New RNY operation terms to learn during this time:
Pouch – this is the upper portion of the stomach.This is where your food goes. It will hold about one ounce, or 30 cc. If you have the micro-pouch, it will hold half that amount. If you had the BPD, then it can hold up to 8 ounces. Over time, this pouch will stretch, but how much it will stretch is up to you. If you eat too much, you can stretch it to the size of your stomach—and then you will lose one of the components of this operation, the ability to eat less and be satisfied.
The lower stomach has been disconnected from the upper stomach.
Anastomosis – this is the opening we weight loss surgeons create between the stomach and the small intestine. The other name for this is the “stoma.” Technically, a stoma is the opening, and the anastomosis is the connection, but this may be more information than you need. This anastomosis is about half of an inch in diameter when we make it. In the first few weeks after the procedure, it will swell, so it is smaller.
Satiety – Feeling full, no hunger. You feel full several minutes after you are actually full. If your pouch holds 30 cc (one ounce), you can put 30 cc of food in it, and you won’t feel full for about five minutes. Try this one at home. Measure 30 cc, or one ounce of cottage cheese or tuna fish. Eat it and wait for a few minutes. That feeling you have—that is satiety, or feeling full. Of course, if you have a micro pouch, then you will find that it takes half the amount to feel full.
Liquids do not produce this feeling. Why? Liquids will go through the pouch quickly, and into the small bowel. They don’t cause the wall of the pouch to stretch, so you can drink a lot of liquids without a problem. However, you cannot, and should not gulp liquids.
Some weight loss surgeons refer to the new anatomy, the small pouch, as a tool that you can use to help learn new eating habits.
RNY weight loss surgery….measure twice, eat once—don’t vomit
Every time you sit down to eat, you will measure what you eat. The pouch has a limited amount of space, so if you overfill it you can either stretch it or vomit.
RNY bariatric operation– goals for the first few weeks:
- Learn to eat to the point of being satisfied without feeling full. Measure everything you eat.
- Start a moderate walking program to facilitate weight loss
- Avoid food that causes diarrhea, vomiting, or discomfort
- Learn to eat slowly and enjoy the food
- Only eat foods that go through a straw until you are advanced to the next phase.
- Time your meals, even if they are liquid. Enjoy them. Sit down for them. The meal should take at least 5 minutes but no more than 30 minutes.
- Measure everything you eat. (You won’t always do this, but for the first six weeks, you will). You need to learn how much you can hold, and not to exceed that amount. Eventually you will be able to measure your food with your eyes.
- Have more than three meals per day, but make certain that you set aside at least three times a day when you act like you are eating a meal—even if it is one ounce of pureed haddock.
RNY bariatric operation – foods to avoid
- Carbonated beverages (the carbonation may stretch your pouch)
- Ice cream
- Beverages containing sugar
- Anything that cannot fit through a straw
- Watch Nutra-Sweet carefully (in some bariatric patients it stimulates an appetite)