RickM

Clear liquids the day before (and then liquids, purees, mushes and soft proteins as tolerated from the hospital on out for the first month on the post op side.)

It's not entirely zero, but close. Iceberg has a decent amount of potassium and vitamin K in it, though romaine is better on both counts (along with a good dose of vitamin A as well,) so romaine is certainly my choice when choosing a commercial salad, but I'm glad that I learned to like spinach for my homemade salads as it's another step up (though how much difference it made early on when I could only afford about 10 g of it in my salads is debatable!)

On the salads that I make at home I use spinach instead of lettuce to get a bit more nutrition into it. Tolerance for these things is a big variable between people - I was starting to play with my little spinach/veg/meat salads at about a month out and did try an occasional bite of lettuce from my wife's salad when we would eat out. Others may have problem with lettuce (or other foods) for many months before they can tolerate them. I never had much of a problem with red meat during this process, though my wife did have problems with ground beef for a while when she went through this a few years ago. The surgeon suggested that patients often tolerate filet better than ground beef (one of the best "prescriptions" that we have ever gotten from a doc!)

My doc's protocol is no immersion or swimming until the incisions are fully closed, which is typically three weeks, but I was down for four weeks as I had some lingering seepage from the umbilical incision.

2 weeks is not unusual for those docs who do a pre-op diet - maybe half the docs require them (mine didn't, and doesn't even do a liquid only phase post-op, either.). Of those who do such diets,some do the liquids only thing while others just do some form of low carb, sometimes with a liquid component (like 2 shakes a day and a low carb meal.) There's lots of variations out there.

Yes, it is the dreaded three week stall (or third week, since it doesn't necessarily last for three weeks!) Here is a good article explaining the physiology of what's happening now - http://www.dsfacts.com/weight-loss-stall-or-plateau.html As noted in the article, there is around ten pounds of Water and glycogen in play here, so it is not unusual for there to be some small amount of gain happening while you restore your glycogen reserves and switch into fat burning mode, so don't beat yourself up over any perceived dietary sins - it's just nature at work and can happens to most when they go thru this phase.

My doc does it on an 'as needed' basis with his VSG patients, but does routinely remove them on his DS patients. He left mine in place as he could not feel any stones in there, or see any other signs of distress. I never had any problem with it thru the weight loss period or in the subsequent year and a half, so it seems like a good decision in my case.

I can't quite speak from direct experience, but binders and compression garments are standard fare after the reconstruction (tummy tucks, lower body lifts, etc.) that many of us go through to get rid of the excess skin after all the weight is off, so it seems like a reasonable bet. It sure seems like I'm wearing a corset much of the time!

Potatoes are about the best source of potassium on a per-calorie basis that we can find in real foods (and potassium is not supported well in our normal OTC supplements,) so they earn a place in my diet on that basis alone. In loss mode it's hard to afford much of them, (or much of anything beyond protein, for that matter!) but I did have some token amounts during that phase. As suggested, adding unflavored protein powder to mashed potatoes is a good early soft protein food, and is a classic suggestion in many plans.

These items should be in whatever program guide or booklet that they provide you, but it is certainly good to ask in case they don't provide much written instructions. The other major thing that I can think of, based upon reading of many others on these forums, is how much weight does the doc expect you to lose with his program (or what goal weight he might assign to you.) This can provide some valuable insight into your doc's philosophy - some will only expect averages, saying something like 'the averages say that you will lose 60% of your excess weight' while others will be disappointed if their patients don't attain 90-100% excess weight loss. This can help you decide whether to follow his guidelines strictly, or maybe be more aggressive on your efforts if you don't want to settle for "average". Exercise is another part of the equation, particularly in the long term, so you may ask about suggestions and progressions, particularly if you already have some activities that you want to resume, Good luck, and welcome to the loser's bench.

An Atkins style diet is one of the saner approaches to the pre-op diet for those docs who require them - much better than the all liquid type that some docs impose upon their patients (which has no particular rationale that I have been able to find.)

I recorded weekly and only had one week without a loss during the entire loss phase, up until the point that I started ramping up the calories to ease into goal/maintenance. I can't say if that was a function of guy metabolism, or not doing the low carb thing (glycogen deprivation is one of the primary stall mechanisms,) or what. It's a big YMMV.

Veg is another one of those big variables between people - some can go quicker on them than others, so try them a little at time to see how you do with them. Remember, protein first - I was doing well enough on protein that my doc was adding veg to my diet at day ten, and I was having small salads with leftover meat in them by the end of the first month. YMMV. Since you are getting along with the V8 juice, try the low sodium version as that as double the amount of potassium as the regular juice (which we need and don't get to any usable degree in our OTC supplements,) and is the best non-prescription source that I have found so far.

The general rule from my doc on this is to try small amounts of new things one at a time to test for your tolerance - if it goes down and settles well, then great; if not, try it again in a couple of weeks as such things can change quite a bit over time.

The typical recommendation is around 60-80g per day for the ladies and up to around 100g per day for the guys; if one is into some serious muscle building then one may use up into the 150 or so range (and no one who is going thru this weight loss is into that category, at least until they reach maintenance!) Anything more than what the body needs is just peed away, and little, if any, is stored day to day (except in our muscles and other lean tissues, and we don't want to be drawing from them!)

It all depends upon individual tolerances and surgeons' programs - some surgeons will still have their patients on liquids at that point, while others will allow them steak. I was in that second group and had no problem with some filet (which is often better tolerated than ground beef,) and some salad veg along with the more typical early proteins of dark chicken and tuna. Basically, I was at 90+% of what I was having at 6 months out and near maintenance. My wife, on the other hand, was a little slower to progress on the same basic program when she went through this some years ago. YMMV.

Typically, just until you can tolerate regular ones, though surgeons will have different opinions and instructions on this (along with everything else, it seems!) I never used chewable vitamins - only calcium supplements as those are typically are such horse pills - and I used them much longer than I needed to simply because I had a big bucketload of them from Bariatric Advantage to use up. I could only take pills one at a time with a sip of water each for a while, unlike the handful at a time as I could pre-op, but I was back to the handful approach (including the calcium horse pills) after a few months.

Yep - and one can get the same result (heart attack) by OD'ing on the supplement, which is why OTC potassium supplements are severely limited (to about 100 mg, or 3% of RDA) and why most effective treatments for it are under MD supervision. Potatoes are about the best real food source of potassium (on a per-calorie basis) but is off of many people's diets; bananas and avocados are also very good, but somewhat more caloric. The best semi-real food source that I have found is the low sodium version of V8 juice which has around 1100 mg in an 11.5 oz can.

There are two basic schools of thought on this topic within the bariatric world. Those docs whose practices have been based upon the RNY, which has some specific structural weaknesses that preclude the use of NSAIDs and other stomach irritating drugs, tend to transfer that experience to their recommendations to their sleeve patients. Those docs whose practices have been more biased toward the sleeve based procedures (primarily the duodenal switch and the VSG), which don't have the same structural defects as the RNY, generally have no problem with the use of NSAIDs; indeed, NSAID use is one of the major selling points for the sleeve and DS over the RNY. My doc, who has about twenty years of sleeve experience behind him, recommends NSAIDs for pain relief as soon as the normal post surgical prescription narcotic pain relievers are no longer appropriate. Even for normal, non-WLS people, NSAIDs are potentially problematic drugs, and consistent use of them (even the OTC versions) should be done under MD supervision as there can be potential organ damage resulting from long term use, Some docs recommending NSAIDs for their VSG patients often recommend that they be accompanied by a PPI, but that need is somewhat controversial. For the "typical" occasional use, there is little difference between a "normal" person and a VSG post-op. As usual, do take your surgeon's advice seriously, but consider that their current position on the topic will probably be changing over time, so should you find yourself in future need of NSAIDs, particularly on a chronic basis, check with your surgeon again for an updated recommendation.

OH has one, but it isn't very active (as in one post from early April that hasn't been answered, and the next most recent is from last December.) The next best thing (or maybe better,) is meeting other spouses at your local WLS support group. I've been on both sides of this equation as my wife had her WLS around eight years ago, and I'm two years out on mine. Between the two surgeries (and subsequent reconstruction surgeries) and the research/insurance battle phases before, we've been involved in the WLS and support group game for about ten years. Once past the initial healing/acclimation diet phase (which with our doc was not very long as we never had any extensive liquids-only stage,) our diets were very similar other than for volume. I've done most of our cooking through this time, and we typically had the same things for dinner, though she would have half as much as I did (and now we are pretty evenly split on portions.) Neither of us did any extreme fad dieting pre-op, post-op or in maintenance, but have concentrated on healthy long term eating that's fairly adaptable to either maintaining good health or weight loss. Breakfast, lunch and snacks weekdays are pretty much on our own due to work schedules, so our main shared meals are dinners and weekends. Eating out has never been a big problem as it is fairly infrequent (maybe once a week,) so the problem of the typically higher calorie restaurant fare is limited; my wife became disappointed if she was not able to stretch a restaurant meal into two or three meals with the normal leftovers, and I am now in that same boat, but the surgery has not had a big impact on any restaurant socializing; indeed, our local support group meeting are held at a restaurant, so we can all compare notes on our meals! You are right, however, that this is a change in our lives, and one that we all need to adjust to - both patients and spouses - but this is par for the course as we all progress in our lives and face the different challenges that life presents us over time.

Yes and no - yes from the perspective that I had various mushy and soft proteins during the first couple of weeks, but no, I didn't cheat in that I was following my doc's plan which combines the liquids, mushy/purees and soft proteins together in the initial phase from the hosptal on out for the first month (yogurt and scrambled eggs in the hospital along with broths and juices,) The over riding key instruction was to test new foods for tolerance one at a time and in small quantities as patients can vary widely in what they can tolerate and when. With some twenty years of sleeve experience behind it, I find it difficult to argue that his program is overly aggressive, risky or unwise.

It depends upon what's on your surgeon's program and what you personally can tolerate. I was having small salads with some leftover meat tossed in with some chopped spinach, tomato, avo, pepper and scallion after a month, but YMMV.

San Fernando Valley here, sleeved in May 2011. Now recovering from some reconstruction work (TT and manboob reduction). Good luck on your journey through all of this.

I wasn't really doing anything earlier than plan, but my doc's plan has a pretty quick progression built in, so things like scrambled eggs and yogurt were served in the hospital, and those things along with most soft proteins and liquids were acceptable as tolerated for that first month, so it is unlikely that you messed anything up. If you didn't feel any distress then it's unlikely that anything happened. Individual tolerances vary all over the map, so what is easy for some can be difficult for others. When my wife went through this a few years ago, her progression was a lot slower than mine, and even liquids offered a fair bit of restriction for a while, whereas I was downing liquids almost like normal (sip,sip,sip, but virtually no restriction on how long or much I could get down in a sitting) from the outset.

It is unusual to not have a stall at this point (though four weeks is on the long side, but not unprecedented,) as it is part of our physiology. Here is a great explanation of what is happening early in our weight loss journey - http://www.dsfacts.com/weight-loss-stall-or-plateau.html As you see from this, much of what's happening is Water hoarding to rebuild that glycogen supply, so keeping your water consumption up is helpful (sip,sip,sip!) and depending upon where you are, winter weather can be very dry which can further increase your need for hydration. Adding a bit of insult to the injury of a long stall is that you should also expect that when your loss resumes that it will be at a somewhat slower rate. That initial loss, as explained in that article, is mostly glycogen, (basically stored carbs,) which burns fairly rapidly at a rate of around 2000 calories per pound, while once you start losing again you will be drawing from your longer term stores of fat which burns more slowly, at a rate of around 3500 calories per pound - but its finally doing what you want to do, which is burning fat!