Phase I & II - the math doesn't add up -help me understand

[trekker954 421]

I'm not seeing how this math adds up. My food intake pre-op usually takes place between 8 am and 7 pm (11 hours). Or am in interpreting this wrong?

Post op instructions from CCF.

Phase I – Day 2 home from hospital (2 to 3 days) (CLEAR LIQUIDS) NO Protein shakes YET

Drink 1 – 3 ounces Clear Liquids every hour (up to 64 ounces per day)

Phase II – FOR 2 WEEKS - sugar free liquids - HIGH Protein Shakes. NO SOLID FOODS YET

Drink 60 grams of Protein per day in the form of liquid, high Protein shake

Drink 4 -8 ounces (1/2 to 1 cup) Protein Shake 3 times per day. Do not skip meals (set alarm)

Stop drinking when you feel full

Drink SF Clear Liquids in between shakes for total of 64 ounces (8 cups)per day

30 minutes RULE to Fluid intake. WAIT 20 MINUTES BEFORE AND AFTER YOUR shake TO DRINK OTHER LIQUIDS.

So help me understand. And I do understand the instructions say "Up To" 64 ounces. But even on the low end, that sounds like a lot in the 1/2 day I'm away. My life is no responsibility to anyone or anything at home, so typically by 6:30, I relax on the couch, watch news; internet, TV shows and usually asleep by 9:30-10 pm. I'm 62.

Phase I. if I were able to consume 3 ounces day 2 and 3 each of my 11 hours that would equate to 33 ounces (half of the daily requirement). Or should I be aiming to drink 5 ounces every hour for my 11 hours, or should I be trying to extending my intake hours. I also anticipate, I'll still be on pain meds, possibly not even being awake that many hours.

Phase II - pretty much the same questions, but this looks like I need to get in more ounces within this period. Will I really be able to up all my liquids to 8 ounces per

[Inner Surfer Girl 12,015]

This does sound complicated. You may have to make a schedule.

For me, all of my fluids (Protein shakes, Popsicles, etc.) counted towards my Fluid total.

For me, the bottom line is: 100 grams Protein, 64 oz Fluid. Sip, sip, sip.

[kmorri 1,689]

The first week to two weeks is really hard to get all your fluids and Protein in.....Just remember the most important thing is fluids.....What my nurse coordinator had me doing that made things easier for me for the first couple of weeks she told me to just focus on getting fluids and not to worry so much about measuring and timing, but to instead make sure I was drinking enough to keep the color of my urine from becoming dark...........Then once I was able to get a handle on getting enough Fluid then start working on protein......and slowly work up to getting the 60 grams of protein......just remember your body will be fine for several days even weeks with not getting enough Protein, but you must ensure you're getting enough fluid....Focusing on one thing at a time is what helped me.

It may be helpful for you to measure out the total amount of Fluid you want to aim for, for the day first thing in the morning, and I know several people who used the small plastic 2oz shot glasses you can get from Walmart....(they're little red Solo cups)....I've heard several folks say that really helped them........they would fill up 4 of them at a time and when they were gone refill them all again.....

Good luck to you!!!

[OutsideMatchInside 10,166]

@@trekker954

You should be drinking Water all day every day. And drinking your Protein shakes at meals times.

In the beginning it is really important to constantly drink as it helps keep your stomach open and prevent dehydration.

I'm not sure why they put a limit on how much you can drink at 64 ounces, but other than that, the instructions make perfect sense.

The instructions are always assuming that you are actually resting after major surgery and not working. I understand everyone can't take 2 full weeks off from work but you do need to keep drinking all day. You can't just chug Water at the end of the day and make up your water needs to avoid dehydration.

[trekker954 421]

I'm actually planning to take 6-8 weeks completely off from work. I travel extensively for work and due to budget cuts, Return from my last trip Aug 4th and have been told I likely won't see anymore work until late October. Since no work for likely 10 weeks, this was the perfect time. I've got at least 4 months sick leaved saved up and plan to retire next year; so why not use some of it this year and the remainder late next year if I want cosmetic surgery.

After my two week checkup, I'm contemplating heading over to my BFF's (3 hours away) who condo development has a rental unit I can use for a month. I think it would be easier being in a condo alone in a walkable city rather than having to share the refrig and seeing my family's food around.

But thanks for the advice. I really want to follow doctors orders, as most say that is how they've been successful. With putting in the no liquids 30 minutes before and after the shakes, yet keep drinking fluids all day, just seems confusing and/or conflicting.

[LipstickLady 25,682]

One to three ounces of clear liquids per hour sounds off. I was told one to three ounces every 15 minutes to keep hydrated. If you went on the low end and stayed up all night, you would still only get 24 oz. That's not right.

[silverthreads 183]

OK...so I'm not the only one who found the instructions didn't add up! My surgeon's program was pretty different, but the math was similarly flawed. Do the best you can and you'll be fine!

At one point my surgeon was lecturing me on the evils of Protein shakes--that I should be getting all my Protein from natural foods, nothing processed. "Protein shakes are slider foods that don't keep you satisfied and you shouldn't have liquid calories". It was early on so I did the math for him--2 oz. of lean protein (all I could eat with the restriction then) 3x/day wasn't going to get me anywhere near my 80 gram goal. He looked stunned for a moment and then relented--"well maybe for now until you can meet your goals without them". I really don't think anyone had pointed that out to him!

Sent from my iPad using the BariatricPal App

Edited July 4, 2016 by silverthreads

[Inner Surfer Girl 12,015]

OK...so I'm not the only one who found the instructions didn't add up! My surgeon's program was pretty different, but the math was similarly flawed. Do the best you can and you'll be fine!

At one point my surgeon was lecturing me on the evils of Protein shakes--that I should be getting all my Protein from natural foods, nothing processed. "Protein shakes are slider foods that don't keep you satisfied and you shouldn't have liquid calories". It was early on so I did the math for him--2 oz. of lean protein (all I could eat with the restriction then) 3x/day wasn't going to get me anywhere near my 80 gram goal. He looked stunned for a moment and then relented--"well maybe for now until you can meet your goals without them". I really don't think anyone had pointed that out to him!

Sent from my iPad using the BariatricPal App

LOL -- that is the whole point of protein supplements: to help us get enough protein until we can eat "real" food!

[Maggie143 94]

I can guarantee you won't even think about what your family has in the house or refrigerator because you aren't going to want any of it. You just turn off. You have to sip sip sip and walk of course and don't worry about making all your goals the first week as your stomach will be swollen and you won't be able to get in that much. The following week you will want a Protein shake and premiere has 30 grams of Protein at 11 oz. So take your time with them and Water in between. your main goal is to not dehydrate which will send you back to the hospital. Your are supposed to build up to the goals you were given. Be good to yourself. You don't want to hurt your new pouch which will be somewhere around 2 ounces. Pay attention to your body and stop when you had enough.

[Kindle 8,667]

Telling you not to drink 20/30 min before and after your Protein shake is just stupid. The only reason for that rule is to not flush solids through your sleeve too soon so that you end up eating more than you should. So it really doesnt apply with Protein shakes . Fluids are fluids. And even the eating/drinking rule is archaic, carried over from the rules of bypass with no real logic behind it when it comes to VSG because out pyloric valve s still intact.

I say do what you've gotta do to get in all your protein and fluids and ignore the stupid rules that don't make sense and actually impede your ability to reach goals. And, BTW, that 64oz is a minimum you should aim for. You should actually shoot for more than that, especially if you are excercising, live in a warm climate, are experiencing a stall, diarrhea or Constipation. I actually got dehydrated on 64oz and now get 100oz every day.

[James Marusek 5,244]

Those instructions sound confusing to me. After surgery, there are three daily requirements that are important. These are Protein, fluids and Vitamins. food is less important because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. It is also important to walk 30 minutes every day (or equivalent exercise).

Right after surgery your body will be in a major heal mode. So it may be difficult to meet your Protein and Fluid requirements. Keep striving towards those minimum daily requirements and you will eventually be able to get there.

Your daily protein requirement is met by a combination of the protein you obtain from meals combined with the protein from supplements (protein shakes, protein bars). But at the beginning your meal volume will be so low you will need to rely on supplements. Otherwise your body will scavenger protein from your muscles, such as your heart muscle, your hair and you will become weak. That is why the focus is protein.

Fluids are also important. As your body destroys fat cells, it releases chemicals and hormones stored in the cells. These need to be flushed through your kidneys and expelled in your urine. So you need to stay hydrated. But fluids are more than just Water. It includes milk, the Water you drink with your Vitamins, the water you use in making your Protein Shakes, tea, Decaf coffee, the water component in Soups. So generally it is not difficult to meet this requirement. But it is an important one.

So 64 ounces per day of liquid sounds like a good minimum. 60 grams of protein per day might be a little on the low side especially if you are active.

[Djmohr 6,965]

Honestly! I had the same problem and because I am a rule follower, I really tried to hit those goals. When I could not even come close I started to freak out.

So, i called my nut. She made some suggestions and told me to simply do the best I could. That there was a lot of swelling and most people don't come close to those goals. LOL!

I was kind of pissed at the time because you give me a goal, I am going to kill myself to get to it. After that call, I really focused on making sure I got my liquids. I was probably 4 to 5 weeks before I even came close to drinking a whole Protein shake in a day. I will say once I did, boy did I start to feel better.

Just do the best you can and realize that the most important thing is to stay hydrated. Your ability to do the rest will come in time.

[trekker954 421]

Thanks these are a lot of good tips. I'm like you DJmohr, I'm a rule follower to the letter.

My plan does not allow me to start back my Vitamins until Phase III (soft/pureed). So not until 2 weeks post-op.

I was worried about patients saying they cannot even drink their Water. I did some research on here and other sites where I have found it may be just the pH in my Water and different ways to soften the water or trying different brands or flavors can may the big difference. Maybe, they mention that in my discharge papers/visit, but its not in the handbook they gave me with my instructions.

I'm grateful everyday for this forum.