It always amazes me, and I'm sure all of you, how variable the instructions are for before and after surgery, and even the method of surgery for the gastric sleeve. Here is a little bit about my instructions and surgery so far:

Before Surgery:

1) Was immediately told to follow low carb diet on my first visit and to bring back a diary in two weeks.

2) Had all the appointments on my first visit (psychologist, NUT, DOC, and the Nurse Practitioner, oh and the PA too)

3) Easy approval through insurance

4) Lots of blood work and had an endoscopy. Results low on Vitamin D, and some mild gastritis.

5) Vitamins: Told to take B12, Vitamin D (10,000 IU), Calcium, a good Multivitamin, Prilosec (20 mg a day), Fish Oil, and a pro-biotic.

6) Told to start exercising.

7) Told to drink 64+ oz of Water a day.

8) Didn't have to do any more logging of food after the first couple of weeks

9) If constipation was a problem, use MOM. (and it has been).

Pre-Op (2-3 weeks prior to surgery)

1) Limit carbs to 20 a day. Can still eat meats, eggs, some cheese, but must have no sugar, excess fat, starch etc, you know the drill.)

2) Start pushing fluids 1 week ahead to be adequately hydrated.

3) Make sure to get enough sleep.

4) Take Emend for nausea 1 hour before surgery.

5) No alcohol

6) Stop taking fish oil 1 week prior to surgery (it thins the blood somewhat)

7) Do the Hibicleans wash night before and morning of surgery.

8) Bring CPAP to hospital

Surgery:

1) Surgeon utilizes no drains. Says not necessary with the sleeve.

2) No catheter.

3) Sends home with oxycodone for pain. (forgot to ask what they use in the hospital immediately after)

4) 1 night hospital stay

5) Four ports for surgery

6) No separate leak test done with barium

6) First follow up visit is 3 weeks after.

After Surgery:

1) 3 weeks of full liquid diet (goal 32oz of Protein shakes a day, and approx. 700+ calories a day and 100+ grams of protein a day). Supplement liquids with non-sweetened other stuff (crystal light etc.)

2) 3 weeks of pureed foods

3) 3 weeks of soft foods

4) No gum ever (well, I think they mean forever)

5) Caffeine is ok to have.

6) No soda pop ever

7) No NSAIDS

8) Two weeks off work is the general rule

9) No heavy lifting for 6 weeks

10) No baths, ointments or creams. Showers ok.

11) Must take Iron supplement, Vitamin D 10,0000, Multivitamin, calcium 1500 mg, B12 100mg, PPI 40 mg, probiotic, Omega 3 fish oil as supplements for a long time All should be liquid afterwards, but small pills may be tolerated.

12) MOM only for constipation. Doc says constipation should NOT be ignored. If 2 days go by and no bowel movement, call the office.

13) Utilize the on call surgeon whenever you feel you need to. Don't wait to call.

14) No straws

Whew!

Yep they are all different

Before Surgery:

1) No added sugar, 25% carbs, 25% fat, 50% Protein for 3 months. Shooting for 50-60 pounds lost pre-op.

2) Back-to-back appointments for NUT & shrink + monthly weigh-in with NUT + separate pre-op follow up with NUT & surgeon.

3) Easy approval through insurance, once we figured out that United Healthcare set up the company's plan wrong. HR sorted it out.

4) Blood work in September, endoscopy in October, blood work & chest x-ray yesterday.

5) Multivitamin.

6) Told to start exercising.

7) Told to drink 64+ oz of Water a day.

8) Still logging food

9) No constipation, no advice in that area.

Pre-Op (2-3 weeks prior to surgery)

1) Same diet as before, no special instructions except absolutely nothing after midnight the night before. Only a sip of water with HBP meds.

2) Bring CPAP to hospital just in case

Surgery:

1) Dunno about drain.

2) No mention of catheter.

3) Sends home with oxycodone for pain. (forgot to ask what they use in the hospital immediately after) - ditto

4) 1 night hospital stay - ditto

5) Four ports for surgery - ditto

6) Leak test done with barium morning after

6) First follow up visit is 2 weeks after.

After Surgery:

1) 2 weeks of full liquid diet (goal 32oz of Protein shakes a day, and approx. 700+ calories a day and 100+ grams of protein a day). Supplement liquids with non-sweetened other stuff (crystal light etc.) - ditto but 2 weeks only

2) 2 weeks of pureed foods - ditto but 2 weeks.

3) 2 weeks of soft foods - ditto but 2 weeks

4) No instructions on gum, but I imagine it's a no-go for a long while at least

5) Don't remember instructions on caffeine, but not my drug of choice anyway

6) No soda pop ever - ditto

7) No NSAIDS - ditto

8) Two weeks off work is the general rule - ditto

9) No heavy lifting for 6 weeks - ditto

10) Showers only. No instructions on creams that I recall, but not my thing.

11) I have a whole bag of Vitamins and supplements from the drug store. All will be crushed.

12) Have instructions on this, but don't recall.

13) Cramps may mean leak = call surgeon or get to ER.

14) No straws - ditto