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I am really amazed at the differences in dietary timelines.



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I am post op day 7 and according to my Dr's office have moved to soft solids. On them for the next 7 weeks. My doctor is Dr. Hoehn at KC Bariatric and they just redid all their guidelines. I was on Clear Liquids for 2 days, soups/puree's for 4 days and now soft foods. Scrambled eggs, turkey deli meat, tuna, cottage cheese, string cheese, soft veggies. All things I would have normally eaten at any given point in time. The Protein Drinks are to be consumed as needed to meet the Protein requirement. I can't tell you have happy I am to need to be able to chew something since I haven't had anything in three weeks. My liver reduction diet was 3-4 protein drinks a day for 2 weeks. That was it. That was hard but I had a textbook surgery so no complaints.

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yeah! real food is great!

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I'm really confused at the variations in the length of time different doctors are requiring for each stage as well. My surgeon adheres to a 10-day per stage plan. I'm doing everything I can to figure out how I can rationalize shortening this stage 1. Today is day 4 for me, and I'm having a horrendous struggle with getting enough clear Liquid Protein in. I may manage 45 gr. today if I'm lucky. Once I get to the full liquids stage, I'm not concerned, as there are several ways I know I can get in the Protein without the taste problems. It's hard to imagine struggling with this all day long for 6 more days. Any comments? :(

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My Dr requires 6 weeks of full liquids after Surgery... sick of Soup - 2 weeks to go! I dont understand all the different requirements either,,,,,dry.gif

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My doctor's office just switched to these new guidelines. Mainly they found people were cheating and there were no ill effects so they went back and did some tweaking. I am on regular soft foods till 8 weeks. Fish, deli meat, eggs, canned chicken, cottage cheese, yogurt, etc. After that complete regurlar food.< /p>

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My doctor's office just switched to these new guidelines. Mainly they found people were cheating and there were no ill effects so they went back and did some tweaking. I am on regular soft foods till 8 weeks. Fish, deli meat, eggs, canned chicken, cottage cheese, yogurt, etc. After that complete regurlar food.

Good for him, I'm glad he's catching up (and that shows the value of cheating, within reason, when things don't feel right.) I could never understand the extensive liquid diet requirement as my doc's program starts at mush/puree/soft Protein stage (and liquids as needed, of course) from the outset at the hospital, and they've been doing sleeves for upwards of twenty years in their practice and they obviously haven't had problems moving their patients along at this pace. Obviously, people progress at different rates, with some having trouble with liquids for a while with others able to progress more rapidly; it's good to have a program that recognizes this and isn't one size fits all. Their experience has been that patients do better with more real food, so they try to encourage that progression within the patients' ability and good medical sense.

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For 2 weeks pre and 4 weeks post op, my dr requires 3 protien drinks / 2 yogurts a day. I think he does this because he sells us the pricey drinks. At 4 weeks post op, we are to switch to 2 drinks and one mushy meal until we reach our goal. Then 1 drink daily for maintenance.

I am 16 days post op. I stopped losing weight on day 11. I am very disappointed. They say a 3 week stall is normal but after 11 days and under 500 calories?

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For 2 weeks pre and 4 weeks post op, my dr requires 3 protien drinks / 2 yogurts a day. I think he does this because he sells us the pricey drinks. At 4 weeks post op, we are to switch to 2 drinks and one mushy meal until we reach our goal. Then 1 drink daily for maintenance.

I am 16 days post op. I stopped losing weight on day 11. I am very disappointed. They say a 3 week stall is normal but after 11 days and under 500 calories?

There's no reason to be disappointed, and if you were on a pre-op diet losing some, that just moves the goalposts back since you started your weight loss early. What's happening is that the initial weight loss comes from your ready stores of carbs and protein; once those are depleted the body usually stalls until it starts tapping your fat reserves, which is what you want. Our bodies have all sorts of mechanisms in them to preserve weight when it senses starvation, but it can only do that for so long before it throws in the towel and lets some of that weight go. That's why most "diets" are fairly easy for a week or two when the initial weight comes off fairly easily but then the stall before the fat starts burning creates the frustration that causes many such efforts to be abandoned early. With the surgery and its' forced limited intake, we have no choice but to stick with it thru the stall, but it will happen. And, it will happen again, maybe several times during the loss period as our bodies resist giving up that weight.

When your loss resumes, don't be surprised if you lose at a somewhat slower rate than before - that initial loss from your ready stores comes out at a rate of around 2000 calories per pound, while after getting into the fat burning mode the rate is around 3500 calories per pound, but now it will be mostly fat. That's worth celebrating (but not too calorically!)

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I am also amazed at the difference in eating time-lines. My surgeon has me on liquids, which he said was anything through a straw but he wants them to be "thin" liquids or Protein Shakes only. Then after two weeks I can his version of "mushy" foods, which is anything that is pureed or does not need to be chewed. Then I am on that for two weeks until I see him again, at that point he said I'll start transitioning to normal food, because at that point I should be nice and healed up. I see people who are on mushies from day one and I just don't get. But in the end we have to remember that overall this is still relatively new. The medical community is learning and adapting just as we are. Maybe one day there will be a "standard" but for now we just need to listen to our surgeon and our bodies and do the best we can.

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I am also amazed at the difference in eating time-lines. My surgeon has me on liquids, which he said was anything through a straw but he wants them to be "thin" liquids or Protein shakes only. Then after two weeks I can his version of "mushy" foods, which is anything that is pureed or does not need to be chewed. Then I am on that for two weeks until I see him again, at that point he said I'll start transitioning to normal food, because at that point I should be nice and healed up. I see people who are on mushies from day one and I just don't get. But in the end we have to remember that overall this is still relatively new. The medical community is learning and adapting just as we are. Maybe one day there will be a "standard" but for now we just need to listen to our surgeon and our bodies and do the best we can.

I think evolution of thought is the right term for this, just as other practices in the medical world have evolved. I equate this situation with the general evolution of how surgical patients in general have been treated in recovery. The stomach is a muscular organ, which actively compresses and manipulates the food as it processes it for transfer to the intestines. After a major injury, it does deserve some rest and recovery, but also some physical therapy and exercise. One may recall that in the 'good old days' patients required days or weeks of bedrest after surgery, while today the normal practice is to get us up and moving as soon as possible because that promotes healing. I suspect that there is an analogous situation locally with our stomachs, that they do better with some moderate early exercise than if they are prescribed weeks of 'bedrest' first. It seems that the docs who have been working with this stomach configuration for a while - those with longer term VSG and DS experience - would lean more toward this philosophy than the docs whose main experience has been the RNY which eliminates much of these basic stomach functions and replaces it with a more static pouch that mostly just gets stuffed and stretched. What still doesn't make a lot of sense to me is the extensive liquid pre-op diets some docs impose - I can understand the interest some have in pre-op weight loss and its effect on liver condition, but allowing an organ to effectively rest for so long before surgery is counter to the normal practice of wanting patients to be in the best physical shape they can be in prior to the knife. Again, maybe that harkens back to RNY practice where they are basically throwing the organ away after surgery and don't care about its' recovery?

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I think a big part of the dietary requirements doctor's provide is for you to grow accustomed to the quantity and the texture of the food our new stomachs need... so in the beginning we have pure liquids to allow our stomachs to heal and become less swollen. This stage also give us an idea of how our stomachs feel and how full they become. The mushy stage shows us the texture of how food should be prior to swallowing it and also helps us understand how much is too much per bite and per meal. Once you have mushy food down then you move on to solid foods but now we've been accustomed to the mushy texture and quantities so we naturally chew to mushy texture (or force ourselves to do so) and are more in tune with how much we are consuming per bite and per meal. I don't think the diet progression is completely based on damaging or not damaging our new stomachs as it is on creating new eating habits which is why there is probably such a large disparity from doctor to doctor. If there was any real scientific evidence regarding mushy foods or solid foods at 2 weeks out vs 6 weeks out then I think there would be more consistency between recommendations.

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I'm really confused at the variations in the length of time different doctors are requiring for each stage as well. My surgeon adheres to a 10-day per stage plan. I'm doing everything I can to figure out how I can rationalize shortening this stage 1. Today is day 4 for me, and I'm having a horrendous struggle with getting enough clear liquid Protein in. I may manage 45 gr. today if I'm lucky. Once I get to the full liquids stage, I'm not concerned, as there are several ways I know I can get in the Protein without the taste problems. It's hard to imagine struggling with this all day long for 6 more days. Any comments? :(

Don't try to change your diet based on what someone says on this forum. Listen to your surgeon, you picked him for a reason and he has the guidelines for a reason. Hang in there and talk to your surgeon before you change anything.

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