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Complications from advancing diet too soon



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No matter how many people get this surgery there are always people who are going to want to do it the softer easier way and that's why they will probably gain back their weight in about five years.

Over the years I've seen too many people from being gung-ho in the beginning with great weight loss that gained back weight in the end anyway.

However, I understand the need to think "this won't be happening to me because I will be the perfect patient following everything to the letter and more" - I'd like to have a guarantee that this whole WLS thing will be the end of obesity as well. Unfortunately there is no guarantee as it seems. Look at the long term studies. Ask any real old timer who is 6, 8, 10 or more years out and is still active on boards or in RL self-help groups.

Many people who were quite smug during their first months or even years have become much more modest after some years, even though they didn't gain back weight or only a bit.

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But then you have people like me who got a diet plan, went in one week post op and was told that they weren't to worried about the diet just try each phase and if it worked out ok if not back up a step. So I'm like totally lost and pretty much just eating the same thing every day.

Wow. As a nurse, that makes me suspect some very unclear communication, either on the part of the surgeon/staff or on the part of what you understood.

My surgeon has one of the most liberal diet progression plans I've seen, and she knew from our conversations that she could give me the written lists and some general guidelines and I'd know what to do with them because I'm an RN.

She started me on full liquids - which on her plan includes Jello, pudding, and greek yogurt and a couple of other pudding consistency items - on day 2 after I kept Clear Liquids down fine on day 1 coming out from surgery. There was no negotiation on that for the first 2 weeks until my first checkup. Protein Shakes, and the things on the full liquids list, period.

She entirely skips the puree phase, as she says it's not functionally much different from the soft/mushy foods phase if your teeth work well, and most people hate it and aren't compliant. So I had a list of soft foods that I could START introducing after my 2 week checkup. One food at a time, from the softest and moistest foods first working my way to firmer consistencies. One new food at a time, tested a couple of times before adding another new food. This was for no less than another 2 weeks.

At my 4 week checkup, she allowed me to start adding in "normal" foods, except for a list of problematic foods such as raw veggies and things with seeds or small hard particles. Those were allowed after 6 or 8 weeks, I forget. I didn't actually try any of them until well after 2 months. But again, it was adding ONE food at a time, trying it several times before adding another.

So if your surgeon really said just "try foods as tolerated" then s/he failed to clearly communicate what the goal of the progressive diet is, and what you're trying to accomplish. That sounds like you can try all the foods in each phase for a day or two and if nothing causes a problem, go on to the next and you're on solids in under a week. Even if that's what s/he *said*, it is very doubtful to me that is what s/he *meant*. Doctors are not the greatest at patient education, it's not generally in their training. A surgeon who is truly advocating progressing the diet that rapidly has very likely not been doing it long enough to lose a patient to a leak or abscess.

That is REALLY good stuff. Well done, well communicated. If gives you a why as well as the what. May I suggest you copy that and put it in the pre-op section with, the horrible warning from the OP? Between the two, this is 90% of your first six weeks post op.

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    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • BeanitoDiego

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    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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