Post-Op Questions

I had my procedure on Monday, December 11th with Dr. Alverdy at the University of Chicago Medical Center.  There are a couple of things I am finding confusing in my diet/nutritional packets for weeks 1-3, etc, as well as a few general questions.  I am wondering if the material provided is just lumping the Rouxen-Y and Duodenal Switch together too much (there is only one packet to cover both). 

Question 1 - How long does one typically have to crush their medication and/or take liquid forms?  This part is killing me the most.  My 2 week follow up appointment is Wednesday, and I do plan to ask my surgeon, but wanted to get an idea as to how most people were directed.

Question 2 - Everything I'm reading says food should all be low-fat and avoid anything fried.  It says in both the soft food phase and "back to normal" phase that you should avoid fried foods, hot dogs, mayonnaise, sausage, salami, butter, sour cream, bologna, bacon, margarine, cream cheese, dips and salad dressings.  While I can understand these things at first, I was under the impression that once all is healed, you can eat most anything and do not need to strive to eat nothing but low-fat and fat-free foods.

These are the main questions I have for now.  I'm doing pretty good with my fluids already (getting in around 60 oz per day on average) and have gotten my protein intake to between 80 and 90 grams since 12/22.  I would just be so much happier if I didn't have to crush these pills; they truly are making me sick, and ruin any joy I feel from drinking .

I never had to crush any pills, I cut a few of them in half, but honestly didn't have to do that for long.  

Fried foods don't bother me now, but I remember the first time I really ate something fried, I paid for it later.  All the grease ran threw me FAST! So I would just try stuff in moderation.  A nibble here and there to see how it goes.  NO BACON??? This sounds like RNY recommendations.  Some DS'ers have issues with hot dogs, I did for the first couple months but not now.   And just so you know I eat tons of butter, sour cream, mayo, cream cheese, chip dips, and everything else you have listed LOL! Those instructions sound like they are for folks that absorb all the fat they eat.  That is not us thank goodness!!!  Eat high protien high fat :)  

 I'm just 3 weeks out and don't crush my pills--but the vitamins upset my stomach. As far as fats are concerned, they're fine--as long as you tolerate them. We need them because we only absorb about 20% of them--and so it's important to eat fats. I'm going to send you a private message with a more lengthy detail of how I'm doing it this early out.

Sheri

You have RNY instructions. I would think that they could have given you better direction. I never crushed pills but I did restrict fat for a while until I healed and my body wasn't in shock over rearranged plumbing. Good luck to you-the DS will do all the hard work though. 

As far as pills go, just take it easy. One at a time and wait about 10 min maybe 15 to take the next one. This was how I did it. This is just my OPINION!

As far as eat, I have yet to see a REAL DS diet. Follow your surgeon's instruction this early out. As soon as you're cleared for a "regular" diet then by all means, eat a "REGULAR" diet. Low carb, HIGH protein, fat as tolerated. My experience is I NEED all the fat I can get. Others have more loose stools with lots of fat. Find your balance, again, once YOUR surgeon clears you for the regular diet.  

Best thing for you to do whilst you're healing is head on over to dsfacts.com and read and re-read everything. Look up old posts here on OH. There's a world of info out there just waiting for you. I have been researching since 2008 and I learn something new EVERY day!

As far as protein, you're doing awesome. Keep sipping and get those fluids up a litlle higher. A minimum of 64. For as early out as you are you're doing great but you gotta stay on top of it so you don't get dehydrated!

Keep up the great work!

Ruby

That is not just wrong but dangerous info. Toolittlefat leads to constipation which can cause fissures which you really don't want. Dump that advice and listen to the vets whom you can find via the link in my signature.

I wouldn't suggest crushing your vitamins either!  I was at a "full" vitamin plan swallowing normal pills around the 3 week post-op post.  I didn't have a problem swallowing pills, and if you order a lot of them from Vitalady, they are all pretty normal or small sized!

As for the low-fat and fried food.... As far as fried food go, I would go by how your system handles them and I wouldn't try any early out.  As for low-fat, I avoid low-fat foods as I 1) need the fat to help myself "poo", lol and 2) I have noticed that low-fat or fat-free foods are extremely high in carbs.  

In my program, both DSer's and RNY's got the same stuff, you're describing on a sheet, but the eating plan was very different.  DSers got a 1/2" binder. RNY's got a 2" binder!

You're right, once everything's healed, the sky's the limit! 

Your body needs fat for many functions. Since DSer's only absorb about 20% of all dietary fat (animal and vegetable), lowfat is fat-free to us.  Do not fear fat!  Fat is now your friend!  Once you are healed, you can eat whatever you tolerate. Early out, when you eat higher-fat foods, you may encounter what we call "oil slicks" in the toilet, where you can literally see the oil from the fatty food you ate floating on the surface of the water.  In time, this will likely disappear.

Eating solids in the beginning is a bit trial-and-error.  What one person may tolerate well will upset your tummy.  Find a high-protein solid food that doesn't make you nauseous (this is common in the beginning) and stick with that, then add another, then another.  You have a whole year for your new tummy to mature to it's final size.  I started out at 2.8 oz.  I can now hold about 8-9 oz per meal, depending on the density of what I'm eating.  Some foods still make me barf, and usually that's because I've gotten too hungry, and I've eaten too fast.

My go-to first solids were scallops, shrimp and bananas.  Make sure your foods are very moist.  That helps a lot.

The only liquid med I had post-op was this painkiller called Capitol.  It's like liquid Oxycontin and looks like Pepto-Bismol. I never had to crush any pills or empty any capsules, but I did have to cut my vites and calcium tablets in half.  I still do this, to allow the stomach acid to get past the enteric coating most pills have these days.  Capules, which are made of gelatin, break down very easily once they make contact with stomach acid.

I do, from time to time "boost" my vites and Calcium by taking an extra dose in liquid form.    Sort of like a "spring tonic" mentality.  I take my ADEK's in *dry* capsule and uncoated tablet form.

Hi there!  I had surgery with Dr. Prachand on 11/15 at U of C.  I am also a DS and I also feel that the instructions that we received are more focused on RNY.  BUT I know your appointment is tomorrow (and I have a follow-up appt at 9am....perhaps we'll see each other in the waiting room!) but I would not stop crushing your pills just yet.  Wait until your appointment tomorrow.  You are still healing and remember that this was a very delicate surgery.  You don't want a pill getting caught in a healing site.  Yes, crushed pills suck! But I was able to go to whole pills after 2 weeks.  Also, since they are not crushed, it takes me 3-4 times as long to get them down because right now I can only take one pill at a time with a sip or two of water, then wait a couple of minutes before I move on to the next. 

After my 2 week follow-up I was advanced from the awful pureed diet to a soft diet.  Tomorrow I am hoping to advance to a regular diet.  Pretty much the last 4 weeks I have stayed away from nuts, crunchy foods and not had many carbs.  It has been difficult going through the holidays without nuts, but once again, I kept reminding myself that my insides are still healing and I don't want to jeopardize getting a leak. 

It sounds like you are really doing well.  Keep it up!

Gina