Sunnyway

Fruit juice is a no-no for ever more. It is liquid sugar. Use whole fruit and berries in your Protein Shakes. Whole fruits and berries contain Fiber which helps metabolize carbohydrates. Using them eliminates the need for sugar and sugar substitutes. Once you are weaned off sugar and sugar substitutes, fruit will taste remarkably sweet!
There are recipes for home-made Protein Drinks online and in bariatric cookbooks. Here is one from The Bariatric Diet Guide and Cookbook, called "The Elvis":
It makes 12 oz. You will only be able to drink about 1 oz at a time at first. If you don't drink it all in one day, you can save it for the next. I like variety, so I would switch it with other flavors. 12 oz contains 31g Protein, but you can add unflavored Protein Powder. One scoop of GENEPRO unflavored protein powder would add 30 g protein.
1/2 C plain Greek no-fat yogurt
1 large ripe banana
1/2 C ice
1 Tbsp unsweetened cocoa powder
1/4 C natural creamy Peanut Butter
1 small handful baby spinach
Optional: 1 scoop unflavored protein powder
In a high-speed blender, combine all ingredients. Blend for 2 to 5 minutes until smooth)
NOTE: Be sure to use an all-natural peanut butter that contains only Peanuts and salt in the ingredients.
The High Protein Bariatric Cookbook says:
"The basics of a Protein Shake include about 1 cup plain nonfat Greek yogurt, or 1 cup milk mixed with 1 tablespoon protein powder and either 1/2 cup frozen fruit or 1 tablespoon nut butter. Then for flavor ad about 1 teaspoon of extract, cocoa powder, and/or flavored sugar-free Syrup or low- to no-calorie sweetener.
...If you make your own protein shakes, the flavor profiles are limitless, and you will know the ingredients going into them. Then, when you have symptoms, it will e easier to identify what the possible cause may be. However, there may be times when a prepackaged protein shake will be more convenient, so do what works for you and hooks you stuck ti tier nutrition goals."
The Lifebridge Health website contains about 30 protein shake recipes. Google "make bariatric protein shakes" to find many more recipes.
Your protein shakes count toward your daily Fluid intake. During the first few weeks of recovery fluid intake is your most important priority. Consume protein as you can.
"You MUST get your fluids in. You SHOULD meet your protein goals. If you CAN, take your vitamins." Matthew Weiner, MD, The Bariatric Diet Guide and Cookbook.

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

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.

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.

I would be concerned but at the same time I would be thankful that you decided to consider this route before it was too late (before your BMI was even higher and the surgeon was not comfortable performing the surgery). I would try to lose as much weight as possible pre surgery. Every bit will help to make the surgery even safer. You can even ask to start with the nutritionist now to drop some of the weight.

I realize I didn't directly answer "Should I be concerned?"
I was concerned. I was in my early 40's and things were starting to go wrong. Hauling around 500+ extra pounds takes it's toll. Looking at the future, I could see I would be bed bound in a couple years, which would impact my life negatively in so many ways. Already, medical issues were becoming increasingly frequent and severe. In a word, the future looked bleak. So, yes, I was concerned.
When I decided RNY was for me and I chose the surgeon for the task, yes, I was concerned. I was concerned that he wouldn't be able to help me because I was so large, it would have been a sentence to a slow, miserable death.
When my surgeon took me on as a patient "concern" wouldn't be what I felt. Hope was what I felt. He told me the plan and I felt it I could do it. He was frank that being as large as I was that I could die during surgery. My wife and I discussed this possibility and both agreed it was better to die trying to change things than to die the slow death we saw ahead. So, I was not concerned about surgery, I would have been concerned to not get surgery.
Was I concerned that my surgeon hadn't had a patient as large as me? No, I thanked my lucky stars he was giving me a chance to live.
I still did my due diligence though. I checked out the surgeons past, since he had been involved in WLS studies, I looked at his documented outcomes. I grilled him with questions as he did me. Turns out I was very lucky.
My concern, if I had one, was that the testing would reveal a problem that would have caused my surgery to be cancelled. Fortunately nothing got in the way.
Good luck,
Tek

Well, it's certainly concerning, but unless your doctor has qualms about it, I would say this is your absolute best chance for what is truly a life-changing opportunity.

Hi! That's because I'm not insured, and I am referred to it via the liver specialist within a hospital setting. That means I am on a waiting list, and there are many loops to go through 1st before I can get the go ahead. All the specialists I have to see have their own waiting list, mostly due to backup from the pandemic. I am sort of happy that I have whole year to form new habits. It could happen quicker though. A year is the max time.

Thank you for posting about your journey. I suspect my friend had a similar procedure 30 years ago but she refuses to look at a revision. I have tons of positive thoughts for you and this next part of your life! I’m 62 and my RNY is on 10/25. I can’t wait for the next part of my life to start!

I agree 100% you need to be able to use your arm to lift yourself. I worried when I went home from hospital I wouldn’t be able to get up without pulling myself up using the bed rails. I figured it out but I definitely used my arms. Sorry to hear of your setback but glad to hear you have a game plan and look forward to hearing more of your story.

A1 - If you are on extended-release medications, they'll need to be switched to standard or immediate release. I went from 150 mg Wellbutrin XL once a day to 75 mg Wellbutrin IR twice a day, and am about to drop the evening dose. I feel fine.

A2 - Yes, but you can only take acetaminophen/paracetamol which is Tylenol in North America and Panadol elsewhere. You will be able to swallow pills, just perhaps one at a time at first.

B1 - I was able go up and down stairs within hours after surgery. If your incisions hurt, take a pillow to brace. Ask your anesthesiologist for what's called a TAP block, it's like an epidural for your abdomen and lasts about 18 hours which is enough time to get used to stuff.

B2 - An elevated bed will actually help because you don't have to squat down to get onto and off of it. But you could buy a little heavy duty stepstool if you want. Just make sure it's stable.

B3 - You absolutely can wipe. Laparoscopic incisions are small. And, honestly, you'll probably be constipated after surgery and won't need to as often, especially if you are on opioid painkillers which back you up. The good news is as you lose weight (which happens fast) you'll become more flexible. A month out and I can wash my entire back without needing a long-handled brush.

B4 - Varies by surgeon. Mine said I could shower immediately, but to avoid scrubbing the incisions, just gently wipe them with a separate cloth.

C1 - Depends on what you do. I have two jobs; the desk job I was back to after two weeks (and could have done one if needed); the outdoor job I'm still not back at because my surgeon wants 6 weeks.

C2 - I was cycling (stationary / assault bike) 2 weeks after surgery with the blessing of my surgeon.

Ask anything, really. That's why we're here.

I recommend this book: Bariatric Diet Guide and Cookbook, by Matthew Weiner, MD. There are guidance and recipes for every stage post surgery.

Hi ClareLynn,
I'm so glad you got the help and the information you deserved to continue onto your journey.
Some doctors can be obnoxious and hear their voice 1st before their patients'.
Do you know anyone else with endometriosis who did the duodenal switch? This forum is so huge, you are bound to find at least one person who can share their own journey with you, with tips and all, specifically around endometriosis in this context.
Take care,
Maroux

I have been lurking for a while and using everyone's experience on this forum to build up the courage to do the surgery. I am nearly done with the pre-op appointments, and then I'm having a duodenal switch (the newer single kind).
I quickly ran into a big snag when I saw the pulmonologist to be cleared for surgery. He insisted that I stop my endometriosis medication (progesterone only) for 3 weeks before and a month afterwards. I have stage iv endometriosis and am disabled without the medication, can barely walk due to pain and usually end up in the ER every month. He just absolutely refused to engage with my questions about how to be smart about blood clots, and also not undo years of work to get to a level of "able to live with endo". I understand the risks of blood clots but he just wouldn't even listen to the risks if I stop either.
I spoke with my gynecologist and she thought that it was fine to be on it. She really blew me away with her support, she called that pulmonologist and got him to agree that the risks of me being off meds outweighed the blood clot risk. I nearly cried to have doctor advocate for me, especially to another doctor on my behalf.
So now I can look forward to the surgery! I am dreaming of doing it before the end of the year (since I've already hit my deductible and out of pocket max) but it's beyond a long shot probably.
Thanks everyone for sharing here on the forum, it's been a great help.

A-1 You will still take your meds. If any are time-release they will likely convert to to immediate release as time-release is iffy with RNY;
A-2 Most doctors have no issue with acetaminophen but some will not like NSAIDs like aspirin at least in the short term. NSAIDs are a ready argument around here, some folks believe they are off the list forever, others that reasonable non-constant use is OK. Pick your sides.
B-1 Most likely.
B-2 Most unlikely. Do you have a recliner? It might be useful for a couple days.
B-3 If you can now you will be able to after perhaps with mild pain.
B-4 Your Doc will tell you. You won't smell to bad when you are finally able to shower, unless B-3 is problematic.
C-1 There are stevedores that worked the dock the night after surgery and home bound people that couldn't manage to get from room to room. You won't know until you know. Probably a week or three.
C-2 I would imagine you would be healed enough to ride within a month, maybe a couple weeks, more or less. Precise estimates are my job, sorta maybe.
A lot of this stuff is personal experience. The Doc is also a good resource on all of the stuff, don't be afraid to engage him/her/it/them/xi.
Now, let's read all the conflicting answers together, shall we? I'll get the popcorn.
Good luck,
Tek

Yes, it should be concerning because the risks are greater. Your surgeon has selected duodenal switch for you which is appropriate. It has the best potential for losing lots of weight.
Nevertheless, it is still up to you you! Do read as much as possible about WLS and afterwards. I've posted lots of book suggestions, which you can see by going to my profile.
Start learning how to eat differently now so that it is habit by the time you have had surgery. Lose as much weight as you can pre-surgery, which will make it easier for your surgeon to get at your organs.

although a stricture would cause vomiting - not diarrhea. At least that would be the case with RNY (I had two of them early out). I agree with what you said about fluids, though - and artificial sweeteners. Those give a lot of people G/I problems - esp sugar alcohols (those whose names end it "-itol" - like xylitol.

RNY does usually result in greater weight loss than VGS, and it usually resolves GERD and Type II Diabetes. These benefits should not be overlooked.

I wouldn't mix Protein powder with milk unless you are deliberately choosing more calories and protein. One normally mixes them with Water.

There are protein mixes for Soup, not sweetened, for example, Bariatric Advantage and ProtiDiet.
I prefer plant-protein protein drinks and shakes over whey-based.
You can make your own Protein Shakes by adding unflavored protein powder to smoothies, for which there are lots of recipes online. Google "bariatric protein smoothies" or get a couple of bariatric cookbooks.
You probably won't need protein drinks once you are eating solid food.

The RNY Gastric Bypass would be more suitable for you. It usually resolves GERD, whereas the Sleeve does not. Sleeves are sometimes revised to RNY because of GERD after the original WLS.

RNY does usually result in greater weight loss than VGS, and it usually resolves GERD and Type II Diabetes. These benefits should not be overlooked.

The RNY Gastric Bypass would be more suitable for you. It usually resolves GERD, whereas the Sleeve does not. Sleeves are sometimes revised to RNY because of GERD after the original WLS.

RNY does usually result in greater weight loss than VGS, and it usually resolves GERD and Type II Diabetes. These benefits should not be overlooked.

Yes, it should be concerning because the risks are greater. Your surgeon has selected duodenal switch for you which is appropriate. It has the best potential for losing lots of weight.
Nevertheless, it is still up to you you! Do read as much as possible about WLS and afterwards. I've posted lots of book suggestions, which you can see by going to my profile.
Start learning how to eat differently now so that it is habit by the time you have had surgery. Lose as much weight as you can pre-surgery, which will make it easier for your surgeon to get at your organs.

Your surgery weight was higher than mine and you had your surgery almost a week later, yet your current weight is lower than mine! If it helps, you're making more progress than me, and my surgeon's office is happy with where I am. It's crazy how different expectations are; my nutritionist said that anything over 8 lbs a month is on track. Stalls are normal along the way and I think it's really difficult to expect to lose 4 pounds a week every single week. Great work so far!