Hi there, I joined this forum in May and have been silently reading and researching all of my questions for months. Now I am close to the end of my pre-op journey, expecting to get my last clearance from dietician on September 1st, and looking back I am amazed at how much is wrong with me ha. I thought I was somewhat healthy before I started this medical journey and now I have diabetes, Barrett's Esophagus from silent reflux and I was critically low on Vitamin D. I felt like every test I took they came back at me with a diagnosis haha.

Don't get me wrong, I believe everything happens for a reason and had any number of my decisions in the past been different and I had not chosen to go this route I NEVER would have known about the Barrett's because I didn't know I had GERD, so I am so incredibly grateful to know early while I can do something about it.

Like many of you, I began this journey hell bent on the sleeve and that all changed for me. But most importantly, my father died of diabetic complications when he was only 58 and that diagnosis single handedly scared me straight. There is just no food on this planet worth your life. I have gone through many emotional ebbs and flows during all of this and at points talking myself out of being vain and then I reminded myself that this is NOT about beauty, bonus yes of course, but I want to be healthy and I refuse to have diabetes. Then the diagnosis of Barrett's came and I spent a couple of days rehearing the words of the Doc "This surgery just went from elective to medically necessary" and for some reason I struggled with that. I don't know why, maybe because the decision was out of my hands? I am not sure, but I can tell you that now that I am close to getting a surgery date and am expecting it to all happen in October, I'm getting nervous.

I read threads about not being able to keep anything down or vomiting because they drank too fast or ate too much and I wonder if I have done enough to prepare. I will be honest, sipping and practicing sipping right now, PRE OP, is almost impossible for me. Chewing 20 times for every bite PRE OP is not happening for me. Have I sabotage myself before even starting? I just assumed, perhaps wrongfully, that common sense would kick in post op. My relationship with food has been severed. For this I am thankful. Like I said, the diabetes diagnosis hit home for me and I have been competing against my blood glucose monitor for 2.5 months and lowered my A1c from 9.1 to 5.9. So in that respect I am ready, however, I question the following things and can't find the answers. If you can help me, THANK YOU SO MUCH.

1. How in the world am I suppose to take my medication? Multivitamin, MetFormin, Prilosec etc. Crush them and drink them YUCK, that scares me

2. I am nervous about getting in 64 oz of water daily. I drink twice that now, but after surgery, taking sips, that seems like a full time job. How is everyone else doing this?

3. The liquid phase scares me more than the others as far as variety, any suggestions would be helpful, however, I just read a thread about someone eating the wrong things in the pureed stage and having to start over. Are bland foods best until solid foods are acceptable to avoid upset?

You guys are awesome, Thank you for taking the time to read my post

Welcome, Chelle.

I will first say that I did feel pretty good before surgery, although my labwork suggested otherwise. I had been obese for so long that I guess I didn't know better. Once I lost all the weight, I realized how "good" really feels!

In answer to your questions:

Taking meds: I did have to crush them for a couple of months and it is disgusting. Unfortunately, that's part of the process. I found that the quickest and easiest way was to simply put the powder on my tongue and wash it down with water. (I tried them in liquid, in yogurt, etc.--even worse.). After trying various multivitamins, I found that "soft chews" worked best for me. Even the so-called "chewables" in hard form made me gag.

Water: It is indeed very difficult to get the full amount of water at the beginning, but it gets better over time. Bear in mind that protein shakes can count as part of the liquid requirement. Just do the best you can. I had a bottle of water with me all day long and took sips as often as I could.

Liquid and puree stages: Yep, they are boring. I found, however, that I had no appetite whatsoever and had to force myself to get enough protein every day, so I didn't really care what things tasted like. If you mean "bland" as in not spicy, that is probably best in the beginning. I ate lots of non-fat Greek yogurt at the beginning, and I got really sick of protein shakes. Again, it's all part of the process and you will get through it. I've never heard of anyone having to "start over" after eating the wrong things during the puree stage. Some people talk about a "pouch re-set" when they stop losing weight, but that's more psychological than an actual physical issue.

Good luck! I promise that you will look back in six months and wonder why you hadn't done this sooner!

You definitely didn’t ruin anything by not practicing chewing or sipping. You’ll figure that out as you go along.
I went from research to surgery in three weeks and only practiced the sipping for about an hour until my wife got annoyed with my phone going off every five minutes :) I’ve made one mistake (eating too fast) just once and I can’t imagine I’d ever do it again. Ironically I was in the hospital with my wife who was getting her own sleeve four weeks after I got mine done and I had some veggie soup and went to town on it not even thinking. I didn’t throw up (I haven’t at all since surgery) but it hurt really bad.
As far as pills each doctor has their own rules. Mine literally gave me a giant (over an inch long) rock hard purple antibiotic in the hospital the day after surgery and had no requirements to chew or crush anything (be careful with this, certain prescriptions cannot be chewed or crushed). It didn’t bother me in the slightest, nor did any of my other meds. The only suggestion was to not take them all at once.
Sipping water is difficult for me, I’ve always been a chugger when it comes to water. I’ve adapted (I’m only 73 days post op) just fine though.
The liquid phase sucks, not going to lie. A variety of broths and protein shakes, anything else that’s allowed on your diet, variety variety variety. I tried a bunch of “cream of...” soups and loved the poblano pepper type made by and sold in a local grocery chain here.. but you’ll be on soft foods before you know it and all of a sudden a whole new world of cottage cheese and eggs and other mushy stuff opens up and the liquid phase will be quickly forgotten. Best of luck on your journey, for me it has been life changing already and I’m just getting started.

I could swallow any pill the size of a pencil eraser or smaller as soon as I left the hospital. There were two pills that were larger than that, but I could swallow them by week 3. You can also get chewable or liquid versions of some meds and vitamins, if that's easier to tolerate - but I was fine.

yes drinking does seem like a full-time job the first few weeks. But you get used to walking around with your water bottle all the time. I could drink faster than I thought i'd be able to, though. But it was a few weeks before I could chug again.

Thank you all for the responses! Great info! So glad to hear I haven’t done something I shouldn't have.

I have my water bottle with me all the time now so that won’t be a problem. 24 oz bottle I fill 5/6 times a day. And I feel foolish for admitting this, but I didn’t realize the sipping was temporary so that makes me happy :)

On 08/25/2020 at 15:59, Recidivist said:

Welcome, Chelle.

I will first say that I did feel pretty good before surgery, although my labwork suggested otherwise. I had been obese for so long that I guess I didn't know better. Once I lost all the weight, I realized how "good" really feels!

In answer to your questions:

Taking meds: I did have to crush them for a couple of months and it is disgusting. Unfortunately, that's part of the process. I found that the quickest and easiest way was to simply put the powder on my tongue and wash it down with Water. (I tried them in liquid, in yogurt, etc.--even worse.). After trying various Multivitamins, I found that "soft chews" worked best for me. Even the so-called "chewables" in hard form made me gag.

Water: It is indeed very difficult to get the full amount of water at the beginning, but it gets better over time. Bear in mind that Protein Shakes can count as part of the liquid requirement. Just do the best you can. I had a bottle of water with me all day long and took sips as often as I could.

Liquid and puree stages: Yep, they are boring. I found, however, that I had no appetite whatsoever and had to force myself to get enough Protein every day, so I didn't really care what things tasted like. If you mean "bland" as in not spicy, that is probably best in the beginning. I ate lots of non-fat Greek yogurt at the beginning, and I got really sick of protein shakes. Again, it's all part of the process and you will get through it. I've never heard of anyone having to "start over" after eating the wrong things during the puree stage. Some people talk about a "pouch re-set" when they stop losing weight, but that's more psychological than an actual physical issue.

Good luck! I promise that you will look back in six months and wonder why you hadn't done this sooner!

Thank you for the tip on the vitamins! I’m going to look into that for sure!

5 minutes ago, Chelle1007 said:

Thank you for the tip on the vitamins! I’m going to look into that for sure!

Here are the ones I use, from the Bariatric Pal store itself:

https://store.bariatricpal.com/collections/soft-chew-bariatric-vitamins/products/bariatric-advantage-multivitamin-chewy-bites-flavors

I like the strawberry/watermelon flavor.

Talk to your primary care provider about your metformin prior your surgery. They may need to change your dose or formulation. Mine had me stop when I started my pre-op diet. I am 90% sure I will not have to restart it, but will be having labs in the next couple weeks to check A1c. ??

Though I struggled to swallow medication the first couple of days after surgery, I was ok after that. I just spread out when I took them across the day (breakfast, lunch, dinner) so I wasn’t swallowing too many at once. (Because meds are absorbed at different sections of the digestive tract, check with your doctor to ensure yours will be absorbed correctly after surgery.)

Like Recidivist, I didn’t enjoy protein shakes & had no appetite either. I’d dilute the shake & soup I’d ‘eat’ each day & literally would take hours to drink them. Some people keep a 5min timer on their phone to remind them to sip. I was a big water drinker before surgery, but still struggle 15.5 months out to meet my water goals. (I supplement with high water content fruit & vege - melons, lettuce, etc.)

I’ve never been able to eat spicy food (sensitivity) So not an issue for me but I’d go the bland diet route to begin especially while you’re healing internally. Plus you’ll discover your taste buds will have changed & things you used to love will become disgusting to eat. (Don’t worry you’ll come to love them again.)

I haven’t heard about the chewing 20 times before swallowing advice, but eating slowly is very important. Put your cutlery down between each bite. I still ask myself if I really need the next bite or am I eating out of habit.

But this was me. You may be totally different.

Best advice I received was to take everything slowly. From how much you can eat or drink, what you can eat or drink, how much exercise you can do, when you can progress through the stages, etc. It’s a lot of trial & error to find what works for you & your tool. Some things will work one day but not the next. Your tummy will soon tell you want it likes or doesn’t & what’s too much.

You’ll do fine. There are so many wonderful benefits to this process. Enjoy each & every one. ?

The liquid phase scares me more than the others as far as variety, any suggestions would be helpful, however, I just read a thread about someone eating the wrong things in the pureed stage and having to start over. Are bland foods best until solid foods are acceptable to avoid upset?

Transitions between food phases can be tricky; a food might be listed as acceptable in your surgeon's list, but your new stomach just says "No" so there is an element of trial and error. If your stomach gets irritated by something you ate the previous day, often it's best to step back to the previous food phase until things quiet down. It's not necessarily bland food that you need to eat, and there is no guarantee that solid food won't upset your stomach. I haven't eaten a scrambled egg in nine years because my sleeve did NOT like them, but I ate steak all the time. You'll learn what and how much you can tolerate over time, but it's an experiment every time you try a new food.