help from synergy people!
x-post...
need help from synergy post-ops!
i think i was stupid and assumed we should be following the diet packette so i ate 4oz of yogurt and then had a 4oz shake for my next meal yesterday --- WELL... he wrote, 60oz of liquids with 2-3oz mini meals (full liquids) every 3-4 hours on my discharge papers...
i think those two bigger meals did me in because i couldnt eat the rest of the night!!!
my stomach was so hard... i wanted to take gas-x strips but i didnt know if i was allowed to yet... i thought maybe getting rid of the bloating would help but... im still a little tight and sore from that yesterday --- today i had a 3oz shake so far... and water... im good with the water... i just try to finish a 16.9 oz bottle of water every 3 hours or so... so usually by the time im getting sick of the 4th bottle i can stop because im close to 60oz!
so some questions...
how soon can we take gas-x?
do you have normal BM after surgery?
did i hurt myself with those 2 4oz meals yesterday?
and lastly... am i supposed to be getting 60-80grams of protein through these 2-3oz mini meals? (doesnt seem possible) i am only eating food with 5+ protein in it now anyways... but...?
also... if we chose to take flinstones chewables... do we take 4 a day or 1 a day?
i HATE the bariatric fusion!!!
need help from synergy post-ops!
i think i was stupid and assumed we should be following the diet packette so i ate 4oz of yogurt and then had a 4oz shake for my next meal yesterday --- WELL... he wrote, 60oz of liquids with 2-3oz mini meals (full liquids) every 3-4 hours on my discharge papers...
i think those two bigger meals did me in because i couldnt eat the rest of the night!!!
my stomach was so hard... i wanted to take gas-x strips but i didnt know if i was allowed to yet... i thought maybe getting rid of the bloating would help but... im still a little tight and sore from that yesterday --- today i had a 3oz shake so far... and water... im good with the water... i just try to finish a 16.9 oz bottle of water every 3 hours or so... so usually by the time im getting sick of the 4th bottle i can stop because im close to 60oz!
so some questions...
how soon can we take gas-x?
do you have normal BM after surgery?
did i hurt myself with those 2 4oz meals yesterday?
and lastly... am i supposed to be getting 60-80grams of protein through these 2-3oz mini meals? (doesnt seem possible) i am only eating food with 5+ protein in it now anyways... but...?
also... if we chose to take flinstones chewables... do we take 4 a day or 1 a day?
i HATE the bariatric fusion!!!
Soiunds like some good questions to pose to your program nutriton dept and possibly surgeon.
Each program is individual, I am not a SYNERGY program person. What I do know is this. I was on liquids x 15 days, no food, then my program started out with 2T as a meal waiting at least 30 min before drinking again.
I do not know what a shake is for you can you tell me more?
Protein to shoot for 60+ grams day is not usually possible with food off the bat, if you are drinking protein shakes that may be the only way to get it in!
GasX is probably safe but a ?? most certainly for YOUR medical provider team! I am not sure it will realy help as the underlying cause is probably just the RNY and your body getting used to things. IF you are eating or drinking high carb meals or even milk that could be the issue. Many become lactose intolerant postop sometimes temproarily others lifelong..
http://www.thinnertimes.com/weight-loss-surgery/gastric-bypass/gastric-bypass-complications/lactose-intolerance.html
Lactose Intolerance and Gastric Bypass
Lactose-Controlled Diet
Purpose The lactose-controlled diet is designed to prevent or reduce gastrointestinal symptoms of bloating, flatulence, cramping, nausea, and diarrhea associated with consumption of the disaccharide lactose.
Use The lactose-controlled diet is indicated for individuals with lactose intolerance or lactase deficiency (also called lactase nonpersistence). Individuals with primary lactase deficiency tolerate various levels of lactose while those having rare congenital lactase deficiency require strict avoidance of lactose-containing foods. Secondary lactose intolerance or lactase deficiency is usually transient and develops secondary to illness or disease and often requires limitation or avoidance of lactose. Modifications
The diet is a general one that restricts or eliminates lactose-containing foods. Lactose is primarily found in dairy products but may be present as an ingredient or component of various food products. (See Table 1 for lactose content of common foods and beverages.) go to above LINK! Depending on individual tolerance, limiting products with lactose may help to alleviate symptoms.
Labels should be read carefully to identify sources of lactose. Dairy products that include milk, milk solids, whey, lactose, curds, skim milk powder, skim milk solids, sweet or sour cream, buttermilk, or malted milk are sources of lactose. Other possible sources of lactose are breads, candy, cookies, cold cuts, hot dogs, bologna, commercial sauces and gravies, dessert mixes, cream soups, some ready-to-eat cereals, frostings, chocolate drink mixes, salad dressings, sugar substitutes, and medications.
Dairy products can be consumed depending on individual tolerance. Most persons with lactase nonpersistence can consume milk without the development of symptoms, particularly if small portions of milk (4 fl oz to 6 fl oz) or lactose-containing foods are eaten at separate times during the day. The ingestion of solid food with lactose-containing beverages modifies lactose malabsorption.2 Food solids delay gastric emptying and/or provide endogenous lactase additional time to digest lactose.2.3 Cocoa and chocolate milk have a suppressive effect on human lactose intolerance as evidenced by significantly lowered mean breath hydrogen, bloating, and cramping.
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gas/odor is related to the malabsorbtion and we can not do much but eat more protein and less carbs. Sugar isn't digested completely and ferments actually causing this! It is an unpleasant side effect of surgery unfortunately. It happens to me and I can't stand to be in the room with myself at times! I've heard this before on many groups:
Eat sugar get gas
Eat sugar free get worse gas
Drink sweet - get stinky gas
Eat carbs - get gas
Eat chips - get gas
Drink Wine- get stinky gas
Go on a high protein diet and have NO GAS AT ALL!
As for bowel habits if liquid in many have liquid out, others get constipated off the bat due to low volume of food and no fiber!
Flinstones makes many varieties some are equal (a whole tab) to a multivit adalut the complete may be, have to compare labels is all I can recommend! I used them or less than a month *YUCK* then went to a regular adult centrum vitamin! Best to ask!
~~~~~~~~~~~~~~~~~~~~~~~~~~
At this stage fluids are most important!
Focus on Fluids
One of the main challenges for a gastric bypass patient over time is to maintain hydration. Your body needs just as much fluid after the surgery as it did before surgery, yet the new stomach pouch limits you to 1-2 ounces at a time. (NO MORE GUZZLING!) Maintenance of fluid intake may also be difficult because of the necessity to take in food or fluids, and not both at once. You must compensate for this by taking small amounts of fluid on a near-constant basis. Usually this means that you should carry your fluid source with you at all times.
*** We cannot overemphasize that the liquid must be a caffeine, carbonation & calorie-free. Patients who use fruit juice or other calorie-containing liquids for hydration may experience inadequate weight loss because of the calories in these fluids, and can experience dumping syndrome from the sugar. Caffeine is a possible appetite-stimulant, diuretic and irritant and can potentially cause ulcers in the new pouch and add to dehydration and low-iron blood (which we already poorly absorb iron post-op). Carbonation can possibly cause gastric irritation, if carbonated beverage also contains phosphorus it may act to leach calcium out of bones, and some feel it may stretch pouch/stoma.
Drinking at least 64 ounces of fluids post-op is a necessity. Water is the body's best source, and serves the purpose to aid digestion and absorption of food; it regulates temperature and circulation, carries nutrients and O2 to the cells of the body and removes toxins and waste.
Dehydration can cause/aggravate constipation, kidney stones, urinary infections, high or low blood pressure, difficulty controlling diabetes and migraines. Dizziness, clumsiness, muscle cramps in arms and legs, dark yellow urine, fatigue, irritability, are sunken eyes, low blood pressure and fainting, bloating, and a fast, weak pulse -- are signs that dehydration is setting in.
Fluids should be consumed on a near-constant basis, but not during meals and not soon following food. If you drink during your meal, you will tend to wash the food out of the stomach pouch, and consume more food than is desirable. It may seem strange at first to eat without drinking but it works fine. A good tip here is to actually not have any fluid on the table while you are eating. In addition to reducing your overall food intake, this new habit will encourage you to chew more thoroughly before swallowing, because you will not count on the fluid to wash down half-chewed food. Also note that soup is kind of like drinking liquids with food - soup is not an absolute "no-no" but recognize that it should not be a regular part of your diet.
Liquids should not be consumed for about 30-60 minutes after eating. This is because the food actually forms a plug that blocks the outlet from the pouch until it has all passed through. If you drink liquids on top of this plug it will create a very uncomfortable sensation and may also force food downstream more quickly than it should go.
A brief review on coordinating liquids and food:
1. Sip liquids constantly, even just before eating. Don't drink liquids while eating.
2. Don't drink liquids until about one hour after completing your meal.
3. When the stomach pouch is mature (six months or more after surgery) it is useful to wait two or three hours after eating before consuming liquid.
If you must choose between liquids and food (frequently true in the first months after gastric bypass) - choose liquids!
Be well keep posting!
more ? ask me off line
[email protected]
Each program is individual, I am not a SYNERGY program person. What I do know is this. I was on liquids x 15 days, no food, then my program started out with 2T as a meal waiting at least 30 min before drinking again.
I do not know what a shake is for you can you tell me more?
Protein to shoot for 60+ grams day is not usually possible with food off the bat, if you are drinking protein shakes that may be the only way to get it in!
GasX is probably safe but a ?? most certainly for YOUR medical provider team! I am not sure it will realy help as the underlying cause is probably just the RNY and your body getting used to things. IF you are eating or drinking high carb meals or even milk that could be the issue. Many become lactose intolerant postop sometimes temproarily others lifelong..
http://www.thinnertimes.com/weight-loss-surgery/gastric-bypass/gastric-bypass-complications/lactose-intolerance.html
Lactose Intolerance and Gastric Bypass
Lactose-Controlled Diet
Purpose The lactose-controlled diet is designed to prevent or reduce gastrointestinal symptoms of bloating, flatulence, cramping, nausea, and diarrhea associated with consumption of the disaccharide lactose.
Use The lactose-controlled diet is indicated for individuals with lactose intolerance or lactase deficiency (also called lactase nonpersistence). Individuals with primary lactase deficiency tolerate various levels of lactose while those having rare congenital lactase deficiency require strict avoidance of lactose-containing foods. Secondary lactose intolerance or lactase deficiency is usually transient and develops secondary to illness or disease and often requires limitation or avoidance of lactose. Modifications
The diet is a general one that restricts or eliminates lactose-containing foods. Lactose is primarily found in dairy products but may be present as an ingredient or component of various food products. (See Table 1 for lactose content of common foods and beverages.) go to above LINK! Depending on individual tolerance, limiting products with lactose may help to alleviate symptoms.
Labels should be read carefully to identify sources of lactose. Dairy products that include milk, milk solids, whey, lactose, curds, skim milk powder, skim milk solids, sweet or sour cream, buttermilk, or malted milk are sources of lactose. Other possible sources of lactose are breads, candy, cookies, cold cuts, hot dogs, bologna, commercial sauces and gravies, dessert mixes, cream soups, some ready-to-eat cereals, frostings, chocolate drink mixes, salad dressings, sugar substitutes, and medications.
Dairy products can be consumed depending on individual tolerance. Most persons with lactase nonpersistence can consume milk without the development of symptoms, particularly if small portions of milk (4 fl oz to 6 fl oz) or lactose-containing foods are eaten at separate times during the day. The ingestion of solid food with lactose-containing beverages modifies lactose malabsorption.2 Food solids delay gastric emptying and/or provide endogenous lactase additional time to digest lactose.2.3 Cocoa and chocolate milk have a suppressive effect on human lactose intolerance as evidenced by significantly lowered mean breath hydrogen, bloating, and cramping.
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gas/odor is related to the malabsorbtion and we can not do much but eat more protein and less carbs. Sugar isn't digested completely and ferments actually causing this! It is an unpleasant side effect of surgery unfortunately. It happens to me and I can't stand to be in the room with myself at times! I've heard this before on many groups:
Eat sugar get gas
Eat sugar free get worse gas
Drink sweet - get stinky gas
Eat carbs - get gas
Eat chips - get gas
Drink Wine- get stinky gas
Go on a high protein diet and have NO GAS AT ALL!
As for bowel habits if liquid in many have liquid out, others get constipated off the bat due to low volume of food and no fiber!
Flinstones makes many varieties some are equal (a whole tab) to a multivit adalut the complete may be, have to compare labels is all I can recommend! I used them or less than a month *YUCK* then went to a regular adult centrum vitamin! Best to ask!
~~~~~~~~~~~~~~~~~~~~~~~~~~
At this stage fluids are most important!
Focus on Fluids
One of the main challenges for a gastric bypass patient over time is to maintain hydration. Your body needs just as much fluid after the surgery as it did before surgery, yet the new stomach pouch limits you to 1-2 ounces at a time. (NO MORE GUZZLING!) Maintenance of fluid intake may also be difficult because of the necessity to take in food or fluids, and not both at once. You must compensate for this by taking small amounts of fluid on a near-constant basis. Usually this means that you should carry your fluid source with you at all times.
*** We cannot overemphasize that the liquid must be a caffeine, carbonation & calorie-free. Patients who use fruit juice or other calorie-containing liquids for hydration may experience inadequate weight loss because of the calories in these fluids, and can experience dumping syndrome from the sugar. Caffeine is a possible appetite-stimulant, diuretic and irritant and can potentially cause ulcers in the new pouch and add to dehydration and low-iron blood (which we already poorly absorb iron post-op). Carbonation can possibly cause gastric irritation, if carbonated beverage also contains phosphorus it may act to leach calcium out of bones, and some feel it may stretch pouch/stoma.
Drinking at least 64 ounces of fluids post-op is a necessity. Water is the body's best source, and serves the purpose to aid digestion and absorption of food; it regulates temperature and circulation, carries nutrients and O2 to the cells of the body and removes toxins and waste.
Dehydration can cause/aggravate constipation, kidney stones, urinary infections, high or low blood pressure, difficulty controlling diabetes and migraines. Dizziness, clumsiness, muscle cramps in arms and legs, dark yellow urine, fatigue, irritability, are sunken eyes, low blood pressure and fainting, bloating, and a fast, weak pulse -- are signs that dehydration is setting in.
Fluids should be consumed on a near-constant basis, but not during meals and not soon following food. If you drink during your meal, you will tend to wash the food out of the stomach pouch, and consume more food than is desirable. It may seem strange at first to eat without drinking but it works fine. A good tip here is to actually not have any fluid on the table while you are eating. In addition to reducing your overall food intake, this new habit will encourage you to chew more thoroughly before swallowing, because you will not count on the fluid to wash down half-chewed food. Also note that soup is kind of like drinking liquids with food - soup is not an absolute "no-no" but recognize that it should not be a regular part of your diet.
Liquids should not be consumed for about 30-60 minutes after eating. This is because the food actually forms a plug that blocks the outlet from the pouch until it has all passed through. If you drink liquids on top of this plug it will create a very uncomfortable sensation and may also force food downstream more quickly than it should go.
A brief review on coordinating liquids and food:
1. Sip liquids constantly, even just before eating. Don't drink liquids while eating.
2. Don't drink liquids until about one hour after completing your meal.
3. When the stomach pouch is mature (six months or more after surgery) it is useful to wait two or three hours after eating before consuming liquid.
If you must choose between liquids and food (frequently true in the first months after gastric bypass) - choose liquids!
Be well keep posting!
more ? ask me off line
[email protected]
Take Care, 
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
I'm a Synergy patient, but I had open RNY with Dr. Caruana. This early out you should probably be trying to eat about 2 oz at a time. Do the best you can for the first couple of weeks and don't worry about the protein until you are more healed. I didn't get near the 60 oz. of water at that point and I did much better with warm decaf tea.
Also, I hated the Bariatric Fusion and went back to the Optisource Bariatric that I can get from Walgreens. They are the kind that Synergy used to have in March. The difference is that the Calcium is Carbonate and not Citrate, so at lunch time I suppliment with Calcium Citrate.
It does get easier and easier, be patient and it will happen.
Good luck,
Jeannine
Also, I hated the Bariatric Fusion and went back to the Optisource Bariatric that I can get from Walgreens. They are the kind that Synergy used to have in March. The difference is that the Calcium is Carbonate and not Citrate, so at lunch time I suppliment with Calcium Citrate.
It does get easier and easier, be patient and it will happen.
Good luck,
Jeannine
Hey Jeannine!
Thanks! I kinda already gave up the protein fight, because i get full around 2 1/2 ozs!
I am surprisingly doing well with water... i keep a bottle by my bed too so i get up and sip all night (still in hospital sleep mode!!! every bump in the night i hear i think theyre coming to check my vitals or draw blood!!!)
I was going to go to walgreens today to try optisource... should i also get a calcium citrate?
i secretly wish i could continue with my flintstones vitamins :(
I know i shouldnt be thinking about this... but my family is big on going out to eat to meet with eachother...
i was desperately trying to find a book or resource that had suggestions of meals for gastric bypass patients... but i have had no luck!
i wont be going out any time soon, but i would like to be able to prepare myself ahead of time!
also... what stage is the wendys chili considered? everyone at the post-op meeting said it was great, easy to eat and lots of protein...
thanks again for all your help!
bella
Bella,
OMG - I love that name.
I have had no trouble going out to eat at all. I wouldn't advise it in the first month, but we go out all the time. Almost all restaurants have their menu online. I always try to go online first and have some kind of strategy before I go there. Also, I dump on high fat and sugar - so avoid anything with a sauce that WILL have these elements. They add sugar to the darndest things in restaurants. (Including alfredo and cheese sauces) I usually order shrimp or seafood and just eat a small amount and take the rest home for the next meal.
I never did well with chili at all. Still can't do chicken very well. You should be able to do Wendy's Chili at about stage 4, but I'm at work and don't have my sheets to look at to double check. I love Fage Greek yogurt which I can get at Tops in the organic section or Oikos brand from Walmart. You seem to be doing much better with water than I was at that stage. I was drinking alot of Unjury Chicken Soup flavor for protein and water. It was really nice for the first month.
If you like the Flintstones then you will like the optisource also. In about a month I would start supplimenting with Calcium Citrate chewables. I ordered mine online from Amazon.com. Mine are vanilla flavored chewables and aren't wonderful, but they aren't aweful either.
Click on my avatar and add me as a friend if you want and we can keep in touch. Perhaps I will run into you some day at Synergy.
Also, feel free to ask me anything you want. I spend most of my OH time on the RNY board but I'm happy to help. I'm 7 months out and remember how difficult it was early out.
Have a great day.
Jeannine
OMG - I love that name.
I have had no trouble going out to eat at all. I wouldn't advise it in the first month, but we go out all the time. Almost all restaurants have their menu online. I always try to go online first and have some kind of strategy before I go there. Also, I dump on high fat and sugar - so avoid anything with a sauce that WILL have these elements. They add sugar to the darndest things in restaurants. (Including alfredo and cheese sauces) I usually order shrimp or seafood and just eat a small amount and take the rest home for the next meal.
I never did well with chili at all. Still can't do chicken very well. You should be able to do Wendy's Chili at about stage 4, but I'm at work and don't have my sheets to look at to double check. I love Fage Greek yogurt which I can get at Tops in the organic section or Oikos brand from Walmart. You seem to be doing much better with water than I was at that stage. I was drinking alot of Unjury Chicken Soup flavor for protein and water. It was really nice for the first month.
If you like the Flintstones then you will like the optisource also. In about a month I would start supplimenting with Calcium Citrate chewables. I ordered mine online from Amazon.com. Mine are vanilla flavored chewables and aren't wonderful, but they aren't aweful either.
Click on my avatar and add me as a friend if you want and we can keep in touch. Perhaps I will run into you some day at Synergy.
Also, feel free to ask me anything you want. I spend most of my OH time on the RNY board but I'm happy to help. I'm 7 months out and remember how difficult it was early out.
Have a great day.
Jeannine
Hi Bella,
Hope you are recovering well! Can you believe its been a week already? I didn't see you at the hospital at all probably b/c I had so much Morphine in me I could hardly stay awake!
When we are all healed we should have a
Synergy get together with all of us folks that are around the same point!
Hope you are recovering well! Can you believe its been a week already? I didn't see you at the hospital at all probably b/c I had so much Morphine in me I could hardly stay awake!
When we are all healed we should have a
Synergy get together with all of us folks that are around the same point!
Height-5'6 .5 primed/ 1st fill: 11/18-2cc /2nd fill 12/16-2cc=4.5cc total in 10cc band/3rd fill 1/12 1.5 cc=6cc / 4th fill 2/9= 7.25 /5th=7.5/ current: 8cc in 10 cc ap band
Pre-op wt/ wt 1 wk b/f surg/ wt at surgery/ current wt /goal wt
224 217 213 175 155
Sounds like you all are doing good-
My surgery is wed- so less than 24 hours away-
I am the type of person who always enjoyed going out to dinner to meet my family and friends-
How long would you say before that happens?
I have to be on liquied for at leat 7-10 days
then I get to puree foods- and so on-
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