Post Surgery Advice

Post surgery advice from a veteran Duodenal Switch patient.

1. Your FIRST job after surgery is to HEAL, not to lose weight. Please stay off the darned scale; once a week is a great plenty. Please turn your focus to "I must heal from a HUGE surgery, and I must do that with minimal belly space for nutrition. This is the most important thing I can do with my life right now, so I will do it RIGHT."

2. WATER is the source of life right now. Not food.

3. PROTEIN is the source of building blocks for healing. So gag down whatever protein source will stay in your belly. If you have a bad gag reflex, brace yourself and FIGHT it. There are lots of meds that can help this. A combination of anti nausea med, acid reducer and a narcotic (unless they give you worse nausea) will do a good job of this.

4. The sooner you can get some vitamins in you, the better. Start with a multivitamin. But do not panic if the vitamins are totally impossible at first. You have stores of these in your body and you will not become instantly deficient. No, you don't have a three-month free ride before you take ANYTHING, but don't worry too much if it takes you weeks to a month to build up to a full supplement regimen.

5. MOVE. You will heal faster and feel better the more you move around. Whatever qualifies as increased activity level for you is good. I was so incapacitated before surgery that just walking around the house was good. You might walk down your driveway and back and increase from there. But don't dive into a full-fledged exercise program until you are cleared to do so by your surgeon and you're getting in your 100 grams of protein daily. You have to be taking in enough protein to support your activity level otherwise you will lose muscle mass rather than gain it, because your body will eat the muscles for fuel.

6. REST. You might feel like pure crap on a stick for months. This is still within normal limits for recovering from major surgery. You need sleep. Don't skimp on sleep.

7. You have to train your body to eat all over again from scratch. Do not try to eat like someone who's two years out from surgery. You need realistic expectations. Quit thinking about "How soon can I have my favorite junk foods again?" Retrain your mind to think about eating for nutrition. This means eating ENOUGH food, rather than thinking in terms of having to eat as little as possible. Throw diet mentality out the window. And it means eating for the nutritional content of the food. Your nutrition requirements are radically different now that you've had your guts altered. Learn the requirements, which are simple but not negotiable, and just do it.

Will you get tired of eating chicken three times a day because it's the only solid protein you can gag down? You betcha. Tough. Eat it anyway or try another protein source. Your diet will broaden with time, probably almost without you realizing it.

If some food is haunting your dreams and you want it worse than sex, hey, have some. AFTER you've had protein. And don't be surprised if it tastes very different from what you expected. Also don't be surprised if it sits poorly. This will change eventually. Don't freak out and go ballistic thinking you'll never be able to eat Chubby Hubby ice cream again. You will, just not a half gallon at a time. Chances are you won't WANT a half gallon anyhow, because the DS gives you a satiety factor that was absent before. You'll eat a normal sized portion, which is half a cup, or maybe two portions, and you'll go, "That was yummy, I'm happy and all done now." It is bizarre to experience but oh, so cool :-).

8. Surgery hurts. Expect to be sore, tired, cranky, grumpy and generally miserable. But by golly, if you're gonna be a hero and not take your pain meds, don't expect any sympathy.

9. Your bowels will behave differently than they did before surgery. They will look and smell different. They will also change almost daily as you heal. The "new normal" might be months away and might require medical treatment to achieve. Constant diarrhea is not normal and requires medical attention. Constipation is also not normal and requires more fat, more fluids, more fiber, probiotics and possibly laxatives. Uncontrollable foul gas is not normal and may require a medication like Flagyl, followed up by probiotics. It might also require changes in your diet. If you insist on eating carbs, don't be surprised if you fart a lot. THAT is normal.

10. Your moods might go mildly or totally bonkers. PLEASE see your doctor and consider getting on medication if you aren't already on meds for mood problems like depression or hypomania or disrupted thinking. If you *are* on meds, don't be a bit surprised if they have to be adjusted, possibly numerous times, as things change.

11. Please don't get pregnant, ladies. Even if you have never, ever been fertile, that could change. Even if you're "more or less" post menopausal, that could change. If you're 65 and haven't seen a period since you were 52, chances are you're in the clear. Everyone else who has not had a hysterectomy MUST. USE. BIRTH CONTROL. Preferably two forms. And DO NOT use birth control pills. Please don't think you're exempt from this. Don't tempt fate. Getting pregnant while rapidly losing weight is so dangerous. Just don't do it.