The Five Rules for Post-Operative Success
Although these rules are essential to your post-operative success, you can start applying each and every one of these principles before surgery. You don't have to wait to change your life!
Thanks to these five easy steps, you don't need to worry about counting calories, fat or carbohydrates ever again. It's important not to follow any other program, whether it is off the Internet or from another surgical office. Your surgery is a tool to be used with these 'Five Rules' and experience shows that unless you follow them, we cannot predict any weight loss results.
Age, overall health and genetics make each person's progress a little different from other patients. Don't compare your progress to another patient - either your weight loss, the amount you eat or how much you can exercise. As long as you follow the 'Five Rules,' you are on the road to success. With commitment and dedication, you can expect to achieve the same long-term success.
When patients reach a 'plateau' and stop losing weight, it is usually because they are not following these simple but very important rules!
- Protein First Every Meal
Eat the protein portion of your meal first - every meal - three meals per day. Eating protein helps the body feel full and sends a signal to stop eating. Remember most people need between 60-80 grams of protein per day (or 20-25qm) meal.
Protein is very important to building tissue in the body. Muscle, your organs, your brain - everything is built with proteins.
- Drink Water - 64 oz. Per Day Minimum
The importance of water can't be emphasized enough. Especially in the beginning, when you can only tolerate a mouthful at a time, it is so important to continually sip water all day. Make sure you drink 64 oz. a day minimum.
Eventually, you will able to drink 2 to 4 oz. at one time. No tea, soda (with or without sugar), coffee, or juices are allowed. Drinking flavorful liquids actually encourages snacking and flavored drinks with sugar can cause dumping - making you very sick.
- Exercise
Exercise every day for at least 30 minutes. Walking is fantastic exercise and is probably the easiest way to get started exercising. We understand that in the beginning you may struggle with a simple walk down the hall and that your energy level can be very low. Your job is to move your body a little more every day. At 4 to 8 weeks (everyone is different!), you will mostly feel back to normal. After you have been cleared by your physician, you may begin other forms of exercise. Eventually, incorporating both aerobic and resistance training into your daily exercise routine will help you remain healthy, at a healthy weight, for the rest of your life.
- No Snacking Between Meals
Eating anything flavorful or containing calories in between meals is considered snacking. If you find that you are physically hungry between meals contact a dietition to discuss your personal options.
The main problem with snacking on flavorful food is that it contains glucose or some other sugar. You feel good when eating sugar and when that sugar is gone, one to three hours later, your brain sends a message to snack again.
Snacking actually makes you hungrier and it will slow down or even stop your weight loss. And depending on how much or how often you snack, you can actually gain weight!
Remember that surgery has only changed your digestive system and not your eating habits. Your commitment to a change in lifestyle is the key to making the surgery work for you for the rest of your life.
- Take your vitamins daily!
Your New Pouch
In the beginning, it is so important to take care of your new 'pouch.' The new stomach is healing after surgery and the tissue is tender and easily irritated. Your stomach and intestine need time to heal properly. If you follow your post-operative instructions very carefully and take care of your new pouch, you will be successful with your recovery and results.
At first, your new pouch will not expand and will not accept fluids or solids comfortably. This is normal. About 8 to 12 weeks after surgery, your new pouch becomes less irritable and can move better, but still can't expand very well.
In the first few months, it is very common for patients to feel nauseated - even if you follow your post-op diet. This is normal. However, if your nausea causes frequent vomiting, you will need to contact us to help you manage the problem. Most of the time (though not always) frequent vomiting is caused by overeating or eating the wrong food or not following the 'Five Rules.'
As your new pouch heals, mucous sometimes is excreted to help break down the food. Sometimes this mucous backs up into the esophagus and causes frothy clear vomiting. Frothing is not a complication and doesn't last long - usually resolving by the third month post surgery. Drinking hot water one hour to 30 minutes prior to eating helps emulsify the mucous so that the food is better tolerated.
At approximately 3 to 6 months, your new pouch becomes more elastic and you will be able to tolerate foods more easily. You'll also be able to tolerate a more normal small amount of food - for example 2 to 3 oz. of protein with 1/2 cup vegetables and a couple of tablespoons of rice.
Listen to your body. When you are satisfied, stop eating!
One of your responsibilities after surgery is to learn what being full means and what it feels like. A meal should take no longer than 15 to 20 minutes to finish. Your goal is not to finish the food on your plate but stop when you are satisfied.
After surgery, you are virtually living off stored fat for energy - and there is plenty of fat to live on for a short period. The 'Protein First' rule is so important because your body will try to 'eat' muscle for energy if you don't supply it with enough protein. Especially when your new pouch is so small in the beginning, it is essential to follow the first of the Five Rules: Protein First.