Your Surgeon's Post-op Program (What was it like? Has it helped or hindered you longterm?)

Do you feel like your surgeon's (or NUT's/RD's) post-op program (or lack there of) had anything to do with your longterm success/failure? What was the plan like?  (Calories, fat, protein, portion size wise.)

I honestly can't remember.  We moved out of state 12 months after surgery and the local surgeon's didn't feel a need (well, their office staff) for me to be seen.  I stopped going to support groups, got pregnant, and it all went downhill from there. I've since gotten back to support groups, and of course, back on the wagon. I had full labs drawn and sent a copy to my surgeon.  My D was low and my PTH was high.  His response was "Keep taking your 2 flintstones."  Umm.. no.  I haven't been on flintstones since I left Kentucky.  My labs are as good as they are from doing my own research and making my own decisions. I recently saw a nut. here locally.. and she's the WLS nut. for a local group (she's going to try and get me in with a surgeon just so I have a contact).  Her guidelines were these: 1000-1200 cals per day 100g carbs over 100g protein 20g fiber 64oz fluids 1c portions 6 meals per day excercise 5x per week, including strength training

Yes, it sure helped me. My surgeon Dr De La Cruz in Miami did my WLS. He has post op meetings every month. He has a dietian there giveing and talking about foods and answering questions. It really helped me alot...in fact I need to go back and listen, listen, listen again.  I , just this last year,  haven't been going to the meetings...and guess who showed up....my old eating habits..which I thought would never return. UNfortunatly I have gain 20 lbs...yes I know what to do...ya know how bull headed we are : (   I am 5 years out...and I love my Dr and my Dietian  : ) Cha

I have a good doctor and support system. They have group meetings once a month for free. There's speakers that tell us about the benefit of exercise, vitamins, how to maintain, psychological stuff that goes along with WLS, all the problems we face. The nut recently told me I should only be eating 3 meals a day, with maybe one light snack, adding up to 1200 calories. So i started tracking, and I eat twice that, and I usually eat about 8 times a day. So I tried to cut down, I got weak and felt like crap, couldn't work out as hard,, and started gaining weight. It goes to show you, our bodies are all different and nobody can tell you exactly what will work for you. But they do try to help us, I'll give them that.

I would absolutely say the basics set me up for what would follow. Primitive as they were i***** it went like so:
4 wks clears (sugar free)
starting day 7, protein supps (only a meager 60g in those days) and vites

The vites were took i***** are STILL Way more sophisticated over all than what most ppl take today, with 2 notable exceptions. We were not issued B12 nor was our calcium type specified (it would be 6 more years before they jumped on that one)

60g in protein supps (we had no whey yet--just grit (soy) or slime (collagen)
2 multi equal to Centrum (adult or chewable)
40k of dry A (retinol)
1600 dry D3
400 iu dry E
260mg (that was 4 x 65) of fe fumarate
vit C to accompany the iron
50mg chelated znic gluconate
1500mg of any kind of calcium (oops)

no milk, no sugar

no grazing, but up to 6 mini meals (protein as main target) per day

meal size 1-2 oz until goal wt

no drinking with meals, officially written as 1 hr after, but
most of us practices 15 minutes ( if the food is gone, there's no danger)

labs every 3 months

office visits monthly (or spaced as time goes on) FOR LIFE
(kept us up to date one news in the nutrition world)

the doc, a triathlon person himself, asked for 20 min of aerobic exercise per day. more if you preferred

64 oz of water , as i water, other non sugar liquids as desired (except milk)

We never counted calories, fats or weiged food. It was, still is, easy to track what goes into me.

Today I take 180g in protein supps, and my vites intake has changed with newer info each few monts, so at 14 months:

no milk, no sugar

still wait about 15 min after meals to drink

eat a reasonable portion in 15 minutes

I still prefer veggies over meat, but try to incorporate some food proteins, as well

vites:
no A today needed (in fact, I need to figure out how to take less than 0, but I suspect the excess will spend down)

50k of dry D3

1600 of dry E

2000mg of C
300mg of iron
2 mg copper (enhances iron)

5mg (5000 mcg) of folic (because of an rx I take)

about 6000mg calcium CITRATE and just adding 2 more forms, not citrate, not carbonate), but not replacing any of the calcium i already take

200mg chelated zinc gluconate

potassium (per labs)

vit K (K 1) (meds I take + malabsorption)
vit K2 (for bones)

B12 by shot by preference (I swallow all pills, so a sublingual is an extra step I wouldn't be faithful to)

Did take B complex, but B1 and B6 reached 3x top end dose, so I cut bac****il they start to drop

I don't push my luck with my insurance, so get labs every 6 months

My dh had the same surgery a year later, so the only diff was that they started them on more A&D and 90 g protein supps.

He can eat more portion wise, but the only gain (35#) he's had was SUGAR. As soon as his sugar was cut off, he returned right to his correct wt immediately.

I've had 3 regains, always sugar, and the first 2 just stopping sugar made me return to normal. the 3rd time, wow, I had to work to get that off.

The others of our peers (93-94-95) who followed these same instructions have all had to tweak their labs, but all are holding 90-100% wt loss. Those of our peers who tossed any part of the program have had 20-100% regain, and of course, the complications of malabsorption.

We are distal RNY, tho, so pouch of RNY, with intestinal arrangement of a DS.

However, the nutritional guidelines we started on back then are much closer to what a standard proximal rny would start on today (more protein, more D). But the basic pattern remains the same, because it worked so well for thousands of us.

Our doc actually did not want us to consult with a dietitian, because their training is so vastly different than how we had to live to be successful. And now that I can count some as friends, they cannot reconcile my formula to their textbooks. Over time, as they work with more and more malabsorbers, they are gradually adopting similar guidelines to where we started, but not til deficiencies show up.

It was very good. They gave me documentation for the first months (of what to eat, portion size...and how many grams or protein were in each portion). They gave me documentation re: vits/minerals/iron. I met with the surgeon several times preop and in the first year.  Same with the nutrit.  Both are responsive to emails (the surgeon does take a bit longer to respond, tho). Bloods were done at least 4x that first year. Along with support groups, I think they have a good support program and that it (esp. the documentation) contributed to how I did.