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vaultboy

Some Post Op Questions

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Hi everyone. I'm a 35 year old male who weighed 215kg and just had the sleeve procedure done on Friday. I was able to leave hospital and go home on Monday and have just been getting used to everything. The thing is, I have a number of questions and would greatly appreciate any help or thoughts you guys might have :)

1.) I've been getting really hungry. Like, stomach growling and hunger pangs every 2 or 3 hours. I usually just have water, milk, coffee or an OptiFast shake, but it still doesn't feel like it hits the spot.

Sometimes it subsides after a while but I was under the impression you wouldn't feel hungry at all, post-op? Maybe its just because all I can have is liquids and my stomach is going "give me something solid!!"

2.) Since I'm on the fluids only stage, they said to take small sips. Which I started doing. But I've found I can actually take normal or regular sized sips and I don't get any reflux or pain. Is this good or bad?

3.) Also, how do you know how much you should be drinking in total in a sitting? I mean, I can easily drink probably about 500ml but should I be keeping it lower to something like 300ml? How big is the volume of our new stomachs?

4.) I usually sleep on my tummy and find it almost impossible to fall asleep lying on my back. The last couple of nights have been terrible, even though I've been back home in my own bed, because I'm sleeping on my back. I was worried about aggravating the wound site if I slept on my tummy, but do I need to be?

5.) What else can/should you drink during the liquid phase? So far I've basically just been drinking OptiFast shakes for main meals, water and milk (sometimes flavored with Quik) for drinks and the occasional coffee here and there because I cant do without coffee.

Should I be drinking protein drinks or shakes as well? Or is there anything else that's low-cal but actually tastes good?

6.) Continuing on, whats the verdict on fizzy drinks like a small glass of Coke Zero/Diet Coke? Some people seem to say its fine others say not to. Whats the consensus here?

7.) Do medications (tablets/capsules) need to be crushed in to powder and/or dissolved to be taken when on the liquid only phase? The nurse said not generally except for one of the ones I take (because its so large), but then how is that different (swallowing solid tablets) vs having mushy or chewed bits of food?

8.) Regarding the Lap-Surgery wound sites. I've had little waterproof gauze pads covering up the 4 surgery sites + 1 drainage site and was never told when to take them off. Do I have to keep them on until I go back for my review appointment in 2 weeks? Or do I just take them off now that I'm home? Or do they have to be replaced with new ones each day or something?

I'm sure I'll have a few others but they are just the ones that immediately come to mind :)

 

Edited by vaultboy
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I'll try by best to answer:

1.)  You're new tummy will be making all sorts of noises, which you may confuse with hunger.  Like I said, you'll get pain but not grumbling, if that makes sense.  It'll take a while for things to settle down.

2.) If you are comfortable, then it's OK.  Once you hit the "full" stage, stop.  You're still healing, so you can't overdo it.

3.) Frequent sips throughout the day is fine.  You need to keep your fluids up so you don't dehydrate and it also helps with bowel motions.  If you feel constipated, try pear juice or prune juice.  Add Metamucil to some water to help keep things regular.

4.) Try sleeping on your side if you can't sleep on your back.  I'm a tummy sleeper too and took about 3 weeks to go back to tummy.  Obviously if you feel pain, don't lie on your tummy.  Try a 45 degree angle, propped up with pillows.

5.) Clear soups, smoothies, runny custard, runny yoghurt.  Think baby food consistency.  Thickness of fluids should be able to be sucked through a straw.  Make sure smoothies, yoghurt contain NO CHUNKS WHATSOEVER.  Coffee is fine.  You may have issues with milk that you didn't have pre op.  Don't be too concerned about "eating the right foods" in these early stages.  My dietician said as long as you're getting "food" in, don't stress about eating protein etc.  You can worry about that when you're back to a full diet.

6.) In the early post op period, avoid as the bubbles can expand the tummy and to be honest, if you take a big gulp, it hurts like hell!  Here and there you can enjoy a fizzy drink but don't make a regular habit of it.  I find "knocking the air out" help with drinking, so it's just got a bit of fizz.  Pouring over ice can do the same.

7.) They gave you full tablets in hospital so there should be no issues, though if your medications are the size of a horse tablet, then break it down but certainly does not need to be crushed.

8.) After a few days, you'll notice the dressing/tape peel off.  If your wounds are yet to completely heal, you can replace them with dressings from the chemist.  If you have ooze of blood, pus, redness or heat surrounding the wounds, call your surgeon or see your GP.

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Thanks for thoughts Nessa, I appreciate it :)

Unfortunately bowel motions are the opposite of constipated at the moment. Not paint too gross a picture, but Its like a fire hydrant. I might be overdoing the water perhaps.

 

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Hahaha I get the picture!!!  1-2lt per day is enough.  Might need to back off on the fibre :)

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Noticed around the site that other people using Optifast have been complaining of the same thing with the new and improved version and bowel motions.  Wishing you well on your journey.

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hey VaultBoy, you are exactly one day ahead of me, I went in on Sat 30th april :)

So definitely not an expert here but my 2 cents I have realised what I was mistaking for hunger pains is actually heartburn, maybe it's the same for you?

 

Also yay Fallout reference.

 

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If that's the case, try Nexium (or equivalent), which you probably should've been discharged home with?  If not, perhaps see your GP or surgeon and ask for a prescription.  Yes, heart burn can mimic hunger pains.

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Thanks guys :)

I use to get indigestion/reflux occasionally before the op and I can definitely tell the difference. I haven't heard of Nexium, but I'm on Pantoprazole (which they discharged me with from hospital) and I usually take Ranitidine (Zantac) for reflux, when I get that.

However, this definitely feels more like hunger. When I get reflux I usually get some burps and/or the occasional hiccup, but with this hunger feeling I dont get those. I also dont get any pain or discomfort up the esophagus or the throat. Just the gut, like when you're hungry.

I've also swapped to OptiSlim instead of OptiFast and going to give that a try :)

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Well you may very well be hungry, after all you've just dropped your intake pretty dramatically.  However its a case of suck it up early on in the process, you have to protect your surgery site and follow orders. I think part of the thing with the sleeve is that hunger hormones drop but it probably takes a while for your mind and your body to adjust to that.   

Hang in there, post op can be really difficult for people - often they are surprised to feel so hungry and find it so hard, but weight loss surgery is after all only a tool.  Your hunger will not be such a problem once you an eat solids

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Hi everyone. I'm a 35 year old male who weighed 215kg and just had the sleeve procedure done on Friday. I was able to leave hospital and go home on Monday and have just been getting used to everything. The thing is, I have a number of questions and would greatly appreciate any help or thoughts you guys might have :)

1.) I've been getting really hungry. Like, stomach growling and hunger pangs every 2 or 3 hours. I usually just have water, milk, coffee or an OptiFast shake, but it still doesn't feel like it hits the spot.

Sometimes it subsides after a while but I was under the impression you wouldn't feel hungry at all, post-op? Maybe its just because all I can have is liquids and my stomach is going "give me something solid!!"

2.) Since I'm on the fluids only stage, they said to take small sips. Which I started doing. But I've found I can actually take normal or regular sized sips and I don't get any reflux or pain. Is this good or bad?

3.) Also, how do you know how much you should be drinking in total in a sitting? I mean, I can easily drink probably about 500ml but should I be keeping it lower to something like 300ml? How big is the volume of our new stomachs?

4.) I usually sleep on my tummy and find it almost impossible to fall asleep lying on my back. The last couple of nights have been terrible, even though I've been back home in my own bed, because I'm sleeping on my back. I was worried about aggravating the wound site if I slept on my tummy, but do I need to be?

5.) What else can/should you drink during the liquid phase? So far I've basically just been drinking OptiFast shakes for main meals, water and milk (sometimes flavored with Quik) for drinks and the occasional coffee here and there because I cant do without coffee.

Should I be drinking protein drinks or shakes as well? Or is there anything else that's low-cal but actually tastes good?

6.) Continuing on, whats the verdict on fizzy drinks like a small glass of Coke Zero/Diet Coke? Some people seem to say its fine others say not to. Whats the consensus here?

7.) Do medications (tablets/capsules) need to be crushed in to powder and/or dissolved to be taken when on the liquid only phase? The nurse said not generally except for one of the ones I take (because its so large), but then how is that different (swallowing solid tablets) vs having mushy or chewed bits of food?

8.) Regarding the Lap-Surgery wound sites. I've had little waterproof gauze pads covering up the 4 surgery sites + 1 drainage site and was never told when to take them off. Do I have to keep them on until I go back for my review appointment in 2 weeks? Or do I just take them off now that I'm home? Or do they have to be replaced with new ones each day or something?

I'm sure I'll have a few others but they are just the ones that immediately come to mind :)

Hi Mate. As a fellow male, I'll try and respond with some insight of my own. I'm nearly 12 months post sleeve. 50kg down and actually well under goal weight.

1: it most likely is head hunger. You hunger hormone ghrelin has been taken out so it's probably your head playing tricks on you. It should subside.

2: After day 4, I was shocked at how much I could drink. I could drink quite a lot. Don't be alarmed. This is a good thing. It means you will have little chance of bcoming dehydratred. trust me, when you lose your weight and you want to have that beer or drink water on a hot day, the fact that you can drink largish gulps is a godsend. When you move to the puree stage, I found I could eat quite a lot of that as well. It's when I moved to solids that I could notice the restriction.

3: calories in, calories out. Don't stress too much about it. try to keep your drinks to low calorie drinks.

4: I am a tummy sleeper too but had no trouble, although I was 135kg and lighter than you. I'd say you could sleep on your tummy, but be careful about rolling over in the middle of the night.

5: Up & Go is a good option. I kept drinking coffee too. Love it. 

6: I can drink fizzy drinks, but can't take large gulps or drink too quickly. But I can have a Diet Coke and take sips without any problems whatsoever.

7: I didn't need to crush mine. 

8: They should just fall off when they are ready. Should take a week or so. Don't remove them, but don't panic if they fall off earlier.

 

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Fizzy drinks in the early days run the risk of you busting your stitches so do NOT go near them. Once you are fully healed in a few months if you really have to have it in your life you can go back to it but right now let your body heal.

I am now around 16 months off of fizzy drinks and hand on heart I don't miss them.

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Having protein with every liquid "meal" will help to stave off hunger. Try, milk, soy milk, runny custard, runny yogurt, runny smoothies with protein powder, egg nog, protein based soups blended smooth and runny with extra stock. Whilst this time is about healing and you don't need to worry too much about what you're eating (drinking), try to stay clear of added sugar like sugar in your coffee and quik. Added sugar spikes your blood sugars and will make you hungry. If you feel like something sweet in your milk, try blending some fruit into it like frozen banana, berries or mango.

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However, this definitely feels more like hunger.

It can take a while for the ghrelin to flush out of our system. I had hunger pains (as well as terrible stomach spasms due to functional dyspepsia) that lasted a few weeks.

Some people continue to feel hunger pains, some have no hunger from day one - everyone is different.

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Thanks for the replies guys, I really appreciate it :)

I've been doing well so far. Nearing the end of week 3 post-op. I've been doing the puree thing this week and everything seems to be going well.

I wasn't told how long to stay on the puree phase though. Does that continue through week 4? or is week 4 when you move on to solid foods?

The feelings of hunger still hit every now and then. I've been having plenty of protein too (protein drinks) but alas it hasn't helped much.

I've been trying to just ignore the hunger pangs and keep hitting the water. I was hoping the hunger would disappear after the surgery, but I guess I'm not that lucky hehe.

But I'm down to 185kg now. So that's 30kg I've lost since February this year (around 11kg post-op). Now to worry about the excess skin that will eventuate LOL.

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Glad you're doing well vaultboy! Speak to your surgeons office to confirm their post op (they should have given you paperwork with all of that!), The typical seems to be 1 week liquids, 1 week puree, 1 week thicker puree, 1 week mash foods, 1 week chunkier mash, then back to introducing normal food in week 6

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I hope you are doing well now, I was sleeved around the same time (2 May), and its been a journey to say the least!

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