Is my surgeon too easy-going and liberal?

[Sara51692 162]

So I had my one month follow-up appointment yesterday and assumed I was moving from pureed foods to soft foods for two weeks until my 6-week appointment. But my surgeon shocked me by saying I'm okay to move onto solid foods. He made a few disclaimers, such as trying new things when I'm comfortable and avoiding fibrous vegetables like celery right now.

So I basically ended up in Stop & Shop with my sister last night looking around like a person who had never been in a grocery store before because I had so many options now. I felt totally unprepared because I was expecting soft foods first! I only bought cucumbers (to eat with hummus) and crystal light. I ate some chicken last night, non-pureed, and it went down fine. So I don't think he's wrong that I'm ready for solids, but I'm still really nervous!

I also asked my surgeon about my calorie intake and I told him I was getting 400-600 a day but the last few days it was more like 700 because I was hitting my Protein goal. He told me I needed to be around 1000-1200 which shocked me too, because I've read about people on here who are maintaining on that...

And finally, I told him how I wasn't getting nearly 64 ounces of Water, and he told me not to worry about it and to keep separating liquids and solids and just drink when I'm thirsty. I'm also allowed to drink alcohol (in moderation, of course) at this point.

I'm just wondering if anyone has had a similar experience? Would this worry someone? My aftercare there has been great and my surgeon and NUT are both amazing at being available to answer questions at any time, but I totally thought my surgeon was tough and fairly strict, but he doesn't seem to be...

[Babbs 14,680]

Every surgeon is different. A month is about right to start solid foods, just take it easy. Soft protien like fish and chicken are good to start with. I would not try salad or uncooked veggies quite yet. Like he said, just try new things and see how your tummy does. It's hit and miss sometimes at first.

I still disagree about the amount of calories he said you should be eating. But you know that

[Sara51692 162]

Every surgeon is different. A month is about right to start solid foods, just take it easy. Soft protien like fish and chicken are good to start with. I would not try salad or uncooked veggies quite yet. Like he said, just try new things and see how your tummy does. It's hit and miss sometimes at first.

I still disagree about the amount of calories he said you should be eating. But you know that

My chicken last night went down well. I think I'm just freaking out because it's a LOT easier to avoid carbs when I'm limited to pureed foods. I'm scared I'll fail. Even though I've already had the surgery, it all feels a lot more real now.

I agree about the calories. I have a feeling him and my NUT feel obligated not to endorse any diet under the minimum recommended amount of calories so they say "You should be getting 1000-1200, but do what's comfortable..." At least that's what it felt like!

[jess9395 5,448]

My surgeon advances that quickly. My plan included anything I could tolerate at that point as well and the same calorie recommendations.

I didn't eat that many calories for many more months though. I just couldn't get them all in when I ate Protein first, etc. Though I did eat a number of mini meals rather than three meals a day to keep the count to 800 at least.

I lost easily and never had any big issues (a few things still don't agree with me and I am 18 months out).

I think if you are careful and choose a surgeon you trust you follow the plan YOUR surgeon lays out. You chose them for a reason, trust their judgement.

I think maybe sometimes if we keep the calories TOO low for too long our bodies adapt. So if you keep them at 400-600 then yes 1200 will become your maintenance intake. I lost quickly and easily at 800-1200 (lots of exercise too) and my maintenance is 1600-1800 (at 135 and again LOTS of exercise).

[Rochellevsg 38]

Every surgeon is different, but I totally understand your apprehension. And to answer your question honestly, yes it would worry me. My surgeon is on the more strict side of the post op diet. I will be on liquids for 5 weeks, soft foods week 5-7, and solids after week 7. My advice (i am not by any means a professional) would be to do what's comfortable. My nutritionist said I can stay on liquids and soft foods as long as I need to. Maybe you could put yourself on a soft foods diet for a week or two until you're comfortable progressing to solids.

[MistyAnnMoon829 387]

Your surgeon sounds a lot like my surgeon and it worked out okay for me. I didn't have a pureed stage at all. I went from liquids to soft meats, and regular meat. I did take my time before eating tougher foods like steak and hamburger, but I had zero problems with anything I ate, so long as I started off with small bites and didn't try to overload my tummy. Double-edged sword that. So I am strongly working on my carb control sounds like you and I have a very similar journey. I'm a day over 11 months out and 97 lbs down. My biggest goal is to be at 100 lbs down by July 24th, my one year surgiversary. I was also at about 1000 calories but right around 6 to 8 months was when that happened, when I could suddenly eat much more. Now I try to stay around 1200, sometimes I'm over sometimes I'm under. I don't sweat it as I feel it all balances out as long as I'm not gaining.

Edited June 25, 2015 by MistyAnnMoon829

[Babbs 14,680]

@@Sara51692

Stick to the rules. Protien first, veggie second, then if you have room, carbs. You will find if you stick to that main rule for WLS patients, you will hardly ever have room for carbs. Plus protien helps keep you fuller longer

[MistyAnnMoon829 387]

Exactly what @@Babbs said! If you eat that way it is really hard to put bad stuff in your body.

Definitely do what feels right to you. And listen closely when your sleeve says no, one bite too many kills, especially in the beginning.

[Sara51692 162]

My surgeon advances that quickly. My plan included anything I could tolerate at that point as well and the same calorie recommendations.

I didn't eat that many calories for many more months though. I just couldn't get them all in when I ate Protein first, etc. Though I did eat a number of mini meals rather than three meals a day to keep the count to 800 at least.

I lost easily and never had any big issues (a few things still don't agree with me and I am 18 months out).

I think if you are careful and choose a surgeon you trust you follow the plan YOUR surgeon lays out. You chose them for a reason, trust their judgement.

I think maybe sometimes if we keep the calories TOO low for too long our bodies adapt. So if you keep them at 400-600 then yes 1200 will become your maintenance intake. I lost quickly and easily at 800-1200 (lots of exercise too) and my maintenance is 1600-1800 (at 135 and again LOTS of exercise).

I know - I really never doubted my surgeon until this point. I think it just really shocked me and I felt unprepared. I'm very good at following things for a short amount of time and then I stray. I wasn't expecting to be able to eat solids so soon. I mean, my family's doing a cookout next weekend for the 4th...don't know how I'm going to handle that!

I was worried about that with the calories...I don't want my body to get used to this amount, and I've heard stories of people increasing their calorie count to get out of stalls, so maybe it'll be good for me to increase my calories a bit and aim a little higher.

@@Babbs I've struggled with that concept because I love veggies. I was a vegetarian for several years and don't like a ton of sources of Protein, but I'm trying. I've had chicken the last several days and nights and that's how I've hit my protein goal lately. Before, I was doing more veggie purees and they didn't give me nearly enough protein.

[bikrchk 1,313]

I'm a little surprised by the Water (drink only when thirsty) and alcohol (it's okay in moderation after 4 weeks) advice, but other than that, I think the calorie advice is spot on and instructions to advance your diet as you are comfortable after 4 weeks was kind of the same speech I got. I was told that as far as causing damage by food choice I was out of the woods by 4 weeks anyway. Yes, separate solids and liquids, but get as much Water as you can tolerate. As for alcohol, I drink in moderation and probably drank too soon at about 3 months. Not that it bothered me, but I probably didn't need the extra calories. After being in maintenance for a year, alcohol is the first thing to go when I bounce outside my range even a little.

[Sara51692 162]

Exactly what @@Babbs said! If you eat that way it is really hard to put bad stuff in your body.

Definitely do what feels right to you. And listen closely when your sleeve says no, one bite too many kills, especially in the beginning.

Yeah, I'm trying to "undestimate" my portions because I know I'm going to want to finish what's on my plate, even if it's one or two bites, so I'm giving myself smaller portions so I'm able to do that still. It's so weird when I realize my mind is on this mindset that just says "OMG eat everything you can, you are NEVER getting food again - KEEP EATING." And it's like, no, brain, you're fine, you can eat whenever you want later, it's not the end of the world and everything doesn't have to be eaten right now.

[Inner Surfer Girl 12,015]

It sounds right in line with what my program is. By one month I was cleared for most all foods.

1000-1200 is also a reasonable calorie range based on my NUTs instructions.

I find that those who focus on keeping their calories low either have very low Protein goals or are not getting enough Protein.< /p>

Your surgeon's instructions are based on you and your specific situation.

Sounds like he thinks you are healed enough for regular foods and are doing well. Congratulations.

[Madmax68 227]

At my three month appointment I was told I was getting too few calories (800-1000) and that I should increase it to 1200-1400 so that my body wouldn't think it was starving. I was scared to do it, but when I did the weight started dropping off. I do work out for a minimum of 5 hours per week, usually swimming, which does burn a lot of calories, so they took that into account too.

[Sara51692 162]

At my three month appointment I was told I was getting too few calories (800-1000) and that I should increase it to 1200-1400 so that my body wouldn't think it was starving. I was scared to do it, but when I did the weight started dropping off. I do work out for a minimum of 5 hours per week, usually swimming, which does burn a lot of calories, so they took that into account too.

Yeah I haven't started an exercise routine yet - just some walking since I do feel like I'm still healing (my abdomen still hurts), which my surgeon was fine with too. I'm hoping switching my calories higher will work in my favor - it's definitely scary!

[hockeyfan7 249]

My surgeon allows solid foods at day 10 if you are tolerating liquids well. Lean Proteins of any kind plus green Beans, summer squash and zucchini.

I'm on week 4 and saw him yesterday. He told me any lean Protein and any non-starchy veggies were fine now. He also said not to worry about the calories - just stick to the food plan, avoid carbs except from non-starchy veggies. He told me that the dieticians are more used to working with direct sleeve patients and it's a little different for people like me that revised from band to sleeve.

I eat around 1,000 calories a day and he said that's fine.