(Almost) One Week Post-Op With a Few Questions

Hi all,

My name is Tish and I had RNY surgery on 9/17.  I'm currently sitting under a pile of blankets and pillows and am *very* grateful that I am teacher because it's summer vacation for me and I have another week to rest before I return to work.

While I've been reading past threads on this board (which I helpful--thanks!), have scoured the materials my doctor gave me, etc. I do find that I have a couple questions that I would appreciate your insight/knowledge on.  They are:

1) The water consumption.  My doctor wants me to drink up to 56oz a day, but I have  been instructed to drink 2oz every fifteen minutes (except for 30 minutes before and after meals of course).  I got this cool phone app that gives me reminders to drink every 15 minutes but I have to admit--it's pretty tiring to drink water 4x a hour all day.  So what's your secret?  How did you manage to get all your water in during the first 1-2 weeks post-op?

2) The only vitamins I was told to take post-op was a multivitamin and a B12.  But my D level was really low before surgery and I wouldn't be surprised if I need to take Iron and Calcium Citrate at some point as well.  Should I start taking some of those vitamins now or wait until a month or so has passed? I have to admit that I don't really understand why we need to wait to take certain vitamins when our body is no doubt starting to get malnourished vitamin-wise almost immediately post-surgery.  Do you have any insights you can share on this matter?

3) I am getting all the meals and suggested protein amount in during this phase (which is 30-40 grams according to my doctor), but I'm wondering if there's anything wrong with aiming to get about 5-10 more grams of protein than was recommended?  I know hair loss is inevitable, but I just thought if I can start with a higher protien intake, I might reduce the amount of hair I lose.

That's all my questions for now.  Thanks in advance for answering this post. I really appreciate it!

1) my doc graduated our water goals, staring with 48 oz, then too 56, then too 64. Initially we weren't eating solids, so the 30 minute before/after rule is kind if irrelevant this early it. As you get further out, you can drink mite in a sitting, making the goals easier. I knew my job was managing water intake, pain meds and post op meds, I set everything else aside to focus on that 'job'

2) my doc had us taking calcium carbonate immediately post op, didn't start the citrate until day 10 or sp, which us also when I started the multi and b12. Why.. I'm not sure, but my first post op labs were good, so silently, no harm was done. 

3)i know there is a maximum number your buddy can absorb of protein, but can't recall what. I don't think you are near that threshold, so if you can manage it, take In some More. 60g was always my goal in every stage.

I have not yet had my surgery and am in the "gathering of Information" process so I don't have an answer to your questions.  But, I must say your post has been valuable to me as pre-surgery patient in putting out there questions I know I willl have once I have the surgery.  

Your post was great and I hope you get some  good answers.....as I will be reading them also.

Take care.

1. There's unfortunately no secret or trick at this stage -- you just have to stay on top of it.  However, eventually you'll be able to drink more at once and won't have to constantly sip.  I'm just shy of three years post-op and I drink like a normal person.  When I'm thirsty I go get a glass of water and have no problem drinking it over the course of a couple minutes.  You'll get there.
2. Talk to your surgeon at your next follow-up.  My program had me start some supplements immediately and others a week or two after that.  They might even be waiting for you with new paperwork before you can even ask.
3. There's nothing wrong with it, just don't overdo it.

Congrats on your surgery!

1.)You really do just have to sip, sip, sip, all day at first. It gets easier as time passes. You do need your water badly early on when you are only eating tiny amounts of food. We get liquids from our foods as well as drinking. If one decreases you must up the other for balance.

2.)Honestly, I don't know why your surgeron is having you wait. Myself, I would get on the calcium citrate if nothing else. Iron if you are premenopause.

3.)There is really nothing wrong with getting in extra protein but at this phase I wouldn't pu****'s kind of teaching yourself to overeat again. "Well it says I should have this  but I can get in all that + so I should right?" Not really. Your hairloss is pretty much set when you go under for surgery. telogen effluvium Here's a bit of information on that.

1) My doctor had me shooting for 36 when I first got out the hospital and then increase it each wee****il I was able to get up to 64. She basically told me to go by my pee. If my pee was light or clear, I was still getting enough fluids in. If it wasn't, try to drink more.  I wasn't eating anything solid until week 4 so I was drinking things all day long.

2) I was on a medication I had to take right out of surgery, but I didn't start vitamins until week 3 per my plan. I started with a B complex and multivitamin and waited to see how my pouch would do before adding others. My stomach was sensitive before to vitamins so I didn't want to get sick. I now take iron and a multi in the morning, B complex and calcium midday, and D & calcium at night.

3) I wouldn't say there is anything wrong if you do slightly over your protein intake. Some days I am over, some days I am under but in general I try to stick to the target number that they gave me. I haven't really noticed that I have lost any hair. It may be that I haven't hit a stage yet where it could fall out more.

Thanks for this advice! I've been using your "light or clear pee" guide and it has been rather helpful!

Hi Trish!

We had surgery almost a week apart, mine was on 9/9. 

First off, every surgeon's post-op care is different, the most important is to follow YOUR surgeon's orders. :)

My surgeon had me getting in 4  - 16.9 bottles of Dasani a day starting the day after surgeon. It was rough and at home I average between 36-60 ounces a day when I should be consuming at least 64. My urine doesn't suggest I am dehydrated in any way. *shrug*

I know what I am about to say is a HUGE NO-NO in the WLS community but I use a straw to get my fluid in. I have never been a guzzler, a soda drinker and have always used a straw for water. I suck up a mouth full and slowly swallow. I have had no complications with using a straw but that doesn't mean everyone should use one. 

I was started on the following vitamins a week post-op: A multivitamin that contains minerals including iron, twice daily, 500-600 mg's of calcium CITRATE, not carbonate 3x's a day. While Citrate and Carbonate are both absorbed effectively, citrate is easier to digest. The multi-vitamin and the calcium citrate must be taken two hours apart. Vitamin D either 5,000 iu a day or 50,000 iu a week. I take one daily. Vitamin B12 1,000 mg's three times a week and they must be sublingual. And finally Omega-3 with DHA and EPA OIL 1,000 mg's a day. I plan on taking Biotin as soon as I can find good deal on it; biotin wasn't on my recommended list of vitamins but everyone I know who has had WLS takes it. Biotin helps with the hair loss, skin irritations and helps with the lack of energy in WLS patients. 

Isn't it a strange yet wonderful journey we are on?!

I never had problems with straws.  It may be a no-no to some surgeons, but there are definitely people on this board who have found them helpful....

Audrey

Hi all,

I just wanted to thank everyone for your advice.  It was really helpful!  Also, isn't it interesting to learn about how other doctor's guidelines are similar/different from yours?

Water consumption is still a chore, but I have started to add flavors to the water to make it more palatable.  Right now, I'm using 2 teaspoons of lemon juice. 

I'll be meeting with the RN in my doctor's office this Thursday and will learn more about when I can begin introducing other vitamins into my daily regimen.

Thanks again!

Tish