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Why do some doctors allow you to eat mushy 1 week post-op?



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Longhorn,

Your doctor does sound like he is very cautious and mostly interested in keeping his patients healthy which is great. At least he allows blended Soups which I am now having anyway as I'm starving. My doctor also insisted on us losing 5% of our initial body weight or he would not perform the surgery. I was told at my pre-op visit that if I didn't lose the last 3 lbs by my surgery date that the operation would be canceled. I had 3 days to get that weight off. I really starved myself. I was weighed on the morning of my operation and had taken off 5 instead of 3. He really has sent patients home instead of going through with the operation. Apparently, dieting softens the liver to prep it for surgery. But if a patient is 1 lb over, he will cancel. Think my doc is a tad OCD? :)

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Hi Cindy:

I believe that I understand your frustration just as everyone else here does to one degree or another. But as Longhorn and stated every DR is a bit different in their approach to WLS.

I believe it has alot to do with their success stories as well as their failures. They are trying to give your new stomach time to heal completely before allowing it the extremely difficult task of digestion.

Some foods are very hard to digest, some easier. Milk although liquid can be hard on digestive systems in certain people and so on. So his approach is caution I believe.

My Dr. required me to be on clear liquids for 5 days before surgery and 3 days after surgery. I lost 10 pounds before my surgery and I will find out this morning if I have lost anymore. I started on full liquids on Monday and I have one week of them and then I start the pureed stage for two weeks and then on to a regular diet.

I agree with everyone here that it is better to suffer through the post op phase a little hungry than to ruin everything you have gone through to only have your band not heal properly to cause you severe problems down the road.

My DR. was very intense in my preop visit that I understand that if I was looking for rapid weight loss then the REN-Y would be the way to go, because banding is a much slower process. But that is why I chose it, I wanted the process to be slower because I feel my body will adjust better and the weight will stay off.

Hope this helps some, I am on my 6th day out and I have yet to be hungry at all. I am having trouble getting all of my Fluid in each day.

:) Good Luck:clap2:

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I still haven't been hungry two weeks out and I just finished clear liquids (and Low-Carb Slimfast.) I think the Slimfast had a lot to do with it -- 20 grams of Protein per can! I also had chicken broth mixed with chicken-flavored Unjury -- also 20 grams per scoop. It's quite tasty, especially when I get tired of sweets. I have the unflavored Unjury, too, and plan to start adding it to my full liquids and mushies to help keep my protein level up. I can add powdered eggwhites in some cases, too.

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Every surgeon I've come across has slightly different requirements, but they're all defined by what he or she feels will yeild the best results. Surgeons (goos ones anyway) aren't looking for loss in the first few weeks, they're looking for healing. Eating foods too soon can cause damage. Just because you don't understand how they can damage you doesn't mean it can't happen. It is VERY important to follow a prescribed post-op diet.

If I starve his way for 2 more weeks then I'm afraid I'll want to go crazy once he allows mushies. Just like Tulipstar said, your body goes into starvation mode and then tries to hord the calories at first. I'll be happy with a steady, consistent weight loss. It's almost winter anyway so we could all look forward to a more comfortable, slimmer summer.
Your body does not go into starvation mode after a few weeks of reduced intake, and cessation of loss after the first handful of weeks does not mean you're starving or that your body is hoarding calories. Vortually every diet "kicks off" with a drop in our body's Water volume. "Starvation mode" for anyone here is synonymous with "I don't understand how metabolism works."

Sorry - normally I just walk on by that phrase and let it be used however it's being used, even use it myself to refer to the process that the poster is talking about (albeit a different process than they think) but it's causing so much confusion and misunderstanding among people trying to lose weight that I just can't.

Try rethinking "starvation mode" as "not actively losing body fat" or "not losing weight because my metabolism has slowed down and I'm not compensating for it" or even "I don't understand the metabolic process." Don't think of it as STARVATION, or some mode that the body just suddenly switches in to because you lose a few lbs. No one here is at any risk of starving. Even IF there was a "starvation mode" it would require a process to get into, and only because that's true for most significant shifts in body function (even acute situations require time for the body function shifts). It wouldn't be a sudden event, where one day you're fine and the next day you've hit this mysterious weightloss resistance because your body thinks it's starving. A process like that would require a LOT of time to adjust to. Few people here have been banded long enough to even remotely experience anything like it, and few bandsters truly eat so little that they're anywhere near starving.

And it really isn't a matter of the body hoarding everything it gets, it's more a matter of your body using its calories more effeciently. Effecient energy means that your body can acquire the energy for less evergy than it takes to get it. Unfortunately our most efficient sources are our lean body mass long term, and glycogen short term, which causes a Water release & is why there's an inital fast weight drop (you aren't losing fat, you're losing water). You'll hear people say, "You can lose a lot of weight by fasting." They're so totally wrong in saying that.

That's also why it's more dangerous for lower BMI patients to lose weight through a starvation-type diet... they have even less fat than MO so their lean body mass is gobbled up that much quicker.

When you decrease your caloric intake, your metabolism also decreases. However, your metablosim doesn't decrease because your calories decreased. It decreases because your body begins to break down the lean mass (remember -- muscle tissues are easier to break down than fat)... in essence it starts to eat itself. At the same time your body also has the programming to know this shouldn't be happening, so it slows down your metabolic (and other) processes so that its lean masses are broken down slower... kind of a vicious cycle.

Anyway, the body's goal in decreasing the metabolism is not to keep up with however many calories you're eating, the goal is to have to feed off itself as little as possible. Then you get into the irony of that fuel that was created by metabolizing your lean mass being converted to sugars by your liver, with the goal of keeping your fat stores in place. Losing weight by metabolizing lean mass is going to produce a really weak, flabby, unhealthy end product. They key is to avoid burning muscle and get the body to burn fat, so ideally you'd target between your BMR and AMR, and not a fixed number like "1,000". That's another misconception.

Also when you hear a number like, "1,000" it should raise some alarms because everyone here is different and we're all going to need different numbers of calories. Someone who is starting off at 450 lbs might have a BMR over 3500. Someone at the same height starting off around 230 lbs might be closer to 2150. There's NO WAY both people are going to have the same goals for how many calories they eat per day... absolutely no way. (Which is also a reminder to adjust your goal intake regularly, depending on your current weight, and not think that what you ate 50 lbs ago is what you should still be eating today).

"Starvation mode" -- remember - we will never experience this - in the most dire, extreme cases there may be added resistance, say in someone who had only 2% body fat and had not consumed adequate fuel in a LONG time... and even then you may see a metabolic drop of... 20% BMR. Think about it. The average person could go 5, 6, maybe even 8 weeks with NO food. Zero calories. Fatties can go longer. It doesn't even make sense for people with plenty of body fat to hit some kind of crazy survival/starvation mode in 1 or 2 weeks. MAYBE once you got to an extreme, dire life/death situation, and your body fat had dropped to... below 5%, MAYBE you might see your BMR decrease... oh... 20%. A reduction like that WILL NOT stop weightloss. If it did, no one would ever die of starvation. wink.gif (As a side note, I've also seen the claim made that starvation mode will "stop metabolism". If your metabloism is stopped, you're dead... no ifs ands or buts. If you're alive, you are metabolizing.)

A good general target for healthy, maintainable weightloss is somewhere between your BMR and AMR (IMO - but also more than just O). I know -- if it's that easy, why are we all fat? It's not that easy, but if we make good food choices, it's EXACTLY what our bands are going to help us do.

Good guidelines for doing this without all the number-crunching is to eat only enough to where you're no longer hungry (focus on "Am I hungry?" DO NOT focus on, "Am I full?" They're NOT the same thing), eat very small servings - understanding it's easier to come back for more than to deal with the consequences of eating too much, and up your intake if you notice that you're getting tired, having a hard time focusing, etc. Generally speaking, if you follow these guidelines AND make good food choices, you will hit a number between the two rates. And you'll need to keep in mind to adjust as your weight decreases. For me, it works well to decrease the number of calories I eat by about 10 for every pound I lose.

Sorry for the novel. happy.gif

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It amazes me how different doctors are. I don't have a pre-op liquid diet. My doctor says that all that liquid stuff weakens you, and he needs his patients at full strength, and fully nourished to start the healing process properly. So I just have to eat three well balanced meals a day for two weeks with LOTS of FRESH fruit and vegetables and LEAN protien. So I have one day of liquids prior to surgery. After surgery I have 2 days of clear liquids, then 2 weeks of full liquids, then 4 weeks of mushies. This seems to be different from everybody.

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I believe everything you just said wheetsin.

Here is what my Dr. has his patients do. Full liquids for 1 week prior to banding- anything that will go through a straw including creamed sopus, pudding, yogurt, and Cream of Wheat. Clear liquid the day before. The day of banding I only got nourishment through an IV or ice chips. then the next morning get the barium swallow then only clear liquids for 1 week or until I see him. Saw him Wed. he moved me to full liquids and told me to come back next week and he may move me to mushies depending on how I do. He wants us to get used to small portions at each meal so we are only allowed 3 oz. at each meal. Of course in b/t we are to sip Water, crystal lite, Protein, etc. Then after a week of mushies we can move to food with caution.

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I just had my 3 hour nutrition stuff yesterday (overwhelming I must admit) and my doc says one week liquids and 3 mushies.... she said though that some people get sick at the sight and smell of pureed chicken and chose just to chew a million times before swallowing.... me I think I will stick with cottage cheese and yogurt....

another interesting note is that my doc says THREE MEALS a day and that is all..... helps to develop better habits for later in life....

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