The three most important elements after RNY gastric bypass surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight.
Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein Shakes.
Many experience problems drinking protein shakes. I hated them. But in the beginning I drank them, three 16-ounce protein shakes a day, in order to meet my protein requirements. You do not have to like protein shakes only tolerate them. There are many varieties of protein shakes available today. Experiment until you can find one you can tolerate. I used Muscle Milk Light (Vanilla Creme) powder blended with Water and a half a banana. That worked for me. But on the opposite end of the spectrum, you might try premixed Isopure.
Without sufficient protein, your body will scavenge protein from other areas of your body, such as your muscles. Protein is extremely important after surgery as its job in the body is to build and maintain tissues including your body's major organs and skeletal muscles. Protein deficiency, when continued over a long period of time can cause a disease known as protein caloric malnutrition. Common symptoms are poor healing, fatigue, Hair loss and muscle wasting. Immediate post op, protein promotes healing of the staple line and incisions.
The fluid requirement is met by a combination. It is not only the water that you drink each day. But also the water you drink when you take your Vitamins and medicine. It is the milk you drink. It is the fluids content of the protein shakes. It is the water component of the Soups you take. It is met by flavored water such as Crystal Light. It is met by sugar free popsicles. It is met by tea and Decaf coffee. It is a combination of all the fluids that you consume during the day.
I had a sleeve but in the same boat - not allowed to take ibuprofen anymore. I will say that since surgery I find that I get headaches a lot less these days. Sometimes a bit of caffiene will help. Other than that I have to hope that Tylenol does the job. I'm all for finding other options as well.
I’ve been an ibuprofen user my whole life. I had to switch after my bypass. I take the liquid Tylenol if something is really hurting, like cramps or a headache. It has been an adjustment for sure.
I meant to post this last month....but during the holidays, time disappears. I’m posting this because before and just after surgery I was ravenous for information. I don’t come to this forum much anymore, as life has adjusted. But I’m hoping this will help anyone like me who wanted to know as much as possible, and from as many people as possible. Please remember....everyone’s journey is different. This is just some notes about mine.
6 month lessons
Yup, it’s a long post. Settle in. Lol. So, I just had my 6 month appt. I know all of our experiences are so unique, but I wanted to share mine as a reference of what you may expect. A bit about me. I had gastric sleeve in Las Vegas with Dr Atkinson. In august of last year I had just begun this process and wouldn’t have surgery until April. My HW: was August 2016 at 345, SW: April 2017 was 343, CW: is 240.5, that’s a 103lb loss. Yay me! (Side note, my insurance didn’t require any pre surgery weight loss....and I had almost zero loss. The only rule was I couldn’t gain). My dr was amazing. If you’re near vegas, I completely recommend him. Surgery went perfectly, recovery was difficult (this crap is hard), but I had very minimal incision pain. There was no 2 week pre-op fast, the leak test was performed during surgery so I had liquid/ice chips right away (liquid was no good, but ice chips are perfect after surgery).....I had super glue stuff on my incisions so no pain and no dressing issues.....he’s one of the highest ranked and most experienced gastric surgeons in the country. I could go on....but I think you get it. His skill and his post surgery protocols are awesome. I had zero problems.
I’ve looked many times on here for how many calories at 7 weeks....how many carbs at 3 months. I couldn’t find anything and now I know why. My surgeon and nutritionist really only care about Protein until 6 months. Unless, of course, there is a specific problem or deficiency. It’s nice to now have some specific nutrient goals, but the focus is still on protein. And even at 6 months, I still struggle to get 90g daily. It’s super important to keep trying!! Get all the protein you can.
Let’s talk hair. Yup, it’s falling out in chunks. Chunks. It’s more than a little heartbreaking. But, I knew it was coming. Doesn’t help, but it is expected. It started at 4 months. As of now, still going strong. I also know it will stop. But while you’re in the falling out phase....it’s stressful. Which just makes more fall out. So try to keep positive. And take your Vitamins. I swore I’d never fall off of that, but I have periodically. It happens. Just get back on track. Biotin supplements and the hair treatment Nioxin has helped too. (Update...at 7 months this has slowed dramatically. Still losing a bit, but nothing like before. I see the light at the end of the tunnel )
Skin. Saggy saggy skin. Another thing I knew was coming, but it’s been difficult. I didn’t start working out as early as I wish I had. Now I feel a bit like I’m fighting a losing battle. But....this is a problem with a fix. When I reach goal I will worry about the cosmetic stuff. But trust me when I say....get working out as soon as possible. Weights. Lift some weights.
Sweets. Stay away for as long as you can. I went 4.5 months without. Then I had some chocolate and it was easy. Not like trying to eat meat. Meat you have to chew to death and if it’s dry, it’s still hard to get down. I can only eat (at most) 2 oz of meat at a time. But chocolate, that went down easy. I had an entire bar in one day. Now, before surgery I’d have 4 bars in a day. But 1 bar is still a lot. So I locked that down and now only allow myself 1 square a day. Now, you might find that that’s too much for you. Again, we’re all different. But if I deny myself entirely....I’ll go nuts and eat until I get sick. Keeping myself honest, and savoring only a small piece is something I can maintain. And maintaining is my ultimate goal.
Emotions. Hear me.....get a therapist!! You are going to go through so many changes you’re head will spin without you even understanding that is what’s happening. Addiction transference is very very real. I really struggled with this and for a time, behaved completely out of character. You absolutely must deal with your issues. It’s the same as getting protein or taking small bites. In my opinion, it’s a must.
Emotions part 2. I had a hard time with the expected things. Hair loss, fatigue, heartburn...check check and check. These are struggles I knew about. But there are others that blindsided me. Like how hard it is at 6 months to still be able to only eat 2-2.5 ounces at a time. Frustrating!!!!!!! You have a craving, you make a meal that fits the bill, you take that first wonderful bite....and 2 bites later you’re full. I struggled hard with this. I know....that’s the entire point of surgery. But the actual experience was so much more frustrating and unsatisfying than I imagined. For a brief time, I tried to force the issue. Eating more than I could hold. That hurt. And it scared me, as the very last thing I want to do is stretch my new tiny tummy (not all fears are rational). My advice...be patient with yourself. Let yourself be frustrated or even angry, but keep working on getting adjusted. I still have moments of “can’t I just eat a fricken chicken breast already?!?!?” Lol. But listen to your belly and take it slow. Weird side note, for me....I know I can’t eat another bite when I get hiccups. Happens each meal. I eat slow, plan out the portion. But if I get the hiccups....I stop even if there’s some left. This has helped cut WAY down on feeling sick after eating. Everyone has their own signal....mine is hiccups.
Finally, once again this procedure is different for everyone. Don’t set too many rules on yourself. Example: I’m hungry roughly every 3 hours. My dr is big on only 3 meals a day. That doesn’t work for me. I still can’t eat enough at any one time to fill me for 4-5 hours. So, I adjusted. I eat a small (1.5-2oz) meal every 3 hours. Mostly really small portions of meat, cheese, sunflower seeds, etc. This works for me. Keep adjusting until you find what works for you.
I’d like to end with what I think are the most helpful things I’ve learned (in no particular order). Good luck on your journey!! It’s hard, really hard, but the good WAY outweighs the bad See you at 1 year!! I’m hoping I’ll have good news to share.
1. Drink your fluids
2. Take your vitamins
3. Be patient
4. Expect to be emotionally unsatisfied (if food is emotional for you)
5. Workout
6. Log your food
7. Avoid sweets as long as possible, then adjust until you find the “sweet” spot of what you can handle. And if that’s zero...so be it. You be you.
8. Talk to someone about what’s happening to you.
9. Take something for heartburn. Not only is it uncomfortable, it mimics hunger and will make you miserable.
10. Stick to the no liquid 30 minutes after a meal. It’s a golden rule.
