Wildly Varying Post Op Diets

[jdel408 1]

There seems to be a plethora of different post op diets and diet plans. To me, this is somewhat disappointing as I feel like there has to be a "more" or "most" correct post op diet. Even if it has to be altered a little bit here and there to meet specific patient needs, there should be a solid, standard, uniform post op diet guideline for foods and scheduling or "phases".

For instance, the very well made, professional looking guideline I have says that I am to be on the "soft food" diet after just 3 days. This includes just about anything as long as it is pureed or mashed. Here is a clip from that:

"• 3 Days to 3 Weeks Post-op: Home Soft Diet (high Protein foods). Try to consume 4-6 oz of fluids

every hour. You should be consuming approximately 550-700 calories and 50-70 grams Protein. "

Some of you are on clear liquid diets for a full 2 weeks after surgery which seems highly unnecessary to me. I am no authority and I only say that because I am doing fine 8 days post op and well off the clear liquid diet.

Even the nomenclature of the the phases and food types on VSG post op diets is confusing and conflicting. Some call it pureed stage, some call it "mushies". My doctor had never even heard the term "mushies" before. What, exactly, is a "full liquid"? I bet there is wildly conflicting definitions of a "full liquid".

The purpose of my post is to put out there the need for an authority on this subject to get into circulation a very STANDARD, post VSG operation diet plan complete with definitions and calendars.

- OR -

Throughout the industry, make the entire VSG procedure incomplete without a very thorough personalized diet plan designed for each individual. Make it an industry standard so that doctors are required to have nutritionalists on site to create your own personalized, easy to follow, well defined diet plan.

Even though I am doing fine, it is concerning to think that maybe I am causing damage to my sleeve by entering stages to early. Conversely, I am sure SOME of you would be ecstatic to know that perhaps you can have some blended Soup today rather than in another week.

It is still a new field but as it grows in popularity, it will need standards.

[FairyStruck 0]

Here's the way I see it. My best friend and I both had surgery recently, she was in December I am just over two weeks out. Our guidelines were totally different since we had 2 different surgeons. She was soft solids as tolerated so after like 3 days, and I was told to do liquid diet for two weeks before attempting to eat anything. Here is the funny thing. I've found I am glad of the diet I was given, because I can't even tolerate soft foods. She may have had an easier tiem eating, but she's not getting all her protien every day either. It is really hard to get all your protien in the serving sizes that you can actually eat when you are first sleeved. After 2 weeks I am still only able to consume about 2 ounces of food at a time. If I try to eat more it doesn't stay down. Listen to your stomach, take your Vitamins, get all your protien, and you will be ok . Good luck and take care!!!

~Kris

[jdel408 1]

Here's the way I see it. My best friend and I both had surgery recently, she was in December I am just over two weeks out. Our guidelines were totally different since we had 2 different surgeons. She was soft solids as tolerated so after like 3 days, and I was told to do liquid diet for two weeks before attempting to eat anything. Here is the funny thing. I've found I am glad of the diet I was given, because I can't even tolerate soft foods. She may have had an easier tiem eating, but she's not getting all her protien every day either. It is really hard to get all your protien in the serving sizes that you can actually eat when you are first sleeved. After 2 weeks I am still only able to consume about 2 ounces of food at a time. If I try to eat more it doesn't stay down. Listen to your stomach, take your Vitamins, get all your protien, and you will be ok . Good luck and take care!!!

~Kris

case in point.

[kalfin13 4]

I have thought the same thing. I know to some degree every doctor will do things a little differently, but the differences for this surgery seem to be from one end of the spectrum to another. I also realize each patient is different, but I agree with you that there should be a little more uniform policy in place. This is something that has concerned me while making my decision to have the surgery, and while it is not going to keep me from being sleeved I plan on talking to my doctor about it in a couple weeks to get his opinion. I think this can cause post surgery results to be a little misleading. As you can tell from reading posts on here, some people are slow losers and some lose really fast. Some of those results can be from the fact that some people are on 2 or 3 week liquid preop diets and then anywhere from 3-6 weeks post op liquid diets while others only have to fast 1 or 2 days before surgery and can start trying to eat soft foods within the first week. Which is why it is so important for people to not judge their results based on what they read about others.

[Luanne 32]

WWW.CornellWLS.com = print-out "The Cornell Weight Loss Surgery Program: Dietary Guidelines fo Laproscopic Sleeve Gastrectomy" It gives the "Sleeve Basics" plus food suggestions, diet progression, supplements, etc.

There seems to be a plethora of different post op diets and diet plans. To me, this is somewhat disappointing as I feel like there has to be a "more" or "most" correct post op diet. Even if it has to be altered a little bit here and there to meet specific patient needs, there should be a solid, standard, uniform post op diet guideline for foods and scheduling or "phases".

For instance, the very well made, professional looking guideline I have says that I am to be on the "soft food" diet after just 3 days. This includes just about anything as long as it is pureed or mashed. Here is a clip from that:

"• 3 Days to 3 Weeks Post-op: Home Soft Diet (high Protein foods). Try to consume 4-6 oz of fluids

every hour. You should be consuming approximately 550-700 calories and 50-70 grams Protein. "

Some of you are on clear liquid diets for a full 2 weeks after surgery which seems highly unnecessary to me. I am no authority and I only say that because I am doing fine 8 days post op and well off the clear liquid diet.

Even the nomenclature of the the phases and food types on VSG post op diets is confusing and conflicting. Some call it pureed stage, some call it "mushies". My doctor had never even heard the term "mushies" before. What, exactly, is a "full liquid"? I bet there is wildly conflicting definitions of a "full liquid".

The purpose of my post is to put out there the need for an authority on this subject to get into circulation a very STANDARD, post VSG operation diet plan complete with definitions and calendars.

- OR -

Throughout the industry, make the entire VSG procedure incomplete without a very thorough personalized diet plan designed for each individual. Make it an industry standard so that doctors are required to have nutritionalists on site to create your own personalized, easy to follow, well defined diet plan.

Even though I am doing fine, it is concerning to think that maybe I am causing damage to my sleeve by entering stages to early. Conversely, I am sure SOME of you would be ecstatic to know that perhaps you can have some blended Soup today rather than in another week.

It is still a new field but as it grows in popularity, it will need standards.

[Tiffykins 673]

There are far too many factors for it to be "standardized" procedure. The sleeve surgery itself isn't even standardized to date. Every sleeve is created differently by different surgeons. Bougie size is not standardized, every surgeon has a different opinion, and technique. You will find the same variations in RNY post-op dietary guidelines. It's just like the PPI need post-op some surgeons immediately prescribe a PPI, others wait until the patient experiences reflux symptoms. Same goes for the whole NSAIDS post-VSG. While the pioneers of the VSG state there are zero ill-effects with taking NSAIDS post-VSG, many surgeons stick with the RNY rule that they are not allowed with VSG.

There will not be a set standard especially with varying opinions, and surgeon's specific experiences. I had a 2 week clear, and while it seems unnecessary to some, I can't imagine shoving food into a newly stapled off, practically amputated stomach. I'm glad you feel great and off clears so early out, but others do not have that same experience. Every patient's body heals differently, and can not tolerate purees/soft solids. The guidelines given are based on each individual surgeon's patients experiences. It's what they choose to follow based on what they "feel" is most effective, and safe for their patients. My surgeon's post-op guidelines have changed with a new nutritionist on board, and they've worked out a different post-op guideline for their patients, and I'm only 21 months out. But, 2 friends of mine that had surgery with the same exact surgeon this last summer, and through the same military hospital program had completely different post-op dietary guidelines than I had just 18 months earlier.

[jdel408 1]

There are far too many factors for it to be "standardized" procedure. The sleeve surgery itself isn't even standardized to date. Every sleeve is created differently by different surgeons. Bougie size is not standardized, every surgeon has a different opinion, and technique. You will find the same variations in RNY post-op dietary guidelines. It's just like the PPI need post-op some surgeons immediately prescribe a PPI, others wait until the patient experiences reflux symptoms. Same goes for the whole NSAIDS post-VSG. While the pioneers of the VSG state there are zero ill-effects with taking NSAIDS post-VSG, many surgeons stick with the RNY rule that they are not allowed with VSG.

There will not be a set standard especially with varying opinions, and surgeon's specific experiences. I had a 2 week clear, and while it seems unnecessary to some, I can't imagine shoving food into a newly stapled off, practically amputated stomach. I'm glad you feel great and off clears so early out, but others do not have that same experience. Every patient's body heals differently, and can not tolerate purees/soft solids. The guidelines given are based on each individual surgeon's patients experiences. It's what they choose to follow based on what they "feel" is most effective, and safe for their patients. My surgeon's post-op guidelines have changed with a new nutritionist on board, and they've worked out a different post-op guideline for their patients, and I'm only 21 months out. But, 2 friends of mine that had surgery with the same exact surgeon this last summer, and through the same military hospital program had completely different post-op dietary guidelines than I had just 18 months earlier.

Well then this would go along with my second suggestion of making it an industry standard to have a specialist on board that will help create a pre and post op diet specific for individuals. I would suggest that before anyone makes a decision on a specific Surgeon, make sure that surgeon has this resource available.

Coming from someone who chose the Mexico route, I would almost guarantee that the SOP on this route is to hand you a pamphlet on your way to the airport that EVERY patient gets outlining your post op diet. So if there will not be a set standard, then having a set dietary guideline for every patient can't be a good thing.

BTW - No one is shoving food into newly stapled off, practically amputated stomach. Simply onto pureed Soups and non-clear Protein shakes.

[chilo1 62]

There seems to be a plethora of different post op diets and diet plans. To me, this is somewhat disappointing as I feel like there has to be a "more" or "most" correct post op diet. Even if it has to be altered a little bit here and there to meet specific patient needs, there should be a solid, standard, uniform post op diet guideline for foods and scheduling or "phases".

For instance, the very well made, professional looking guideline I have says that I am to be on the "soft food" diet after just 3 days. This includes just about anything as long as it is pureed or mashed. Here is a clip from that:

"• 3 Days to 3 Weeks Post-op: Home Soft Diet (high Protein foods). Try to consume 4-6 oz of fluids

every hour. You should be consuming approximately 550-700 calories and 50-70 grams Protein. "

Some of you are on clear liquid diets for a full 2 weeks after surgery which seems highly unnecessary to me. I am no authority and I only say that because I am doing fine 8 days post op and well off the clear liquid diet.

Even the nomenclature of the the phases and food types on VSG post op diets is confusing and conflicting. Some call it pureed stage, some call it "mushies". My doctor had never even heard the term "mushies" before. What, exactly, is a "full liquid"? I bet there is wildly conflicting definitions of a "full liquid".

The purpose of my post is to put out there the need for an authority on this subject to get into circulation a very STANDARD, post VSG operation diet plan complete with definitions and calendars.

- OR -

Throughout the industry, make the entire VSG procedure incomplete without a very thorough personalized diet plan designed for each individual. Make it an industry standard so that doctors are required to have nutritionalists on site to create your own personalized, easy to follow, well defined diet plan.

Even though I am doing fine, it is concerning to think that maybe I am causing damage to my sleeve by entering stages to early. Conversely, I am sure SOME of you would be ecstatic to know that perhaps you can have some blended Soup today rather than in another week.

It is still a new field but as it grows in popularity, it will need standards.

I had the same sort of guidelines, was on soft/pureed/mushy diet from day 3. I live in England though, here doctors seem to have similar guidelines.

[CBL 3]

I was on clears for 1 day, then fulls for two weeks, and will be on purees for two weeks, soft for four weeks, and released to anything after that.

Only part that surprised me was that they considered refried Beans a "full". I havent tried that as it seems kind of Gummy for this early.

I agree with the OP about the standards and procedures, but also agree with Tiffy. Medicine is far more art than science in some cases, and I think you find surgeons would chafe at having it all too standardized.

[Tiffykins 673]

Well then this would go along with my second suggestion of making it an industry standard to have a specialist on board that will help create a pre and post op diet specific for individuals. I would suggest that before anyone makes a decision on a specific Surgeon, make sure that surgeon has this resource available.

Coming from someone who chose the Mexico route, I would almost guarantee that the SOP on this route is to hand you a pamphlet on your way to the airport that EVERY patient gets outlining your post op diet. So if there will not be a set standard, then having a set dietary guideline for every patient can't be a good thing.

BTW - No one is shoving food into newly stapled off, practically amputated stomach. Simply onto pureed Soups and non-clear Protein shakes.

But, even with RNY and DS is there is NOT a set industry standard because every surgeon/program is different, and RNY has been performed for nearly 30 years, and DS was started in '88. There are some consistencies with RNY and DS diets, but a surgeon might have variations based on his/her experience.

I agree that having the resource of a nutritionist, but at the same time, with my program, I've seen 3 different nutritionists, and they all had a different opinion. So, even in the same standardized program, a different nutritionist can put a twist on it. That pamphlet that is given for every patient is going to be based on that surgeon's patients experiences. It's nice in theory to think there "should" be a standardized procedure, dietary guideline, but it's just not going to happen considering there are far too many variations in each individual surgeon's patients recoveries. Especially for self-pay patients that do not have the additional funds to foot the bill for nutritionist visits post-op.

BTW- I wasn't implying anyone was shoving food, but to call something unnecessary that is prescribed my educated, experienced medical professionals is a slap in the face for those of us that had to endure a more prolonged, more conservative post-op diet.

[swizzly 901]

I agree -- I can't believe how wildly varying the programs are. It has caused me a lot of confusion -- though I of course at the end of the day follow my own clinic's program. My program calls for no pre- or post-op liquid diet at all. No Protein shakes or supplements. Any and all foods (except raw fruit and veg) from day 3-4 post-op. I've been eating "real" food up to the night before surgery and from day four after surgery. It has caused me angst to put real food (though obviously that was pretty mushy at first lol) in my wee sleeve when everyone else was drinking clear or full liquids still. I have to say, though, that I have not had a problem with eating and haven't eaten anything that didn't agree with me really. I've had an amazingly smooth time of it (touch wood) and have lost ~22 pounds in 3.5 weeks. I can pretty much eat half a cup of food at a go -- like half cup of chili for instance. I can eat meat and chicken. bread, not so much -- but I use wholegrain crackers instead. My program demands that you have a balance of Protein, fruit/veg, and carbs -- which is also counter to most other programs. It's totally confusing and sometimes stressful, but I just shut out the questions and follow what I'm told to do.

At least my entire clinic/practice is completely aligned, so when I see a different nutritionist or doctor, I get the exact same advice and guidance. I was also prescribed a twice-daily PPI for the first month, and I'm allowed to use ibuprofen.

So random.

[Shanny 70]

I had to be clears for 1 week, full liquids for 1 weeks, puree for 1.5 weeks, and then softs for 1.5 before solids. I'm glad my doctor did it that way because I couldn't tolerate anything more. whenever I tried to push the envelop and jump ahead to the next step, I made myself SICK!!!! I learned me lesson.

I do wish that my plan allowed for Tomato based products though. Can't have Pasta sauce for 4 months

[Susanne 32]

My surgeon explained it to me with the failure rate they are willing to accept.

In a manufacturing facility, they strive for a certain degree of perfection - quality assurance, max failure rate etc. This is reached through quality control and certain ways of manufacturing the widgets. The higher quality you want to reach, the more careful you have to be, the more expensive your tools are and the better your people have to be trained. Makes sense, right? That's why some car manufacturer have a much better record than a Yugo or so :-)

He said the same is true for surgeons. A surgeon's practice has a certain percentage of failure they are OK to accept, in this case failure is issues with the staple line, leaks etc. I believe it is pretty obvious that the longer you are on Clear Liquids (and then full liquids), the more time you give your staple line to heal. Some practices are willing to take more risks in order to make patients happy. Others are really strict to avoid issues as much as possible and are probably overly cautious.

Believe me, I was 2 weeks on Clear Liquids, and then 4 weeks on full liquids - I was NOT a happy camper.

It is just an area that you cannot look at. Only if it fails (and it is too late) do you know you did it wrong.

How do you know you are doing fine? Just because you are not in pain (or not in pain yet) doesn't mean you are fine. The earlier you eat solid food, the earlier you stress your freshly operated stomach. Some people heal faster, others heal slower -- but no one knows that for your particular case.

Say 90% of all patients are good to go after 2 weeks. 6% need 4 weeks to heal on clear/full liquids. The remaining 4% of all patients need the full 6 weeks to heal on clear/full liquids. You can either take a chance on those 4% and make your 96% happier, or you can say I don't want to risk it for the 4% so everyone has to be on clear/full liquids for 6 weeks. Or you take a chance on 10% and say everyone can go on soft foods after 2 weeks. It's a question of statistics, probably involves insurance rates and other issues too, how a surgeon decides.

The numbers are totally made up though, he told me some but I forgot. Does that make sense?

[Staci 4]

I am following my physicians plan to the letter- full liquids for 2 weeks, pureed for 1 week, soft foods for a week or so, then introduce (very slowly) regular foods, plus lots of Protein & Water daily. Medicine isn't an exact science so a physician/nutritionist can only advocate what they are taught and are comfortable with. I am a RN and know from experience that the majority of patients don't follow what they are told to do by their doctor perfectly, maybe some docs prolong the Fluid only recommendation a little longer so their patients will hang in just a little longer than they would otherwise. It's tough to set an industry standard to treat anything, let alone a lifestyle change such as what we're all going through, but we've taken the first step by having the surgery, we have to trust that our docs a well versed on the procedure and play by their rules.

The one thing that seems to be agreed on by everyone is the importance of water and exercise

[Liberty 1]

I was wondering the same thing! Mostly because I am supposed to be on clear liquids 1 week, full liquids on week 2, then move to pureed foods. I am so ready for pureed foods and feel a bit jealous of the those who can have them on day 3 because I am hungry!

There seems to be a plethora of different post op diets and diet plans. To me, this is somewhat disappointing as I feel like there has to be a "more" or "most" correct post op diet. Even if it has to be altered a little bit here and there to meet specific patient needs, there should be a solid, standard, uniform post op diet guideline for foods and scheduling or "phases".

For instance, the very well made, professional looking guideline I have says that I am to be on the "soft food" diet after just 3 days. This includes just about anything as long as it is pureed or mashed. Here is a clip from that:

"• 3 Days to 3 Weeks Post-op: Home Soft Diet (high Protein foods). Try to consume 4-6 oz of fluids

every hour. You should be consuming approximately 550-700 calories and 50-70 grams Protein. "

Some of you are on clear liquid diets for a full 2 weeks after surgery which seems highly unnecessary to me. I am no authority and I only say that because I am doing fine 8 days post op and well off the clear liquid diet.

Even the nomenclature of the the phases and food types on VSG post op diets is confusing and conflicting. Some call it pureed stage, some call it "mushies". My doctor had never even heard the term "mushies" before. What, exactly, is a "full liquid"? I bet there is wildly conflicting definitions of a "full liquid".

The purpose of my post is to put out there the need for an authority on this subject to get into circulation a very STANDARD, post VSG operation diet plan complete with definitions and calendars.

- OR -

Throughout the industry, make the entire VSG procedure incomplete without a very thorough personalized diet plan designed for each individual. Make it an industry standard so that doctors are required to have nutritionalists on site to create your own personalized, easy to follow, well defined diet plan.

Even though I am doing fine, it is concerning to think that maybe I am causing damage to my sleeve by entering stages to early. Conversely, I am sure SOME of you would be ecstatic to know that perhaps you can have some blended Soup today rather than in another week.

It is still a new field but as it grows in popularity, it will need standards.