I am five weeks post op and finally starting to feel hungry enough to want a small snack in between lunch and dinner. I was wondering if you enforce the no-drinking 30 mins before/after rule with small snacks. I've been holding firm to the rule and totally understand the rationale behind it, but it definitely is making it hard for me to reach my water goals. I have no problem drinking, but having to give up 1.5 hours of drinking time per meal really adds up! It seems like giving up another ~1.5 hours for a snack just isn't worth it.

How do you handle drinking around snacks? TIA!

2 hours ago, ChunkCat said:

those of us with a pyloric valve have stomachs that will close that valve and keep things in until the food reaches the ideal consistency to move on. This is why we shouldn't drink more than a swallow with our meals, because fluids will then take up too much room. For those without a pyloric valve, drinking with or soon after meals will wash the food out of their pouch and into the small intestines quicker because there is no pyloric valve stopping that process.

Thank you for this. One of the reasons I'm rebellious about some of the diet rules is the nutritionist applies all the same rules whether you had a sleeve or bypass. I don't like the doctor on the nutrition team because she has static goals regardless of your personal abilities. I didn't get a "good job, you're getting closer to your goal of 80g protein and 800 cal." I got "It's been 6 months, you need to consume 100g of protein and 1200 cal." This was very disheartening because I told them my stomach would hurt from trying to force myself to eat the 3/4 cup portions she told me to eat and I felt like all I did all day was eat and drink and still wasn't reaching the prior goal. It passed me off and I just mentally told her to go to #&%$ and took it at my own speed. I found more help here than from her.

1 hour ago, GMaJen said:

Thank you for this. One of the reasons I'm rebellious about some of the diet rules is the nutritionist applies all the same rules whether you had a sleeve or bypass. I don't like the doctor on the nutrition team because she has static goals regardless of your personal abilities. I didn't get a "good job, you're getting closer to your goal of 80g Protein and 800 cal." I got "It's been 6 months, you need to consume 100g of protein and 1200 cal." This was very disheartening because I told them my stomach would hurt from trying to force myself to eat the 3/4 cup portions she told me to eat and I felt like all I did all day was eat and drink and still wasn't reaching the prior goal. It passed me off and I just mentally told her to go to #&%$ and took it at my own speed. I found more help here than from her.

You are welcome!! I'm one of those people that really want to know WHY I'm being told to do something. The dietitians at our practice do apply a lot of rules to everyone instead of differentiating between the surgeries, which is annoying, so I'm glad they differentiated in this respect, because type of surgery makes a big difference in a lot of things!! And yes, it is frustrating when they have a mark on a paper you are supposed to reach, but they don't take into account where you were vs where you are and the improvements you've made!

Everyone's restriction is different and this is hard for a non-bariatric patient to understand. Our fullness is not like the fullness pre-op. That fullness post-op can be painful and really exhausting if we ignore it and try to push to finish something! And each person's restriction relaxes at their own rate. Some people have high restriction all the time, others it depends on the protein. 3/4 of a cup is a lot of food for any surgery a year out, but especially could be uncomfortable for a bypass because your tummies are so much smaller than even a sleeve patient. And even for those of us with sleeved stomachs, some keep high restriction permanently...

I'm glad in that respect you went your own way, You are the expert of your own body, no one else can know exactly what you feel. And you are the only one who can advocate for you in that way and if the doctors and nutritionists aren't listening, you just have to research and find your own best practices... You are the one who has to live with them in the end!

On 1/23/2024 at 2:26 PM, ChunkCat said:

My dietician explained that there have been studies that show that pure liquids usually exit the stomach in 5 or so minutes. Everyone's transit time is different though. But he advised we stop drinking a few minutes before we start eating, to allow the fluids to drain out before we start adding solids. Once you add solids, those of us with a pyloric valve have stomachs that will close that valve and keep things in until the food reaches the ideal consistency to move on. This is why we shouldn't drink more than a swallow with our meals, because fluids will then take up too much room. For those without a pyloric valve, drinking with or soon after meals will wash the food out of their pouch and into the small intestines quicker because there is no pyloric valve stopping that process. But regardless of the surgery, the "wait 30 minutes before" rule has been disproven for most people.

I know for a fact that my stomach works this way because I saw it do this with barium contrast during a GI fluoroscopy pre-surgery. It was really cool! So I always drink up until a few minutes before I'm ready for food. Even with snacks!

This makes SO much sense. Thank you for taking the time to explain it!

For me, I am cautious with every food I have been trying. Thankfully, with the exception of chicken, I am not finding myself adhering to that rule, again cautiously. It all depends on how your body is reacting, everyone is different.

On 1/23/2024 at 5:26 PM, ChunkCat said:

I know for a fact that my stomach works this way because I saw it do this with barium contrast during a GI fluoroscopy pre-surgery. It was really cool! So I always drink up until a few minutes before I'm ready for food. Even with snacks!

To rule out the possibility of a post-op leak, I did a swallow test the morning after my surgery (with a thinner liquid, not that chalky stuff). I got to watch on the monitor as the liquid went down my throat, into my pouch, and through to my intestine in the amount of time it took for me to carry on some chit chat with the imaging tech. It was less than a minute before the liquid was nearly all gone from the pouch and traveling through my intestines. Having watched it with my own eyes, I feel the evidence is pretty strong that waiting a full 30 minutes to "empty" your pouch of water is nonsense.

22 hours ago, NickelChip said:

To rule out the possibility of a post-op leak, I did a swallow test the morning after my surgery (with a thinner liquid, not that chalky stuff). I got to watch on the monitor as the liquid went down my throat, into my pouch, and through to my intestine in the amount of time it took for me to carry on some chit chat with the imaging tech. It was less than a minute before the liquid was nearly all gone from the pouch and traveling through my intestines. Having watched it with my own eyes, I feel the evidence is pretty strong that waiting a full 30 minutes to "empty" your pouch of Water is nonsense.

They should do this for all bariatric patients! It brings it home seeing it yourself!

On 3/1/2024 at 2:41 PM, NickelChip said:

To rule out the possibility of a post-op leak, I did a swallow test the morning after my surgery (with a thinner liquid, not that chalky stuff). I got to watch on the monitor as the liquid went down my throat, into my pouch, and through to my intestine in the amount of time it took for me to carry on some chit chat with the imaging tech. It was less than a minute before the liquid was nearly all gone from the pouch and traveling through my intestines. Having watched it with my own eyes, I feel the evidence is pretty strong that waiting a full 30 minutes to "empty" your pouch of Water is nonsense.

I'm so glad you got to see this even though it is annoying to wait for a leak test post op! It really is amazing how quickly the stomach can empty of fluids. I expect for those with the bypass it is even faster because of the lack of a pyloric valve to slow things down. It is such an outdated "rule" that so many people (and doctors and dieticians) push without realizing the science doesn't really back it up. It is one of the downsides to there not being a standard set of rules from a governing body of bariatrics that actually has to use science to back up what they advise!

I don't follow the liquid rules. They don't make sense, biologically, and, as you've noticed, they make getting enough fluids in almost impossible. I don't drink much while eating because it's uncomfortable and usually I wait 5 to 10 minutes after eating, again for comfort.

When I was closer to surgery, I generally waited longer after "eating" out of an abundance of caution to limit discomfort or dumping.

On 1/18/2024 at 12:30 PM, BlondePatriotInCDA said:

Needless to say they found me funny. I wasn't going for "funny!" Said they'd never had a patient break it down before. I told them I'm a Histologist who manages a laboratory measuring in microns/millimeters/centimeters etc. everyday what did they expect?..

Perhaps they should have done the math before asking patients to do something! I asked who has time for that!? That's when they said to work up to it, its not expected for awhile, to just try..its a goal to shoot for. Eventually you'll be able too. So no worries, just do the best you can!

 ?

I've broken down all of my team's advice this way. (Also a biologist.) Most of it doesn't add up. They don't care for me. The feeling is mutual.

I suppose they can blame my lack of compliance for the utter failure of my surgery. ?

12 hours ago, Nepenthe44 said:

I don't follow the liquid rules. They don't make sense, biologically, and, as you've noticed, they make getting enough fluids in almost impossible. I don't drink much while eating because it's uncomfortable and usually I wait 5 to 10 minutes after eating, again for comfort.

When I was closer to surgery, I generally waited longer after "eating" out of an abundance of caution to limit discomfort or dumping.

I've broken down all of my team's advice this way. (Also a biologist.) Most of it doesn't add up. They don't care for me. The feeling is mutual.

I suppose they can blame my lack of compliance for the utter failure of my surgery. ?

It's nice to see I'm not the only one Nepenthe44 to break down the science for them and yes that when you do they view it as noncompliance and being difficult. I've even had it suggested that if there's not enough time in my day - wake up and drink a few sips during the night. Science states we as humans require uninterrupted sleep more than those few sips of water.

So Nepenthe44 I hate to agree because there will be those that say they really do care, but I do, what people fail to remember is the dieticians are doing a job, one most likely they've never personally experienced for themselves; being a bariatric patient vs. nutritional counseling for bariatric patients having never experienced bariatric struggles. I finally suggested the next time she had the stomach flu and was nauseated and exhausted - wanting to vomit picking up a glass and start drinking water and to make sure to get her 80 grams +- of protein in and getting down 60+ ounces of water, she finally "understood." What is a requirement on paper doesn't always equate to what actually works for people much less a bariatric patient. Its all theory. A body is set up that when you need water lo and behold you feel thirsty!

I realize the nutritional requirements for the human body per weight/sex are all fairly similar but the comparisons/suggestions for likes/wants vs needs on food replacements isn't even close E.g. heart of palm noodles vs Thai noodles - in NO way are they taste comparable. So to suggest when I say I miss Thai noodles - heart of palm noodles as a replacement is absurd. That's like suggesting when I say I want a hamburger to replace it with a 3oz of fish - not equal! I didn't say "I miss protein"! They don't understand the struggle and since its their job, not a family member or a true friend they really don't "care."

Lastly, I realize they are trying to help and its their job to help me achieve my goals in a healthy way (for those who are thinking this as they read this), but in reality they don't really have a personal investment in my success. I do as they suggest, for the most part, but I also decide what goals are obtainable realistically and which aren't based on consumption quantity vs. time in my day vs. work schedule vs. my employers needs.