Hi all and hope you're all getting excited for labor day weekend!

So my surgery was 7/17 and I finally went back to work last week (wound up taking more time off than expected due to some challenges eg; dehydration, severe upper right abdominal pain, etc.) I'm unfortunately having a bit of a hard time particularly with eating and drinking enough - and with the scale.

I work in global marketing in a high pressure office environment. I am constantly in meetings or else "in the zone" on my computer doing work. I always had a problem drinking enough fluid even before surgery and have trying hard to be more mindful since surgery, but I am having even more trouble now particularly from the no drinking 30m before or after a meal rule. I am rarely eating breakfast, don't feel like I'm eating enough lunch (partially from rushing and partially because I can only get a couple bites in before feeling like it's getting stuck), and same with dinner. Plus I'm getting lots of comments from colleagues on how little I'm eating (I've been private about the type of surgery I had) which makes me super self-conscious and not wanting to eat in public (and I'm in an open office environment to boot.)

I am definitely not getting enough of food groups outside of protein as even getting enough protein is a struggle because I get the stuck "full" feeling nearly instantly.

I've also been on a stall since Week 3 so going on 3 weeks now - only lost 2 lbs, which is especially disheartening when I feel like I'm barely eating.

My questions are:

1) Does anyone have a good method for making sure you get enough of your food groups including and outside of protein eg; veggies, fruit, etc?

2) How do you make sure you get enough water? I have a big thermos I try to carry around but I either forget to drink out of it or I don't drink enough before it's time to try and get some protein in - this whole no fluid 30m before or after meals is a doozy!

Bonus question: How long until you felt like you were able to eat a well-rounded meal while still maintaining the amounts of each group needed to prevent malnutrition?

Thanks in advance!

Edited September 1, 20178 yr by ebroms17

Hi Ebroms17, firstly I am sorry to hear you are having such a hard time. I can only say, is should get easier as time goes on. But for now here are a few things that I know.

• I stalled week 3 after surgery. It happens and we all go through it. Check your measurements not just what is happening on the scales. Stick to your plan. Many factors can affect your weightloss. I am dealing with insulin resistance, graves disease, blood pressure and injuries. Make sure you speak to your doctor about what you might be dealing with so you understand how that can affect you.
• The advice from my surgeon and nutritionist for me is 1/2 a cup of food at meal times. Eat your protein first. Protein is critical for body repair, growth and weightloss. It keeps you feeling full. If you can't eat anything else, then make sure you get your protein.
• Take your vitamins. These are to ensure that what you are missing out on you get back through vitamins. Hopefully you are having some regular blood tests done to check your levels so there is early warning if you are lacking in anything.
• I was also told to take Benefiber every day. Because you are not able to get the normal amount of fiber that you need, this is very important.
• What kind of protein are you eating? I found early on it was easier to eat things like mince, or chicken cut up small with a sauce because I could chew it up and swallow it easier.
• Try adding some diet cordial to your water. I found it much easier to drink that way. I use Lemon/Lime Cordial for mixed drinks as I like the flavour.
• For Breakfast try taking a protein bar with you in your bag to work, that way you can eat it when you are ready for it.
• For colleagues all I can say is, that I am on a diet recommended by my doctor. They can't argue with that.

I'm no export, these are just the things I have been told to do by the experts. It is important to talk to your doctor, and nutritionist. But I hope some of the above might be helpful to you.

I had RNY gastric bypass whereas you had the Duodenal Switch. But many of the main points apply to both types of procedures.

The three most important elements after weight loss surgery are to meet your daily protein, fluid and vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight.

It is common for your taste buds to change after surgery. Be willing to experiment. After surgery, my taste buds changed dramatically. Even water changed. In the hospital it tasted excessively chlorinated and I could not drink it. So I experimented. Sugar free popsicles became my best friend. Some individuals find hot or cold can help with fluids. For me, I found that I could tolerate flavored water. So I began using Crystal Light. I also found a new drink Bai which I liked cold. In the winter, I found that I tolerate hot drinks such as piping hot cocoa. But you have to use the "No Sugar Added" variety. Also fine English teas were very good.

The fluid requirement is met by a combination. It is not only the water that you drink each day. But also the water you drink when you take your vitamins and medicine. It is the milk you drink. It is the fluids content of the protein shakes. It is the water component of the soups you take. It is met by flavored water such as Crystal Light. It is met by sugar free popsicles. It is met by tea and decaf coffee. It is a combination of all the fluids that you consume during the day.

It is important to begin your day with breakfast.

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.

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.

It might be a little too soon to transition to protein bars. It wasn't until the 3rd or 4th month that my nutritionist recommended them. Your stomach may still need a little extra time. A protein bar is probably too dense at this point. I used Quest protein bars. These bars were good in that they had high protein, minimal sugar and also contained fiber. They also came in a lot of different flavors.

Protein bars are good when you are on the go and can't drag along a blender in order to mix a protein shake.

A Quest protein bar contains 220 calories and provides 21 grams of protein. A Muscle Milk Light protein [2 scoops of powder in a 16 ounce glass] contains 210 calories and provides 25 grams of protein. So they are comparable.

I found that softer foods such as chili and soups went down much easier than harder foods such as steak and chicken. So therefore I relied on these. I have included some recipes in the following article. Generally I make a pot and it last me for the entire week. http://www.breadandbutterscience.com/Surgery.pdf

There are a lot of 'smart water bottles' and apps that remind you to drink. One bottle might vibrate, light up, etc to get your attention. Or download an app that vibrates your phone, etc.

I was horrible with these type of things pre op, but I decides it was critical, so I developed a habit of every time I went to the ladies room, I'd grab my water bottle and walk around the building. It's my new habit, and helped with my water and exercise. Can you do something like this? You're worth it!



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First, I'd seriously consider drinking right up until mealtime. Liquids tend to leave the stomach within minutes. If it doesn't work for you, you can always go back to waiting.

Secondly, try to eat your solid meals before and after work, have your shakes and soup during the workday. You'll consume what appears to be more normal "diet" portions, and you'll do better staying hydrated. You don't have to wait to drink before or after protein shakes, and only have to wait 30-40 minutes after soup.

Good luck!

At 6 weeks from surgery and working all day...

I would sip on protein drinks and not water all day. Your calorie needs are higher as a DS patient due to your malabsorption rates. The only way you are going to get enough protein and fluids in early on is to drink them.

Thanks all for the support and tips! these are super helpful!