Hi, I am new here. I am pre-op, and pretty sure the sleeve is the way we are going soon. I have my consult next week.

I have a couple of questions:

Soda/carbonated beverages/beer:

never again?

Low carb diet forever?

No caffeine forever?

Thanks!

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No carbonated drinks. Ever. Again. Caffeine yes, after 2 months

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I had heard from others that only applied to RNY

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You can drink carbonation. It's that it is not recommended.

I honestly think they are not sure whether or not it's okay so they err on the side of caution. Nothing wrong with that though.

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My surgeon said specifically that carbonation expands your pouch and makes it uncomfortable. Continuous use of these drinks will stretch your pouch. He said it. I believe it. Up to you.

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I am a sleever and my doctors orders are no carbonation ever again. Low carb is the recommended diet. White flour (pasta & bread), sugar, rice should be avoided for weight loss success. But most sleevers CAN digest them (slippery slope so I personally avoid them all together since I know that is my trigger). Carbs are fine in the form of healthy low starch veggies as long as you meet your protein goal. Caffeine only has to be avoided post op, not forever. Sadly my sleeve doesn't like coffee.

I don't have a pouch. I have a sleeve.

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My surgeon said specifically that carbonation expands your pouch and makes it uncomfortable. Continuous use of these drinks will stretch your pouch. He said it. I believe it. Up to you.

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You say "pouch", so you had RNY?

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Sleeve. The stomach is reduced to a banana shape pouch.

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[emoji23]

The no carbonation rule is due to the fact that carbonation can cause discomfort in sleeved patients. Definitely avoid it while your stomach is healing. After that, you can try it and see how you feel. Some people on these forums drink carbonated beverages every day. I personally haven't felt the need to, so I avoid them still, though I have had a couple of beers with no I'll effect, other than getting sloppy drunk off of one beer now. I was allowed alcohol at 3 months. Don't have it often because I am such a lightweight now.

I was allowed caffeine at 30 days post-op. Every surgeon has their own guidelines there.

Definitely high Protein diet forever. That doesn't necessarily mean low carb. Some people are more sensation to carbs than others, so you will have to figure out what works for you long term. I personally never tried to stay below a certain number of carbs, but I found that getting all my protein in (100 grams a day) left little room for carbs.

The difference between "sleeve" and "pouch" is not a big deal.

But ... as I understand it, per medical nomenclature, a "pouch" is a food container created from the upper portion of the stomach during RnY (gastric bypass) surgery. During RnY surgery, the surgeon staples the greater portion of the stomach separating it from this smaller portion of stomach. This smaller portion of stomach does not include the pyloric valve at the bottom of the larger stomach, which regulates the flow of food from the stomach to the intestine. This new smaller stomach area (without a pyloric valve) is now called a "pouch." The surgeon then stitches the bottom of this pouch to a portion of the upper intestine that's lower down than the natural length of the intestine above it, giving food less intestinal surface and length along which it can be absorbed. Without a pyloric valve, food that's eaten flows directly (without restriction) from the pouch into the intestine.

The banana-shaped sleeve created during VSG surgery still operates just like the larger stomach did (with valves at both ends -- the hiatal valve up top and the pyloric valve at the bottom). With both valves, the sleeve offers food restriction that an RnY's pouch does not. And with the stomach fundus removed (not just stapled off), VSG surgery removes ghrelin (the hunger hormone) from the equation altogether.

In short:

1. RnY (gastric bypass) uses intestinal malabsorption to help patients lose weight.

2. VSG (sleeve) surgery uses restriction and greatly reduced ghrelin to help patients lose weight.

Anyway, that's how I've understood the major distinctions between these two procedures. (I'm a sleeve patient.)

EDIT: Here's a picture of the new gastrointestinal connections found post-RnY surgery:

http://www.bariatric-surgery-source.com/image-files/ximg-med-rny-gastric-bypass.jpg.pagespeed.ic.bt9H0OYtw3.jpg

I usually only follow my one rule......get the Protein in.

If I have room and haven't gone over my calorie count for the day.....then whatever I choose can follow.....

I have coffee every morning. If I don't have my coffee it is best for all creatures--great and small---to be afraid--very afraid..

Whenever I feel ill, I drink diet gingerale--just like Mom gave me many, many years ago.

I think every WLS person has to mix and match their own needs/wants within their individual program.

You'll know soon enough just what your sleeve will tolerate and what it won't.

There is no template that is "one size fits all". It's up to you, your sleeve and your bariatric team to solve the puzzle as to what pieces will fit together to make your new life --picture perfect.

Thanks. Just what I was looking for. I have a close friend with RNY so her directions are different from what I am facing.

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Soda/carbonated beverages/beer:
never again?

I usually have a small glass of champagne at Christmas -- but carbonation hurts me so otherwise I choose to avoid it.

Low carb diet forever?

For me, yes. If I stray from low carb, I end up on the slippery slope to regain, because for me high carb foods both cause cravings for more high carb foods and are super-easy to digest, meaning I can eat tons of them. Danger! YMMV.

No caffeine forever?

Depends on your team's plan for you and your choices. I went back to high-test coffee about 3 months after surgery and now drink more coffee than water. Like, a lot more. So far so good.