Post-op vomiting

I am three weeks post-op taday (have lost 26 lbs)  The last week I have started to vomit. I vomit once every couple of days, twice was with fish. Is this something I should be concerned about, or just part of the post-op course.  Als haven't been able to drink protein drinks, make me nasause! Any thoughts of suggestions?

Deb,
Sometimes when you are newly post-op things tend to get "stuck" on the way down. The the vomiting starts. Try the fish in a few weeks, it may go better. If you are at all concerned, call your surgeon. I had a number of strictures and I threw up everything!! Every time I ate, I got nauseaus and threw up. If that starts to happen, I would suggest calling the doctor right away. I waited over a week and was so weak I could barely move. It's an easy fix with an endoscopy so don't wait.

Try some different protein supplements to get in the protein. If the shakes make you nauseaus, you can find hot chocolate, cappucino, and even soups. I added "unflavored" Unjury to alot of things to get in enough. It has a slight taste, but not bad.

Good luck. I hope things start to get better quickly.
Hugs,
Lisa

Lisa,
Thanks for the advise, needed some re-assurance. I will try the unjury.
Deb

I am 4 days post op. Having trouble getting in the fluid. Milk is bothering me so the shakes are not going down. I feel full all the time and the nausea I cannot get rid of. Any suggestions????

Jennifer,
I was only allowed clear fluids for one week post-op  I found sugar free ice pops were tolerated the easiest. I sipped peppermint tea for nausea or a plain saltine cracker nibbled very slowly.Feel better
Debbie 

Shakes are best made with water and ice only (for our benefit that is less calories and riskof lactose intolerance issues).

I was on clear liquids 15 days postop (no milk!)..jello helped as did sf popsicles, dehydration is nasty and w/o 64 oz or so a day of fluid nausea is sure to follow, it is CONSTANT sipping all day. Look aat it like this each hour you are up (say you are out of bed from 8am to 8pm that is 12 hrs you need to get in 5 1/2 ounces each hour to make 64 in a day! No easy task so no naps and no slacking, keep the water bottle at your side at all times, I even needed to mark down my fluid each hr on a pad for weeks! It gets easier I wouldnt force food at this stage if choice is food or fluid choose fluid!
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http://www.thinnertimes.com/weight-loss-surgery/gastric-bypass/gastric-bypass-complications/lactose-intolerance.html

Info on lactose intolerance at above link..

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!
CLEAR LIQUIDS IDEAS:
***(VARIETY IS THE KEY TO GETTING THROUGH THE FIRST 2 WEEKS!)******TIP
Keep a journal of each hour in a day for the first week of fluids. Write down what you drink in the hour and what activity you do! You should move every 1-2 hrs even if it is just walking around the house to avoid respiratory or circulation problems. This helps keep you mindful! Remember you cannot catch up on fluids later in the day OR take a 2 L soda bottle empty and fill it each time you sip some fluid with same amount this is a great visual as to how far to go and how much u have drank, set midday to have it 1/2 gone!!!!

I ws on clear liquids x 2 weeks, then advances SLOWLY to soft mushies (yogurt, cottage cheese, ricotta cheese, sf/ff oudding like consistency for a week or so 2-4T was a meal.....then I went to blended foods like tunafish, chicken or shrimp or crav/seafood or egg salad made with mayo in a minichopper consistency of pate...again 2-4T a meal.....advance on food at a time so if an issue can identify it. Eat slowly chew well even blended foods and jhjello, like 25-50tmes each bite,place utensil ddown in between moutfulls, use small saucer, baby sooon/fork to help, eat over 15-20 min no less or more....stop BEFORE full...
Fishis flaky and can be dry an irritating, your pouch once irritated/angry can remain so for a meal or day, go back to warm liquids such as broth for a few times then retry food...



Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and or noncompliance with a diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 1/2 up to 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%.

VOMITING is not expected, if you address all the behavioral aspects such as eating too much, too fastm not chewing well, drinking too soon after eating (less than 30min to 2 hrs) or wrong foods (high fat/sugar) that can cause dumping or lactose intolerance then seek medical intervention to rule out phyical reason (ulcer, stricture, internal her ia). If you can not keep down food, fluid or vits it is an issue and not expected outcome of RNY!