Jacks133

Hi everyone, I’m the member of a cancer forum having completed treatment for Stage 3 cervical cancer six months ago. I’ve put out feelers to try and find anyone else who had had bypass surgery (RNY) previously, and have drawn a blank. The RNY meant challenges for me, especially as the cancer had spread to my para-aortic lymph nodes, so my stomach and whole gut were irradiated for 6 weeks. The no-ghrelin effect also returns for gastric cancer patients as the radiotherapy knocks out those hunger hormones. Just wondering if there is anyone else on the forum who has had cancer treatment after their RNY?

Dalila you are doing great! You’ve reached your goal and you need to be a bit kinder to yourself. It sounds like you’re making very sensible food choices. Everyone stretches their pouches - you would not be able to sustain enough nutrition for a normal life if you didn’t. You are a success story! Enjoy your yogurt with strawberries and peanut butter - it must slip down very easily and sounds nutritious, tasty and highly digestible. Brilliant!

I think you’ve probably answered your own question in that you realise you’ve gained a bad habit, and why. It’s going to take determination and willpower to break that habit and eat differently. If you’re now getting enough food and your weight loss has stopped, you don’t need to snack - it’s as simple as that. The stopping of snacking is not so easy, because you have to retrain your brain. It may be that you need to construct some other ‘habits’ by working out something to do instead of snacking. If you DO want to snack, put aside small portions of healthy snacks you will allow yourself, but only so many in the day. Calorie count them if necessary. Avoid making your snacks sweets and chips. You must have other, healthy things, you could eat. But don’t allow yourself to snack too much anyway - find a strategy. Sticking to it at first will be hard, but like with any habit, it can be broken and a new habit can be achieved. You do not want to start gaining again, because it’s demoralising and you don't want that. Your brain is telling you that you NEED these unhealthy things - you don’t. You can retrain it!

It could be coincidence, of course - I can’t imagine what the dentist could have done to you to upset your stomach. Maybe you found it extra stressful after all you’ve been through, or maybe you’re actually a little unwell. If you are concerned call your team for some advice, but otherwise I hope you’re feeling better soon!

Tofu is a magic ingredient - high in protein and so versatile. Once you can tolerate them nuts are amazing - I ate them quite early, by grinding them down in my mouth until they were practically liquid before swallowing. Once you can eat them they are brilliant for adding high protein and energy.

Looking good, Lisa! You’re going to need to change your profile picture I think! X

I think maybe you need to talk to your surgical team about a diet sheet and guidance - plus there are posts on here about cook books for bariatric surgery. I suspect a change of food mindset is required - you may have loved Greggs pasties before your surgery, but Greggs pasties maybe have contributed to your problems in the first place - I don’t know. But melted cheese and onion sounds very dense and clogged to me, and not the sort of thing your small stomach will find easy to deal with. I used to love getting a spaghetti bolognese if we were out for a meal and picking the mince and sauce out of the pasta when I was further down the line - a tiny bit pasta, well chewed, may be fine - but the prize was the protein and the tomato sauce… in easily chewable and digestible forms. You started this thread saying you are 9 days post op - you shouldn’t really even be thinking about pasties - please get your surgical team to do their job and give you guidance on what to consume. You are in this for the long hall and you need to take things slowly. All the best.

I agree with Bariatric Evangelist - high levels in the blood do not necessarily indicate high usage - actually the opposite. I was always told by my bariatric team that you should take 5mg Folic acid a day to help you process and absorb the B12. Otherwise it’s not being utilised by the body. The tiredness is more likely to be because you cannot utilise the B12 in your blood, not that you’ve got too much of it. The reason the blood count would be so high would more likely be because of non-absorption to the tissues. Further investigation is needed.

Don’t be scared to drink. Just let your stomach settle for a little while. It sounds like you had no room for the water, and it simply tried to expand your stomach further. Well done for sorting it out - it doesn’t sound like dumping syndrome however, which is the effect of the food being processed in your gut. It sounds like you’d eaten something too indigestible or got a block from the food - maybe not chewed enough, or something clogging together. This is why when you vomited it felt better immediately. After my daughter had her bypass she had a number of times when she ate the wrong thing and it ‘clogged’ and the pain was awful, she said. It put me right off doing that when I had my operation. I have always remembered to stop eating before you feel full, and leave it for a bit to see how well your stomach deals with the food before eating more. Never eat to feel full… Feeling full after bypass or sleeve surgery is NOT a nice feeling at all.

One thing I got early on was a set of body composition scales - like Tanita. There are lots on Amazon. This tells you a lot more about yourself that just your weight. As you’re small like me (I’m 5ft 1 inches) we need a lot less ‘maintenance’ calories than the average for a woman. It’s not hard with an unmeasured calorie intake to be having too much. Equally, if you deprive your body of maintenance calories too long your body will try to conserve rather than spend your fat reserves. Starving yourself is not a good option. It may be that some of the foods you’re eating are too high calorie for you. Because you’re a sleeve patient rather than bypass you won’t have the same issue with malabsorption and it is possible a year out from surgery that you’re simply eating too many calories. The gas and nausea doesn’t sound nice though and I would not have expected this a year out, so good to have a talk to your physician about this. Maybe you’re just going through a difficult period - you’ve lost over a third of your body weight from your start date, which is amazing! I wish you every success getting to your goal.

my dietitian thinks I should be losing about 4 lbs a week… your dietitian is probably thinking that if you’re walking 10km a day they would be losing 4lb a week…. You are doing great! You’re probably converting fat to muscle as well, which is heavier. You don’t want to lose as much as 4lb a week, you want your weightloss to be steady and healthy. You’re going great. You’re in this for the long term - it’s not a competition. Xx

My daughter had a RNY bypass up 2011 and went on to run over 100 marathons in a year… She loved it. She found she eventually tolerated the gels, although they wrecked her teeth! She ran most weekends until her dog pulled her over during a walk and she hit her hip and damaged the cartilege. She found she needed to eat almost every waking hour if she wasn’t running to keep her weight up. It was hard work managing as she also couldn’t eat much before she ran. Taking on fluids was the most important thing and she would need the salt tablets too. She was also a vegan at the time… It can be done!

Sorry you feel this way, Pookie, but try to be positive. Thinking you should never have had the op 5 weeks afterwards is not helpful. This is a life-change, and a life change that is not immediate, but takes time, like the opening of a lovely flower. I am 8 years down the line. There have been times (like when I’ve had serious dumping syndrome from stupidly drinking a few mouthfuls of sugar-laden milkshake) when I’ve thought I never want to eat or drink again IN MY LIFE… but it passes. From being a little short, depressed ‘pudding’ who couldn’t walk down the stairs in the morning because of the pain in my joints, and would refuse requests to go out because a couldn’t walk anywhere without discomfort and pain, who had to by huge clothes to get over my ginormous bosom, I am now a normal woman, who can look in a shop window and see a slim lady who can walk without pain, without her thighs rubbing together, who has the energy to enjoy life and likes what she sees. Who no longer has to take blood pressure and heart drugs, who has a normal pulse rate and no more GERD. I could not have done this, and kept it off, without the op. How could I regret giving myself a chance of a healthy life being the person I want to be? You must keep your eyes on the prize as well. That’s why you’re doing this. It will work, but it’s not a magic wand, it takes time. But you can do it! X

Lizonaplane, My daughter may be atypical, but she is bipolar and had a RNY bypass over 10 years ago. She was on three meds; antidepressant, psychotic and anxiety. They tried crushing the tablets which made her throw up, so they changed her to Epilim as it was a liquid. Part of her weight gain had been the bipolar drugs. After her surgery she started to lose a lot of weight. Unknown to me, she weaned herself off the drugs, going cold turkey with the anti anxiety meds, because she started running. She found the endorphins from running made her feel good and moderated her condition. At her peak running she was doing 2 marathons per weekend many weeks. She is highly unusual as a Bypass patient in being able to do this! She injured her hip, and couldn’t run, so now she lifts weights. She was determined to take control of her life in every way. She has been drug free for years and is fit, healthy and active. I wanted to share because her psychiatrist at the time said the Bypass would not help her with her mental health, and refused to sanction the op. We paid a psychiatrist to assess her and they concluded she was sane enough to make her mind up. As a person who had previously attempted suicide on more than one occasion, she is an example of the positive outcome possible from gastric surgery. It saved her life, literally, and has given me my daughter back. I wish you all the best.

The principle of not ‘washing’ your nutrients through your stomach too quickly (and thus increasing malabsorption or decreasing time until you feel hungry again) is an important one. However drinks do not all take 30 minutes to go through your stomach. Liquids leave the stomach faster than food or soup because there is less to break down: Plain water: 10 to 20 minutes. Can go through as fast as 5 minutes on a completely empty stomach. Simple liquids (clear juices, tea, sodas): 20 to 40 minutes. Thick soup can take hours… As long as you are prioritising protein and healthy foods, once you are a surgery ‘veteran’ (so some way down the line) and your stomach has expanded, you should not always have to wait 30 minutes after drinking before eating, especially if it’s water.

Only for the first weeks/months. I drink now immediately before eating - I’m Bypass 8 years on. I don’t drink while I’m eating because I don’t want to fill up on liquid. My daughter can, though, eat and drink at the same time. She’s 10 years out. To start with when my stomach was tiny I did the 30 minute before, 45 after thingy - then narrowed it to 15 mins before, and then eventually no delay after drinking. It depends on the size of your stomach…

SORRY JUST NOTICED I’M ON THE GASTRIC SLEEVE FORUM - I’M A BYPASS PATIENT hence the comments below about injecting B12… SORRY! I’m in the UK and 8 years out from my op - the first few weeks I was forced to take liquid vitamins that were disgusting (drinks that fizz!!) but I’m now on permanent prescription tablets here in the UK and because I’m over 60 I get it free at the point of delivery (all working individuals pay into a national insurance scheme). I do know that we were told categorically that 1) we had to take multivitamins (bariatric grade), plus zinc, calcium, (and if you’re a pre-menopausal lady) iron daily; and 2) that we had to do B12 injections. I take 500mg chewable Calcium with vitamin D (daily), Zinc 220 mg (2 0r 1 alternate days), Iron 210mg twice a week and Foreceval multivits & minerals (daily). B12 can be done either intramuscular (absorbs quicker, but done generally by a health care professional) or intradermal which is easy to do yourself. I do the latter, as I do the injections once a month by myself. There are videos on YouTube about how to self-inject. The syringes are only small like insulin needles, and painless. I source these myself as the UK is very behind the US in their appreciation of the merits of B12! Oh - and I barely, if any, lost any hair… maybe a few more than usual when washing for a couple of weeks, when the weight was coming off quickly, but nothing I could ever see.

Thank you for your lovely well wishes. I had ‘no evidence of disease’ in May after finishing treatment in February. My next scans are in November and I’m keeping positive. VERY important to flatten your Pepsi - your stomach cannot cope with carbonated liquid - and get the Max (no sugar) versions as otherwise the sugar will give you dumping syndrome as it will metabolise too quickly…. I have one bottle in the fridge (flattened) and another being flattened on the counter 😂. I keep squeezing and shaking, then letting the gas out. Once the gas lessens I drop a tiny lump of sugar in, and close the top not quite fully… If you do this too soon it will spill over - if you get it right it will de-fizz away nicely. Then when you think it’s flattened pour on ice, and that will finish it off… if you’re not sure stir it with a metal spoon. I keep a glass full in a shelf in the fridge so I’ve always got one ready 😜. I am a determined person.

You will hear all sorts of stories because none of us is exactly the same…. My daughter had her bypass 10 years ago and she can throw up - she also gets things lodged. It’s common to ‘foam’ first before retching. I had my bypass 8 years ago and I don’t get things lodged; I also couldn’t actually throw up for nearly 8 years, but would foam (that would be the first indication something hadn’t agreed with me) and then retch, but not bring anything up. After my first radiotherapy session for cancer (they blasted my whole abdomen) I came home and tried to eat something and threw up and retched for 3 hours until my family got hold of a nurse on the phone and she recommended flat Pepsi or coke…. Must be flat. It worked. It’s been my go-to drink ever since (Pepsi Max Cherry, completely flattened, with ice 😆). Since then I threw up medication also with the treatment, but not since. The important thing is to know yourself. As I understand it the stomach, when it’s very small, is often not muscular enough to actually throw up, but now I know it can be done! 🙄 - not that I wish cancer treatment on anyone… I’m sure you’re connected alright - you also know now that you can get clogged and chewing things properly is really important. I used to foam at the mouth and feel I was going to throw up every time I tried peas in the first year - I think because I didn’t chew them properly and they were rattling round like little bullets… 😜 x

I’m 64 now, and had RNY surgery 8 years ago when I was 56. My surgeon told us that you have a window of about 1 year to 18 months to lose the weight you want - thereafter the ghrelin levels in your stomach and gut (which are disrupted by the surgery) increase. Ghrelin is known as the ‘hunger hormone’ because (amongst other things it does) it triggers hunger. Shortly after RNY surgery you may feel hungry, but this soon passes and you have a ‘honeymoon’ period where you don’t, where you need to build up to a health and sustainable diet. The other thing is that your tiny pouch will stretch in time (the stomach acts as a muscle) and if you consistently eat too much you’ll get a bigger appetite back. It is unusual, but not unknown, for someone to put all the weight back on that they lost from RNY surgery. Of course, why do that to yourself? Probably because you have not sorted out an unhealthy relationship with food. Another thing I was told was to exercise, to prevent muscle loss and encourage weight loss. To be honest I didn’t do enough of this. However, from BMI of 35.7 and weight of 190lb (at 5’ 1”) I dropped to my lowest weight of 105lb and BMI of 19.7 at 14 months after surgery. That was nearly half my bodyweight lost. I stayed at 112lbs or under until April 2015, when very, very slowly I put on a bit of weight over each year, I guess as my appetite and tolerance grew. By January 2021 I had been just under 140lb for 3 years, but wished I could be less. Then came cancer treatment and radiotherapy to my entire abdominal area. Left with nausea and no appetite at all, I gradually built back up to eating a healthy diet. I lost 16lb in a few weeks with sepsis in March, but after recovery have lost more through cutting back on carbs and walking every day, to get back to my prime 112lb - and this is where I want to stay! It may be harder to lose weight after the menopause but the equation is still the same - too much food in and not enough energy out = slow inevitable weight gain; keeping to what you need (or slightly less) and more energy expended = slow loss. We have a wonderful tool to help us achieve this - which is very hard for an individual with a normal stomach. Plus we have absorption issues, and potential to suffer if we eat too much fat and sugar (especially at once). We can use this tool to achieve our goal, and use it alongside lifestyle changes to maintain it, whatever our age. 😊

Thank you, lizonaplane. I was required to eat a low fibre, high carb diet whilst on radiotherapy because of the affect on my stomach, but such a diet is counter indicative with the bypass and nausea and diarrhoea were my daily companions. But I’m through it, and hopefully for good. 👍🏼

Hope you’re starting to feel better now! Whilst I was still in hospital they made me thin protein rich soup - in this case tomato and chorizo - no bits, of course - and that was SO tasty. I too could not tolerate thick shakes and I actually became a bit lactose intolerant after the surgery, which is not unheard of. It’s a long time ago for me and I can tell you that it DOES get better - you’ll get there, even though you fear you won’t. After I got home I used to have tiny bits of protein bars and dissolve them in my mouth until there was nothing left but taste and saliva, and then swallow… I really worked at getting protein in. You are a few weeks in to you new world now, and I hope things are better. My step-daughter had surgery YESTERDAY and she has all this to come! X

This does not sound like dumping syndrome, but I can sympathise. I too find that the blend of solid food with liquid (noodles and soup for example) makes me feel like throwing up, and you get that froth in your mouth. Actually unlike some others here I find that throwing up is VERY hard since the bypass - I think because there’s less stomach muscle to power it. The only time I actually threw up was in the last few months when I was having cancer treatment and my stomach was blasted with radiation… I find a hot wheat bag on the stomach helps to settle it, and strong peppermint sweets sometimes.