WTH??!! Absorption a few years after RNY??

There are these little tiny things in your small intestine called villi.  They are like fingers that grab up calories and absorb them.  When they bypass part of the small intestine, suddenly there are fewer villi in there to suck up the calories.

However, your body quickly figures that out and it is afraid it's gonna starve.  So your small intestine starts to grow more villi in the part that has not been bypassed.  After two or three years, you have about the same number you had before surgery so you absorb about the same amount of calories again.

It's pretty cool if you think about it.

However.  We continue to malabsorb vitamins because only certain spots in the small intestine absorb each one of those.  That never goes away because some of those spots are bypassed forever.

The point of they RNY is that we have restriction forever and that we lose weight rapidly in the beginning due to the temporary malabsorption of calories.  The hormone that tells us we are hungry is also decreased with RNY.

Wow - the fact your surgeon's office did not make this clear to you is scarey.  It was made very clear to us and emphasized why it is so important to  change our habits for a lifetime.

Kelly is right - you need to call them express your concern over the lack of pre-op education.  Not that it will do you any good at this point, but perhaps it will help someone else!

I am going to go to the online forum for my doctor's office and ask about this tonight. I went through all my educational materials that I got pre op and it says nothing about the malabsorption lessening as time goes by. I am so pissed right now! I'm going to get to the bottom of this, thanks everyone!

I really would've gone with the VGS if I would've known this fact, makes me mad!

I don't blame you.  I would be mad too.  I know a lot of surgeons do a poor job of educating patients about vitamins and labs and stuff, but this is something pretty basic that absolutely should have been made clear before you consented to surgery.  In essence, you did not give informed consent to surgery, since you weren't informed of the basic facts.  It really, really bothers me when docs do this.  I think it's unethical.  They should be giving patients all the information before they operate on them.

Personally, I do not understand why you are so mad. The malabsorption lets us lose most if not all of our excess weight, then it is up to us to learn good habits to keep it off. Without the rapid losing, helped by the malabsorption, many of us would not get to our goal weights. I know many VSG peeps in real life and NONE of them are as small as me. I can eat 2000-2500 calories a day to maintain my weight, which is "normal" for non-WLS people. I love my RNY.

Laura

Laura, I don't know about you, but I was SELF PAY and paid a ton of money ($18k) to have this surgery done- that's why I'm mad.  My cousin and her hubby had the RNY done back in 2001 and only paid a small amount, like $50 each for both of their surgeries (insurance covered theirs!!).  

I would've liked to have received all the info necessary from my doctor to know which surgery I should've chosen.  I am glad I had it done but just that bit of missing info would've been nice to know!!!

"My cousin and her hubby had the RNY done back in 2001..."

And how are they doing 10 years out?  Have they gained back all the weight they lost?  I'm guessing probably not--otherwise why have RNY with such an example before you?  Did they change their eating habits in such a way that the weight has stayed off?

Did you do any research of your own about WLS?  Frankly, when somebody is going to be messing about with my anatomy in any way, shape or form I research the procedure up the ying yang.    In researching RNY I found repeated references to the fact that the malabsorption doesn't last forever and that the surgery is a tool you learn to use to keep your weight down in the coming years.  And if I was going to be covering all expenses out of my own pocket I'd leave no stone unturned in a search for info.

But that's just me, maybe.

 The fact that the body learns to absorb calories again was not written in any of my pre-op materials.  It may have been explained in the class - I don`t recall.  But I do remember like it was yesterday my first visit with the surgeon.  He explained it very clearly and simply - you will have 1 year to 18 mos to lose a lot of weight - and you must use that time to learn a new way of eating.  After that you start feeling better and your appetitie comes back and your body remembers how to absorb calories.  That`s pretty much what he said.  He also explained the part about the need for vitamin supplements for life.   I guess it was one of those teachable moments for me - because my memory is so vivid.      So it is possible that the information was passed on at least verbally.  But that is not NEARLY good enough.
I felt like a two year old when I went to the pre-op class.  They told us things that were simply not true.   I learned later that this is because they try to scare away people who are not serious.  So they said things like you will NEVER be able to eat sugar again (I think they made us sign a pledge), and they also said we could never drink carbonated beverages ever again.  No wonder there is so much misinformation floating around about this surgery!     The information I get on this board is far more sophisticated than anything I learned in that class.  
I`m not sure how I found out about OH - but it wasn`t through the official program.  This board (even with surgery wars) has been a tremendous source of SUPPORT through information sharing, and the kindness of the people here willing to help each other out, over and through the challenges we face.

Yes, it's true.  I had already answered your reply to my original comment by the time I saw this.  You can read the other reply there, but the metabolism gets messed up because your body reacts to you dropping your calories so low for so many months post-op, and then only raising them to an amount that is still significantly lower than what your body has been used to, so the body often permanently maintains the lowered metabolism from the early post-op period.

IMO, it is unethical for surgeons NOT to tell patients that the caloric malabsorption is NOT permanent (this phenomenon doesn't just happen with people who have RNY, BTW... the same thing happens when people have part of their intestine removed because of cancer or something like Crohn's Disease)... but MANY surgeons don't tell their patients about it (and I know of one case where the surgeon actually denied it when a patient asked about it, and continued to deny it until she took in a copy of one of the medical journal articles about it).

Lora

wow Lora, thanks for the info- interesting stuff! I posted something on my doctor's support group board and we'll see what people and/or the nurse at the dr's office says. I bet if they disclosed that info in the pre op class about the malabsorption going away a few years after surgery (at least in my classes and many others out there), a LOT of people wouldn't do the RNY and would either do the DS, lap band, or the VSG!! 

I know I would've probably done the VSG instead!!!  I wanted the RNY because of the malabsorption issue and that I thought it would continue to do that after surgery forever, to keep the weight off for me!!!!!  I am so PISSED OFF at my doctor right now, arghhhhhh!!!