Friend just had Sleeve surgery, I already had RNY. Best way to support her journey?

I had RNY 8.5 years ago, so I know about RNY.  I had 3 babies post op and a whole slew of health issues with fibromyalgia, plus I suffered deep depression, so I fell off the wagon a bit after losing down to my goal of 137.

A childhood friend of mine just had Sleeve surgery on Wednesday and I offered to support her by going back to day 1 of my RNY surgery and progressing with her.  It's an opportunity to get back on track anyway, now that I'm finally getting good treatment for my health issues.

Anyway, when I had RNY, I don't think the Sleeve existed.  I want to know from those who are there now how I can best support her.  Are the requirements of RNY similar to the Sleeve?  What can I do to help make this the most positive journey for her and cheerlead her.  I'm on day 4 of the liquid diet and I'm doing great.  Unfortunately, she suffered horrible nausea after her surgery and had to be re-admitted.  She just got back home tonight, so I'm not sure where she is as far as her diet.  I know she has been able to drink protein drinks, but not sure how much, etc.

I'd love insight so I can be the most supportive to her.  Thanks!

http://www.cornellweightlosssurgery.org/pdf/dietary_guidelines_sleeve_gastrectomy.pdf

Start here with this guide. Some others do vary as all doctors do not do the same program. I believe some doctors on the west coast have been doing the vsg for close to 10 years now. The sleeve has been around since the 1800's as a partial gastrectomy for ulcers and stomach cancers.

To be a supportive friend, be there for her. She will be tired and probably going through some head hunger issues while she is on liquids and pureed foods. Stay positive and also read the many pages here. Send her here so she can read up on stalls, vitamins, dietary tips, exercise etc.

My best friend had rny 6 years ago and I was sleeved 11 days ago.  Today while out shopping she drove thru the taco bell drive through.  I told her I couldn't believe she would taunt me with the smells of what I can't have.  She was truly surprised because the first several weeks after her surgery she was always so stuffed full she couldn't think about eating anything.  I told her that whil I am experiencing no hunger, I feel no fullness either and my cravings are triggered by smells and sight. 

This is a good example of how different our experiences can be.  With the rny the stomach is sewn off and you had feelings of fullness right away.  The entire length of my stomach has been cut and the nerves need to heal.  I won't experience those sensations, at least correctly, for a few months.  Right now I measure everything and eat that portion, with my onlymotivation being to get my protein in.

You are a good friend to restart your journey with her.  I would try to get mine on board but she's 21 weeks pregnant :)

I like that guide that was given a couple of posts above.  I do want to mention though that it is for informational purposes to fill in the blanks.  Her surgeon and or nutritionist likely has given her a set of rules or post op plan that she should follow strictly.  If there are questions about what she needs to do next her best bet is to talk with her surgeon and / or nutritionist for the best advice.  

Most plans have a phase where you have about a week (give or take) of clear liquids.

This is followed by a week or so (give or take) of full liquids.

Then that is followed by a few weeks (give or take) of pureed foods ... on here sometimes referred to as mushies.  My nutritionist defined that as anything that can be mashed with a fork.

Then the next step differs somewhat ... some people go on to adding regular foods back into their diets slowly to make sure there are no issues with those particular foods.

My nutritionist had a step before that referred to as soft foods.  Something a little more solid than pureed foods but not like a pork chop or steak or hamburger (at least 90% fat free that is).  

The basic idea is that you eat proteins first and if room allows vegs and if still some room whole grains.  The first several months will likely be nothing but proteins in various forms.  Her goals would be something like 8 cups of liquids (water, or flavored water) per day that she will be sipping on slowly.  And another daily goal will be to get something around 80 grams of protein per day.

During her weight loss phase she should be working on:

8 cups of liquids per day

600-800 calories per day

40 grams or less of carbs per day

Now as I mentioned this various from surgeon to surgeon and the numbers are likely to be off a little bit but these are fairly standard.

She would expect weight loss the first couple of weeks and then it will slow down and she will hit what on here is called the three week stall.  She will likely be upset at not loosing the weight during the stall.  Remind her that during the stalls she will have her weight in her body redistributed and this will result in loss of inches in various places during the stall.  After the stall is over weight loss kicks in pretty fast followed by a slow down and another stall.  It is a cycle.  

For protein shakes as per my nutritionist she should be getting the following in a "shake"

Whey Protein Isolate (which is recommended over any other protein source such as Whey Protein Blends or Soy)

One serving should have 5 grams or less of fat.

One serving should have 5 grams or less of carbs

One serving should be about 24 grams of protein.

 

I think that pretty much covers the basics.  Any other questions can be answered in this forum.  I would caution her as I do everyone that most people on this forum are not doctors or even in the medical field.  Do not get medical advice from this forum.  If there is something that comes up about medications and use or discontinued use or what she can and can not have ... she needs to have these discussions with her surgeon.  He/She will know what is best.

The posters above have given all the information I can think of. I just want to say that it is AWESOME that you are being such a great friend. Keep in mind, head hunger is a beyotch. Just be there to push her along when she feels down, and you guys can help keep each other on track.

I just wanted to make a point that I am following HER post op requirements.  They honestly are about the same as RNY.  I'm also dealing with head hunger because post op RNY, I didn't have any issues with dumping or any food sensitivities.  I truly am going back to day 1 of surgery.  Her surgeon's guidelines are:

2 days clear liquids

12 days of full liquids (yogurt and pudding allowed, blended soups)

1 week of pureed (refried beans, etc)

1 week of soft foods (cottage cheese, blended chili, etc)

 

I'm following her diet to a "T" only I can obviously get liquids in more easily.  Day 1-3, I had clear liquids whenever, but on full liquids, I'm drinking throughout the day, but I make my "full" liquid choice (yogurt) my meal.  So I stop drinking 15 minutes before I have yogurt and don't drink again for at least 30-60 minutes.  I'm on day 6 and going strong:)  I have 4 little ones, so I'm having to be vigilant about not licking the peanut butter knife, etc.  I drink calorie countdown milk with my pills that require me to have food in my stomach.  I have to take 27 pills a day between supplements and vitamins and other meds for my health issues, so I have about 10oz of milk morning and night to get all of those down.  Milk is not my friend, but this works for now because we can't drink with food. 

The following of the diet is in support of my friend and get me back on track, but my question was more geared toward how this surgery affects you health-wise.  For RNYers, we have the malabsorption issues to be aware of and keep ahead of.  We also have the same issues sleeve patients have with decent weight loss week 1 and 2 with a stall week 3.  It seems the surgeries are very similar.  But do sleeve patients have issues with pain or strictures or ulcers?  I read that GERD can become an issue, but is that just in the beginning?  Is the weight loss plan to achieve goal similar to RNY in that most get there around 12-18 months?  Will she ever have to deal with future surgeries?  Are NSAIDS a no-no, like they are for us?  Are there potential health concerns that the sleeve can eventually trigger?  Those are the kinds of things I'd like to educate myself on so that I can be helpful in her journey. 

Thank you to everyone who has responded and I appreciate your feedback.  :)