New and clueless

Hi everyone, I'm new here, had my VSG eight days ago and have lots of questions. I'm sorry but this may get long.

I've received very little information or preparation from my doctors in conjunction with this surgery, either before or after. I'm American but live in Germany and had it done here.

To personally prepare I read as much as I could and watched all the videos I could find online, noted the general things people were doing. The pre-op diets, the very specific advice for how to eat afterward, the stages, what vitamins to take, how to proceed with your medical team in the months following, etc. 

My concerns:

-I'll be working with my GP who has limited knowledge of how to take care of bariatric patients. I fear I'm her first. There doesn't seem to be medical teams or support available in my area to handle this kind of patient. Is anyone else going through that and if so... ?

-There was no preparatory diet whatsoever. No prep at all from the doctors.

-On the surgery day I was told I would speak to a nutritionist before I went home.

-In the hospital I received no IV fluids or special treatment aside from general wound care and a radiology visit to check for leaks. My pain meds were stopped as quickly as possible. I had to ask for fluids later when I began getting a headache and feeling fuzzy.

-I was allowed broth 24 hours after being operated, and in the four days after that I got a regular tray geared toward people on diets - low fat, reduced sugar solids. A cup of reduced sugar joghurt with blueberries, a slice of white bread topped with low-fat cheese and a piece of lunch meat, a boiled egg, a cup of tea, and a little note saying to chew well, eat slowly, and I didn't have to eat everything on the tray. For lunchtime, the big meal of the day, I received soft boiled veggies, noodles and tender beef in brown gravy along with cream of wheat with applesauce as a dessert, for example. I picked at a little of everything.  

I trusted they knew what they were doing and chewed everything into oblivion. The egg just about killed me. On days four and five I was able to take in half of the slice of bread with half the cheese and lunch meat but basically existed on the joghurt and water. When I asked the nurses why the solids when I'd heard I was supposed to be having nothing but liquids for a long while yet the response was "Oh just use your common sense. If you try something and it doesn't work, stop eating it and go back to something softer."

-This was the same advice I received from the hospital nutritionist visit on the day of my discharge. He said the new research they have shows people who're kept on liquids for three weeks then soft puree after that, etc., develop malnutrition and have problems with malabsorption much faster than those who are allowed to progress as they may using common sense. Quote unquote "Try a thing, eat slowly, chew very well, if you experience discomfort stop immediately, go back down to soft. If you find you're too tender for soft, go to liquids for a few days. Progress at your own pace depending on what you can do. But the goal should be to eat normally albeit in small amounts as soon as possible."

???

This goes against everything I've read and seen until now and although to a layman it seems plausible they may have info I don't - my surgeon is currently one of the best if not the best in the country - I don't feel confident in following this advice especially since I've encountered no one else anywhere being told the same. Please correct me if I'm wrong. What I have seen time and again is people being advised not to go too fast or risk death due to complications from inadequate healing of the staple line.  

As for how I'm doing so far, it's still the beginning but I'm eating soft solids with no problem and minimal pain. I feel very ignorant and so far very lucky but also like I'm in an unsure and risky place.

Anything thoughts you're willing to share are greatly appreciated, thanks in advance. 

Did you have it done in a military hospital?  German Hospital?  You are SO LUCKY you didn't spring a leak in the hospital, which would have been due to their complete ignorance!

 

I would encourage you to keep to soft foods for a while.  At least two weeks more.  THEN you should progress to stuff LIKE soft bread.  But bread is COMPLETELY off the menu if you want to make the best of your main weight loss window.  Protein protein protein.  Good shakes and lean meats, but the lean meats need to wait a couple more weeks.

 

There is a lot of information on here.  Start searching and reading.  There was one in the last few month about 'Phases'.  Talking about post-surgical dieting periods and what foods are allowed.  There are also a lot of different protein brands, pre-made shakes, and bars that are good, or snake oil.  You can read about those as well. 

 

We are here to help.  Please stick around.  We're here for each other, you included!!

 

Hi Rachel, I had it done at a regular German hospital. I have diabetes type 2 and my diabetes specialist recommended both the operation and my surgeon, said he was the best surgeon the country had to offer regarding bariatric operations. While I was there I noted plaques and awards all over the place for this man so it must so. The hospital itself and the nutritionists I've encountered so far not so much. I get the impression they're still very much in learning mode compared to the U.S. experience.

I'll look up the post on Phases, thanks very much for the tip and encouragement!

Wow - I don't know which part of all that was more insane than the other. I'm having my VSG done on 1/23/16 and I just had to take a quiz all about it at my surgeon's office yesterday. I would read this site; drink, drink, drink water; puree proteins; take vitamins daily and progress from there. The most important things are water and proteins - in that order. Eat 3 meals and 2 snacks according to the clock.

Please take it slow and easy. That whole post worries me.

Jan

Hi Jan, I will definitely take it easy. Something about chewing steak at this point feels completely wrong. I've been reading a lot today, bookmarked many things and plan to read more. Thank goodness there are online support groups or I'd be completely lost.

Here is the plan I was given by phase- designed to allow that stomach to heal. I think it is insane what they put on your food tray. 

First two weeks: protein shakes, yogurt (no seeds or chunks of any kind), broth, cream of wheat... nothing that you "chew" no chunks and absolutely nothing small like the seeds of strawberries that can get lodged in the staple line.

Weeks 2-4- puree/soft food still nothing you "chew" no chunks or anything. Examples scrambled eggs with melted cheese, refried beans, soup that has no chunks, etc. 

Weeks 4-6 soft food examples are like poached fish (not fried) soft cooked veggies, well chewed.  If you Google you can likely find a bariatric meal plan example or search on here.

Also, you will not experience feeling full like normal- that vagus nerve was cut so you don't feel it. MEASURE- no more than a couple of ounces at a time. This early out maybe 2 ounces max. Sip water in between, wait to drink 30 minutes after eating.

Post tons of questions here and we will try to help :)

Here is a sample plan I found online. I didn't read all 42 pages, but a quick skim... it was on point an loaded with all of the information you lack. Read. It. All. Ask questions!

Thank you SO MUCH. I just skimmed it quickly and it looks like exactly what I was looking for. :)

When it comes to measuring food, fluid or solids, do it by weight in grams/mL.  You already know, far more precise.  And there is a huge difference in volume and weight.  Always go with weight.  Happy Teacher put you in the right direction.

Lisa, check your messages.  I'm sending you a link that I believe will help you a lot!