First Post-Op Visit with Surgeon

[OldBroad]

I had my first post-op visit with Dr. Elariny. He took a lot of time to respond to my questions about vitamins, protein, eating, drinking, etc.

He made a couple of persuasive points about why in the early weeks at least, it is important for even DS patients to put some separation between eating and drinking. He did a little demonstration with the sleeve of his jacket to show how narrow the passage at the bottom of the stomach is because of all the stapling and folding. He also used a drawing to demonstrate that the issue is that liquids don't have room to pass over any food that is sitting there digesting, at least not until there has been more healing and reduction in swelling.

We talked about my problems taking medications I've been prescribed for depression. I haven't been able to take them. I've tried crushing the Lexapro tablets and dumping the Vyvanse and Deplin capsule contents into applesauce, into juice, into pudding. No go. The taste is so awful I just can't. Well, Dr. Elariny suggested I try taking each pill alone with water, waiting several minutes between pills to see how my stomach tolerates it. I tried that this afternoon and it went fine. So there's another problem solved.

We weren't able to come to an complete agreement about what to do about vitamins. He insists that I need to be taking everything I outlined in this post: http://bariatricfacts.org/threads/initial-post-op-ds-vitamins.2733/#post-40536 I told him I thought it sounded like a lot, given that I probably have reserves and asked him to prioritize the ones that he thought were most critical. He did say he worried most about D3.

He also insists that I need to get 100+g protein everyday starting right away. I'm getting 50-60 at this point, and it's a real effort. He put it to me that his priorities to avoid hospitalization were:

1. Hydration
2. Protein
3. Vitamins
4. Diet progression.

He also invited me to communicate via email with him, which is awesome because he (like most people these days) is hard to reach via phone. I'm happy to wait for answers to my questions if he's OK with using email.

All in all, a good experience for me.

 

[Spiky Bugger]

All good news, but I would put vitamins/supplements ahead of 100 g of protein this early out.

 

[DianaCox]

There are a couple of new phrases you need to learn - "Smile and nod" (said to yourself as you are subjected to stupid or irrelevant instructions). And "I hear what you are saying" (said out loud to acknowledge something told to you that you have no intention of agreeing with or following).

You KNOW we are adamant about protein and vitamins. But it is beyond a doubt our experience that hydration is 90% of the concern in the first month or two; protein of increasing importance (the 30:60:90 "rule"); vitamins as soon as you can - but I've never heard of anyone who was well nourished at the time of surgery needing to be hospitalized for not taking vitamins for 3 months - ever.

I would say that there is something of secondary importance that he has NOT mentioned - and that is getting some physical activity. Get up and start WALKING! Every day. Around the block, around the mall, you MUST get some physical activity. Join the Y and start swimming. As you know, as you lose weight, you are going to want that weight to be coming from fat and not at the expense of muscle - you need to keep the big muscles you already have from lugging around your pre-op mass, especially in your legs, to stay big by keeping them active and toned. Your heart has been getting a workout - you want to keep your cardiovascular system stimulated as well. As your body changes in proportions, your joints are going to have to readjust to the different weight distribution and pressures - keeping the muscles around them fit will prevent problems.

 

[aaa]

I sipped much more than I ate. As a matter of fact I didn't reach 50 grams till about 6 mos. I just made sure I drank a shake a day. Did that for the first 2 yrs. in fact; as I just couldn't eat enough.

My vits. were gradually increased as time went on. We didn't start heavy due to ( like you said) reserves.