Question About the Reasoning Behind the Pace of Advancing Through Food Stages

Hi friends,

I had my surgery a week and a half ago on July 27 and am doing great.  I haven't had any instances of nausea, dumping, vomiting or things get stuck.  This is great, but also a little bit of a curse as my mind seems to forget I had the surgery and wants to nibble on everything.  No fear, I have been scolding her and saying "no" to these temptations!  

However, I do have a question about advancing on through the phases.  My post op appointment isn't until Thursday so I figured I'd as you all.  Are there other reasons for the diet phases and their length other than trying to gently acclimate your body to the foods?  I left the hospital on Phase 2 (full liquids) and have been "dancing" with phase three (a little thicker purees) since shortly after that.  I've mostly stuck to ricotta cheese mixed with tomato sauce, refried beans and cottage cheese but all of these are going down very well.  I feel like my body is ready to advance fully to phase three, but don't want to do any harm if there are other reasons for the slow process.  Are there other reasons for us to follow such a slow progression?  The only I have heard is because our bodies take a long time to get ready for it.  This is clearly not the case with my body, though.  I think my new stomach might be made out of titanium or something.  :(

Also, most websites say that I should only be able to consume 2-3 tablespoons at a time.  This has also not been the case with me.  It may be the slider food phenomenon, but I am able to eat 3/4 a cup of ricotta/tomato mixture.  I'm wondering if advancing to the next stage might help me eat some things that will "stick" with me longer and cause me to eat less at a time. 

Does anyone have any insight on this? 

Yeah, it's the sliders.  Advancing to the next stage will probably mean you can eat less than you can right now because the food will be denser.

The reason for gradually progressing to more dense, solid foods is to give the internal organs (mainly the stomach/pouch and small intestine) time to heal.  Advancing your diet before your doc OK's it may or may not cause any problems.  Different docs have different ideas about how fast or slow to progress, so it's not like there's one right answer.  Really, I think it's a matter of some people being ready faster than others.  But if you eat something before your pouch is ready for it, you'll feel really miserable.

The stages are strictly surgeon preference.  Some surgeons (like mine) release patients to soft foods after only a couple of days as long as they do ok with a day of clear liquids, a day of full liquids, and a day of purees. (I had a couple of bites of a scrambled egg before I ever left the hospital after open RNY)   The vast majority of my surgeon's patients have no trouble with soft foods very early out (although, as with even extremely conservative food progressions, some people do have trouble with certain food items the first time or so that they try them). There is no evidence that soft foods can cause damage to a new pouch and the anecdotal evidence in the experience of my surgeon and the other one I considered for my surgery is that people *****sume soft foods quickly actually have LESS trouble with eating post-op... almost as if "babying" the pouch causes it to be "grouchier" about solid food.  In any event, the body doesn't really need time to "get ready" for non-liquid, non-pureed food.

The 2-3 tablespoons of food at a time is also largely surgeon preference.  Even with some swelling, there is ample room for more than that in a new pouch, but since we do not have the ability to sense "full" (we mostly just sense "uncomfortable" if pressure is put on the healing area of the pouch) it does make sense to limit the amount of food very early out in order to avoid causing distress or undue pressure. 

Yes, you will almost certainly eat less volume once you are eating more solid foods that do not slide right through your pouch.

Lora

agreeing with ****ro. My drs' plan was REALLY strict: 3 to 4 weeks clear, 3 to 4 weeks full, 3 to 4 weeks purees, 3 to 4 weeks soft woth raw veggies and meats coming in like 3 to 4 MONTHS out.  And as ****ro mentioned my pouch is BEYOND sensitive.  I can't tolerate salads/raw veggies and MOST lettuces, cant eat beef/pork but maybe once a week and MUST be home cause it will most certainly make me feel yucky. 

Kelly is right;  it's mostly to let your insides heal.  You really don't want to have those stitches
compromised.

As to the amounts you can eat right now--I could drink my liquid shakes easily when I was immediately post-op, but food was another thing.  I'd like to suggest that "just because you
can doesn't mean you should" is a good slogan right now.  Our nerves for "full" aren't oper-
ating, so it will be too easy to overeat.  You will regret this when it happens.

We've all spent so many years just shoveling food into our pieholes that NOT eating is an
entirely new experience.  I'd like to recommend that you not push your limits just yet.  You
probably  don't know when you've reached your limits, because you no longer have the
enormous feeling of satiety we used to have when we've eaten, so watch for your "High
Level Alarm".  When your nose starts to run, you're done.  Stop eating right then. 
Of course, your signal may not be a runny nose;  some folks burp, others hiccup. 

Whatever it is, stop eating.  This is all part of our new conciousness:  Mindful Eating.

I'm very pleased that you've had such an easy post-op period.  Congratulations on your
successful surgery, and I'm sure you'll have a lot of fun Wow! moments to enjoy.

Best wishes,  

Glad you are doing great and having an easy time. I, too, have a cast iron tummy. However, I would suggest you follow your Drs advice regarding phases.  He/she has a reason for doing it that way.  And expecially follow the intake amount guidelines.  You don't know when you are full and why pu****  Our plan was for 1/4c, 6-8x a day early out.  You really aren't hungry either or will feel full so just eat your small amount and wait until the next meal.  You don't want to start pushing limits now.  Use this time to establish good habits.

 I'd agree with Kelly. Your stomach/pouch needs time to heal. It's sort of like a newborns stomach.... you wouldn't try and feed them baby food when they are only 3 weeks old... you stick with formula because that's what is best for them. 

Also, I saw you said something about tomato sause. I would be careful with that because tomato sauses tend to have a lot of sugar and also they contain so much acid which may not be good this early out. Different surgeons say different things, but mine recomended avoidong tomato products until 4 months out. 

Thanks for the input...I will stick where I am until the doc clears me for "takeoff" to the next level.  Hopefully at my appointment on Thursday! 

I truly appreciate all the insight!

 Thank you for asking this question.  I woke up thinking about this same issue.

I wld do what I feel is ok. Like my doc says no carbs what so ever for 6 mos. Well occasionally I wld like a bite of potatoe or even some beans so I do. Now I am not gonna go get a bag of potatoe chips. I am 12 weeks out and struggle to even get in enough calories or protein to function so I have had to eat what I can so beans have lot protein so I have em. I kinda jst go with my instincts on what I can handle. If u do have something to soon ur body will def let u know!! Jst start out slow and don't pu****