from getting hypoglycemic. I pre-freeze my Propel bottles and drink them as they melt.
    Katherine
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