Best advice for post-op - ThinnerTimes

LisaM · 07-30-2007, 06:22 AM

I'm also starting a similar thread in pre-op. Everyone gets lots of advice before and after their surgery. Thought we'd put it all in one place, like the best of nutrition thread. You guys add yours to the thread, and I'll put it all on the front, as I've done before. Here we go with a few that are still in my memory.

General Advice

Do What YOUR Doctor and Nutritionist Ask. Every doctor and dietician have different instructions regarding when you can begin to eat various things. Please pay attention to your own medical/nutritional support team.
Don't Weigh Every Single Day. If you can throw your scale away and only weigh at the doctor's, you will be much less crazed on a daily basis. If you can't resist weighing, at least make one day a week your "official" weight for recording, and try to keep the insanity to a minimum...
Keep Your Eyes on Your Own Plate. Everyone who has the surgery loses at different rates. You can come on Thinner Times and ask people how much weight they'd lost by six weeks or six months, and they will tell you. However, that does not mean you will lose the same amount in the same amount of time. Be aware, too, that men often lose much more weight much more quickly than women do. This also applies to food--just because someone else is on solid food by the same time post-op doesn't mean you will be.
Enjoy Your Honeymoon! This is what we call the first six months to a year (seems to vary--the more you have to lose, the longer the honeymoon lasts). Weight loss is easy, and other than head hunger (see below) your appetite will probably be pretty much nil. Take advantage of it! This is the time to start and entrench the exercise routines and the eating habits that will last you the rest of your life.
Read the Labels. You will be amazed at what has sugar in it when you start reading labels on food. Frozen swedish meatballs comes to mind...Look at the ingredients list--danger words: "high fructose corn syrup," and "sucrose," come to mind. If you didn't already know, the higher up the list of ingredients, the more that food contains, in proportion. If the first word in the ingredient list is sucrose, it's pretty much pure sugar. Also be wary of sugar alcohols. Some of us aren't sensitive, but most of us apparently are. My experience with sugar alcohols is that they make me feel like a Diet Coke that's been shaken really hard... very ummm... bubbly. In other words, they cause major, major gas pains. Some of those danger words are: Arabitol, Erythritol, Glycerol, Isomalt, Lactitol, Maltitol, Mannitol, Sorbitol, and Xylitol. So, look for words ending in "ose" and "tol," to check for these problems. Most "sugar-free" items contain sugar alcohols. We can handle a little bit of sugar, and a little bit of sugar alcohols, but once you get to a certain level, you may have major discomfort.
Which Brings Us to... Dumping Syndrome. A lot of people have some funny ideas about dumping... Here's the straight scoop from Wikipedia: Symptoms of early dumping include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. "Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness. Many people have both types. Here's the link to the rest of the explanation of it on Wikipedia. The "fatigue" mentioned above can include zoning out or even passing out for some of us. Most of us dump on sugar, some of us dump on sugar alcohols or excess carbs of any kind. Personally, any amount of carbohydrates makes me sweaty within a half hour. You will find out what makes you dump simply by trial and error. Most of us WANT to dump--it's the best aversion therapy possible for sugar addicts, because it's bloody miserable.
Everybody Poops. WARNING: This gets a little graphic, but it can be important. Elimination is still an important bodily function that needs to be encouraged. Don't go too long without going! Because of the changes in our diet and absorption, some people's stools will be loose, and pain medications in particular can cause constipation. Colace will help keep things moving without causing laxative dependency, and drinking water is vital in ohsomany ways, excretion being just one. There are many other things that can aid in the production and passage of stool. Let your surgeon be your guide as to which products are best suited to your needs, as some doctors frown on OTC products like Milk of Magnesia as being too harsh, and physical remedies like enemas can be drastic for our already taxed systems. Some folks experience very loose stools, especially if you have dumped on something. Sugar, lactose, lots of fruits and veggies can cause diarrhea. If that is an ongoing issue, speak to your surgeon, as you don't want to take meds like Immodium without their blessing. Bypass patients are at a higher risk for bowel obstruction, so if you haven't had a bowel movement in several days, are feeling horribly bloated, are vomiting, have severe pain and are not able to pass gas, call your surgeon immediately. Bowel obstruction can be deadly! The pain alone is guaranteed to get your attention. If your stool has red blood in it ("frank" blood) or is very black and tarry (digested blood), or looks like coffee grounds, call your doctor. They will need to figure out where the bleeding is, why you are bleeding, and what to do about it. As post GBS patients, be prepared to discuss your poop as matter of factly as you discuss what you eat. Our entire alimentary canal has been re-plumbed, and we have to observe what comes out as much as we notice what goes in.

Hell Week - First Post-op Week

We Call It 'Hell Week' For Good Reason. Some people sail through the first week. However, the majority seem to have a tough time. Just keep sipping your fluids, walking as much as you can, resting, and then repeat those three actions as necessary. Recite to yourself, "This too shall pass, this too shall pass." You may have issues with the gas they pump into you to inflate the surgical area. You'll feel this as a pain in your shoulders. Count yourself lucky if you don't have it. Also, the left side of your body is where they put the bigger instruments, and the thingie-whatsit that they use to hold your liver up, so it will be more sore than the right side. Personally, I relieved some of my pain by calling my friends up and crying like a madwoman.
Which Leads Us to Buyer's Remorse. This is the intense feeling of, "Ohmigod, what have I done to myself? I could have lost the weight if I'd only tried harder." Well, you DID try harder. Nobody tried harder than you. You had this surgery for a reason, this feeling will subside. Swear, cross my heart.
Head Hunger. This seems to be a very early phenomenon--you'll see a commercial on TV, or smell something that makes your mouth water, and you'll feel intensely hungry. However, it's all in your mind. Should you try to indulge, you'll find that your mind is playing tricks on you.
Can You Drink the Water? At two year's post-op at this writing, I STILL can't drink plain water. This seems to happen to a number of us. If it feels like you just dropped a brick in your pouch every time you drink water, then it's happened to you, too. If you will change the specific gravity of the water with something, whether it's sugar-free drink powders, or even just a packet of Splenda, it will be much less painful.

One Month Post-op

Stalls Happen The four- to six-week mark seems to be the point where a lot of people experience at least a one-week stall in their weight loss. Don't panic! Your body truly believes you are starving to death. That's why you feel so fatigued most of the time--your body wants you to sit down, be still, conserve energy, so it can use the little nutrition you're getting to stay alive. It will pass...
Real Food? Most doctors/nutritionists have released people to eat real food by this time--be careful! It takes six weeks for inner incisions to completely heal, and you still need to be very careful not to overdo it. Be kind to your pouch... you're going to be together for a very long time. So chew, chew, chew everything, and stay focused on your protein. Every meal, you should be eating protein first, then veggies, then carbs if you get that far. Any meat should be cut up to the size of a pencil eraser, and eaten one bite at a time.
One Thing at a Time Add only one new item per day. If you add two new taste sensations and you start feeling ill, you're not going to know which one made you feel like ca-ca, and you'll be avoiding them both.
Try, Try Again Just because something makes you ill today doesn't mean it will tomorrow. Eggs made me yak for months, but I kept trying, and I can now eat an egg like once a week without losing it. This advice is only meant for healthy things that you NEED to be eating... not stuff like donuts are Zagnut bars... Someone else was lactose intolerant for the first eight months post-op, but can now drink milk. Keep trying if a food is important enough to you.
Learning to Deal With Hunger. I know this sounds kind of silly for morbidly obese people, many of whom still weigh in the high 200s, 300s, and more. Post-op GBS, many people experience a significant absence of hunger as we knew it. Some of it is due to severing of certain nerves along with the dissection of our stomachs, and some is due to the aversion therapy of constant nausea, throwing up, or dumping syndrome, and some of it is due to the smaller stomach area. It's important to learn the new symptoms of hunger that our body exhibits, as we no longer have the same reserves we once had, and hunger is more of a biophysical response. You may find that you forget to eat--and that your first signal is weakness, dizziness, inability to concentrate. You may find that hunger for you is something totally different. Take the time to learn what your body does when you're low on fuel, because now it can be dangerous, you can end up passing out behind the wheel of a car, fainting in public, etc.
Which Leads Us to Venturing Out. You'll start leaving your house more now, so make sure you take some things with you: 1) a big Ziploc bag in case you feel sick in the car. 2) Water or other bottled liquid--you need to stay hydrated all the time now, or you can start feeling really awful. You should be carrying some form of liquid with you all the time. 3) Emergency protein. If by some chance you end up stuck beside the road for hours with a flat tire or something, you need to have some form of protein with you all the time. Some people can eat beef jerky by this point, some can't, but it's a handy-dandy protein source, along with turkey jerky if you can find it. Others take protein bars, etc. We have become protein-sensitive by this point in our journey, we need it, and it can make almost an instantaneous difference in your alertness and your ability to function. Keep some with you all the time.

Two Months Post-Op

Hair Loss. You may start losing your hair about this time. It seems to vary on a completely individual basis, and everyone seems to lose different amounts. Some people and their doctors swear by biotin, or that it's the amount of protein you absorb that affects whether or not you lose some hair. No one appears to lose all their hair...
Start Looking For a Goodwill Store. Seriously, it's going to be really hard to keep yourself in clothes for the next six to eight months, so you need to look for your local Goodwill/Salvation Army/St. Vincent DePaul's, whatever. I was more than a year and a half out before I stopped dropping sizes.

Four Months Post-Op

Stalls Happen. Repeat after me... "I will continue to lose to weight. This is just a stall. The fact that I actually said to my spouse, 'If I never lose another pound, I'd be happy anyway, because I feel so good,' has not doomed me to being this weight forever. I will continue to lose weight."
Keep Measuring Up. Even though you're stalled, your body is continuing to adjust. Keep taking your measurements every month... and don't forget to take your four-month post-op photo, and make sure you note your weight. You'll be amazed later on, I promise.

Six Months Post-Op

It's Baaaaccccckkkkk. Two things happen right around your six-month mark. First, you get your appetite back, and second, it feels like your pouch doubles in capacity. So not only do you WANT more food, you can EAT more food. This will scare the living crap out of you. Relax! Normal! Your weight loss probably will slow down at this point. Also normal, also natural. Remember, it's healthier to lose weight more slowly. Here's where that exercise program you began, and the good eating habits you've established (first protein, then veggies, then carbs, remember?) come into play. To keep your weight loss going, change up your exercise program. You're probably in a rut. Add some exercises, take some away. Up your cardio, or add a second cardio session after your resistance work... you can do it!
The Results Envelope Please! Most doctors do labs once a month for three months, then again at your six-month mark and your year mark. You should be getting at least yearly labs. You and your doctor need to know that your body is holding on to iron the way it should, and whether you're getting enough of the rest of the supplements you're taking (you are taking your supplements faithfully, aren't you?). You must never forget that not only do you have a smaller pouch, your body no longer absorbs nutrition in the same ways. You need to keep an eye on your vitamin levels regularly, with regular lab tests, and you must take your supplements faithfully. Even if you do, you may still find that your body needs more of certain things, so your supplements may require regular adjustments.
Skip a Size or Two, Go Ahead! This point is where I dropped two sizes at a time without warning. Even though my weight loss slowed, my body really started making changes, shifting the weight around. Unfortunately, this was also where the droopy skin started to become really apparent. Keep repeating to yourself... better than carrying around the blubber that I've already gotten rid of. Go shopping! Just don't buy too much, because there are more sizes to lose.
Keep Measuring. Keep taking your measurements... and don't forget to take your six-month post-op photo, and make sure you note your weight.

Eight Months Post-Op

Ooh, Ooh, Ooh, Is That Hair I See? Hopefully by this time, your hair will start showing back up... it will be fine, short hairs, so you may have to look for it, but you should start seeing something between now and month ten. Cross my heart!
Keep Measuring. Keep taking your measurements... and don't forget to take your eight-month post-op photo, and make sure you note your weight.

One Year Post-Op

The Honeymoon is Definitely Over Most people seem to regain their appetite by the six-month mark, but for some, they get a year's honeymoon from hunger. Don't know why the year seems to be the upper limit, and anecdotal evidence (stories, ok? like most of this is based on) tells us that it's usually only those who had much more weight to lose to begin with. For all of us, it seems like carbs are now much harder to avoid. You're still losing weight, but the rate of it has certainly slowed by this time, as long as you're healthy.
Your Head is Playing Catch-Up to Your Rapidly Shrinking Bod... Your mind probably has not yet caught up to your body in terms of realizing that you are much smaller. That is not unusual. It took until nearly my two-year mark before I could look at a pair of women's size pants and see they were too big for me. I was still wandering around in the women's section automatically when I had already made it to a size ten. Trying on clothes is fun at this stage!

elisse · 08-02-2007, 02:48 PM

What a great post...I wish I'd had it right after surgery!! Definately passing it one to friend here.

Duckie · 08-02-2007, 03:00 PM

what a great post!!!

OsoDelDesierto · 08-02-2007, 09:28 PM

Wonderful post, Lisa - thank you!

Debz · 08-02-2007, 09:42 PM

Wow! Great post, Lisa. Can't wait for the new installment. Thank you for taking the time to do this for all of us newbies.

sxymac03 · 08-02-2007, 09:49 PM

Lisa! I can't thank you enough for putting this together! As I will be going under on the 21st, this was real helpful for me! I love it, and can't wait for the rest!!

mikenbaltimore · 08-02-2007, 09:51 PM

This thread is SOOOOOOO helpful to those of us about to have surgery! Thanks!!!

LyndasRoom · 08-02-2007, 10:04 PM

Book book book...subliminal message to lisa...book book boook...I love your writing style...book book book.

paige52 · 08-02-2007, 10:18 PM

I think lydia is right you should write a ook

JenBear7 · 08-03-2007, 07:17 AM

Things to take to the hospital? That is another common question.. (as is the what do I stock up on question? (SF Popsicles, broth.. etc)

This truly is an awesome post.

As for a book... wouldnt it be neat, if The TT Family did a book? a collection of everyones story?