Reflections on Bariatric Surgery and Eating Changes

After the surgery there was a lot of emphasis on water.

Not as much emphasis as what I'm eating, mind you, but there was more attention on drinking adequate amounts of water than before.

Like so many other things I've discovered in my research regarding weight and diet and exercise, your intake of water has some mixed messages thrown in there. I could see some concerns after a shift in my eating habits both before and after the surgery.

With regards to drinking I had to give up my favorite drink: the soft drink. The doctor was specific on this. For months before the surgery I had to give up sodas. I was a soda fiend; I could slam 1-liters of diet Pepsi like candy. I usually drank at least three a day. Notice I said diet Pepsi. I at least tried to watch calorie intake, although today there is a growing chorus of people saying that the additives in diet soda have other health effects. I guess it doesn't much matter to me anymore.

I gave those up at the beginning of the year. Apparently carbonation in the new stomach pouch is bad.

I can't drink through a straw. Air bubbles or something like that regarding the pouch.

I'm not supposed to drink for a period of time before and after a meal.

I was told to avoid alcohol. I later found people who had the surgery and do drink some alcohol. There's supposedly a growing number of post-ops becoming a alcoholics, substituting an addition to the firewater for their addiction to food.

The hard part for me is that I tend to go by the numbers. I need solid evidence and instructions to feel comfortable with things. Even when I'm supposed to be creative with something, I usually need some way to feel like I have permission to take the reigns before taking over something. This gives me problems because with the surgery there's a certain amount of individuality that figures into the equation, and that's added to what is apparently subjective information from the doctors themselves.

For example: when I had the surgery, I was warned I could only sip water. I'd be lucky if I could ever drink a half liter of water at a sitting. The one other guy who had the surgery near the same time I did would come in and talk about having to crush pills into powder and taking hours to drink an 8 oz glass of water.

He was saying this as I was finishing half a liter of water that I had started maybe twenty minutes beforehand.

Every morning now I'm taking nine different pills, uncrushed (one is split in half because it's a whopper of a calcium pill), with a 1/2 liter of water before walking out of the house in the morning. That's downing it in fifteen minutes without any discomfort.

I told some of the team overseeing me about my concerns of stretching the pouch. They kind of dismissed it as a non-issue right now; as long as I wasn't eating to discomfort habitually, as long as I was mindful of how much I ate, I'd be fine. The body will tell you.

I can drink like a fish and it doesn't bother me.

Drinking through straws I thought was supposed to be a no-no. It can cause pain due to air getting into your system, and burping isn't as pleasant as a post-op. I accidentally drank from a straw shortly after surgery. It was just me being absent minded.

Nothing happened.

I was warned that as a post-op I would have some horribly stinkstarded gas. I mean the kind that will make my wife pass out when it billows from under the covers.

Post surgery I can't pass gas to save my life. I thought I had to and my wife said she thought was I was going to do more than toot.

Of course some changes make logical sense, but others I question what I'm being told. Doctors are human, after all. They're not infallible. They simply have more authority on the matter. (I'll also note that I don't put it past doctors to lie a bit just to get patients to cooperate a bit more. The only thing keeping me from having ice cream and cake at a birthday party is the fear of utter pain and agony from sugar crashing from my digestive system into my bloodstream and flooding my brain...look up "dumping" if you want to know more of the nasty part, but if you thought the writing about gas was bad you probably should avoid it).

Example: sugars are bad. Avoid processed foods and sweets...candy, cakes, brownies...basically the good things in life that fit in your piehole (why do you think it's called a piehole if it's not meant for pies?). I can't have barbecue sauce either (I've found many online horror stories from post-ops who tried ribs and ended up curled in the fetal position afterwards).

But I have had some honey mixed with oatmeal. Not bad. I'm not mainlining honey but it does contain a natural sugar.

So..am I being told to avoid sugars in general because for most patients it's easier than educating them on the specifics, that some forms of sugar are bad while others aren't? Is it possible my body still has some amazing tolerances? Maybe instead of not tolerating sugars, post-ops can only tolerate certain amounts over which I end up a twitching, crying baby?

I am not supposed to drink before and after meals. Why? Is it because there's not enough space in the pouch, so I won't eat enough nutritionally? Will it help empty the pouch faster, preventing proper digestion, thus reducing my calorie count more (which I'd think is a good thing...)? Is it for my own good, avoiding pains and discomfort?

I was also told to listen to my body, and that it would signal hunger and satiety. I can eat then drink within five minutes and there is zero discomfort. No pains. No felt side effects.

I was also told that I could be satisfied with just a dixie cup of food three times a day. Surgery was about five months ago and I can tell you...no. I definitely feel like more. Head hunger? Or physical hunger? I definitely eat less than I used to. But a dixie cup...no. I eat approximately six ounces of food (I weigh it out on a kitchen scale) three times a day plus some peanuts during the day, and so far I'm losing weight. No pains. No other issues that I know of, at least until I get blood test results saying I'm malnourished.

Is something wrong with my pouch? Or is it just the individual effects of the surgery on my body? Everyone reacts differently but I sometimes wonder if I wasn't fed a few bits of misinformation along the way. I wonder if I've "damaged" the pouch but from what I was told that's basically a non-issue, or I'd know about it if I did something like that.

There were times I really wondered if something was wrong so I pushed my meal sizes early on. It was a glorious day for me when I had a little too much at Panera one day and felt pain. I knew that meant that yes, my stomach was indeed smaller. I've had this happen to me maybe four times in five months; not agonizing pain, but just a twinge uncomfortable enough that I would have to stand and walk it off or sit and twist around a lot until it passed in about fifteen minutes.

Those times were reassuring that something did still work.

Maybe sometime I'll get more of the full story on these issues. In the meantime I'm still curious if much of what I'm told isn't the dietary equivalent to telling children about the Boogeyman coming to get them if they didn't pick up their rooms; "If you eat a brownie, you'll feel pain that makes you wish you had DIED!" Most of what they're telling me seems an awful lot like a conspiracy to make me eat less and make more healthy choices in what I eat, to eat more sensibly under threat of digestive retribution.

Then again, maybe that's what it takes for some people to lose weight. Fear.