Need practical advice (long)

[samuelsmom 670]

Mmmmm.... if that was the case, why do so many of us have such different pre-op and post-op diets?

Oddly, that's exactly what my doctor told me to do.

This has an easy answer! One of the reasons (and I'm sure there are others) that there is such variability in pre and post op diets is the lack of solid research as to which is the most efficacious. Therefore surgeons make their own opinions and go with them. Everyone gets the same instructions because that is the norm the surgeon is comfortable with. Now, are there exceptions? Of course. Someone may have pre-existing conditions, allergies, etc. that result in different instructions.

As more research is done, there may be more standardization of the pre and post-op diet regimen. You can already see some trends in that the majority of people have some type of liquid or lean Protein based pre-op instructions and all bariatric patients are started on Clear Liquids and progress to full liquids, purees, etc. Just the timing is different.

Regarding what your surgeon said to you, I am sorry that happened to you and I am appalled at the lack of empathy shown by your surgeon.

I am curious to see what the pre and post op regimens will look like in 10 years. Should be interesting!

[LipstickLady 25,682]

Mmmmmm... I disagree and the words you quoted from me were a bit tongue in cheek.

I am NOT at all sorry my doctor said that to me, he was right. I got fat because I ate too much crap. I then chose to cut out most of my stomach in order to lose weight. That staple line is fragile and my surgeon has an excellent track record of successful surgeries. I chose HIM because my research said he was the best in my area and I entrusted him with my life.

I didn't chose YOUR surgeon or Betty Sue's or Bobby Ray's. By choosing MY surgeon, I chose to go along with his diet plan and food progression. Following the plan your surgeon prescribed to you and then you describe to me (you being general/plural) isn't a smart choice in MY OPINION.

Living on sweet shakes for a couple of weeks wasn't going to kill me. When I couldn't tolerate shakes, I subsisted on watered down Gatorade. My doctor was pretty insistent that liquid was more important than Protein and as long as I was drinking, he was fine. He didn't want me eating and while it was a long sucky 19 days, I had no doubt I could do it. And I did.

[emilees_mom 43]

Mmmmmm... I disagree and the words you quoted from me were a bit tongue in cheek.

I am NOT at all sorry my doctor said that to me, he was right. I got fat because I ate too much crap. I then chose to cut out most of my stomach in order to lose weight. That staple line is fragile

Living on sweet shakes for a couple of weeks wasn't going to kill me. When I couldn't tolerate shakes, I subsisted on watered down Gatorade. My doctor was pretty insistent that liquid was more important than Protein and as long as I was drinking, he was fine. He didn't want me eating and while it was a long sucky 19 days, I had no doubt I could do it. And I did.

Lipstick lady .... I agree with you. Now mind you I have not had surgery as of yet I just finished my 5th of 6 months. I honestly want to be normal on the bmi charts, and can't wait to be on the recovery side. I honestly pray I have your strength when it comes to my liquid pre and post op diets! I keep telling myself "suck it up buttercup you wanted this every time "fear" sets in!

[samuelsmom 670]

I'm not sure why people feel they cannot negotiate with their surgeons and must follow plans exactly. I also picked my surgeon because he was highly rated in my area. However, that doesn't mean I can't research, ask questions, and change something that doesn't work for me. I am NOT advocating reckless behavior at all. I am advocating individualized care. Medical care is supposed to be individualized. If I have a problem with something than I should discuss it with my care team and they should help me out. If there really is nothing they can do, than a full explanation and support is in order.

@ LipstickLady I'm glad his comment did not upset you. Good thing we all have different personalities!

[LipstickLady 25,682]

I'm not sure why people feel they cannot negotiate with their surgeons and must follow plans exactly. I also picked my surgeon because he was highly rated in my area. However, that doesn't mean I can't research, ask questions, and change something that doesn't work for me. I am NOT advocating reckless behavior at all. I am advocating individualized care. Medical care is supposed to be individualized. If I have a problem with something than I should discuss it with my care team and they should help me out. If there really is nothing they can do, than a full explanation and support is in order.

@ LipstickLady I'm glad his comment did not upset you. Good thing we all have different personalities!

I'm not sure why you would assume that people don't "negotiate", ask questions or do their research. I certainly didn't lie down and accept everything that was told to me without question -- I am far too intelligent for that.

And you hit the nail on the head. INDIVIDUALIZED care. That's exactly why I would never suggest that someone go against their doctor's orders. What MY surgeon told me based on MY body, MY questions, MY research, MY procedure bears little on what applies to anyone else.

[ProjectMe 909]

While I agree with @@samuelsmom that there seem to be more similarities than differences amongst plans...however on this site and many others...folks tend to do whatever they want anyways rather than follow the plan the way the surgeon intended...which results in a slippery slope and lots of subsequent posts of I'm failing, I've gained weight, Help, etc.

Which leads me to agree that at some point one must accept responsibility for ones actions including how one chooses to follow their surgeons plan...so yes, some serious sucking it up has to occur to be successful on this journey. No matter what stage you are in...there will be challenges along the way. Expect them, suck it up, and keep pressing toward your goals.

Edited February 7, 2015 by ProjectMe

[GreenEyes604 753]

I have to completely agree with @@LipstickLady on this subject.

Having VSG surgery is not some simple, fly-by-night procedure. This process is a very devastating and shocking change to your entire body, and unless you did absolutely no research on how and what this process was going to do to you physically, emotionally, psychologically, etc., you are totally setting yourself up for failure and complications by not following your doctor's and NUT's instructions.

I too had a horrible time with getting Proteins in, and there were other avenues that I wanted to take because I felt so weak, tired, frustrated, and miserable. I talked to my surgeon about the things I was experiencing, and thank the good Lord that she told me the same thing, "SUCK IT UP".

None of us truly know what to expect or what it will be like post op until we get there. You can research your heart out, but until you have actually transitioned to the other side, you have no clue what is going to happen to you. Now I do not sign "MD" behind my name, so I don't pretend to have all the medical answers. And to my knowledge neither do any of you. So why in the world would you not follow your health teams advice to the tee, and risk putting yourself in a situation where you are medically worse off than you would have been if you had done what your doctor told you to do.

Yes, I know first hand how tough the first 3 months or so of post op life WILL BE! I am 8 weeks post op, and I still struggle every single day to get the amount of Protein and liquids in that I am supposed to. But the one thing I do know that I'm not going to struggle with is negotiating different foods, etc. with my NUT or my surgeon. I'm going to do exactly what they tell me to do.

I know this will not last forever, and my body will recover and I will eventually be able to meet all my requirements. I will be able to eat quasi-normally again, and I will work this gift that I have been given to the best of my ability.

I know so many people inside and outside of this bariatric world with medical problems who constantly are trying to negotiate with their doctors about something. You made the decision to chose whichever physician you did. If you made the mistake of not believing that the medical team you picked was not qualified to take care of you and have your best interest at heart, then you have no one to blame but yourself. I entrusted my doctors with my life, and whether or not you agree with me, I trust them to know what is best for me without question, or I would not have chosen them.

So when I asked my surgeon 1 week prior to my surgery if I could have one last big send off meal, and her response to me was "NO! Bye Felicia!", you know what I did? I laughed my ass off at her for saying that to me, and what was more hilarious was that she even knew what she was saying, went home and drank my Protein shake, and thanked God that my surgeon cared enough to tell me NO and suck it up!

So I say, put your big girl panties on, suck it up, and know that you are stronger than you think you are, and you will make it through!

Don't tell me what you CAN'T DO, tell me what you CAN DO!

[ProjectMe 909]

@@greeneyes Love your response! #StopNegotiatingSuckItUp. Definitely my personal motto Someone needs to design a shirt

[monopoly2015 27]

Do not just suck it up. Definitely call your surgeon/NUT and explain the situation. They are not going to tell you to suck it up if you are gagging and dry heaving with the Protein powder and new lactose intolerance. They will have solutions and offer options (that they approve).

To answer your original question: many patients are put on mushies (pureed) day 2 after surgery. Many more are at 1 week. I was at 2 weeks and that is pretty normal. Some doctors do say 4 weeks. But you can have applesauce and yogurt and things (full liquid) well before that.

The refried Beans at 10 days or whatever you are didn't hurt you. However, call and explain the problem. You aren't negotiating. You are explaining a problem you are having and see what YOUR surgeon/nut recommends.

We didn't have this surgery to diet and be miserable the rest of our lives. We had this surgery to apply better/newly learned eating habits with the assistance of our tool (sleeve). We do not need to omit everything from our diets. It's now going to be moderation. Instead of a whole pizza, it will be 1 slice. Instead of 6 tacos, it will be 1. Instead of 10 diet cokes, it will be Water.

[samuelsmom 670]

@@LipstickLady

I wish i did see more individualized care, but frankly, I don't. My practice has a manual that applies to everybody. If you look online, you can see lots of manuals from different practices. I am sure for people with unique needs there is some discussion, but that is a guess. Manuals are great, but certainly not individualized. As I recall the original poster was miserable and gagging from what was on the "approved" list. This is not beneficial for healing and really should be addressed.

I think there is a time and place for "sucking it up," like avoiding the pre surgery pig out, for example! Or making good choices, or getting the Fluid in.

We can certainly disagree, which is rather unusual as I typically agree with your posts, but I just don't think being miserable and gagging shortly after surgery is one of those "suck it up" situations.

[ProjectMe 909]

Problem: milk based Protein caused issues

Solution: jump ahead to pureeds

I had this particular problem because I too am lactose intolerant. Here's how it worked for me:

Problem: lactose intolerant

Solution: googled lactose free Protein products, searched on this board for folks with identical problem, looked up recipes for lactose free shakes using soy, almond, or other lactose free solutions...still followed nutritionist/surgeons plan

Also regarding the whole moderation and why folks got the surgery theory mentioned in a previous post...Not all of us have that same philosophy. I recognize that I have a serious problem with carbs. I can't eat a slice of pizza, have a sugary drink, or eat a few crackers without craving carbs for the rest of the day and binge eating all day. I'm not going back to that cycle.

[LipstickLady 25,682]

@@LipstickLady

I wish i did see more individualized care, but frankly, I don't. My practice has a manual that applies to everybody. If you look online, you can see lots of manuals from different practices. I am sure for people with unique needs there is some discussion, but that is a guess. Manuals are great, but certainly not individualized. As I recall the original poster was miserable and gagging from what was on the "approved" list. This is not beneficial for healing and really should be addressed.

I think there is a time and place for "sucking it up," like avoiding the pre surgery pig out, for example! Or making good choices, or getting the Fluid in.

We can certainly disagree, which is rather unusual as I typically agree with your posts, but I just don't think being miserable and gagging shortly after surgery is one of those "suck it up" situations.

Yup... we will have to agree to disagree.

I find your messages a bit mixed/confusing. You said all plans are basically the same. You also said we should negotiate with our surgeons to make sure our needs are being met to in an effort for them to be more individualized. Then you said you rarely see individualized plans... Perhaps I am missing something.

As for sucking it up? I would never tell someone who is risking their health to suck it up. That's craziness and I was obviously unclear in my wording. My apologies.

*I* had to suck it up because what I was told to consume was disgusting to me -- all the sweet stuff was making me gag and feel nauseated. It was mental for me, not physical (until the soft foods came in, that was a stricture). Most of the problems discussed on these boards as far as "I CAN'T" are mental, not physical. That's where I am more apt to think "suck it up" is entirely appropriate.

Smoooch!

[BLERDgirl 6,417]

@@samuelsmom - I never had a clear liquid stage pre or post op.

My practice has a manual. It's not online, but they have one. I am one of those exceptions being a vegetarian and having allergies. Many people come here and vent, when they need to go back to their nutritionist and say, "This isn't working for me." The answer may be "suck it up" or it may be "try almond/soy/rice/hemp milk, try soy Protein powder." It may even be a third option I haven't thought of. Regardless unless you go back or call your nutritionist you won't know.

Edited February 7, 2015 by BLERDgirl

[samuelsmom 670]

@@LipstickLady

Sorry- Didn't mean to be unclear. I do believe care should be individualized. When I said they were not individualized I was talking about the standard post-op diet where everyone in the practice is given the same instructions (unless there are other factors). I'm not against this and it certainly worked for me, however, it may not work as well for someone else. I don't think plans should be so rigid that someone who will be truly miserable should have to be.

My NUT could have told me to "suck it up" on Thanksgiving Day, and I would have followed those instructions, but it would have messed with my head and really started me out on the wrong foot. Instead, knowing that purees are commonly started sooner she told me I could go ahead and puree the turkey, which I did. I think empathy and working with people is really important. If there truly is no other options that is one thing (for example- having nothing to eat or drink before surgery). But if there are other options, I think the health care team should be responsive and work with the person.

[BLERDgirl 6,417]

I haven't from the the OP, but I will say in this case "Suck it up" wouldn't be a bad thing. She had like 2 days left before she transitioned to purees. I was ready to toss Protein drinks after a week so I totally understand the feeling. It just seems that if she made it this far, 2 more days wouldn't kill her.