Sunnyway

You can carry ready-made or powdered protein drinks on ship and in Italy. Individual envelopes of mix are available from several companies; Bariatric Advantage and ProtiDiet come to mind. Or you could fill single portion baggies to keep in your luggage. The water onboard is safe to drink, but in Italy you may want bottled water if you are unsure. You may no lonhrt be drinking protein drinks by the time your trip rolls around. On the ship there are plenty of things you can eat both in the dining room and buffet. You can order just soup and/or starters and not the main course. They usually have sugar-free desserts. Be careful! It's so easy to eat, eat, eat on a cruise. It's so good. Avoid the bread: It's SO good! Avoid alcohol. Save some room for lobster tail, escargot, and prawns--seafood usually goes down well at 6-7 months out. I couldn't eat steak for a year or more post-RNY, pasta got stuck, and pizza crust is too much carbohydrate. Italian pizzas are not loaded with sauce, meat, or cheese like US pizza. They get a swipe of tomato sauce, and you may find things like artichokes or a fried egg on the pizza. Pizzas are personal-sized. I would say to taste your husband's pizza, but don't order one for yourself. Seafood is a good choice in Italy as well as on the ship.

Stalls are normal. Keep sticking with the program. Do get some bariatric cookbooks so that you can learn to cook and eat differently than pre-surgery.

With RNY gastric bypass, "not hungry" is "full". Getting a chest pain, hick-ups, or "the foamies" is a sign that your pouch is overfull or something is stuck. You can up-chuck to remove it. Regurgitation is not the same a vomiting.

I had RNY in 1990. Back then RNY surgery involved stapling between pouch and stomach, not separation. It was open surgery and I was in the hospital for 7 days. I had no pre-op or post-op nutritional guidance. I was handed a 1-page low-cal diet and told not to throw up. Two follow visits post-surgery were to check the incision and I was then left to my own devices. I learned on my own to take Vitamin and mineral supplements; no one told me. I lost about 75 lbs from a high weight of 319, stopped losing after about six months, but kept the weight off for about five years before starting to gain it all back again. For the past 20 years, I've yoyo-ed with countless diets and food plans but always return to that same high setpoint. I'm now 73 years old and am going to give it another shot. My knees and hips are shot, I've got a pacemaker, and I figure I'll die within a few years if I can't lose all this excess weight. I first learned about revision surgery about a year ago, just before COVID hit. This spring I followed up with a hospital bariatric clinic about 2 hours from my home. I've been on a liver-reducing diet for three months. I had a barium swallow a couple of weeks ago that revealed that the staples had given way and there was a fistula between the pouch and stomach, which explains why I stopped losing weight from the RNY. I had an endoscopy today and had a conversation with the surgeon who told me that the leak occurred because of peristalsis of my stomach, not (as I thought) because I ruined it due to up-chucking too often. The new surgical methods are much improved and there is extensive pre-op and post-op guidance and follow-up. I will have my psych evaluation in two weeks. I'm within 2 pounds of my prescribed pre-op diet, but don't have a surgery date yet for the revision. I do not want to fail again, so I will probably seek therapy for food addiction even if it is not recommended during the psych evaluation.

Update: My surgeon asked for an abdominal CT (I assume to see what mess, if any, my prior WLS surgeries caused), which has been completed. Because my last two EKGs had some irregularities and because I have a pacemaker, he also wanted a cardiology evaluation. The cardiologies wants me to have a chemical stress test and an updated echocardiogram. Office visited completed, and I have to go to the hospital 90 miles away for the tests, perhaps in the next week or so. I am very happy with how thorough the surgeon and cardiologist are being, in stark contrast with my prior WLS surgeons. If the cardiologist approves the surgery, the paperwork will go to Medicare. When Medicare approves the revision (apparently a slam-dunk with my comorbidities), I will finally get a surgery date. I've been stalled, going up and down the same 2-4 lbs for since early September, reinforcing why I need this surgery. Also, I finally got a call-back from the local psychologist-dietitian on whose waiting list I've been on since July. I'll hopefully get an appointment shortly. I did have an evaluation by the clinic's psychiatrist and a tele-visit consultation with another psychologist (who didn't think I needed therapy), but this one is local and I hope can help me develop coping strategies when the cravings appear. They have been an issue for the past few months and will be again after the surgery honeymoon period ends. I know from experience that I am going to need help to avoid regaining.

That lack of hunger feeling does not last beyond the honeymoon period. Don't rely upon it. You must learn to eat differently during this period of grace. .

Vomiting (with bile) is very rare after gastric bypass because the content of your pouch doesn't contain bile. However, you can up-chuck, which is not the same as vomiting. It is merely regurgitating what you have masticated and swallowed along with some fluid. You can make yourself do it if something gets stuck or you get the chest pain signal that you ate too much too fast. I can do it by gently putting a spoon handle in the back of my throat and coughing as I lean over the sink or toilet. Genuine vomiting would be medically concerning. Dry heaves would not.

I wouldn't use even diluted fruit juice except Diet 5 Cranberry. Fruit just is pure liquid sugar. My plan strictly forbids fruit juice as do many of the WLS books I've read.

I cut my own toenails!

During this transition period, check out thrift stores, too. While you are there, drop off your gently-worn too big stuff.

Yes, in time. Be sure to have regular checkups with your dentist in case it's something more than ketosis.

Not necessarily. Food that you don't tolerate now may be tolerable in a few months (o longer).

Try Walden Farms Amazin' Mayo. Zero Calories. It's runnier and tangy-er than the mayo I'm used to, but tasty. Walden Farms has a vast product line of Zero Calories salad dressings, sauces, syrups, jellies. I usually can't find more than one or two items in the supermarkets near me, so I order them online.

Yes, if it is a problem, you should consider therapy or perhaps Overeaters Anonymous to learn coping mechanisms. At this stage, the "wrong food" is likely to make you feel crappy. Take advantage of that! I also strongly encourage you to get some bariatric cookbooks so that you can try new recipes in order to stay away from the foods you used to eat.

Always call your dietitian when you have fears and issues like this.

Some bariatric surgeons recommend banana smoothies and "Nice-cream", soft serve "ice-cream" made with frozen bananas and berries or cocoa. (It's delicious.)

Yes, take your CPAP. If you are kept overnight you will use it.

Yeah, bad breathe and horrid farts go with the territory, at least in the beginning. The bad breathe is probably due to ketosis. The bad farts are due to malabsorption.

I don't believe what you experienced was "dumping syndrome", which is caused by fats or sugar rapidly entering the small intestines. Water wouldn't do it. Nevertheless, I'm glad your problem resolved.

I use the Baritastic App and I just recalled the recipes on the app. There are several for home-made protein shakes that use cottage cheese and non-flavored protein powder, and no artificial sweeteners.

Yes, that baffled me at first, when we can only drink 1-2 oz at a time in the beginning. However, one could consume much of the recipe over the course of a day. I'd probably want to alternate different shakes so that I wouldn't get bored. They should store well in the refrigerator. Later, one can drink more at a time. The calorie count is high, but for a whole day's worth, it's not unreasonable. I wouldn't drink them as smoothies, but as protein drinks they meet the bill for sustenance.

The RNY is a gastric bypass, with the rerouting of the duodenum and small intestine (the "roux" in Roux-en-Y). The intestinal portion does not need to be shortened during my revision, but the anastomosis (the opening from the pouch to the small intestine) will be made smaller, along with making the pouch smaller, The stomach will be detached and a large portion of the fundus (the top of the stomach) will be excised. This is a much more complex surgery than I expected, The surgeon will schedule six hours for the surgery, but may be done in about four. Fortunately, he is very experienced with RNY revisions,

Thanks. I didn't know that a revision was even remotely possible until I met a man just before the pandemic started who had had an RNY revision prior to total knee replacement surgery. COVID blew it out of my mind until this past April. I then decided to follow up, learned I was a candidate, and am progressing through the program. I have just had a CAT scan, and will have a cardiology evaluation next week. If approved by the cardiologist, the papers will go to Medicare. My surgeon says I should be able to have the revision before the end of the year. Despite losing 50 lbs pre-surgery, I am still over well 100 lbs overweight. Revision surgery doesn't work as well, but he thinks I can lose another 60 lbs, which would take me to 215. I would really like to pass 200. We shall see. My dream goal is 175. For what it is worth, my surgeon says I am NOT too old for the revision. While the surgical part is complicated, the laproscopic incisions will be so much easier for recovery than the open surgeries I had previously. Why don't you encourage your friend to follow this thread? I will update my progress post surgery.

Wow, thanks for the tip. I do take 150mg XL Wellbutrin I have been taking it for 3 years (and before that 10+ years of 300mg XL) with by old stretched out pouch and had no issues. My pouch after revision will be only 1 oz, so I'd better advise my prescribing physician

One assumes that the user will be drinking as much water as they can tolerate in addition to protein shakes.. I agree, powdered PB2 could be substituted, but there really is no need to reduce calories during the first couple of weeks after surgery. Later on, yes. (BTW, I did not create this recipe, I copied it from The Bariatric Guide and Cook Book as an example of how one could make their own protein shakes._)