Question:
Only liquids are tolerated; pureed foods & soups cause terrible pain and nausea.

I had an open RNY proximal on October 7 of this year, and am just two weeks out of the surgery. The reason I am writing is because I read about problems with strictures and I was wondering if I might have one. I see my surgeon & dietitian Tuesday morning and will go over the problems with them then, but was trying to find out anything I could in the meantime. My starting weight was 273 (5'4") and in the 12 days since surgery I have lost down to 249 pounds. My sister is really upset and thinks something awful is happening because of the fast weight loss (-24 lbs in 11 days) and because I can't keep anything down but liquids. I don't see any need to call my doctor since I see him in less than two days but I would like to be able to calm my sister's fears about this. I was in the hospital (Obici in Suffolk) for six days due to minor complications, but have done well at home since then. I could eat very thin oatmeal and keep it down my last day in the hospital, and could eat thin soups & applesauce for my first few days home. Now I can only tolerate protein drinks, sugar free popsicles, and fat-free yogurt; anything else causes horrible pain and nausea with the first bite. I feel perfectly full with just these foods and am getting about 500 calories a day with about 50 grams of protein. I've tried baby food and tried making my own pureed food but can't get any of that down. The last non-liquid food I tried was very thin cream of wheat and I was sick for hours after that. At this point I feel I could live happily on protein drinks and yogurt for the rest of my life just to avoid the pain and nausea that real food brings. Wow, this is long! I didn't mean to write a medical report but I do feel more anxious after talking with my sister. Also, sad because I don't want to have to go back into the hospital for any more procedures! Anyway, I was hoping to hear other people's viewpoint since who have had complications from strictures and other things. I'm not sorry in the least about having the surgery, and am pleased with my progress so far. I don't feel bad physically and am walking a little bit each day and I live alone and am doing well taking care of myself. Thank you for any input you can give, and for any reassurance that I didn't make a mistake in not contacting my surgeon before now. (I'm second-guessing my decision now!)    — Phyllis M. (posted on October 20, 2002)

October 20, 2002
Hi, When I had surgery, I was only allowed clear liquids the first seven day. Then the next two weeks only full liquids. That included protien drinks, skim milk, cream soups(strained) popsicles(sugar free), sf pudding, etc. Your pouch is still healing and it needs time to heal before it can handle certain foods. After the full liquid stage was pureed foods for two weeks. Your pain may be just too much too soon. Weight loss is always fast in the first 3-4 weeks. A lot of it is fluid loss due to the fluids you recieve in the hospital. I had to drink and eat in very tiny sips and slowly too. Otherwise I would have sharp pains in my chest/pouch. It would even kind of burn if I went to fast. Also you have to be very careful of the amount. Just a tiny bit too much could cause it to come back up. If you had a stricture you would more than likely be vomiting even the yogurt, and liquids. I say to tell your sister to relax and make sure you talk to your doctor in two days. I think you're fine. Lori Beilman-open rny/8 weeks out/-37 lbs.
   — lerli1

October 20, 2002
Hi Lora, Thank you for your reply; it was helpful in settling my anxiety! :-) When I saw the dietician last Tuesday she started me on pureed foods and that is when I noticed that anything other than liquids/yogurt did not agree with me at all. Other than that, I feel wonderful and am enjoying my new life without that horrible urge to binge on food!
   — Phyllis M.

October 20, 2002
I hope I can put you and your sister's mind at rest. I had open RNY proximal 7/25/01. My stats are similar to yours; I'm 5'3" and started at 260#. My surgeon sent me home from the hospital on full liquids for 3 weeks, then I was to see my surgeon and start on pureed if ready. My surgeon told me that the only things I had to worry about the first month were getting in at least 70 grams of protein, 48-64 oz. of water, and my chewable Flintstones. He said not to worry about eating at all-just get in the protein, liquids and vitamins. At that time I was using a soy powder mixed with sugarfree Tang or sugarfree Crystal Lite for my protein and drank my 70 grams of protein every day starting on the first day home from the hospital. My only "food" was nonfat light yogart and occasionally thin oatmeal. When I went to my first post-op visit 10 days after my release from the hospital I discovered I had lost 14# in 12 days. My surgeon recommended adding a protein bar by Metrx that quite literally melts in your mouth. The nutritionist said that also meant I could advance to pureed foods. Well, I was ready physically but the idea of trying to figure out what I could and couldn't eat was rather overwhelming for me. I was a bit confused after surgery and had trouble concentrating {more than usual-;)}. I wanted something easy! I added the protein bar (could only eat 1/3 of the bar at first) and dabbled with cottage cheese and babyfood (the greenbeans were the only thing I could stand). My the end of the third month I was trying more and more regular food, just chewing in very thoroughly. I healed incredibly fast and have had no complications! So---as long as you feel good, you don't NEED any food beyond the sugarfee popsicles and fat free yogart!! I would just suggest upping your protein some more, getting in your water, and making sure you take your vitamins. Good luck in your journey!
   — LLinderman

October 20, 2002
I did not have stenosis, but did have marginal ulcer. Vomiting is NOT normal or OK. You are wise to question it. I think it's fabulous that you can continue to stay hydrated & proteined during this time. The 24 # doesn't scare me at all--that's the whole point of surgery. You are being nourished, so you're not "starving". We are clear & protein (& vites) ONLY for 4 weeks. HOWEVER, all that said, if you cannot tolerate real food, then of course that problem has to be addressed. The stoma can close to the point of liquids not passing, too. So, of course, you are being seen--be as direct & descriptive as possible. An EGD (scope) is pretty close to painless (well, I personally do not like IV's), takes about 20 min, but you lose that day to the drugs, as far as driving & working. It's fast, effective and then you're on your way. It's not another in-patient with pain, and all that.
   — vitalady

October 20, 2002
Phyllis, I can't help you with your problem, but I wanted to let you know that I also lost 24 pounds in 10 days, so assure your sister that it is normal. Please let us know what your doctor says on Tuesday!!! Take care..
   — karmiausnic

October 23, 2002
Hi everyone....this is an update to my original question. (Thanks to everyone who posted an answer and sent email replies.) I saw my surgeon Tuesday and everything is fine! He said they had just started trying to start patients on pureed foods before leaving the hospital, but had previously kept the WLS patients on a full liquid diet for the first month. Some people take longer to heal and for the swelling in the intestines to go down and I'm perfectly fine staying on protein liquids and yogurt for now. He was pleased with my protein intake (thanks Michelle Curran!) and my weight loss so far. Praise God for blessing me with this surgery and my new life! :-) I feel great!
   — Phyllis M.