Why are so many stages different?

[Djmohr 6,965]

@@summerset

WLS are not on liquids for so long to promote fast weight loss. In fact, most Bariatric surgeons prefer you lose at a consistent pace. It is safer and healthier. Did you hear that somewhere? I am just curious.

The real deal is because our stomachs have been cut and stitched and require a long period of time to heal. That is also because we can only tolerate so much Protein which assists in healing and in the beginning weeks, you can barely get a whole Protein shake into your tiny swollen tummy.

Those that lose that quickly and cannot get their Protein in end up having more complications down the road. These are words my surgeon used with me. And it is also why when you have a patient that cannot tolerate anything for the first few months, they lose a a lot of weight but end up sick in the process.

[Djmohr 6,965]

@@ChunkyMonkeyGoneSlim

I feel your pain with the Pasta thing. I am Italian and we ate Pasta type dishes at least 3 to 4 times per week previously.

Now that I am 22 months post op I can have it on occasion but choose lower carb pastas and whole grain pastas instead and it is maybe once every few weeks.

The other thing I noticed is that I can no longer eat pasta or rice al dente. I have to almost over cook it for my tummy not to feel heavy. I personally will only eat a spoonful or two and mostly the meat and sauces.

[madadams 130]

I've eaten Pasta since week 7 when of went on solids. But only tiny amounts. And rice. And bread. I rarely have them but I am allowed them. They haven't hindered my weight loss.

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[summerset 5,265]

@@summerset

WLS are not on liquids for so long to promote fast weight loss. In fact, most Bariatric surgeons prefer you lose at a consistent pace. It is safer and healthier. Did you hear that somewhere? I am just curious.

Some patients simple suspect it. Others said something like "Ok, they maybe want us on liquids for two weeks but because the doubt our compliance they tell us 4 weeks so we're doing it for 2 week".

The real deal is because our stomachs have been cut and stitched and require a long period of time to heal. That is also because we can only tolerate so much Protein which assists in healing and in the beginning weeks, you can barely get a whole Protein shake into your tiny swollen tummy.

Same thing with e. g. tumor surgery where most of the stomach has to be removed. They also need time to heal and yet they're on solid food much earlier (of course some patients need longer because they don't tolerate it) - but I bet there are different protocols regarding this out there as well.

[Djmohr 6,965]

@@madadams

I have also been on a very balanced diet that included veggies, fruits, nuts, crackers and even bread if I wanted them. And yes there were times when I tried a quarter of a piece of whole grain bread.

The bigger issue is, the further out from surgery it does slow your weight loss down some and can even cause stalls which can be lengthy. Mostly because you end up eating more of it.

I learned that early on if I avoided breads, crackers, rice, Pasta etc my scale moved faster. The minute I introduced them back into my diet two things happened. I would stall and worse yet, I would crave them......and sometimes I would give in to those cravings.

It is a personal choice to include or not include starches into your diet. I am personally very choosy about which ones I include and extra careful about how much of them I eat. For me though, I learned quickly that it was best to wait until I was almost at goal.

I did however include veggies and fruits into my diet and kept them there since the beginning. I would just limit the fruit to one serving per day.

If I eat bread now, I usually will only allow one slice or less and I choose a whole grain or multi grain bread.

Early on I think the thing I missed the most was just having a sandwich.

[Djmohr 6,965]

@@summerset

WLS are not on liquids for so long to promote fast weight loss. In fact, most Bariatric surgeons prefer you lose at a consistent pace. It is safer and healthier. Did you hear that somewhere? I am just curious.

Some patients simple suspect it. Others said something like "Ok, they maybe want us on liquids for two weeks but because the doubt our compliance they tell us 4 weeks so we're doing it for 2 week".

The real deal is because our stomachs have been cut and stitched and require a long period of time to heal. That is also because we can only tolerate so much Protein which assists in healing and in the beginning weeks, you can barely get a whole Protein shake into your tiny swollen tummy.

Same thing with e. g. tumor surgery where most of the stomach has to be removed. They also need time to heal and yet they're on solid food much earlier (of course some patients need longer because they don't tolerate it) - but I bet there are different protocols regarding this out there as well.

So from your response, I am getting that this is an impression or a guess and not fact?

The reason I am asking is there are a lot of people new on this site and many times want to hear what they won't from their Bariatric team. If your surgeon puts you on liquids following surgery I am certain it is not to make your weight loss faster, it is to allow the time for it to heal given the limited amount of Protein you can consume.

I cannot speak for ulcer patients, but having researched post WLS diets for the last 3 years and speaking with multiple bariatricians and surgeons, and Bariatric nurses and Bariatric nutritionists. The first several weeks following are all about healing and NOT weight loss. Weight loss just happens because the change is so significant and the lack of food volume.

[summerset 5,265]

So from your response, I am getting that this is an impression or a guess and not fact?

It's patients gossiping of course. Even if I would know for sure it's nothing I would ever write down here.

[Inner Surfer Girl 12,015]

His whole food plan was insane. They had him on full liquids from day two. But, he is fine. He is down 100 pounds already. I was like I am down 26 pounds at 14 days post op.

My plan is liquids including Protein shakes in the hospital and until day 8 when we are allowed purees. No Pasta, bread or rice "forever" (or anything doughy that expands in stomach). I remember seeing a post from a woman who was eating lasagna (pureed) a week after surgery because she felt she should be able to eat what her family was eating. I always wonder how those people make out in the long run. Even if my plan allowed Pasta - I wouldn't be having it - it's a major factor in why I'm fat!

Were Italian so for us leaving pasta out is like leaving a part of us. But, I can do it I weighed 279 April 7th of the year. On the day of surgery I weighed 244. It's exactly two weeks later and I am down to 218. So, I'll skip the pasta. I was just blown away that they recommend it for him that soon and even had directions for the lasagna roll up.

But, anywho thank you for all you responses.

Every culture has a staple starch (or starches). It is possible to enjoy the Proteins without the starch: think meatballs and sauce, pasta sauces over vegetables, etc.

[RickM 1,753]

Much of the program protocols that we see in the WLS world are based upon RNY practices, as that has been the default procedure for the past couple of decades, and carried over to newer procedures such as the VSG as much for the convenience of the surgeons' staff as for an abundance of caution with a new or unfamiliar (to them) procedure.

We see variations based upon the experience that different surgeons bring to the table from their varied backgrounds. For instance most of the DS programs that I have seen have a more rapid progression than we typically see in the majority of bypass oriented programs - I was on scrambled eggs and yogurt, along with liquids, in the hospital, and we progressed into most pureed and soft Proteins including most seafood as tolerated from there, with everything else added after the first month. Their general finding has been that patients seem to do better as the move to real food from supplements and shakes only. I'm not sure what a "lasagna roll up" is, but such a thing is conceivably tolerated at a couple weeks, particularly if it's primarily cheese and sauce. Given what I have seen from the DS world, it seems like the sleeve is somewhat more robust than most bypass oriented surgeons give it credit for, and many are slowly recognizing this as programs are slowly moving to more rapid progressions. Things like saltine crackers and mashed potatoes (particularly laced with Protein powder), while not necessarily ideal weight loss foods, are easily digested early on and can have a place in the progression as one moves toward more nutritionally dense foods for the longer term.

Looking at how these procedures, and similar non-WLS gastric procedures are structured, it seems that the common thread is what type of tissues are being grafted together and how quickly those connections heal. The VSG is only stomach tissue connected to other stomach tissue (same with the DS, which is a sleeve plus intestinal rerouting, which adds intestine to intestine connections). Contrast with the bypass, which connects stomach tissue in the pouch directly to intestinal tissue - that's a tougher healing process (and indeed is the root of the bypass's much greater NSAID sensitivity relative to the VSG/DS)

Looking at non-WLS gastric procedures, there are some straighforward partial gastric resections to remove ulcerated or other diseased areas, but are confined to just the stomach tissues (sort of a "partial" VSG), while there are some partial gastrectomies that remove the lower part of the stomach and leave a pouch that connects to an intestinal loop - the origins of the RNY gastric bypass. Getting more radical, a total gastrectomy typically removes the stomach end to end, connecting the esophagus directly with an intestinal loop (often with a pouch formed from intestinal tissue). This is an even "tougher" heal than the partial or bypass gastrectomies, and often uses a feeding tube for several weeks to maintain nutrition while allowing for the connection to heal.

[linah 92]

I just had the gastric sleeve op on Aug 5th. My Dr's plan was 3 weeks liquid, 2 semi- liquid, 3 weeks soft food

[ChunkyMonkeyGoneSlim 7]

Thank you all for you wonderful replies. I have included a couple of links with different post op plans that kinda blew me out of the Water also, one that even has lasagna rolls that my cousin was telling me about. I am at day 16 and I was suppose to start soft moist foods this week on day 14 but, my "green book" with my post op food book is so unclear.So, I have been scared to try anything. I have been trying to call my Nut all week and even stopped by her office today but, she wasn't in. I was needing her to clarify what I am actually suppose to be eating. Because, it gives a list but, contradicts its self in the next paragraph.

http://www.drshillingford.com/patient-information/weight-loss-surgery-nutrition/after-gastric-sleeve-gastric-bypass-diet/

http://www.upmc.com/Services/bariatrics/approach/post-surgery/diet/Pages/soft.aspx

http://blog.riversidesurgicalweightloss.com/blog/gastric-bypass-recipes-after-surgery

[Peggy D 124]

You want restrictive? This is my surgeon's plan:

Week 1 - Clear Liquids only

Weeks 2-4 - Clear Liquids plus Protein shakes

Weeks 5 & 6 - pureed foods

Weeks 7 & 8 - soft foods

Week 9 & on - introduce regular foods

Never again eat - "white" foods (pasta, potatoes, rice, Cereal, etc.), root vegetables, fruit (any kind especially watermelon & bananas)

[ChunkyMonkeyGoneSlim 7]

You want restrictive? This is my surgeon's plan:

Week 1 - clear liquids only

Weeks 2-4 - clear liquids plus Protein shakes

Weeks 5 & 6 - pureed foods

Weeks 7 & 8 - soft foods

Week 9 & on - introduce regular foods

Never again eat - "white" foods (pasta, potatoes, rice, Cereal, etc.), root vegetables, fruit (any kind especially watermelon & bananas)[/quote

Yikes!! That is super restrictive.

[dede_mont 105]

My doc and nut have me set up as

Week 1 (or longer if i feel i need it): clear liquids with clear Liquid Protein drink (isopure)

Week 2: full liquids with watery baby cereals or watery cream of wheat

Weeks 3-8: purees or watery foods

Weeks 9-12: soft foods

After 3 months i can work with more solid foods

No white foods from now on and no booze for about a year..

Im not worried about anything past stage 3 so i might be off on a few donts

I know my surgeon put actual stiches in my stomach so that could be why its so different from others.

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[higher 966]

You want restrictive? This is my surgeon's plan:

Week 1 - clear liquids only

Weeks 2-4 - clear liquids plus Protein shakes

Weeks 5 & 6 - pureed foods

Weeks 7 & 8 - soft foods

Week 9 & on - introduce regular foods

Never again eat - "white" foods (pasta, potatoes, rice, cereal, etc.), root vegetables, fruit (any kind especially watermelon & bananas)

wow. That's tough. Not sure I could have done it. All power to you.

My plan was

Clear Liquids in the hospital

Full liquids (incl Protein shakes) for 10 days upon release from hospital

Purees with a gradual progression to soft foods for the next 10 days

After that- time to introduce regular food one at a time.

Nothing is banned for life, but protein then green veggies then carbs is the rule for each meal.