Good Afternoon. Dribble before you nibble

Ok, RagettyAnn has got me thinking about this thing the NUTs tell you pre-op about not drinking before, during or after you eat. I got the same info for immediate post-op but was told on the DS board that since I have my pyloric valve, I didn't have to worry too much about that, so I've not followed the guidance since I can remember. I went back to my surgeon's web site and the instructions and reason why are pretty much identical for the DS, VBG w/sleeve and the RNY...you know the one, "stopped up drain effect". Well, with the pyloric valve in place, we don't get the stopped up drain effect and the only other explanation on the site is the desire to minimize reflux. 

Now, Dr E did tell me something this past year about the pyloric valve staying open longer if you become a "musher" and don't eat solid foods but until just that recently, I'd never heard that explanation. The instructions that I thought were only for immediately post-op are to stop drinking 15 minutes before you eat and not again until 30 minutes after. Am I the only one that drinks during a meal?  What were your instructions about drinking around meals for the long haul and were you given the reasons why you should follow this guidance?

--gina
    

Gina, I was told the same thing but because "my pouch" would let everything thru so fast. When I reminded them that  DS'er doesn't have a pouch, I got the RCA dog look and then, we'll just follow it anyway.

In other words, no reason. Just a "just because we said so" answer. Which is not an answer at all.

Liz

I was told not during or after so that food would stay in my pouch longer, to increase digestive time spent on your meal and retain a sense of fullness longer.  Seems like that would make sense for every type of WLS, no?

Yes, and that's what Ragetty's surgeon told her. But protein shakes make me feel full and curb my cravings, and I don't like feeling full. My labs for nutrition and such are pretty dang near perfect and my sleeve is still plenty restrictive. Just makes me go hmmmm...you know?
 

Actually, I thought the no drinking rule would also be a good one for non-WLS folks to follow as a weight-loss technique.  The premise being, the denser the food in your stomach, the longer you'd feel full.   But I was never told that trick, nor can I think of ever reading about it in any diet book, and I've read hundreds in my lifetime.  I also can't say if it worked for me pre-op, as I didn't incorporate this technique until after surgery.  So maybe this trick doesn't work for full stomached folks, or for those of you with pyloric valves.

I was told like everyone else, nothing to eat 30 min prior or 30 min after. Do I follow this nope.... I am non compilant in this area and I know I need to do better. I may stop drinking about 10 min before I eat but at the end of my meal, I have to take a small sip of something to wash stuff down. I dont drink a big gulp just a sip, then when I feel less full... could be 10-30 min later, I will drink again... I am still losing weight, I still feel full and I still have extreme restriction. Am I wrong to do this?

My surgeon told me a sip was fine, just no real drinking. I think back pre-RNY, I drank a lot of water during meals. I wonder if that was a factor in my ability to consume mass quantities in one sitting.

I think we all have to do what works for us as individuals... using lots of common sense.  I drink all the way up to my first bite of food...  it flows through quick and I stay hydrated.  So, who's to say?  Nowadays, since I'm doing good, my NUT gives it more leeway and says, "We give you guidelines but as you go along you have to figure out what works best for YOU."  

So we all have the same shopping list but we don't go through the store in the same order.  It's nice having control over what good habits we can establish based on our own needs.

I do believe it's only smart, at first, to follow instructions to the very best of our ability.  There's time enough for modifications after the surgery has healed.  Yes??

lol  Yes, to be sure. I did follow the rules at first but when you hear from vets with your same surgery that something isn't required and is somewhat ridiculous, it makes you wonder about the advice you're getting from your doc and NUT.  "Because we've always done it that way" just isn't enough for me, I want to know why and if its real or theory.
. 

I know 'zactly what you mean.  I think there's a lot of liability issues that prompt them to instruct us by the book.  I've purposely emailed my NUT with controversial questions to see how she wiggles out of it, and it used to be that she always referred back to "the white book" from whatever the heck organization it is that tells them how it's supposed to be done.  LOL    My Bariatric doc said that, when the surgery was new to everybody involved, they used to let people go through on a Fast Track if they were paying with cash.  Until they discovered they sometimes had disastrous results from that (as in death).  Now, they take 5 - 6 months preparing each and every patient to make sure they have as much material, education, support as they can give them... not to mention to weed out those who are in too much of a hurry and wouldn't be compliant.  I think they know that not all the rules apply to each and every person, but it doesn't hurt for everybody to follow them... especially until they are out of the woods.  Some patients don't understand that it's major surgery, Major!

:-)

I really do get where you are coming from and don't know if you'll ever get a straight answer from a medical professional.