How close do you follow your dr's Post Surgery plan?

[dathvick 150]

I had RnY Surgery on Sept 6th and so far am down 42 lbs. I followed the doctors instructions to the letter for the first 2 weeks but have been deviating a little here and there. I am still eating pretty much nothing but Protein. My diet consists mainly of eggs, cottage cheese, Greek Yogurt, re-fried Beans, lunch meat, chicken breast meat and the occasional can of cream Soup. everything I eat is the Low fat or No fat variety.

Here is where I have deviated, Today I had 2 cups of coffee (I am not suppose to have caffeine until week 8), I went back to puffing on the occasional cigar about 2 weeks ago, in the last week I have started having either wine or a little whiskey with my cigar. I was told not to go to the gym until week 6 but found myself there for the first time today (4 weeks after surgery).

I feel great and healthy and strong, I have plenty of energy. I had surgery on a Wednesday and would have gone back to work on Friday if I hadn't already turned in my time card for the week. I did go back to work the Monday after surgery and never had any problems, not even any discomfort.

I think everybody is different and we can all tolerate things differently. I don't think I am doing anything wrong when it comes to my recovery or weight loss but I do feel a little guilty for not following all the instructions I was given.

[PrayingForWeightLoss 337]

I follow my program to the letter. I just don't want to go back to the things that contributed to my obesity. I made a personal choice to follow the program because my own "program" obviously failed me before.

[catwoman7 10,845]

I followed mine to the letter as well. I didn't want any complications and I wanted to get rid of the weight once and for all.

[James Marusek 5,244]

I followed mine down to the letter.

It is common to do a little experimentation after surgery. That is how we learn. Some people can tolerate anything after surgery while others have problems and can tolerate very little. Weight loss is achieved during the short weight loss phase through meal volume control. The two operative words here are short and volume. So if you want to maximize your weight loss during this phase, you need to adhere to the program guidelines. I slid into the maintenance phase at 7 months.

[dathvick 150]

I still follow the diet guidelines completely, I still can't eat more than 1 egg at a meal or 4 oz of cottage cheese. The only place I really deviated was with the coffee yesterday morning and the occasional cigar (they don't want you to smoke whether you have had the surgery or not). They never said I couldn't have a drink from time to time they just told me I would feel the effects of the alcohol a lot quicker. The reason I was told to stay away from caffeine was because it slows down the healing process and after 4 weeks I thought I was pretty much healed. As far as going to the gym, I just can't sit still I want to get up and be doing things all the time. 2 days after surgery I resumed my 1 to 2 mile daily walks. I have always been very active and to sit around and do nothing for 6 weeks would kill me.

Edited October 8, 2017 by dathvick

[Berry78 4,259]

Your stomach is not healed. The initial scar tissue isn't completely in place until 6-8 weeks postop. Leaks can still happen until 9 weeks postop.

Smoking will slow down the healing process.

Your stomach is still tender, raw, and swollen at 3 and 4 weeks postop.

Please follow your doctor's plan for the first 9 weeks. If you wonder about the veracity of my statements, feel free to ask your team.

Edited to add... I noticed you are a bypass patient. Leaks may not be as much of a concern for you (I was thinking sleeve), but ulcers and strictures ARE a concern, so you don't want to irritate your pouch. Again, please ask your team.

[jess9395 5,448]

Note... you say you are eating pretty much nothing but protein... realize that the dairy products, even if unsweetened, contain naturally occurring carbs in the form of lactose which is milk sugar. And the refried Beans have carbs as well, though it's Fiber. Even eggs contain carbs and fat. Not saying they aren't good things to eat, just making sure you and others who read this are aware.

1/2 C 2% cottage cheese- 14g Protein, 4g milk sugar, 2.5 fat

1/2 c fat free cottage cheese -15g protein 5g carbs (my plan would prefer the fat to carbs)

Greek yogurt--all six oz servings

2% plain - 20g protein, 4g fat, 8g carbs

Fat free pain - 23 protein, 0 fat, 9g carbs

Oikos triple zero 15g protein 14g carbs (almost equal!)

Dannon light and fit 12g protein, 9g carbs

(The sugar added are even more sugar of course)

1/2 Fat free refried beans-

rosarita- 6g protein, 18 carb

Bush's 9 protein, 24 carb

Kroger 7 protein, 20 carb

Egg 6g protein, 4g fat, 1g carb

Why would you trust your surgical team to literally cut you open and then not follow their dietary advice? At least for a couple of months? Better yet, why not six months or a year? Alcohol, cigars, coffee will all be there in a few months. So will the gym. How do you know you can tolerate it?

Usually when we feel guilty it's because we know we are doing something wrong, even though we may say we aren't. When we are truly not doing something wrong we don't feel guilty.

But you asked a question. I followed my doctors rules to the letter for a year till I was at goal. I chose the surgeon I trusted so I trusted them to know way more than I did about weight loss surgery and how to make the best recovery and lose weight most efficiently and permanently. I still follow it most of the time and I'm four years out.

[dathvick 150]

as stated earlier, I am following the diet with the exception of having 2 cups of coffee yesterday. Other than that I have eaten exactly what they have told me I could eat. I have no plans or desire to eat out side their set plan for me.

[Berry78 4,259]

Smoking and drinking this soon could irritate the stomach. That's what might be off plan. I don't worry too much about the coffee (but combined with these other things, it could be "the straw").

Drinking, eventually, isn't usually a problem. Ask your team how soon you can start. The typical answer is 6 months to a year postop.

[jess9395 5,448]

as stated earlier, I am following the diet with the exception of having 2 cups of coffee yesterday. Other than that I have eaten exactly what they have told me I could eat. I have no plans or desire to eat out side their set plan for me.

Sorry, alcohol counts.

[eden30 111]

I would be worried about the smoking, just because of the risk of ulcers especially with a bypass. I’m not sure about the alcohol, I think I read somewhere 3 months.
You sound like you’re doing pretty well with the food though.
I understand it’s hard with these changes and we often fall back into the familiar.
I used to smoke many years ago and I think people do find it relaxing so it’s a hard habit to break. But for you it’s pretty dangerous so I guess forewarned is forearmed.
I don’t expect everyone is an angel but I do think it’s probably important to follow the plan in terms of not slipping back into bad habits. It’s so easy to sabotage yourself.
I wish you the very best of luck. We are all human and don’t always make the right choices. Give it some thought.

[Amburmist 55]

I guess i thought the alcohol was worse than ur making it seem@berry78. Perhaps the info i was given was wrong? Ive been told that with bypass, alcohol is especially bad for us because we no longer have the stomach to metabolize the alcohol so its entirely upon the liver now to do that, which its not designed to do, which is why cirrhosis of the liver is something like 4-5 times more likely for bypass patients who drink. I imagine theres quantity and frequency dependencies that go into that stat, but drinking nonetheless for bypass patients regularly is playing liver roulette. No?

As for coffee, i agree, no big deal. My team is more concerned about caffeine being a diuretic, so thats why they dont want me drinking caffeine until many weeks out.

[Berry78 4,259]

Thank you @Amburmist for bringing this up.

I did a bit of digging, and essentially it boils down to this.

During the first year postop, the entire body is working hard to lose weight. The liver has often been stressed prior to surgery because of fatty liver. It continues being stressed during the weight loss period (and maybe longer if it had significant damage).

Alcohol doesn't appear to be more dangerous to the liver postop than it would be in another person whose liver is in the same condition.

What does happen is the alcohol is metabolized differently... we get drunk sooner and stay that way longer. We may be at risk of drinking excessively due to addiction transfer... and excessive alcohol is a problem for anyone.

Our blood alcohol level goes up more on a given quantity of alcohol than that of a non-patient. More alcohol in the blood means more work for the liver.

So, my recommendation is that we shouldn't drink for 6 months postop AT ALL. From 6 months until maintenance, limit alcohol to maybe once a month, and only 1 serving.

During maintenance, 1 serving 2-3 times a week at most.

And of course, this is assuming the doc has said its ok for the individual.

Tylenol affects the liver and should be carefully controlled as well.

Smoking is strongly associated with ulcers. Smoking and drinking and NSAIDS, combined, are worse for ulcers. I didn't see where alcohol by itself causes ulcers.

Just as our meals need to shrink, the size of our alcohol servings should too.

In the study, participants drank 5oz of wine. The non-bariatric patients had a blood alcohol level of .02. The patients' was .05-.08!

Do NOT drink a 5oz glass of wine or a 12oz can of beer and think you can drive less than 2 hours later.

And when I was recommending servings... you might want to consider a serving to be 1/2 of a normal one. 6oz beer or 2.5oz table wine... especially if you want to indulge more than once a week.

[Amburmist 55]

Thx@berry78. Good info. In my research, i also saw that alcohol can cause hypoglycemia and failure to absorb the critical Vitamins we now need. Of course, this is from lots of drinking, but ppl be aware.

Heres the info i read with that data
http://bariatrictimes.com/alcohol-and-the-gastric-bypass-patient/

[dathvick 150]

Thanks for all the great information. I am sure there are a lot of people reading this who will find it very useful.