NSAID question

Yeah, I've watched several of his videos. If I didn't have such disordered eating around vegetables, I would probably try his system. It makes a lot of sense to me. Though I don't have any clue how a post-op puts away that much vegetable matter!! ;) I can eat MAYBE a cup of non-dense food at a time, and only about 1/2 cup if it's a good dense protein.

Yeah, you definitely can't eat nearly that many vegetable for awhile post-op. You start out on protein shakes just like everyone else. He just likes you to transition off of them when you're able. I was making my own natural protein shakes with banana, peanut powered and cocoa within weeks.

Then you gradually increase from there. It took awhile, but now that I'm 18 months out I have no problem eating 1lb of vegetables a day. I can eat a pretty large salad if I go that route. Today I had like 6oz of broiled carrots with lunch. I also had two snacks of sugar snap peas of 3oz each and about 6 oz of roasted mushrooms. I also had an omelette loaded with veggies for dinner so i definitly exceeded a pound of veggies today.

I can still only eat maybe up to 3 oz of meat protein at a time. Often I only eat 1-2 oz. but I can out away vegetables no problem. I can also eat larger quantities of non-animal proteins like lentils and beans, which is important as they are not as high protein as meat.

I rememeber from previous posts your extreme aversion to vegetables. That's a bummer. If you're ever able to work through that maybe you can give it a shot! If not, there are a whole lot of people who eat almost nothing but meat and seem to do very well.

Yeah... I'm working with a therapist on the PTSD-type response I have to foods outside my comfort zone, and a RD to find ways to expand my palette. I doubt I'll ever be someone who loves vegetables, but I would like to have a bigger repertoire of food. :) I get good supplements, and I've tried to quit worrying overmuch about my "horrible" diet. LOL. Right now I'm trying to work toward a place where hubby and I are cooking real food at home instead of eating out so much or eating packaged foods. I figure that's a bigger bang for the buck in getting better nutrition than stressing myself out over veggies. :D

Best of luck to you, and totally agree. I am 43 years old and have never felt better in my life. I'm sure a large part of it is the 180+lbs I've lost, but certainly some of it is the focus on eating "real" foods and largely avoiding processed (especially highly processed) foods and eating out MUCH less than I used to (1-2 meals a week as opposed to 7-10 meals a week). I know longer have blood sugar spikes and crashes (or "shaky hungry" as I used to call it) and my GI system is MUCH more stable/healthy than it has ever been. I just kinda feel good almost all the time, and when I don't, I know exactly why and it's totally self inflicted.

There are a million different diets out there and I try to not judge people's choices because if it works for you, then I am completely happy for you. I am pretty well read on the topic, but am no expert. My thought is that a life of eating small amounts of lean meats, non-animal proteins at least once a day and copious amounts of fresh vegetables and fruits while maintaining a healthy weight while largely avoiding processed foods and refined sugar/grains just can't be bad for me. It works for me, and I feel great!

As the surgeon who is now running our support group likes to say: eat as close to dirt as possible - eat what grows in the dirt and what eats what grows in the dirt, with as little packaging/processing in between.

For moving outside your comfort zone, what I found worked for me was to slide into it gradually. I worked on upgrading my diet substantially years pre-op (while my wife was going through her WLS) and one of the techniques was just to add some veg where ever I could hide them. Add some to spaghetti sauce, or do a teriyaki stir fry. Start with a few and gradually add more each time you make it. One of our "gateway" dishes to this end is a chicken cacciatore, basically a tomato based stew using canned or fresh tomatoes, chicken and whatever veg you want to fle**** out with - pepper, onions, broccoli, squash, shrooms, etc. Start chicken heavy and work up the veg over time - beyond the tomatoes, we're running around 1/2 - 2/3 veg in the mix now. I've done a similar thing with salads, adding more and varied veg to the mix beyond the basic spinach, tomato, avo and meat starting point. Overall, I'm not far from Dr. Weiner's pound a day ideal, though I'm not specifically following his plan (I'm not quite as meat and grain averse as he is) but there is a lot of merit to what he is doing.

This is unfortunately common with many things in the bariatric, and medical world in general. Doctors form different opinions on things based upon their experiences - two bariatric surgeons with 20 years' practice behind them can have dramatically differing views on things. Pre-op diets vary between "no eating after midnight before surgery" to weeks or even months of liquid dieting. Post op can see some patients having steak at the same time as others are still on liquids.

The blurriness in the VSG world regarding NSAIDs stems from some history of the bariatric world itself. Most surgeons today have been raised on the RNY which has this specific sensitivity to these medications. Given that the bypass has be the dominant procedure for the past 30 years or so, many surgeons have spent their entire professional life being NSAID averse, and this carries over into newer procedures like the sleeve. Their brain knows the physiological differences, but many just can't quite get over their lifelong aversion. However, there is a smaller group of surgeons who adopted the DS as their preferred procedure, and given that one of the advantages and selling points of the DS is lesser sensitivity to NSAIDs, these surgeons have gotten used to using and prescribing them in their practices, and this carries over into the sleeve world, as the DS is based upon the sleeve. So, we see this spectrum of opinions from "absolutely not, no, never" through cautiously "yes, under limited cir****tances" to "sure, no problem..."

Given that the medical world in general has grown more cautious about NSAID use in general (some docs feel that they never should have been taken off prescription status), I look at them as something to be avoided if possible, but that the sleeve based procedures provide more flexibility in their use if such is needed. Sometimes they may be the best alternative, even if there "tons of other options for pain management" available.