11 weeks out with questions

 I am now 11 weeks post-op and have many questions.  Hopefully you all will have answers or advice for me.

1) Still having problems getting protein in.  Using shots now.

2)  I can't barely get 1/4 cup of food in at a time and that's a really good meal for me. Even though I eat small amounts I end up vomiting.  I truly don't believe it's a stricture, seems that only certain foods sit and digest well.  Is this normal?

3) Rash on my lower right leg.  Started right after surgery and it's awful.  Dermatologist says it's lichen amyloid but it's not getting better.  Could this be a deficiency or problem with protein?

4) Still challenged with fluids.  

5) I am NEVER EVER hungry.  The doctor said I'd begin to feel hunger after about 6 weeks.  Not that I'm complaining, but I just wonder if this is normal?

I am taking my vitamins and calcium but still am finding it a challenge to get in more than 400 calories a day.  I guess I want to know if this is normal or if I should be concerned.  Hoping you all can help me out.  Thanks.

Danette

1.  Do you mean those little vials of protein?  Those are no good because they contain mostly collagen protein which does not have all the amino acids.  If you want a decent amount of protein in a small amount of nasty tasting liquid, you can make your own shots by mixing a scoop of whey isolate protein powder in a couple ounces of water.  You'll be able to absorb that..

2.  Some people seem to have pickier pouches than others.  If some things stay down well, then I would say to stick to those things for a little while, then slowly try to add new foods.  If it seems like most things make you vomit, though, I'd call your surgeon.

3.  I don't know what lichen amyloid is.  What does the dermatologist say to do about it?  I doubt it has anything to do with protein or a vitamin deficiency - EXCEPT if we don't get enough protein, our immune system doesn't work very well.  So it can make it easier to get sick and harder to get well.

4.  What's challenging about the fluids?  How much are you getting in?

5.  It seems like it's different for everyone.  Some people feel hungry two days after surgery, some two weeks, some two months, etc.  I didn't start feeling hungry again for about three months.

 Thanks for replying.  

1. Yes, I'm using Profect protein shots.  It's a combo of whey protein isolate, collagen, and some other amino acid protein.  My problem is I can't stand the shakes anymore and there's no way I can eat enough protein.  Much harder than what I thought it would be.  Any other suggestions on how to get the protein in?  My hair is starting to fall out, not bad, but I notice the increased amounts in my brush and in the shower.  

2.  I guess I'm doing ok with the food, cheese enchiladas are my friend but I worry they will stop my weight loss even though I only eat about 1/4 to 1/3 at a sitting.  I guess I just have to do the trial and error thing.

3. Dermatologist says it's an autoimmune thing.  I guess the protein is leaking out of my cells and causes horrible rash and itching.  Like nothing I've ever experienced before.  Been going on 11 weeks so he's given me some very strong cortisone spray to apply directly.  

4.  I am averaging about 45 ounces of water daily plus whatever I get in through food.  I know it's not enough, but it's so difficult!!

Yeah, those shots have a little bit of whey isolate but are mostly collagen.  Collagen is the ingredient listed first, right?  So you are hardly getting any protein from them so you're pretty  much wasting your money.

I had a really hard time with protein too the first three months.  I could not get enough from food.  It took me that long to find a shake I liked, though.  The best suggestion I have is to try some more shakes and try making them different ways.  The same powder can taste very different depending on whether you  mix it with milk or water, or make it a hot protein drink, etc.

Getting enough protein will help your immune system.  I'm not saying it will fix your rash, I have no idea about that.  But a strong immune system sure won't hurt, and protein will help your immune system.

 I know the feeling with not being hungry.  Most days I'm not hungry but I do start to feel some hunger, albeit slight, on some days.  I make sure I eat three times a day and I am truely forcing myself to eat.  So far I haven't had any problems getting in any food I've tried.  Grant you I'm only eating things like cottage cheese, black beans, tuna, canned chicken, ricotta cheese, tofu, egg beaters.... I haven't ventured too far from that.  I honestly don't know if I've been getting in enough protein but I am averaging anywhere from 500 - 900 calories a day when I do track it on sparkpeople.com.   

I abhor the protein shakes now and I used to love those...  a protein shake was my morning staple after by band was placed and I couldn't physically eat until later on in the day due to my demon band being too finicky. 

I would definitely keep trying to get in the protein by trying different sources... maybe your NUT or surgeon will have different ideas to try as well.   It doesn't have to be strickly one food. 

I have had a rash on my face for the last 4 weeks. It is a spotty rash -- a few under skin bumps that dry out, peel, and itch. They started as oblong, flat, bumps under my eyes. I can now see them in numerous spots on my cheeks, nose, eyebrow. I have been treating them with hydrocortizone cream. It makes the spots dry up. Any other treatment just seems to make the spots fat and happy. I am going to increase my protein. I'll make a derm appt next week if this mess doesn't go away.

Good luck to you.

Hattie

 Hunger has remained a constant companion with me throughout my entire process. And I don't mean head hunger, i mean pouch growling grumbling hunger. The good thing is that it takes much less to satisfy that hunger now. 

One big area for improvement for my bariatric program is that we need a bariatric nutrionist or dietician. They send you to a generic one affiliated with the hospital, and i got the sense that she wasnt  extremely knowledgeable bariatric wise. I say that to say, that the people divying out advice about food intake are the MFT's and the RN, and they say eat 3-4 meals a day, or eat every 3-4 hours, seems I heard different things from different people.

I've basically stuck with the 3 meals a day, when I am moving around more and using up more calories, I'd add a snack or two. LIke string cheese, or an additional protein shake. 

I am 10 months post op ... and agree with many of the answers of those before me.

1. Try finding different kinds of protein. The shots are collegen protein and now well absorbed. At 3 months I was able to tolerate 1/2 of a protein bar at a time. Also found that Nectar protein was lighter than one mixed with milk and able to take in easier. Titan protein cookies worked for me as well (but could only eat 1/2 of one at a time.)

2. I too did vomit frequently til around 3 months. Since that time, I've only vomited once. I could eat ground turkey easily but not ground beef. I also liked ground chicken, but could not eat a piece of solid chicken (in fact quickly found out how to cook PF Chang's lettuce wraps made with ground up chicken breasts). Also at 3 months I started wanting flavor back in my life. That was a challenge, but made a conscious decision to do that.

3. Don't know about the rashs, but continue to follow up with the dermatologist. What I have found is my skin is much dryer than prior to surgery. This is because of the drastic difference in fat intake in my diet. I use moisturizers a couple of times a day. Try to find an alcohol free one.

4. Make every thing you take in count. Since I like flavor and also started having problems with constipation, I use a couple of packs of flavored Benefiber in my water a day. Propel also flavors water well.

5. Enjoy being NEVER EVER hungery. It took 6=8 months for that to return and luckily not to the extent it was before. Remember nerves were cut to make your pouch and those need to regenerate. I truly hope mine never completly regenerate. I do have other physical signs that it is time to eat.. I can tell when my blood sugar drops.

Around 3 months post op I also had this great surge of energy... my kids, friends and neighbors used to laugh at me, because I was like a wind up doll... wind me up and watch me go. It has not gone away since and hope it never does.

 Thanks for all your replies, great advice and good to know that I'm not a freak!!!

I'll keep trying to get the protein in and I'm very grateful that I am not hungry.

I guess I'll just have to work on trial and error with food and learn what's best tolerated for me.  I'm making a huge effort at chewing, chewing, and more chewing to paste consistancy and that seems to be helping.

Today I am at the 200.8 pound mark.  1 pound and I'm in ONEDERLAND!!!  I'm so excited and I think that has kind of reved me up again.  

Have to run off to work and drive in the wonderful snow :(