Greetings!

I had my RNY surgery on Tuesday, three days ago. Things went well and I came home from the hospital yesterday around noon. I did okay at drinking water, but when I attempted a protein drink (unflavored Isopure), it was exceedingly difficult to get down due to smell/taste.

A few hours after that, I began getting a lot of rumbling and gurglings in my upper abdomen that I associate with hunger, and then an hour later the hunger began. This was not head hunger -- this was physical hunger. I didn't think I was supposed to feel hunger at all, and the panic began to build. The feeling continued all evening, getting stronger, and I ended up taking a Xanax just to calm down -- my monkey brain was terrified at the prospect of unrelenting hunger that could not be satiated. It took more than an hour to fall asleep because I was so uncomfortable with the physical sensation of extreme hunger, or whatever it was. I was woken up every hour or so with it (along with crazy, hunger-associated nightmares) until about 4:00 am when it seemed to subside. I was able to sleep for a while and I am feeling okay right now.

Are you supposed to feel hungry so soon after surgery? Could it be something else that mimics hunger? Does it go away? I am having a hard time dealing with this, I will admit. I was in a very dark place last night and I felt completely unprepared for these feelings.

This morning, upon feeling better, I got up and tried my Isopure again. This time I mixed it with 4g of sugar (one teaspoon), because my dietician said I could have up to 5 g of sugar in my protein drink and that would not be an issue. (I cannot tolerate the taste of artificial sweeteners, and that intolerance has only gotten worse post-surgery.) It tasted tolerable, but about 15 minutes after having the first ounce, I began feeling weird -- my heart beat faster, I felt sweaty and lightheaded. I stopped drinking and it gradually went away.

This couldn't be dumping syndrome already and so fast, could it? Or was it something else? What did I do wrong?

I dumped a bunch of my water into the protein drink and the feeling has subsided, but now I have to drink a lot more just to get this first batch of protein down.

Any advice you can offer would be greatly appreciated.

Jennifer

It sound a little like head hunger. Since you added sugar to your protein shake, you may have experienced some dumping. Adding sugar to a protein shake is something I would not do.

Generally your loss of hunger doesn't really begin when you are in the full liquid stage. It is something that you will probably experience when you transition to solids. So don't be too concerned at this stage.

Many experience problems drinking protein shakes. I hated them. But in the beginning I drank them, three 16-ounce protein shakes a day, in order to meet my protein requirements. You do not have to like protein shakes only tolerate them. There are many varieties of protein shakes available today. Experiment until you can find one you can tolerate.

There are many different types of formulations on protein shakes. I would recommend that you keep experimenting until you find one that you can tolerate. You don't have to like it, just tolerate it. I used Muscle Milk Light (Vanilla Creme) powder blended with water and a half a banana. That worked for me. But on the opposite end of the spectrum, you might try premixed Isopure.

If you tried all the various varieties and still are unsuccessfully, then there is the fallback of fortified milk. 32 ounces of 1% milk fortified by adding 1 cup of dried milk provides 56 grams of protein. It also takes a dent out of meeting the fluid requirements. Mix up a pitcher and drink a little throughout the day.

Without sufficient protein, your body will scavenge protein from other areas of your body, such as your muscles. Protein is extremely important after surgery as its job in the body is to build and maintain tissues including your body's major organs and skeletal muscles. Protein deficiency, when continued over a long period of time can cause a disease known as protein caloric malnutrition. Common symptoms are poor healing, fatigue, hair loss and muscle wasting. Immediate post op, protein promotes healing of the staple line and incisions.

Thank you for your reply!

My understanding is that head hunger is cravings, wanting to eat when you're not actually hungry. I recognize this, I've experienced it many times, but I'm not having it right now, which is good. What I experienced last night was very visceral, very physical. Sharp pangs, at sometimes pains, in my upper abdomen. It was accompanied by long audible gurgling and bubbling, the typical things I get when hungry. It was indiscernible from my pre-op hunger. Even though I felt these hunger pangs, I did not actually want to eat -- I had no cravings, other than an overwhelming desire for relief from the feeling. Just a really intense sensation of hunger. And I've never had head hunger wake me up at night or give me nightmares.

I would not have considered putting any amount of sugar in my protein drink at all, except the dietician said it was okay. She advised against using artificial sweeteners at all, especially in my case. Keep in mind my protein is JUST protein -- I'm using Isopure unflavored 100% protein. There is nothing added to it at all. And all my documents say that an acceptable protein drink should have less than 5g of sugar, which mine did even with the sugar added. Because it was nothing more than Isopure 100% 20g protein + water + 4g sugar. I'm just surprised I would have an issue on so little sugar even though I was told it'd be okay.

Since I added the water to the protein shake, the weird dizzy/sweaty feeling has not come back. I've now managed to finish one. I consider this a win. I will simply keep adding more water and hope it continues to work.

My dietitian and doc do not allow protein shakes the first week unless they are watered down to a clear consistency. Only CLEAR liquids the first week. Sounds like you had a ton of gas moving around causing the pain. I'm feeling a little better today, and it's day 4 for me, and I still have not met my daily fluid or protein goals. However, I am adding more each day.