Is there a standard guideline?

[NovelTee 13]

Does every doctor interpret this treatment process differently? I've been reading so many different timelines that everyone is being given, and I'm confused as to whether there is actually a "norm" and then doctors deviate accordingly, or if each doctor/medical group sets their ideal SOP?

For instance, my surgeon required 2 full weeks of liquid only diet for pre-op and at least one night in the hospital after surgery. My first in-person check-in was at one week. I have video/phone appointments until my next in-person at 6 months. Pureed/soft foods don't start until week 3. Solid foods will start week 7. Red meat/shrimp at 6 months.

I have Kaiser in the DMV, so the food part is proscribed by the bariatric department, but even the overnight requirement was different with other people having surgery the same day as me. A nurse said my surgeon makes it a standard while others are out in hours. Obviously, it looks like my doctor is moving out of an abundance of caution, which I appreciate, but is anyone not in the Kaiser system getting the same guidance?

[Bypass2Freedom 762]

Heya!

I think every Dr/Surgeon must do things with a slight variation, but it is always best to follow the advice given by your own Dr/healthcare team - it is often tailored to you e.g., in terms of weight, health conditions etc.

I had my dietician appointment today and we went through when I am starting the LRD, which will be for 2 weeks, and then went through the different food stages which for me are:

Week 1 - Liquid

Week 2 - Puree/slush

Week 3 - Mush (thick/lumpy foods)

Week 4 - Soft foods

Week 5 - 'Normal' foods

[NovelTee 13]

2 minutes ago, Bypass2Freedom said:

Heya!

I think every Dr/Surgeon must do things with a slight variation, but it is always best to follow the advice given by your own Dr/healthcare team - it is often tailored to you e.g., in terms of weight, health conditions etc.

I had my dietician appointment today and we went through when I am starting the LRD, which will be for 2 weeks, and then went through the different food stages which for me are:

Week 1 - liquid

Week 2 - Puree/slush

Week 3 - Mush (thick/lumpy foods)

Week 4 - Soft foods

Week 5 - 'Normal' foods

Thanks for this! I fully intend to follow the guidance, it was just a curiosity as to how they determine their guidance. I just think it's really interesting to basically still be on full liquid to week three post-surgery.

Maybe yours is tailored and mine is just sort of a set rubric? The food guidance I have isn't tailored to me––it's a PDF that's given to every bariatric patient in our medical group. My assigned nutritionist shared with me that her department always receives random updates to the diet directly from the bariatric department when the issue the new PDFs (we went through two updates while I was waiting for my surgery to be scheduled. When I have update calls with my nutritionist, she just asks me if I'm getting in my fluids and Proteins and following the PDF for guidance on what I'm allowed to have.

Either way, really interesting! Hope your surgery goes smoothly!!

[Bypass2Freedom 762]

@NovelTee Of course It is definitely interesting to see how other people's Drs advise!

I'll admit, it is a bit of strange one that you are on the liquid stage for 3 weeks, but then again they may just be over-cautious! Either way, I am sure they have their reasons haha. It seems like they are keeping up good communication though, which is always a plus

I was looking to maybe try Protein Water for to hit those protein goals during my liquid phase...but we shall see!

Thank you so much!

How are you recovering?

[ShoppGirl 4,861]

I found it interesting that a friend of a friend who has surgery with my same dr got the same packet as me since I had sleeve and she had bypass. If I had to guess they keep it simple by going by the stricter guidelines for everyone?? The. Again maybe it truly is same for both surgeries. I agree it’s interesting that different doctors do it differnt though.

[NickelChip 1,253]

At my surgeon's office, they have one set of guidelines for bypass and another for sleeve. Interestingly, bypass moves out of the liquid phase faster, perhaps because we don't have that long line of staples to worry about? But as far as I can tell, the American Society for Metabolic and Bariatric Surgery sets certain guidelines for programs to be considered Centers of Excellence, which many insurance programs require in order to cover the procedure. But these do not include a lot of specific dietary guidelines. A lot is left open to personal preference by the doctor or practice, although they are required to stay up to date on medical research.

[catwoman7 11,215]

surgeons do vary. At my clinic, both sleeve and bypass people were on the same plan. They had us on purees as soon as we left the hospital, but they changed that (I had my surgery nine years ago) and now they have to do a week (or maybe two?) of liquids before moving to purees.

[NovelTee 13]

On 04/05/2024 at 10:27, Bypass2Freedom said:

@NovelTee Of course It is definitely interesting to see how other people's Drs advise!

I'll admit, it is a bit of strange one that you are on the liquid stage for 3 weeks, but then again they may just be over-cautious! Either way, I am sure they have their reasons haha. It seems like they are keeping up good communication though, which is always a plus

I was looking to maybe try Protein Water for to hit those Protein goals during my liquid phase...but we shall see!

Thank you so much!

How are you recovering?

Thank you too! Recovery has been really smooth so far. The hardest part was my overnight in the hospital—my nurse refused to let us sleep and wanted us to drink two ounces of Water per hour, which felt impossible at the time. Once I got home, I was able to do it no problem. Everything seems to be healing well and I haven’t had any digestive issues or needed pain meds, which has been a blessing.

[NovelTee 13]

On 04/05/2024 at 11:16, NickelChip said:

At my surgeon's office, they have one set of guidelines for bypass and another for sleeve. Interestingly, bypass moves out of the liquid phase faster, perhaps because we don't have that long line of staples to worry about? But as far as I can tell, the American Society for Metabolic and Bariatric Surgery sets certain guidelines for programs to be considered Centers of Excellence, which many insurance programs require in order to cover the procedure. But these do not include a lot of specific dietary guidelines. A lot is left open to personal preference by the doctor or practice, although they are required to stay up to date on medical research.

Ahh, this is really interesting! Thank you for this perspective!

[NovelTee 13]

On 04/05/2024 at 17:38, catwoman7 said:

surgeons do vary. At my clinic, both sleeve and bypass people were on the same plan. They had us on purees as soon as we left the hospital, but they changed that (I had my surgery nine years ago) and now they have to do a week (or maybe two?) of liquids before moving to purees.

Oh, how interesting! I wonder what caused them to make the adjustment, but I’m glad it moved closer to what my doctor does. Though a total of 5 weeks of liquid makes me want to cry lol. I’ve got 2 left.

[Arabesque 7,332]

No there is no norm or standard plan for before or after surgery. Much like there is no standard for how you will recover, how much weight you’ll lose, what ‘fun’ side effects you’ll experience, etc. There’s just generalisations & averages. There will be similarities across plans & differences. Like in the pre surgery eating plan. Some don’t have any. Some do three shakes a day while others do two shakes & one meal. Me I had to do Keto. Same with the post surgery stages. Differences can be around how long each stage is or even what foods you can or can’t have at each stage. For example potatoes are allowed on many plans but were a big no in my plan.

I do know my surgeon adjusts his plan depending on the individual patient & their specific needs & situation. My friend who saw him was on the 2 shakes one meal plan. Her friend, also same surgeon was all shakes. Our ages, starting weight & general health were different.

It’s why we say it’s always best to follow the plan you were given and if you are having difficulties to contact your team to see if & how you can tweak it to better suit you & your needs & experiences.