I find it so amazing how all these doctors want and manage to get the same outcome (for the most part)... yet such DIFFERENT rules!!!!!
This stems from 2 posts I was just reading about ...
1- protein intake - food vs shakes
2 - whole pills vs crushed

Sometimes I wonder if my doc is crazy! 

I am just shy of being 5 months out.  I am told to continue to drink protein shakes basically FOREVER.  That it should be my MAIN source of protein.  He says its my FUEL and that my "snacks" during the day are just a little bonus.  I have been drinking 2 isopures everyday to get my 80g in and then I have 3 small snacks. 
*Absolutely no grazing during the day 
*And am not to go over 
     60g carbs
     15g fat
and not exceed 700 calories.... 

Does this make sense???  I can be honest - I do not count anything out - I figure -- I don't eat enough to worry about it.

As for the pills - he said when he does colonoscopies on patients he has found pills in patients colons that have not completely dissolved, so he does not believe in ever swallowing a whole pill.

Sorry so long... just had to share...    

Jamie

I don't doubt that there are some people who have to rely on protein supplements because they have a metabolic issue and that there are some people who are so controlled that they could exist on protein shakes for the rest of their life.

However, for those of us who do not have clinical issues that make supplementation a necessity, I doubt that your doctor's regime can be followed in the long term (ie for life).

I love food and would not swap protein shakes for it - UNLESS my life depended on it.   I didn't have this surgery to stop eating - I had it to help me get to a normal (ish) weight and then maintain it - pure and simple.

At the end of the day our doctors are not living in our homes (or our lives) and we all have to do what we feel is best for us - for some it is religiously following our doctor's "rules" and then running the risk of feeling like "failures" again when they can't sustain that lifestyle and for others it is weighing up the information we can glean from professionals AND our own resources and making our own decisions on how we live our lives ...

edit : removed
i'm just in a bad mood waiting for the weekend

I do not believe he has found undissolved pills in a patient's colon.  Even if your pills were not dissolving, they would come out when you pooped.  Anyone here ever seen a whole pill in their poop?  Anyone?

But anyway, prior to a colonoscopy, they give you this stuff to drink that makes you poop like crazy.  They need your colon empty so they can see in there.  If you had a pill in your colon, it would be gone before your colonoscopy unless you just did not do the bowel prep as instructed.

The fact that docs have all different kinds of "rules" but end up with about the same outcome indicates that they are basing many of their rules on their own personal preference rather than on anything scientific. 

My surgeon recommended doing protein shakes forever but said we should get lots of protein from food too.  We were supposed to eat regular meals and they were not a "bonus."  Personally, I cannot see why it matters if you get your protein from food or from shakes, as long as you get it.  The only issue I would have if I did a couple shakes and three small snacks every day is that I would be hungry.  Those Isopures will not keep you full as long as solid food with protein.  If that works for you, though, then I see no problem with it.

I do not think 700 calories is enough though, especially if you get much exercise.  Again, if it works for you, then I guess that's what you should do.  Your weight loss might stall from not getting enough calories, though.

I'm just in the beginning but I'm pleased with my surgeons long term plan.  After the first six weeks it's 75% dense protein 25% complex carbs, eat 5 -6 times a day, the volume changes with time,  but not grazing all day.  I am to drink minimal calories, but drink over 2 liters a day.  Nothing is forbidden, I should include it as part of my diet and plan for it. 

I'm happy to not have to drink shakes forever, a few weeks is more than enough. 

Though Kelly has already said it as well - I am EXTREMELY skeptical about your doctors claim to have found whole pills during a colonoscopy. Even if they didn't dissolve in the stomach, there is a strong possibility they would dissolve in the intestines, and beyond that they would simply come out barring some incredible unforeseen complication. I have never seen any pill that hasn't dissolved or the most part or been passed on its own.

Your doctor has hopefully mentioned that not all pills are ok to crush. Some are absolute no-no's for crushing or altering in any way. And many, many others the medication is not evenly distributed so if you break pills etc, you may not be getting the correct dosage.

Personally, I eat my protein for the most part. I give myself a jump start in the morning with a protein drink but beyond that, I eat it. I can't imagine what logic is behind the concept of only drinking your protein and using food as a bonus.

Thank you everyone for your posts.

I absolutely agree with the posts about the pills... Just was putting the info out there that he gave me and preaches about when I have seen him.

Thanks again,
Jamie

 Allegra D goes in as a whole capsule..then the insides come out and you normally "poop" out the shell...my doc called them ghost pills.  thats the only thing i have ever seen go through.  Magnesium citrate and any other bowel prep pretty much cleans you out  pretty good.  
I refuse (personally) to ever get my protein from shakes...instead i would use a protein shake for a breakfast item or a snack item if i get hungry.  

I am addressing each part of your post by .......followed by my comments.  Couldn't make the editor work to change the the color of the font.

I am just shy of being 5 months out.  I am told to continue to drink protein shakes basically FOREVER........ Many people continue to supplement with 2-3 shakes a day.  They just find it easier to meet their goals.

That it should be my MAIN source of protein....   .It shouldn't be your main source of protein in my opinion.  There are plenty food sources for protein.

He says its my FUEL and that my "snacks" during the day are just a little bonus.......actually protein is converted to amino acid to build and repair muscles and tissue.  Glucose (sugar and carbs) are the body's source for fuel and energy.

 I have been drinking 2 isopures everyday to get my 80g in and then I have 3 small snacks....There is nothing wrong with this, if it works for you.  Just remember that eventually normal hunger patterns will probably return as your body begins to "overcome" some of the malabsorption issue in 18-24 months

*Absolutely no grazing during the day......That is is great and probably the best habit you  could develop. I have no problem for the most part but now some days I just "want" something.

*And am not to go over 
     60g carbs
     15g fat
and not exceed 700 calories....  .......These are the "standard" guidelines, I think, for most people after sugery.  Ingesting more can sabotage your weight loss.  As for the calories, one can't get in many calories from eating during the first few months due to the restriction that the surgery created.  But over time we are usually able to eat a little more, thus increasing our calories.  Another issue for me and calories, was every time I hit a stall in the first few months, I found that if I increased my calories by as little as 200 per day I would start dropping pounds again.  The body will slow down its metabolism when it thinks it isn't getting enough food. And when the metabolism slows down, the pounds will not.

Does this make sense??? ... I can be honest - I do not count anything out - I figure -- I don't eat enough to worry about it..............I don't count much either, but I do watch portions because I have found that many days I can eat more than I should.

As for the pills - he said when he does colonoscopies on patients he has found pills in patients colons that have not completely dissolved, so he does not believe in ever swallowing a whole pill.......I find this one funny.  The body will pass undissolved pills pretty quickly ( I know this from personal experience).  So unless he is doing a colonoscopy within 3-4 hours after someone has taken them and doing it without a bowel cleanse first, I think this would not be possible.  Sounds like a "scare" tactic to me.  At 5 months out you should be able to swallow any pill or capsule you need to.

I am sorry but I disagree with most of what your surgeon is telling you.  Yes, protein shakes are good for you and many of us  do absorb the protein in them better than food but if you eat normal meals throughout the day you will get enough protein and you can supplement that with shakes but you shouldnt' be making your shakes your primary source of intake.  you need fruits, vegetables, fats even an occasional starch.  You can live on protein only. I can't attest to the amount of carbs and fats since I have never counted them and was never given an amount. 

At 5 months out, 700 calories is way too low.  Of course, if you are only eating 3 snacks and 2 isopures, you aren't going to have many calories but you are also going to go into starvation mode eventually and stop losing. Your body needs calories to survive.  The best way to increase your metabolism, decrease hunger and maintain a constant blood sugar avoid reactive hypoglycemia is to eat 5-6 small meals per day  - high protein, low carb and low fat.  You eat every 2-3 hours, each meal must have protein.  You can count one of these as a protein shake and if you want to do a second shake, do it in between 2 of the meals.  You also need to get atleast 64-80 ounces of fluids.  As far as calories go, at 5 months out - I would say about 900 calories = atleast.  My protein shake has 300 calories just for the shake but it also has 45 grams of protein.

As far as the pills go - it makes no sense.  When a colonoscopy is done, it is after a total colon cleanse and no pills for atleast 12 hours.  If pills are still found in the colon then either the pills were taken recently or no colon cleanse was done.  Any colon cleanse would eliminate any existing pills that would still be there.  I think he was just trying to scare you into using chewables which I am not sure why.

You can use centrum silver chewables - these are very good and taste good. Calcium citrate comes in chewables from bariatric advantage but much more expensive than citrical and the citrical works just as well.  b12 needs to be done with sublinguals or injections.  Vitamin D3 needs to be dry D3 - which is either a tablet or capsule.  Iron can be taken chewable but it is a much lower dosage in the form of carbonyl iron which we need and then you need to add extra vitamin c.  As far as your pills, make sure you talk to your pharmacist because not all pills can be crushed.  But just know - there is absolutely no reason why you can't swallow regular pills by 5months out.  I took pills at 1 month out and all my blood tests are fine.  That is the way to know if your pills are working.  IF it is a cholesterol mediation - how is yoru cholesterol. etc. The one thing that we tend to have trouble with is thyroid - make sure it is synthroid and not generic. There is a difference and have levels checked frequently.  Don't take within 2-4 hours of your calcium or iron.  I take topamax to prevent migraines - if it wasn't working I would have alot more migraines than I am getting. Before taking the topamax, I got them daily and sometimes for 3 days at a time.  Now that I take topamax, I get them about once per month or once per 2 months - so it still works.