3 wks post op - Eating too much/fast, hungry, stall, stretching?

Your anatomy is not so special that what has worked for "hundreds of clients" will be any different for you.

Have you stretched your stomach? Unlikely. But eating like this can cause your staple line to blow wide open, which is arguably more dangerous. You'll definitely know when stomach acid goes flooding into your abdominal cavity.

Search "three week stall" in the forum search box. This happens to just about everybody.

Read your surgeon's plan, both food type and volume, and STICK TO IT. You should be eating protein almost exclusively; most successful patients skip fruit and nuts until well into the maintenance phase because they don't contribute to important patient goals.

No more russian roulette! Go back to your surgeons plan for you. Its not too late to get back on track. Are you on a ppi? Acid mimics hunger. You might have to change it. Head hunger however is harder to tackle. Seeking out therapy/support might give you some ideas on how to handle it.

You feel like you can eat more because nerves have been cut during surgery. Your stomach is lying to you right now which is why its so important to follow your surgeons plan to the letter. None of this advancing mess. Of course your surgeon handed you a packet & expected you to follow it. Same thing if you got prescription drugs & it had instructions on the bottle, you follow it.

I don't think you stretched your stomach, but do check in with your Dr & tell him what you've been doing. He might connect you with support groups to help you thru this.

I see huge red flags here -- you are not following your post op eating plan, eating things you shouldn't be -- you are eating more than you should.

PLEASE GET SOME COUNSELING NOW to deal with your relationship with food. You can save this still --- but if you continue the way you are now, you will waste your honeymoon period and post in a year how WLS failed you.

I just can't.

First as far as feeling hungry.

Head hunger and physical hunger are 2 different things. It is basically impossible for you to be feeling real physical hunger because the nerves to your stomach are not reconnected and that doesn't happen for some weeks or months as you heal.

Are you taking a PPI and an antacid? If not you need to start right now and take them every day for at least 6 months, acid can feel like hunger.

Next...

Your food stages are to prevent complications. Just because you feel you can handle the food now doesn't mean that you can. Making your brand new stomach work harder than it should now can lead to complications down the road.

Secondly advancing your food stages is a disservice to yourself. The secondary purpose of food stages besides preventing complications and allowing your stomach to heal is to teach you how to eat again properly, like a baby. This is your mental reset. You get one shot at this easy mental reset then it is gone forever. Surgery makes it easy for you to follow your plan if you want to.

You are not even a month out and you are working against your sleeve and squandering your reset. Think long and hard about why you chose this surgery and felt it was your best option.

If you can't control yourself with food and you are having emotional issues, find a therapist, just do it fast. This is your one time chance at easy mode, and you are wasting it.

I posted this on another board a long time ago, after many people were posting about "cheating" on the post-op diet plans. After seeing this post, I went and dug it up to copy/paste in its entirety here. I hope it's helpful.

TheAntiChick.

ETA: To admin staff -- I forgot the other site automatically puts links in for certain keywords. I have tried to strip them out, if I've missed any please just edit them or let me know and I'll edit them... it's entirely unintentional. :)

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Over the last few weeks, I've seen a number of posts about "cheating" on the diet plan in the days and weeks immediately following surgery, and I am very concerned about this trend.

I am not a doctor, I do not play one on TV, and I am not dispensing medical advice.

However.

I am a registered nurse, and what I'm about to say is an informed and educated opinion.

Surgeons tend to give VERY detailed instructions about what to eat after a stomach surgery, and for VERY good reason.

Even when the surgery is arthroscopic and looks to be a very tiny surgery on the outside, it's a VERY BIG surgery on the inside. The VSG surgery leaves a staple/suture line the entire length of the stomach. That incision has to heal, and if you could see it, it would look like raw beef. If the incision were on the outside, we would be very careful with it, keeping it clean and bandaged while it healed. Of course, it's on the inside, so we can't do that. But we need to keep in mind that it needs to heal in the same way.

We have to eat, and that food will be against that raw incision. At the same time that we have to protect the healing stomach, we also have to get in plenty of fluids and nutrients, specifically protein, in order to support healing. Protein is the primary building block for tissue, so it's critical to healing. Carbs are mainly just energy sources, so they're not as important, especially given that people having bariatric surgery have plenty of energy in their fat stores. This is why protein is stressed so heavily over carbs in the diets.

Additionally, the stomach is now in a new shape, and it basically has to learn how to function as a slender tube instead of a big bag. There's a learning curve. Kinda like a newborn baby's stomach. We don't dump steak and salad into a newborn's stomach for good reason - it doesn't know how to deal with it. Similarly, we don't want to do that to our new sleeve. We start off with stuff that's easy on the suture line and easy to digest, and as the suture line heals and the sleeve learns its job, start working our way up to "real" food.

So over the years, doctors have learned what foods are best for a healing stomach, and that translates into the post-op diet progression instructions.

Typically, that looks like this: Clear liquids, then full liquids, then pureed foods, then soft foods, then slowly move into a "full" diet beginning with high moisture content foods first. When moving from one stage to the next, it's typically advised to add just one food at a time, in small amounts, and see how it's tolerated. A food that's not tolerated well can be tried later on as well. If an entire stage is not being tolerated, back up to the previous stage for a while, and then try again more slowly.

Surgeons tend to specify how long to stay in each of these stages, what types of food make up each stage, and how to transition to the next stage. Every surgeon's instructions are a little different, and it's based on their experience and sometimes changes based on the patient's specific medical case.

The general idea in the very early weeks is to eat foods that will not stress the healing suture line, and do not have particles that are known to cut into the raw tissue or get embedded into the suture line. If a cut or embedded food particle gets infected, it can become an abscess and develop into a leak. A leak can be life threatening, and at the very least cause the patient to have to be hospitalized and possibly have more surgery to correct it. Foods that are particularly known to cause issues are those that swell up like rice, have seeds like strawberries, or have rough hard edges or hard to digest fibers like wheat crackers or raw vegetables.

There are people who eat all sorts of things against their doctor's orders and have suffered no ill effects, but this should not be used as an argument that the doctor's orders are not important. Similarly, you will find some people who smoke a pack of cigarettes every day and drink a pint of whiskey every day but live to 100. They are not representative of most people, and should not be used as the example other people follow.

The reality is that some people will develop abscesses and leaks because they ate things before they were cleared to by their doctors, and there is no way to predict who will have the complications and who will not. And the consequences can be as severe as death. It's not common, but that's how bad it can get. That's why the doctors give the instructions they do. They're not just testing you or trying to make your life hard. They are giving you the best information they have to keep you safe.

Violating these orders is not "cheating" on a diet. It's risking your life. I am not being overly dramatic with this statement, it is a fact that it has happened. You are risking your safety and your health if you violate these orders. It's not about "being human", it's not about "food addiction". It's about your safety and your health. It's hard to be on liquids only for 2 weeks (or more). Some people have huge cravings, or "head hunger" as we tend to call it here. Or just want desperately to chew something. No one is saying it's easy. But it's necessary. Distract yourself. Eat/drink anything that's allowed on your plan - freeze it, heat it up, try something that's opposite of what you've been having to shake it up. Walk around the house or the block. Suck on an ice cube. Count to ten or a hundred. Post about how hard it is, and ask people to help you get through it. But muscle through. It's nothing less than your health and safety.

As for why one surgeon will have his patients on clear liquids for 2 weeks while another only does 2 days? Or why one will skip a phase entirely? Each surgeon has different experiences that inform his practices. One is not right and the other wrong. They are each operating out of what they were taught and what they have seen in their own patient groups. They may have even modified the plan because of a specific health concern in your specific case. As a patient, you need to fully understand what your surgeon expects, and if you have a problem with the protocols get it straight with your surgeon and team BEFORE you go under the knife.

If you don't trust your surgeon and his protocols, find another surgeon. I personally would question a surgeon who doesn't allow any Protein drinks including the clear ones for 2 full weeks post op (saw that in one patient's instructions on this site) and likely wouldn't work with that surgeon, given what I know about the needs of protein for healing. But after surgery is not the time to be questioning the surgeon's protocols. Get those questions asked and answered to your satisfaction well before the surgery date.

If you are having surgery, and you have not been given your post-op instructions, at the very least for the first 2 weeks post-op, do not proceed with the surgery until you have that information. We have people posting here stating that they were sent home without clear instructions as to what they were supposed to eat or drink, just a vague statement about "full liquids". That is not sufficient information, and instructions should be given WELL BEFORE the surgery, not after. You should fully understand what will be expected in the weeks after the surgery before consenting to the surgery, or your team is not doing their job.

(This ends my sorta rant about post-op diets and "cheating")

Good luck to everyone!

Great advice!

What an excellent post. Everyone should read this. Diane S

Please, please, please copy this reply and make it its own post on the VSG board. You would be doing such a kind service to those who are researching and are getting ready for surgery.

Your post is EXCELLENT and a must read for anyone preparing for WLS!

I'll happily do that once I'm back to a keyboard. I'm happy to share my experience and opinion wherever it can help people.

I can see a couple of places where I can tighten up the writing and perhaps expand on the information a bit... Maybe even post it to my blog, so if anyone has constructive criticism, I'm happy to hear it. The post was literally a one draft rant after one too many people posted in another forum about eating fast food days out from surgery and was basically pasted on the head and told that's alright we're only human and food addiction, yadda yada and I blew my stack. LOL.