Nutritional guidelines after surgery/sorry-long

Dreamofpeace
on 8/2/11 8:37 am - Rochester, MN
As part of my pre-op schedule, I met with a nutritionalist today and here are some of the tidbits I got from it.  Please let me know what you think because some of it conflicts with info. I've read. 

*She said my diet after surgery would be very similar to the RNY or sleeve surgeries that were also recommended to me. 
*After surgery I'll be on liquids for 1-2 days, pureed foods for a month, then mechanical-soft foods for a month, then soft foods for another month and finally regular foods.
*I'll start out having 3-6 small meals a day and work towards 3 meals/day with no snacks (because snacks tend to make you gain weight).  She even discouraged sugar free popsicles as snacks.  Each meal will be 1-1.5 cups of food.
*Protein shakes are not recommeded after the first month-should be on regular foods from then on.
*Vitamins required after surgery are: 2 chewable vitamins, 2 Tums Ultra (more if I can't get 3 cups of milk in every day) and a Vitamin B12 injection every month.  She made it sound like more supplements/vitamins are often NOT needed other than those.
*Blood labs are taken every 3 months for the first year and yearly after that. 
*Must maintain low fat/low carb diet long term.....avoid oils, butter, gravy, nuts, avacados, peanut butter, bacon, sausage, whole milk cheeses, sweets, fried meats, etc. 
*Goal of 60 grams of protein daily....maybe a little higher in the long term with the DS

Here's a sample menu for a pureed diet (while still in the hospital):

7:30-8am: 1 medicine cup of pureed, cooked cereal with a small amount of skim milk to thin or moisten the cereal.  1 soft, scrambled egg.

8:30-9am: 8 oz. skim or 1% milk.

10-10:30am: 2 medicine cups pureed cottage cheese, 1 medicine cup pureed fruit.

11-noon: 8 oz. water or other low-calorie, non-carbonated liquid.

12:30-1pm: 2 medicine cups of pureed lean meat, 1 medicine cup of pureed vegetables.

1:30-2:30pm: 8 oz. skim or 1% milk

3-3:30pm: 2-3 medicine cups of sugar-free/no-sugar-added pudding or custard

4-5pm: 8 oz. vegetable juice

5:30-6pm: 2 medicine cups of pureed lean meat, 1 medicine cup of mashed potatoes.

6:30-7:30pm: 8 oz. of skim or 1% milk with no-sugar-added instant breakfast mix

8-8:30pm: 2-3 medicine cups of no-sugar-added pureed fruit.

9-10pm: 8 oz. water or other low-calorie, non carbonated liquid.


zuzupetals2u2
on 8/2/11 9:06 am - Sedona, AZ
discard everything she said and keep reading here.
   
1985 Verticle Banded Gastroplasty to DS revision 2010     sw 280 gw 140 cw 188 hw 360

“If the person you are talking to doesn't appear to be listening, be patient. It may simply be that he has a small piece of fluff in his ear.?
Winnie the Pooh
  
  
newyorkbitch
on 8/2/11 9:06 am
Any nutritionist who told you that that what you need is very similary to RNYers is an idiot.  No regular food for three months?  Why on earth... ?????

Snack tend to make you gain weight????  What kind of moron is this nutritionist???  Sugar free popsicles are WONDERFUL post-op.

Her vitamin recommendations are INSANE.  Go check out vitalady.com

Low fat for DSers????  Okay now I'm going to kill her.

Pureed fruit and cereal right away?   What you need is PROTEIN and FLUID - no carbohydrates!

soft scrambled eggs,  cottage cheese,  protein shakes...


MarciRenee
on 8/2/11 9:10 am - IA
Yeah that's all bull****

And just know now that most NUT's don't really know what the hell they are taking about - and clearly this one doesn't if she's telling you that your way of eating is going to be similar to that of an RNY person post-op.

Who is your surgeon?
Marci       
Dreamofpeace
on 8/2/11 9:45 am - Rochester, MN
My surgeon is Dr. Kendrick at Mayo Clinic.  The nutritionalist took a general "Nutritional Guidelines after Bariatric Surgery" booklet, spent 5 minutes making her own notes in it and then explained it all.  This is the SAME booklet they gave me for the band 5 years ago with the same exact advice.  I meet with my endocrinologist on Thursday and am going to have a more in depth talk about all of this.   Ugh.  I think my surgeon is skilled enough to perform the DS but I worry about my aftercare at Mayo.  I don't have much of a choice though.....either have insurance cover most of the insurance there or pay up to 50% out of pocket somewhere else.
beemerbeeper
on 8/2/11 10:08 am, edited 8/2/11 10:09 am - AL
How many DS surgeries has Dr Kendrick done?  Whom did he proctor under?  What is his complication rate?  How many of his DS patients have you talked to and how far out are they?  What size sleeve and what length common channel is he planning to give you?

In other words?  He's not a vetted DS surgeon.  The Mayo clinic in Minnesota right?  You've got a top notch DS surgeon in your own state.  Check DSFacts.com.

AND you are a REVISION?  I'm terribly worried about you now.  

~Becky






newyorkbitch
on 8/2/11 10:12 am
How many revisions to the DS has he done ?  You MUST find this out.
beemerbeeper
on 8/2/11 10:04 am - AL
Oh for crying out loud.  I hope you have the ability to forget all that and learn from the vets here.

Tums?  They even stopped recommending THAT for RnY patients.  So even if you were getting an RnY you would be getting bad advice.

What surgeon is this?

~Becky


larra
on 8/2/11 10:23 am - bay area, CA
This advice is so bad I don't know quite where to begin.

The vitamin advice is all for lap band and RNY, and not even correct for them. A couple TUMS, for pete's sake! You need calcium citrate (as do they, esp RNY), not calcium carbonate, and the amount is insufficient also.

milk - you (any anyone with RNY) have a fair chance of becomming lactose intolerant, but even if not, you won't tolerate it well early out. Definitely something to avoid for at least a few months, if not longer.

And why on earth would you need a pureed diet? Have you even seen, or smelled pureed food? I never once ate pureed food after my DS. It's disgusting. I could eat soft foods by the time I left the hospital, and by that I mean things like cottage cheese, scrambled egg, shrimp, scallops, etc. I couldn't eat much, but it was real food.

Low carb - sure. Low fat - not on your life!

It's clear that, as often happens, she knows NOTHING about DS nutrition, just assumed that all wls are alike and gave you advice for RNY, and not even good advice at that.

I could go on, but surely you get the idea. She knows so little that her advice is worse than neutral, it could actually be harmful. Ignore!

Larra
NoMore B.
on 8/2/11 10:30 am
 Hold on, I just barfed at that food.

No, no, no...this is all wrong.

The supplements are no where near enough.  Where is the A,D,E,K ?  Iron?  Protein needs to be 90+g, not 60g.  120+ is even better, 90 isn't even enough for lots of people.

You will need to be on some type of soft food / puree for the period immediately following surgery, but it progresses quickly to real food as you can tolerate it and as your surgeon suggests.

After that, it's all about protein and low carb.  The very same stuff she is telling you to avoid (bacon, full fat cheese, avocado, nuts, etc) will become staples of your DS life.

Also the quantities she is suggesting - 1 medicine cup of fruit? - seem like they are for an RNY pouch.  You should be able to eat a lot more than that with the DS, even early out.

Disregard, keep reading.  
Also, your surgeon isn't known for DS's. You should consider one listed on www.dsfacts.com


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