Weight Loss Surgery - Post Op Diet




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MadCowOnTheMend
03-07-2013, 09:26 AM
Several of the threads have mention of poor care for the post-op diet from medical staff that aren't really educated on the needs after WLS.

This is the basics of what my team gave me and I wanted to get your opinions.

PRE-OP
They had me start the 2-3week pre-op diet. Three protein shakes a day w 20g of protein, plus 2 meals of lean meat and veggies a day. I'm testing several different protein powders in advance to see what I like best. I've lost 3 lbs since Monday of water weight I'm sure.
Two days before surgery, liquids only.

WEEK 1- Smooth liquids (I have a list) ensuring 60-80g of protein from protein shakes daily. Sip fluids all day with a goal of 4-8oz per hour for a total of 64oz per day.

STAGE 2 (1-3weeks long) Full Liquids diet, adds in applesauce, non-fat yogurt, thinned cream soups w no chunks, pudding thinned oatmeal, etc.

STAGE 3 (1-2 weeks long) Pureed to soft diet (mashed sweet potato, canned fruits, eggs, hummus, cottage cheese, oatmeal)

STAGE 4- Soft to regular diet (add 1 food at a time, avoid carbs, lean meats soft cooked vegetables)

Then it has the success sheets that describe what to watch for, etc...


Seems pretty comprehensive to me. Each stage above has 2 pages of info or more. I'm trying to predict what will happen w my food sensitivities. Some of them will go away with surgery. Most of them are related to my Fibromyalgia and avoidance because it helps me keep pain under control, so it may be that I can have them in these small amounts.

I tried whey protein yesterday. I didn't have any immediate awful issues but did have a rough day with digestion. And it made me gag.


jiffypop
03-07-2013, 10:21 AM
hi there!

from one RNY to another - immediately postop- WATCH YOUR CARBS. don't consume more than 15 grams of carbs in ANY form at any one time [that includes applesauce, creamed soup, sweet potatoes, fruit, oatmeal, yogurt - read all the labels]. And i'm sure they also told you to get your 60-80 grams of protein a day for several months, right? To tell the truth, if you get that in plus your water, it's unlikely that you'll be able to eat more than a couple of bites of anything else. hard to believe, but true.

please be aware that your tiny tummy will likely be cranky - and foods that you think will work just plain won't. and what works one day won't work the next. just put those foods aside for a few days and try something else.

i couldn't keep scrambled eggs down for more than a year, but deviled eggs made with salsa and hot sauce went down just fine. go figure!

a lot of the comments about the postop care are not so much about the surgeons but about the longer-term care from primary care and other physicians. after you're turned over to your PCP for blood work and so on, THAT's when you'll have to keep on top of things. bariatric surgeons have pretty much gotten past the contempt that many healthcare professionals have about overweight people, but other physicians and nurses may not have.

MadCowOnTheMend
03-07-2013, 12:04 PM
WATCH YOUR CARBS. don't consume more than 15 grams of carbs in ANY form at any one time [that includes applesauce, creamed soup, sweet potatoes, fruit, oatmeal, yogurt - read all the labels]. And i'm sure they also told you to get your 60-80 grams of protein a day for several months, right? To tell the truth, if you get that in plus your water, it's unlikely that you'll be able to eat more than a couple of bites of anything else. hard to believe, but true.


Yeah, I noticed that there were many carbs in the suggestions. I have been through the process with 3 different people and seen their issues with carbs. I really intend to stay away from them. With my gluten issues (don't do oats either), I'm used to avoiding them.


a lot of the comments about the postop care are not so much about the surgeons but about the longer-term care from primary care and other physicians. after you're turned over to your PCP for blood work and so on, THAT's when you'll have to keep on top of things. bariatric surgeons have pretty much gotten past the contempt that many healthcare professionals have about overweight people, but other physicians and nurses may not have


Ok, I see. My PCP is very experienced with it, and has supported 2 people I know and his own best friend through the after care. I think I'll be in good hands, then. But I don't want to just rely on them and miss something.

Another question about the protein powders. Is the idea to mix them with water alone? I have been mixing them with spinach and lowfat coconut milk, coffee powder for a frappucino style treat. What are your thoughts/experience on that? Should I try to get used to just the powder and water?


Zeitgeist
03-07-2013, 06:39 PM
Your schedule looks very similar to the one I was given, although I think the weeks on each stage were 2-4 each. I ended up being on stage 2 for months, though, due to complications.

Depending on the protein powder, you can mix them with any liquid that tastes good to you and doesn't add too many additional carbs. I used almond milk for most drinks except the Syntrax brand, which I think tastes better with water.

I don't know about mixing in spinach or coffee postop, though. Coffee was supposed to be off limits for at least six months (although they would prefer never having coffee again) and vegetables weren't to be added until stage 4 (which as I've stated above was months for me). As a preop, I would do what you think is best, in terms of following your plan and enjoying yourself. Protein drinks can become monotonous.

And finally, as Jiffy stated, most of the encounters that I've had with medical professionals were about postop care, not the advice given to me by my surgeon. Although you are wise to ask, as some nutritionists that work with the surgeon do give out poor advice, like taking Flintstones as your multivitamin.

MadCowOnTheMend
03-07-2013, 06:56 PM
LOL, yeah. They did say to take flinstones. I'm intending to order organic liquid vitamins. Actually, I should go do that now!

jiffypop
03-08-2013, 12:44 AM
oh. i forgot to answer the Q about mixing protein supplements. I like syntrax, and, like Jen, i mixed them with water, at least the fruity ones. can you have goats milk yogurt? if you can, you can also mix the protein powder with that for something pudding-ish.

Another thing - even with the milk- mixed protein powders. i COULD NOT get them down if i blended them with ice according to the instructions. But i did need them to be icy cold. soooo i just poured them over ice. and sometimes consumed them with a spoon because they were just too thick to drink.

you can also mix them with coffee AS LONG AS YOU COOL THE COFFEE a little, and don't re-heat it. heat denatures the protein and you'll end up with a coagulated mess. and definitely decaf. i think most docs say NO COFFEE but recognize that most folks have to have at least one cup in the morning [i drink tea, but i ended up being forcibly decafeinated]. do what you have to in order to consume the protein. you'll be using it for awhile so you might as well not dread it [notice i didn't say learn to enjoy it! :) ]

read the labels on the vitamins - i think centrum's spongebob vits have a little more of something or other than flintstones. and i took two a day. not quite sure why i did that - i think a long-term postop in the IRL support group told me about it. it worked.

Zeitgeist
03-08-2013, 05:35 AM
Regarding vitamins, the ASMBS (American Society for Metabolic and Bariatric Surgery) publishes a lot of interesting materials, including recommendations for dietary care after WLS. Their research is what a lot of surgeons use to base their postop care requirements on. Here is a link to their nutritional data; of particular note is table 5. It lists what vitamin supplementation should look like for the various surgeries.

Table 7 is also interesting in that it talks about the different protein supplementation sources. You want to stay away from collagen/amino acid sources, as they won't meet your protein needs (these are usually found in those "protein shots" that have become popular).

Anyway, maybe you'll find some use in the link. I love research and as such really like the documents the ASMBS produces.


http://asmbs.org/2012/06/asmbs-integrated-health-nutritional-guidelines-for-the-surgical-weight-loss-patient/

jiffypop
03-08-2013, 09:31 AM
great resource! thanks, Jen

MadCowOnTheMend
03-08-2013, 06:42 PM
Zeitgeist- That is fantastic!!! I read through it and will again after the kids go to bed. Thanks so much for sharing the link