DLCoggin

About 50% of RNY patients never experience dumping. Some experience dumping and fail to recognize it and others experience symptoms similar to dumping and assume it is dumping when the cause is actually something else. Regardless, there is no scientific evidence that folks who experience dumping are any more or less successful than those who don't. For those who qualify, there is a long list of life-changing benefits from RNY. Not one of them is attributed by medical science to dumping. Complete loss of appetite immediately following surgery and in some cases extending up to several months is quite common. But your appetite does eventually return. And that is most assuredly a very good and a very healthy thing. It is absolutely nothing to fear. But you will find that your appetite is different than it was pre-op. Very recent research studies are just beginning to understand some of the underlying causes of the changes. For example, the results of a study published in May of this year found that there is a decrease in an appetite stimulating hormone (ghrelin) following RNY. They concluded that the decrease may explain why the sensation of hunger is often diminished following RNY. In another study published in March of this year, researchers at Harvard and Massachusetts General Hospital found that gastric bypass performed on mice produced dramatic changes in the microbes found in the gut. Those bacteria tend to not only boost metabolism, but also extract fewer calories from food during digestion. Even more surprising, they found that the changes seemed to occur almost immediately following surgery. Like all research, new findings invariably lead to new questions that must be answered. It will likely be several years before application for humans (if any) is known but these initial results are promising. Still other very recent studies have found that a procedure they named "bile diversion" has produced results similar to RNY in rats and several recent studies have found a number of links between obesity and a previously unidentified gene known as "FTO". The fact that RNY works in a very high percentage of cases is undisputable. Exactly "how" it works is still in the very early stages of being understood. For now it is perhaps most important to remember that the ultimate success of all forms of bariatric surgery is, and always has been, about the Prime Directive - lifestyle changes. The surgery is a life-changing tool that makes those formerly impossible changes, possible. You're gonna love the new you!!

I had exactly the same problem. I very intentionally never set a weight goal. My focus was on following the protocol as closely to the letter as I possibly could. I made a decision from the very beginning that my body would know when it was at the weight that it needed to be at. And that's exactly what happened. I followed the protocol and when my weight loss stabilized, that was the number. Your family and friends have the very best of intentions. You gotta love 'em. But your body and your doctor will give you healthy, objective feedback. You're gonna love the new you!!

ccwolf3, you can Google "5 Day Pouch Test" and use it to determine the capacity of your pouch. Personally, I believe that walking and using a food log are much more important toward helping you achieve your goal. But if you're really concerned, the test may help put your mind at ease. Stay focused on following the protocol as closely to the letter as you possibly can, stay active, log your food and stay away from the scales for at least a week and two would be even better. You're gonna love the new you!!

Are you logging your food? If not and you decide to start, you'll never again be "clueless"! Your confidence will soar and you'll learn more about managing your weight in a month than you will in a year of just going with the flow. It's quick, it's easy and it gives you an enormous amount of information about every aspect of your food intake. Very powerful tool.

Do you maintain a food log? I have maintained a log for almost two years and find it to be hands down the most powerful weight management tool in the arsenal. Great confidence builder, allows you to "manage" your weight, and teaches you literally in black and white, that it's all about control, not denial. Averages are the key. Highly recommended.

180 lbs in seven months - OH YEAH!! Congratulations!! Love your comment about following the protocol to the letter - that's the road to the promised land!! Do you maintain a food log?

Welcome PapaJames! Lots of great folks here and we're all eager to help and share your journey! You're gonna love the new you!!

I'm not going through the same struggles but I highly recommend a food log. My Fitness Pal is excellent, free and has a huge database of foods. But there are other good apps as well. Tremendously powerful tool that will take you anywhere you want to go - lose, gain or maintain. And you can log your exercise as well. Great confidence builder. Welcome to the forum! It's always great to have another veteran join us! Please share your experience with everyone!!

I think we all can relate. But losing too much weight is something to be wary of as well. If I recall correctly (big if lol), you said in one of your posts that your doctor set a goal weight for you somewhere around 130 to 140. At 105 you're 25+ pounds below that. That's a lot - some might suggest too much. The only way you're going to gain confidence in your ability to control your weight is to test it. Experiment. Nice and easy - minor adjustments. Your food log is the absolute perfect tool for doing just that. Use it! You will very quickly discover that you absolutely can precisely control your weight - up, down or maintaining. Your confidence will soar. It's all about confidence and control, not fear and denial. You can do this and you'll be oh so glad you did!!

Perhaps your body is telling you that isn't enough? Consider increasing that to 1300 or 1400 for a week. If you maintain or lose weight, increase it again. If you gain weight, keep it at that level until you're at the weight you want to be at and then adjust it down slightly until you're stable. The cool thing about calories is that you can increase or decrease them without changing the volume of what you eat - just the food choices that you make. There's no "try" grasshopper, just "do". Lol!

Mami, if I remember correctly, you maintain a food log (MFP?). Have you tried increasing your daily calorie goal by 100-200 calories for a week and seeing what impact that has on your weight? I've dropped lower than my goal a few times and a moderate increase in my calorie intake has always got me back on track. Logging has worked equally well for me for weight gain, weight loss or maintenance.

After your RNY revision, you will definitely want to follow your doctor's instructions regarding no fluids for at least 30 minutes before and after eating (some doctors may recommend a longer period). There are some very good reasons for that - do a search for the topic "Why no water with meals?" on the forum and you'll find lots of good information including a great video.

Everyone is different so it's impossible to accurately predict exactly how you're going to be feeling at any point in time. So a gentle reminder to your husband that the Saturday road trip sounds great but you will probably be two days out of the hospital following major surgery and you may not be up to it would be appropriate. A gentle reminder that taking care of the little person sounds great but there will be strict lifting restrictions for several weeks and possibly months following the surgery. Failure to observe those restrictions could land you back in the hospital and possibly require additional surgery. So a reminder that you may not be up to it for a period of time would be appropriate. Hopefully he will be understanding. If not, you may have to go back to basics - just say no.

Is your happiness and joy really the source of your husband's unhappiness? He may think so. You may think so. But is it really the source? Is it not more likely that when all is said and done, the source of his unhappiness is the fact that he suffers from a progressive, life-threatening disease - obesity? A disease that he feels powerless to do anything about? A disease that affects his quality of life on a daily basis. From that perspective, what can you do? You made a very personal decision to do something about the same disease. He did not make the decision for you. And it is not your responsibility, or even possible, for you to make the decision for him. What can you do? You can be an example of what is possible. You can be happy. You can be joyous. You can Celebrate your success. You can enjoy every delicious moment of the journey to better health and a better life. You can literally be the most precious gift your husband will likely ever receive. Be understanding. Be supportive. Be patient. But most of all, be the example of what is possible. It is a very rare person indeed who will not be motivated to inspired action in the presence of what can be.

Wow - how good is this?! Show and tell is always a lot more fun than just plain tell! Thank you Dawn!! FYI I had to expand the video to "Full Screen" in order to see it so if you can hear him but not see what's happening, just expand it. Great video!

My understanding of the no liquids 30 minutes before is exactly what you said - you are more apt to feel full and are tempted to eat less than you should. Or some might eat the same amount of food but that raises the potential problem of the combined volume of the food and the liquid stretching the pouch. That said, your comment about washing the saliva from the pouch prior to eating would certainly seem to be a valid one. And would result in reducing the digestion of the food in the pouch in much the same way that drinking after eating does. Thank you! We're learning!

Prior to having RNY you had your stomach and the pyloric valve at the base of the stomach. The valve kept food in the stomach to allow time for the digestive process and then periodically opened to allow small amounts of digested (partially) food into the small intestine. That process continued until the stomach was emptied - approximately two to three hours. After RNY, the pyloric valve is still there but there is no path from your newly created pouch to the valve. So the valve is effectively removed from the digestive process. Instead of the valve, you now have a "stoma" which is simply the opening between the pouch and the intestine - no valve to open and close. And since the pouch does not produce gastric acid like the stomach does, digestion in the pouch is more dependent on saliva (which contains about 40% of the digestive enzymes needed to digest our food) to do most of the digestive work in the pouch. The longer the food you eat remains in the pouch, the more digestion takes place. Food can remain in the pouch for up to two hours IF you don't drink any liquids for at least 30 minutes before and after eating. The longer food stays in the pouch, the more it is broken down in preparation for the intestines to do their job of absorbing the nutrients. The minute you add fluids, the consistency of the food in the pouch is obviously reduced and it passes through the stoma into the intestine much more quickly. Since the food is only partially digested, the absorption of the nutrients by the intestine is reduced. The partially digested food can also be a source of constipation and even intestinal blockage in extreme cases. And as noted above, moving the food too quickly from the pouch to the intestine reduces (or even eliminates) the feeling of fullness or satiety. This is partly because of the empty pouch but also partly because if the food moves too quickly, the pouch does not have time to signal the brain that it is full. Finally, there is some risk of stretching the stoma as the result of partially digested food being pushed through by the addition of fluids. Some doctors consider that to be an even more serious problem than stretching the pouch since there is nothing restricting the movement from the pouch to the intestine. There are very sound reasons for not drinking fluids 30 minutes before and 30 minutes after eating. Follow the protocol as closely to the letter as you can possibly can and you're gonna love the new you!!

Amazon sells "Ring Snuggies" - just a little piece of plastic tubing that's cut on one side. They have a number of different sizes. They take a little getting used to but help to hold your ring on. I used them for months and still wound up having my wedding ring resized - twice. Lol. I've also seen metal bands that I believe most jewelers have. Same principle, a little more expensive, but a little more attractive.

You didn't specify who told you that all of the weight loss occurs in the first six months but I'm telling you that is absolute nonsense. As others have said, you're doing absolutely great! Congratulations - you've earned it! Your decision to have the surgery was a very personal one. Why give your spouse, friends, family or anyone the power to control your destiny? They can't take it, demand it, force it or order it. There is one and only one way anyone can have that power - if you give it to them. You cannot control the way others think. That's just fine because you have total, absolute control over your own thoughts. Embrace that. Reach for a better feeling thought. It is not possible to go from sad and regretful to joyous and thankful in one giant leap. It is possible to feel a little better, one step at a time - and that is enough. That is all it takes. Change your thoughts, and you'll change your world. There are more than 31,000 members on this forum alone and hundreds of thousands of others all over the world. You're not alone and we're all here to help. Keep posting, keep asking questions, stay focused on following the protocol as closely as you possibly can, log your food, stay active, and stay away from the scales for at least a week and two or even three would be even better. You're gonna love the new you!!

Dawn, I'm 21 months out so haven't quite made it into the "veteran" circle yet but I'm getting close. It seems to be an unfortunate fact that veterans often disappear from the forums after about a year post-op. That's unfortunate not only because they aren't there to share their experience with others who could benefit from their knowledge (and mistakes), but also because they themselves lose the ongoing reinforcement of their own commitment to a healthy lifestyle. We may no longer be obese. But we are, and will always be, susceptible to obesity. This is truly a life long commitment. What better way could there be to keep that commitment strong than a daily reminder of all of the real life struggles and triumphs that are such an important part of forums like this one?

Joanna, do you log your food? Logging is ideal for this kind of "fine tuning" of your weight. I think it's ideal for managing your weight period. But it's exceptionally useful for making the occasional (and unavoidable) course corrections.

I would be very interested in what your nutritionist says. If you're logging your food (and exercise), a 30%/30%/40% ratio of carb/fat/protein would probably be a good starting point. I lost 130lbs in 13 months using that very general guideline. My surgeon requires her patients to eat 100g of protein a day so I often exceeded the 40% protein. If you are logging, you might want to ask your nut to give you a carb/fat/protein percentage ratio for easier input into your app. My Fitness Pal will give you a snapshot in the form of a pie chart of those three numbers at any time. Makes it easy to see where you're at after each meal and, if necessary, make adjustments in the next meal.

That's what I'm talking about! Fantastic!! You're gonna love the new you!!!!!!

I don't have any experience with Plavix but I have been taking low dose aspirin (doctor's orders) daily for many years and continue to do so, with the exception of a brief period pre-op and a week or two post-op (as I recall). Aspirin is a blood thinner so doctor's usually instruct patients to discontinue prior to any surgery. It can also be an irritant to the stomach lining. But interestingly the doctors did not suggest that I discontinue the low dose aspirin following the diagnosis of the ulcer. The exact cause of the ulcer I had at the anastomosis is, as far as I know, unknown. In the specific case of us RNY folks, a correlation has been identified with post-op smoking and/or the use of NSAIDS, and the development of ulcers. But in my case, I don't smoke and was very careful to avoid NSAIDS. Relatively recent research which I believe DiminishingDawn recently shared with us indicates that 90% of duodenal (intestinal) ulcers and 70% of stomach ulcers are not the result of stress and diet as previously thought but instead the result of H. pylori bacterial infection. If you're interested you can read more at http://www.pdrhealth.com/diseases/ulcers/diagnosis?source=dlp-pdr . Note that this study was based on the so-called "general population" as opposed to gastric bypass patients specifically. Ulcers at the anastomosis (often referred to as "marginal" ulcers) are a well documented complication following gastric bypass surgery. Although they can in rare cases be serious, the majority are not and respond quite well to medical treatment. In my case "medical treatment" was simply increasing my Prevacid from one capsule a day to two. There are in fact indications that many patients who develop this type of ulcer never have any symptoms at all and are unaware that the ulcer exists. Bottom line - instead of worrying needlessly about something that statistically you are unlikely to ever have, consider focusing all of that energy on all of the incredibly exciting life-changing things you are about to experience! Forget about "what if" and focus on "I can't wait until"! You're gonna love the new you!!