Your stomach is sore and tender from the operation. The anastomosis has to heal; the only thing holding it together is staples and sutures. After RNY weight loss surgery, everything swells—which means you have to be careful of how much you drink, and be careful not to eat anything solid. Can you screw it up? Yes—so you have to learn satiety. Drink only one-third of a medicine cup full at a time and no more. If you stuff yourself, bad things can happen. It takes a six full weeks for the anastomosis to heal to 60 per cent of its strength. So, if you drink too much you can disrupt the staple lines and cause a leak.
Vomiting will happen after RNY weight loss surgery:
The stomach is upset from the procedure, and even if you follow instructions to the letter, you might occasionally vomit. Some RNY weight loss surgery patients never have this problem. Persistent vomiting is not normal or expected, and your weight loss surgeon will want to hear from you if this is a problem.
RNY – going from clear liquids to full
This happens once you are able to tolerate the clear liquids and have demonstrated you can regulate them in the hospital under strict supervision. You should be able to drink 1 and 1⁄2 quarts to 2 quarts (32-48 oz.) a day of clear liquid. If for some reason you cannot, you may need to have nutrition through a vein. If your doctors put in a gastrostomy tube, you may have to be feed you through this tube for a period of time. Once you can tolerate clear liquids, you will start on a meal schedule—starting with things like Boost, Carnation Instant Breakfast, or some equivalent mix.
Graduation from full liquids to puree
(yippee real food)
The theory is that liquids can wash food out of the pouch, allowing you to eat more. Now like all theories, we held this as absolute for years, and now we have discovered this isn’t the case. But, if you gulp liquids down, to force down food, you can force it out of your pouch. A safe habit is to drink before you eat, and drink again an hour after you eat. The other possibility is that the food won’t wash out, and you will either vomit or stretch your pouch. Now this might only apply the first few weeks after the operation. Later on this rule can be relaxed. Early on, the pouch is swollen from having the operation, and it is difficult to tell when you are satisfied and when you are not.
RNY weight loss surgery and protein
Terms to learn during this period:
- High Quality Protein: This is protein that is low in fat. High quality proteins are easy to digest, provide the building blocks which you need to heal from your weight loss surgery, and don’t have fats that are associated with cardiac disease. Typical examples of high quality proteins include tofu, egg whites, whey proteins, fish, and shellfish. Most weight loss surgery patients find they enjoy tuna fish (either in the foil packet or water packed) or shrimp as a good source of protein during this time. These high quality proteins are not only healthy, but they digest much easier than proteins such as red meat, fatty meats, poultry, or other proteins. In contrast to high quality proteins, which not only contain little fat but also have essential amino acids, there are low quality proteins. The most common are those found in gelatin. While gelatin is essentially fat free, the proteins in it are not useful for rebuilding your body after RNY weight loss surgery.
- Protein powders: Okay, I admit it. I can be a bit of a skeptic. I always say I like weight loss surgery patients to receive protein from food instead of a shake or a drink, but enough of them have used them and benefited from them, that now I am a believer. (Isn’t there a Monkees song about that?) If you go into most nutritional stores or some gyms, or the health section of the grocery store, you will find an abundant source of protein powders, shakes, and other foods. Here are a few keys: whey protein is easier to digest than soy protein. Egg white is a great source of protein. Protein drinks can cause some discomfort, such as gas, and loose stools. I recommend Isopure and several others.
Good protein choices
- Low fat cottage cheese (it comes in handy containers that are easy to carry to lunch), custard, and low fat yogurt.
- A number of puddings are made especially for weight loss surgery patients (Resource, Sustacal).
- Liquid scrambled eggs—or eggbeaters (that you can pour out into nice portions).
- Some people like to use baby food during this time (comes in neat containers, but you do receive some interesting looks as you spoon it out).
The important key is that you have only puree and soft foods, something that will go easy on the pouch and not lead to vomiting.
Soft Foods to Real Food
For weeks now since your weight loss operation, you have been giving your stomach a rest by carefully avoiding certain foods. Your stomach is still a bit tender, probably not ready to have a steak, but you are pretty tired of protein shakes. Now is the time to test your stomach a bit. This is a transition phase from soft foods to regular foods. This isn’t the time to go from yogurt to steak with vegetables, but it is time to test things a little. Some soft foods go down well, and some don’t. Moist chicken works well. Chicken or turkey breast, which is a bit drier, might not be as good. Chicken salad works great, and can be a good source of protein. Put the blender away, and start to experiment just a bit with your diet.
You will also decrease the number of meals you have from five to seven a day to three or four. Every weight loss surgeon has his or her own way of getting you through this phase and their own time schedule, but typically this transition occurs around the sixth week.
|Clear Liquid||Full Liquid||Puree||Soft||Regular|
|In hospital||1st week||4 weeks||2 weeks||After 6 weeks|