Roux-en-Y education

Many people I talk to don't know about RNY or gastric bypass surgery. Most assume it is stomach stapling, when in reality it's a different procedure from what that was.

Here's a pic of what it'll look like when the Doc is done....description to follow.

As you can (probably) tell, my whole stomach will stay in there. Darn, I bet that sucker weighs a few pounds and would give me a jump start, ha! Basically Dr F will make me a new pouch for a stomach. It'll be about the size of an egg. Yes, an egg. Not a jumbo sized one either. I remember when my boys were born being told their stomachs were about the size of a golf ball. So my new stomach will be about the same size as a newborns, that amazes me (and I'll be honest, slightly worries me too!).

The doc will decide where to cut my small intestine at, there isn't any textbook rule as to where it'll be cut or reconnected. It varies on the person and what things looks like once the surgeon gets in there. Anyways, the new end of my small intestine will be brought up to my new pouch where they will be connected. Then the small intestine will be stitched together. This will allow for my old stomach to still produce all the "juices" to help with food (what little there will be) digestion. The new pouch will not have the pyloric sphincter, that'll stay with my old stomach. So there really isn't a way for the food to be gradually put into the small intestine. Which is one reason I will not be allowed to drink with meals, or about 30 min before and 60 min after. Yikes, that's going to be an adjustment for me! The reasoning is it speeds up the digestive process. Instead of having solid food in my pouch, liquids would make it mushy and run right out into my small intestine. Therefore I won't have the full feeling as long and keep eating more. Basically defeating the procedure because I would still be getting more food and absorbing everything from the food. Also, when I can drink (which should be constantly except meals) it's little sips, little sips, little sips. It should take 5 minutes to finish 1 oz of drink! Yikes again!

Post-op eating life is going to be very different. There are several stages I'll go through.

• Phase 1: Clear liquids. Total meal size about 1-2oz. This is usually just for the 1st day AFTER surgery (day of surgery I won't be allowed anything! maybe some ice chips). After I pass a UGI (test where they are looking for leaks in my pouch), I'll be able to "eat." So for that day I'll be able to indulge in things like jell-o, koolaid, popsicles, chicken broth (everything sugar free, of course!)

• Phase 2: Full liquid diet. Total meal size about 1-2oz. Post-op day 2. I'll be able to have some thinned out grits (mmm, grits! and I seriously do love them...no sarcasm!), yogurt, pudding, cream of whatever soups, etc. I'll also begin drinking some protein shakes. I'm ordering some from www.bariatriceating.com. It's a great site with lots of goodies for after WLS! I'll also be ordering my vitamins from there.

• Phase 3: Puree. Total meal size 1-2oz. Post-op day 3, and should be discharge from the hospital day too. Woot! My food processor and Magic Bullet is going to come in handy here. I'll be able to eat things like pureed egg, pureed chicken, pureed peaches, cottage cheese, pureed banana, chicken broth, and of course lots of protein drinks! This phase is going to last about 5 weeks!

• Phase 4: Soft. Total meal size 1-2oz. Foods such as scrambled eggs, oatmeal, deli sliced turkey meat and cheese, chicken, creamy peanut butter (in moderation of course!), and things along those lines. This phase doesn't have any clear cut rules of how long to stay in, I'm supposed to advance as tolerated.

• Phase 5:Regular. Total meal size 1-2 oz. Similar foods to phase 4. Eggs, oatmeal, chili, chicken, cheese, apple slices, chicken salad

• Eventually....a "regular" diet with a size of 3-4oz. Eggs, cheese, toast, sliced deli meat, cottage cheese, macaroni salad, veggies, fruit, etc. But this is where you have to be careful to watch the sugar and carbs.

All phases I will need to drink a lot of fluids (a min. of 60 oz/day) and take in a lot of protein (a min of 60 grams/day). Foods will have to be eaten slowly. As in about 20 minutes for a meal. Remember, this meal is only a few ounces in size!

I'll also be on a strict regime of vitamins. Being I won't be eating as much, it will be impossible to get the nutrients my body will need from food. So I need to do everything possible to prevent nutrient deficiencies. I've chosen to take Celebrate chewables. The multi-vitamins have enough B-12 that the majority of users do not need an additional B-12 supplement. This is one reason I decided on this brand. Also, the flavors they come in are more appealing to me than the other options. So assuming the Celebrate ones work out for me, I'll be taking the multi-vitamin, calcium, and iron pills. My surgeon also will put me on some other medications for a short time. Like one to help prevent gallstones for the first 6 months. Also Biotin to help with my nails and skin, and hopefully hair too. About 4-6 months post-op I will begin to shed. It's an inevitable thing but the Biotin is said to help with this some. I'll do what it takes!

There really is A LOT that goes into this surgery. It is a major procedure! I'll have 6 laparoscopic incisions (about 10-12mm each). One will have a drain from it for a few days, or longer...it'll be up to Dr. Friedman depending on how I'm doing.

I'm ready for my day to be here! I've very excited I have this opportunity and will be gaining such a wonderful tool to aid me in my weight loss journey. Although it is scary to think of it all, I browse online and at my Dr's office through before and after pics. Seeing them amaze me! I cannot wait to begin to drop the pounds and get into normal sizes again!