Revision prevention

I am almost 2 years out from my RNYGB.  I can eat a lot more foods now and not get sick or dumping. I don't have problems with getting food stuck or vomitting.  I know the number one thing I can do to prevent pouch and anastomic dilation is continue to have proper portions, however it seems I am back to sometimes not feeling fully satisfied.  Other times, I will adhere strictly to great portion sizes and calorie consumption and 2 hours later I feel so hungry like I haven't eaten all day.  Also, sometimes it seems the healthier I eat, the hungrier I am.  What is going on?  I see tons of people having revisions after only a few years and I really don't ever want there to be a reason (on MY part) for a revision to be warranted.  I did one VERY EXPENSIVE surgery for LIFE...  Help!!  Thoughts??  Suggestions???

I would just stay on top of things. Eat healthy most of the time. Weigh yourself on a regular basis and make adjustments if you gain. If I hit my goal weight, I track my food and cut bac****il I am 3-5 pounds below my limit. 3 pounds is easier to lose than 30.

I think the revisions you see are revisions TO rny.

Some people who are not successful with RNY revise to DS or band over bypass. The further you get out, the easier it is it regain. We must stay diligent.

Laura, I see your surgeon is the one I have found on FB.  I follow him diligently and WISH I had the at power to eat 100% vegan.  I still eat a lot of dairy and meat for my protein though.  I have learned a lot just by following him.  May I ask how long you are out and what does your typical diet consist of?  

Yes, that's what I had.. the rnygb is same as rny.

It is natural that you can eat more and that you can eat without getting sick.  (In six years I have never had anything get stuck and have only vomited from food twice.) The only way to stretch the pouch or the stoma is continuous overeating.  If you chew everything completely, even slight overeating will not stretch the stoma.  If you are still hungry (or not satisfied) after eating, then perhaps you are not eating enough for being two years out.  If and your pouch is not telling you that you are full, you can likely eat a bit more.  Just eat slowly and be aware of signals that you are full.  Having just a couple of additional bites may very well get you to feeling full/satiated.

The key to maintaining your weight loss is your healthy eating habits and portion control. I would pay attention to what you are eating when you are hungry again just a couple of hours later.  You will likely find that at these times your are NOT eating dense proteins.  People who are having revision of their RNYs (as opposed to people revising to RNYs) are probably not going to be any more successful with a revision than they were with their original surgery because in most cases the problem isn't with their anatomy, the problem is that they didn't learn to eat healthy, well balanced meals and went back to snacking or grazing, or eating too many "white" carbs, etc.

If you are hungry again a couple of hours after eating, you can either eat a small, protein-based snack, or can try drinking a large amount of water or other liquid.  Even if your pouch is full, when your intestine is filled with a lot of fluid, you will likely not feel hungry.

Lora

Thanks ****rogirl..  I am already adhering to a lot of your suggestions here.  I just want to make sure I am doing the best I can to stay where I am and possibly lose about 5 more pounds, even though that is not my focus.  I am just so scared of ruining all the hard work I've put into this, ya know?  The one discipline I love that I have is that ever since I had surgery I only weigh myself on Wednesday morning's.  This way I don't under-weigh or overweigh myself.  It is a GREAT discipline that I reccommend to everyone.  

I also read that after approx. 2 years post op (which is about where I am) rny'ers really don't malabsorb calories anymore.  Any truth to that? I don't understand how we can continue to mal absorb nutrients, but not calories.  

Yes, it is true that the caloric malabsorption is temporary but that the lack of vitamin absorption is permanent. 

Your body has the amazing ability to recognize that part of your intestine is "missing".  The food the lower intestine gets has not been processed by the stomach and upper intestine as the lower intestine expects.  The body responds by growing additional villi, and lengthening the existing villi, in the portion of the intestine still being used to make up for that.  The body starts this adaptation process almost right after surgery, and it takes about 18-24 months for the process to be complete (but the process is gradual, not abrupt... you have been absorbing more and more calories as time has been passing. 

The problem with the vitamins is that they are absorbed only in very specific portions of the intestine, and many of them are primarily absorbed in the portion of the intestine that is bypassed.  Your body cannot adapt to account for that, so the vitamin supplementation needs is lifelong.

Lora

Depends of the food - some makes me full and happy for a few hours - others make me feel like I am starving 1-2 hrs after a meal.  The one that keep me happy and full - are mostly protein, and some non starchy veggies. But if I eat carbs - like starchy carbs, or fruits,  or even proteins - with not enough fat - I get very hungry.   Fat is great for me.  I am 5 years out and so far so ggod.

My body process the carbs very fast, so almost anything that can turn into sugar in my body - will affect my hunger.