What's Up With Doctors' Protocols - SO Much Variation

Burning question of the day - why does every surgeon/nut have various approaches, rules, regs.  I'm thinking specifically about immediate post op eating.  Much to the shock of my VSG pals, I'm on a blended diet from day one, instructed to have 6 small meals per day.

If anyone knows about this or about research based/emergeing protocols, please post!

Same here with pureed diets.  I know where I had my surgery done is a bariatric center of excellence.  They are very into evidence based practice and what the research shows.  They have some research going on.

I am only doing 3 meals, I know that has to do with making that a habit now to prevent grazing and snacking later on as my sleeve stretches.

They also reccomend doing dairy for protein versus shakes, but I became lactose intolerant so that is not an option for me.  I am going to be brave and try some lactaid pills and see how it goes.  Did not like the lactaid milk, tasted sweet to me.

I do know that the new research shows minimum 80 grams of protein per day and thats what my team is reccommending.

It is interesting how different the post op advice is.

I'd like to know what research they are basing their recommendations on.  I've not been able to find any that indicates using dairy for protein is better in some way than using protein shakes or that only eating three meals a day is better than eating more smaller meals.

I had surgery at a Center of Excellence too and that does not guarantee you are getting evidence based recommendations.  Maybe your Center of Excellence is basing their advise on research, but obviously they aren't all doing so or we would have gotten the same advice.  And my Center of Excellence did stuff like tell me to take calcium carbonate, when there is plenty of evidence we can't absorb that.

Anyway, I'd like to know what research your Center's recommendations are based on.

Kelly

it's true. my surgeon has a very strict post-op diet and I trust him so I followed it to the letter - in fact, it was one of the reasons I chose him. but others have posted their docs have them on pureed foods before they leave the hospital!

I went to youtube and watched all the VSG surgeries and it seems to me that after such a procedure, more caution  is better.

when your stomach is trying to digest it physically churns to do so and that can break the scar tissue you WANT to be forming around the stable line. the easier to digest (I was on thin liquids for 10 days post op before advacing to full liquids) the less churning the easier for your stomach to heal.

that's my take.

My Surgery was 9-29-10 and i am still on full liquids....i go back to dr the 19th

 Multipet mom - what you say makes sense.  However what my doc and others say makes sense from their perspectives, too.  I think I'm trying to ask not so much what's "best" but *why* there are so many different ways, *and* that each doc feels "my way is the only way."  

Lucy, I think some of it is that not all the facilities have a lot of experience with sleevers.  Most of the info I received before my surgery was geared to RNY and Lap-band. Afterwards it was more a couple of sheets on what to eat and we can eat stage II foods, like cottage cheese, sf pudding, sf Greek yogurt, sf applesauce, strained "cream of" soups and blended soups (no chunks or pieces. One protein drink per day,( 40-55 g protein worth). After two weeks I see the dr and hopefully can continue to stage III, adding 1-2oz tuna w light mayo, saltines, toast. This is for 6-8 weeks, then we can finally have eggs, fruit (peeled) etc.  These stages takes 2 - 2 1/2 months.  Seems slower than a lot of people on here.       

It does seem strange but I guess each one really believes their way is best.  For example, my surgeon did not have us do the liquid diet before surgery. He encouraged us to lose weight but there was no "lose or else" protocol.  I know some people can not have their surgeries if they don't lose a certain amount.

I was with a friend all week in Savannah. She had a complete hysterectomy and it was a very involved surgery with the removal of 2 huge fibroids...soccer and football sized! It ran late into the evening and she was allowed a few ice chips. The next morning I thought she could have liquids, then soups, yogurt etc...but nooo, they told her regular diet! She was allowed to order from a vast menu...she having issues with food (we know about this) ordered generously. Bisquits, gravy, eggs, taters, grits, sausage and a fruit cup. I was like...uhhh...take it easy. Within a couple of days, the food started backing up on her because the bowel was not awake yet. She was not even passing gas yet but they allowed it. I knew better.

So, why would they all be so different?? I suppose they really do think that their way is best. You would think they would use research...maybe they do? Now, looking at your request, I should delete this...you said if we knew about the research...please post but now I've typed it all out so forgive me.                        Connie

the difference, I think, is because it's not based on research.  It's partly based on a doc's personal experience, partly on what he learned during his residency, and partly just his own personal preferance.

For instance, if a doc had a patient start solid food soon after surgery, and that patient had a complication, that doc might advise all his patients to stay on liquids for several weeks.  But if another doc has had patients start solids very early and they've all done fine, that's what he'll continue to recommended.  But neither are basing their recommendation on a study or anything scientific.

Kelly

In all likelihood, your surgeon will not be happy if you fail to follow his or her particular protocol.  Surgeon's have specific protocols that are based on their experience and guidelines they find the most beneficial to their patients.  You should try to attend some support meetings for your type of selected surgery, where you can speak to recent post ops.  Most surgeons have some type of support groups, where you'll hear from his/her patients.  Good luck. DAVE