Quiz for Pre Ops

This quiz is just for pre ops.  Test yourself to see how prepared you are for your RNY. 

What is a stricture?  What are the symptoms and how is it diagnosed and treated?

Why is Ursidol or Actigall prescribed for many post ops?

Why do we need to take so many vitamins after surgery?

When does the ASMBS say you can start swallowing whole pills after surgery?  And how will you take your vitamins and medications until then?

Why are RNY patients usually advised to avoid NSAIDS?  Can you name at least three common NSAIDS?

How long should you use protein shakes after your RNY?  What’s the best type of protein supplement to use (best as in absorbed best)?

What is dumping syndrome?  Name the common symptoms.  How can you avoid dumping?  Do you know how many people experience dumping syndrome after RNY?

Post ops, feel free to chime in on the answers, but let’s give the pre ops some time first to see how they do.

What is a stricture? What are the symptoms and how is it diagnosed and treated?

A stricture is a swelling of the stoma (the knew opening from your pouch to the intestine) that prohibits food from passing from the pouch to your intestine. Symptoms are most commonly the inability to "keep food down"; meaning any foods or liquids consumed will be thrown up. To be properly diagnosed; your surgeon will scope your pouch & if a stricture is discovered it will be stretched during a procedure where an inflatable "balloon" is used to dilate the opening. (This may need to be repeated multiple times in order to get the stoma opening large enough.)
  Why is Ursidol or Actigall prescribed for many post ops?

This is used to help with the gallbladder. Gallbladder upset can begin due to the rapid weighloss. I haven't done extensive research on it since my surgeon removes the gall bladder during the RNY.

  Why do we need to take so many vitamins after surgery?

1. We won't be able to eat enough food to get all of the required vitamins through food alone. (Thus the need for a multi)
2. Even if we could the part of the intestine that absorbs particular vitamins has been bypassed causing malabsorption and while eventually your body will "regrow" the villi needed to absorb the calories in our food you cannot "regrow" the part of the intestine that would absorb the vitamins.

  When does the ASMBS say you can start swallowing whole pills after surgery? And how will you take your vitamins and medications until then?

I believe you can start to swallow whole pills approx 1 mth out (that is what my surgeon's plan states but idk if that is per ASMBS guidelines. I will take a chewable form of the vitamin when possible & crush those which don't have a chewable alternative.
  Why are RNY patients usually advised to avoid NSAIDS? Can you name at least three common NSAIDS?

NSAIDS can cause ulcers in the "old" stomach which is blind (meaning it cannot be scoped) the only way to properly diagnose an ulcer in the remnant stomach is through surgery. Some common brands of NSAIDS are aleve, asprin & midol. Naproxin & acetomeniphin (?) are forms of NSAIDS.
  How long should you use protein shakes after your RNY? What’s the best type of protein supplement to use (best as in absorbed best)?

You should use protein shakes until you are able to meet your protein needs through food alone. Typically expected to last until you are able to tolerate a regular diet. However; due to complications or personal plans one may extend the use of protein shakes past that point (I would check with my NUT or surgeon prior to relying on protein shakes for an extended period). Whey protein is the best type of protein to use.
  What is dumping syndrome? Name the common symptoms. How can you avoid dumping? Do you know how many people experience dumping syndrome after RNY?

Dumping syndrome is the term used to describe the physiological reaction a persons body may have to large amounts of sugar or fat entering the intestine. Common symptoms are dizziness, nausea, diarehea (sp?), chills. These symptoms will appear shortly after eating the offending food. In order to avoid dumping you should stick to your surgeons meal plan & not "test' your boundaries; however, it is possible to experience dumping even when you are compliant. Some people are sensitive to small amts of sugar or sugar alcohols. It isn't a science; more of a trial & error thing. Only 30% of RNY patients will experience dumping.

Very good!  Only one correction.  Acetominophen (Tylenol) is NOT an NSAIDS and we CAN take that.

 don't they say we can start swallowing pills immediately as tolerated too? i started pills the day after surgery

You're correct, they do.

Thanks for posting, I didn't know most of the answers...  I'm just starting my research.   So in regards to NSAIDS.. it sounds like you can't take anytype of asprin/tylenol/ibuprofen... what do you take?

We CAN take Tylenol/acetominophen.  We CANNOT take NSAIDS/ibuprofen.

If Tylenol doesn't do the trick, we can use narcotic pain meds.

 Great thread as I am just starting to research RNY.

Question--when you are scoped for a stricture, are you awake? That sounds pretty awful to be awake for something like that! 

They sedate you.  I think they use Versed and something else when they did mine.  I had two of them and slept through both.  I told the doc and the nurses that they had to make sure I was totally asleep or I would freak out, and they did.

Occasionally, I hear a story from someone that was not fully sedated and was awake for at least part of it and it does sound really horrible.  That should not happen, though.  If you have to have a scope, that's something to discuss with your doctor.

I fell asleep just as they were starting mine and woke up when it was over, feeling just fine.

 Thanks Kelly! Whew! That's good to know!!