64 Ounces A Day

I have a question. On the pre-op diet I am paying more attention to my intake, since it's all liquids.

I think I drink at most 40 ounces of liquids. But postoperatively you are supposed to have 64. Do you really have 64 ounces, post-op people, and are you in the bathroom peeing all day?

And with tiny stomachs, how hard is it to actually drink 64 ounces in a day?

Unless you have a complication, you can do 64 ounces after surgery. But reember, that's the minimum recommendation, not the maximum. I feel like crap if I get below 120 ounces, and usually am over 200.

Your body will need extra water to heal. It also needs extra water to burn fat. Think of it like fire needing oxygen. No oxygen, no fire. No water, no fat burning. I can give you some of the science behind it if you really want.

And last, right after surgery, you will feel like total crap if you start to get dehydrated. You will get nauseated, have no energy, and likely be dizzy. So work hard to get that fluid in. The numer one reason, by far, that people get readmitted to the hospital after WLS is dehydration.

I would love to have scientific details if you have them. It would be helpful to others as well perhaps...

Post WLS a much higher percentage of our diet should be made up of protein. FOREVER. Protein consists of amino acids. On a molecular level each amino acid contains an amino group, an acid group, a hydrogen atom and a distinctive side group all attached to a central carbon atom (amino means containing nitrogen). When an amino acid is broken down (this occurs when they are used for energy or to make glucose or fat), they are first deaminated -- stripped of their nitrogen containing amino groups.

Two products are created as a result: ammonia and a keto acid.

Ammonia is a base and in excess it will upset the blood's critical acid-base balance. To prevent this from happening your liver combines the ammonia with carbon dioxide to make urea which is much less toxic. So the more protein you eat, the more urea your body produces.

To get rid of the urea your liver cells release it into the blood, then your kidneys filter it out of the blood for excretion in the urine. To keep urea in solution, the body needs water so a person who consumes a high protein diet must drink plenty of water to dilute and excrete urea from the body. Without the extra water a person on a high protein diet runs extra risk of dehydration because the body uses its water to rid itself of the urea.

You can also see that the liver and kidneys are working extra hard in this scenario, which is one of the many reasons alcohol should be avoided after WLS.

Thank you very much for this explanation.

I'm really curious about what you said about feeling like crap if you get less than 120 ounces. Since surgery I have been feeling really light headed when standing. My surgeon even made me go to the ER to be sure I didn't have a blood clot! Fortunately I didn't. I almost always drink my 64 oz, so the doctor didn't think it was a hydration issue, but now reading this it's making me wonder. What are your symptoms if you don't drink 120 oz? Also, how do you manage to get that much in? I'm only 5 weeks out from surgery, so I'm eating 4-5 times a day. With waiting 30 minutes before and after it really limits drinking time. Thanks in advance for any info you can offer.

Lightheaded when standing is orthostatic hypotension. Also referred to as positional low blood pressure. There is a ton of information out there, and it's very common the first year after surgery. Be certain to stand slowly, in stages if you can. Drink more. Fluids will help. And more salt and electrolytes helps.

Are you on BP meds? You should talk to your doc about those if you are.

They teach nursing students how to test for orthostatic hypotension, so it's really easy to diagnose.

Thanks for your reply. I've been tested for orthostatic hypotension, and my BP was ok in all positions. So far my doctors are stumped as to what it is, and I'm grasping at straws trying to find a solution, so I can go on with my life and do what I want to do without feeling light headed. I will keep trying to increase my water intake and see if that impacts how I'm feeling. I got in about 80 ounces yesterday, and am aiming for 100 today.

Trwat 64 ounces as a minimum, not a maximum. You need to wait 30 minutes after eating before you drink, but you can drink right up until you start eating. Fluids will pass right through an empty stomach, so there's no need to wait.

Keep making fluids a priority, and it will get easier.