078 Tips for Success After Weight Loss Surgery

We are now past the three month mark and Jimmy is doing great! I really am proud of all that he has accomplished. I want you to have that kind of success too. So today I am sharing an article with you that I read on About.com which summarizes a lot of things that we have already heard from our doctor and other WLS friends. I hope you enjoy!

25 Tips For Success After Weight Loss Surgery

What to Do and What Not to Do After Weight loss Surgery

By Jennifer Heisler, RN, About.com Guide   •   Updated May 02, 2010

You will be making many changes to your lifestyle after you have weight loss surgery, which will include following your surgeon's instructions to the letter. Check out these 25 tips for success after gastric bypass surgery:

Know when to call your surgeon. In the weeks after surgery, you should call your surgeon if:

You develop a fever over 101 degrees

You have uncontrollable pain

You cannot keep fluids down

You are short of breath or have difficulty breathing

You notice dark or tarry (bloody) stools

You suddenly begin to bruise easily

Your incisions begin to leak pus or bleed heavily

You develop unexplainable severe leg pain

Don’t drink calories. Your caloric intake will be very limited after surgery, which should help you lose weight. Don’t work against your surgery by taking in liquid calories that provide no nutrition and slow your weight loss. Make every calorie count by focusing on protein, fruits and vegetables.

Avoid sugar. Sugar is the ultimate empty calorie. Sugar will make your blood sugar climb, cause hunger pangs, provide no nutrients and, for patients of certain types of gastric bypass, cause dumping syndrome. Avoid sugar and any foods that list sugar in the first three ingredients, whenever possible.

Avoid carbonated drinks. The bubbly nature of carbonated drinks, such as soda, can cause gas pain and increase the pressure in your stomach, which can be harmful to staples and sutures, especially in the months immediately after your surgery.

Don’t drink fluids immediately before, during or after your meal. It is essential that you reserve the small amount of space you have in your stomach for high-quality, nutrient-rich food. Drinking before and during your meal will fill your stomach with fluid, instead of food, and drinking immediately after your surgery can “wash” food out of your stomach, making you feel hungry sooner. Separate food and fluid by at least a half an hour, whenever you can.

Keep your follow-up visits. After surgery, your progress will be closely monitored. Skipping appointments may mean that a nutritional deficiency, surgical complication or other issues may not be discovered in a timely manner. Also, appointments are a good motivator for staying on track with your goals.

Don’t stop taking any medications without your surgeon’s approval. Many diseases can improve with surgery and weight loss, but that doesn’t mean you should stop taking your medication. Talk to your physician prior to stopping any medications.

Don’t snack. Snacking is a habit that can slow your progress and hurt your long-term success. Stick to high-quality meals and avoid junk foods. If you are hungry, have a meal, but don’t snack between meals.

Protein, Protein, Protein! Protein should be your primary focus when sitting down for a meal. Not only will it help you maintain your muscle mass while losing fat, but it will also help you feel full longer after your meals.

Skip alcoholic drinks. Alcohol is full of empty calories that provide no nutritional value. It can also contribute to stomach ulcers, which you are already at risk for because of your surgery. Weight loss surgery also makes you more sensitive to alcohol than you were before, so a little goes a long way.

Chew and then chew some more. Chewing your food thoroughly is essential to preventing nausea and vomiting during and after your meal. Large chunks of food can have trouble passing through the digestive tract after surgery, and if it gets stuck along the way, it can cause pain.

Avoid pregnancy for the first 24 months after surgery. Your body will be in high weight-loss mode for at least a year after your surgery. During that time, supporting you and a baby would be unhealthy for you and disastrous for a developing fetus. If you are sexually active, use a reliable method of birth control, and consult your surgeon before attempting to become pregnant.

Find a support group. There are more than 140,000 people having weight-loss surgery each year, so people who have walked in your shoes are not hard to find. Not only do support groups offer emotional support, but they can also provide advice on the wide range of changes you are facing as you lose weight. Support groups are available in most areas that have a bariatric surgeon and are plentiful on the Internet.

Don’t take over-the-counter drugs without your surgeon’s approval. Over-the-counter drugs can pose risks after surgery that were not a concern prior to surgery. Pain relievers like ibuprofen and acetaminophen increase the likelihood that you will develop an ulcer. Remedies forconstipation shouldn’t be taken without physician approval, as constipation can be a sign of complications or a need for a change in diet.

Listen to your body. Don’t eat if you aren’t hungry. Just because the clock says it is time for a meal, doesn’t mean you should eat one. Learn to listen to your smaller stomach and only eat when your body wants you to.

• Avoid simple carbs.

•  Simple carbohydrates are highly processed foods such as white bread, pasta, sugar and white rice. The rule of thumb is this if it is white, it may be a simple carb. You are better off with more wholesome alternatives such as brown rice that contain fiber and nutrients that white rice does not. Simple carbohydrates can also elevate blood glucose levels, triggering hunger pangs and cravings.

• Exercise. From the moment you are able to after surgery, exercise. Even if you can’t walk far or for very long, get started. Your results will be better, and you will be encouraged by how quickly your stamina improves as the pounds shed. Walking also helps prevent serious complications, such as pulmonary embolus and blood clots, if you start immediately after surgery.

• Eat mindfully. No more eating while watching television. Focus on what you are doing when you eat, and stop the moment you feel full. Giving food your full attention will help you learn to say when and develop new healthier habits.
• Stay hydrated. Drink lots of water. This will help you feel more energetic, and it will prevent you from mistaking hunger for thirst. Many adults confuse the two sensations, so if you are well-hydrated, you won’t ever wonder if you are truly hungry.
• Surgery won’t fix your life. Remember that surgery is a way to lose weight, but it is not a miracle fix for every problem in your life. Being thin won’t make your children clean their room without being asked, it won’t fix a bad marriage and it certainly won’t make your nosy relatives behave themselves. Be realistic in your expectations of life after surgery.
• Say goodbye to caffeine. Caffeine is the most-used drug in the world, and it is a drug. Caffeine alters your mood, increases your heart rate and is a diuretic. If you drink caffeine, you will be working against your efforts to stay well-hydrated and increase your risk of a stomach ulcer.
• Find healthful coping skills. If you need bariatric surgery, the chances are high that you used food as a coping mechanism for stress. It is time to find a new way to cope, whether it is exercise, reading a book, talking to a friend on the phone or whatever works for you other than eating.
• Milk? Maybe. If you must drink calories, skim milk is an excellent option. Be aware, though, that many weight-loss surgery patients develop lactose intolerance after surgery, even if they didn’t have it before. Go easy on the dairy products until you know how your body will tolerate lactose.
• Kiddie meals and doggy bags. Restaurant portions are going to be massive in comparison to your needs after surgery. Plan on taking food home or ordering a child’s portion. If you aren’t sure you can resist joining the clean plate club, divide an acceptable portion away from the meal and have the server remove the rest before temptation sets in.
• Stop using straws. If you are going to drink, don’t use a straw. Straws not only allow you to drink too quickly, so you may end up with an uncomfortably full stomach, but they also allow air into the stomach that can cause serious discomfort.

_Sources Bariatric Surgery For Severe Obesity. Consumer Information Sheet. National Institute of Diabetes and Digestive and Kidney Diseases. March 2008. http://win.niddk.nih.gov/publications/gastric.htm Jones,Nicolas V. Christou, MD, PhD; Didier Look, MD; and Lloyd D. MacLean, MD, PhD. " Weight Gain After Short- and Long-Limb Gastric Bypass in Patients Followed for Longer Than 10 Years."Annals of Surgery 2006 November; 244(5): 734–740.

049 Commonly Asked Questions

Morning, everyone! It is now three weeks to the day since Jimmy had his gastric sleeve weight loss surgery. It is simply amazing how quickly time passes. We are still on the long road of changing our lifestyle so that he can continue to have success in his weight loss, but we are making it.

As time passes, more and more questions arise about weight loss surgery and what the experience is like. I know we did this massive 20 Questions post a few weeks back, but I have decided that from time to time I will post additional Q&A posts to answer a few of the current questions we have been encountering.

Q: Does gastric sleeve weight loss surgery affect your breath capacity or activities related to lung capacity such as singing/swimming/etc.?

A: No. Gastric sleeve WLS reduces the size of your stomach. It does not effect lung capacity or the function of your diaphragm. Of course, the hospital will give you breathing tests before you are released from care but this has more to do with the anesthesia and the surgical process rather than the gastric sleeve itself.

Q: Is irritability common during the pre-op liquid diet?

A: In general I would suppose that the answer to this would be yes but I am sure that it varies from person to person. If you get cranky when you are hungry now then you should expect to be irritable and cranky when you are on the pre-op liquid diet. Every program is different so the pre-op foods you are allowed may be vastly different than mine were but you can read more about my pre-op liquid diet here.

Q: How soon will I be able to go back to work after surgery?

A: You can return to work after you have been cleared to do so by your surgeon. If you have a desk job this may be as soon as two weeks. The more physical your job is the longer it is likely to take to return to work. Talking to your surgeon about your particular circumstances are very important. Also, keep in mind that you need to take some time to make mental and emotional adjustments to your new stomach and eating habits. These adjustments may be harder than you anticipate.

Q: What has been the hardest part of your first 3 weeks of post-op life?

A: The social adjustments. You need to find other ways to celebrate life, family, and friends. You also will mourn some of your favorite foods that you either can't eat right away or may never be able to eat again. Plus, you begin to realize for the first time just who big of a role food played in your pre-surgery life and it can be really hard to face those facts and changes.


Q: What is your appetite like after the surgery?

A: Jimmy hasn't had much of an appetite. In the past three weeks there has only been one or two days that I can remember him saying that he is really hungry. I believe that Jimmy's appetite reduction is due in part to the reduction of his stomach and part because he is getting tired of eating the foods he is allowed in his diet at this time.

Well, everyone, I hope that these Q&As helped answer some of your thoughts. Like I said, I will make posts like this periodically so if you have questions just message us and we will try to answer you and possibly get your question up here next time. Hope you have a great day!

031 Twenty Questions

Hi, everyone! We posted on Facebook and Twitter last week that we were going to have a Q&A post and that we needed your questions to make that happen. First I want to say thank you to everyone who submitted questions. I am sorry that we could answer all the questions (this got long as it is) so we picked twenty of the ones we felt we could best answer for you. So here it is...

20 Questions!

1. Is Gastric Sleeve Surgery safe?
A: Gastric sleeve is non-invasive when done laproscopically which decreases the risk of complications and speeds up the healing time. Also, gastric sleeve does not have any re-routing of the small intestine which reduces risk as well. Read More about the risks and rewards of Gastric Sleeve.

2. How long have you two been married?
A: Jimmy and I have been married just over 6.5 years. We were married in May 2006. Read more about Jimmy & Christiana.

This is one of our engagement photos taken by Hannah & Jeremy Tate.

3. Will I have to do a liquid diet if I have WLS?
A: It's possible. We have talked to several different people from several different surgical programs. Some had to do a full blown two week pre-op diet like we have and others had little to no pre-op changes in their lives. It really depends on your surgeon and the surgical program you are using. Read about the benefits of doing a pre-op liquid diet.

4. Will having WLS fix all my weight problems?
A: NO! WLS is a tool to be used in conjunction with a lot of sacrifice and hard work. WLS in and of itself will not solve your weight problems. If you are not following the doctors diet regiment, making changes so you have healthier eating habits, and exercising then eventually you will gain the weight back after surgery. WLS is a tool not a magic wand to make you suddenly skinny and never to gain weight again. Read forum posts about people who thought WLS would solve all their problems.

5. How long have you been in youth ministry?
A: Jimmy has been doing youth ministry since college. His first full-time youth ministry was in Texas in 1999. So that's something like 13 years of full-time youth ministry. We started doing youth events together when I was still in high school in 2000 but I didn't join his ministry full-time until January 2006 when I (Christiana) moved to St. Louis before we got engaged. We have been doing ministry together ever since! Our current youth ministry is called #winningSM and is located at McCarthy Baptist Church in St. Joseph, Missouri.

This is the photo we took at our very first Sunday School times at McCarthy Baptist Church.

6. How much does Jimmy weigh?
A: For personal reasons (and because we have found people to be really judgemental about the weight number), Jimmy has asked that I not publish his actual weight. However, we will be posting the number of pounds lost. Eventually we may post the actual weight in pounds but that will be determined later.

7. How much weight will Jimmy lose?
A: According to Dr. Hornbostel, Jimmy can expect to lose approximately 200 lbs within the first year of his WLS. Read more about the amount of weight you can expect to lose with WLS.

8. What kinds of food can't you eat after having gastric sleeve surgery?
A: The kinds of foods that people can and cannot tolerate after WLS surgery varies as different people's bodies handle foods differently. In general, individuals who have had WLS should avoid foods high in fat, carbs, and sugars. Read more about eating after Gastric Sleeve Surgery.

9. How much does WLS cost?
A: Without insurance coverage WLS can cost between $20,000 - $35,000. That's why it is really important to make sure that you have insurance pre-approval before proceeding with WLS. More about the cost of WLS.

10. How does your family feel about Jimmy having WLS?
A: Both of our families really support that Jimmy wants to be healthier and increase his chances of having a long and happy life. They also accept the fact that the best possibility for him to make this happen is through the assistance of WLS. It was really important to us to sit down and talk to them about this and to get everyone all on the same page. We really couldn't do it without them.

Jimmy and Me with Jimmy's Mom (Shirley)

Left to Right: Me, Dad (Jim), Jimmy, Mary, Scotty, Gretel, and Mom (Janice)

11. How long does it take to get back to work after Gastric Sleeve Surgery?

A: The typical recovery time is 2 - 6 weeks. Each individual is different and recovery time varies. Your recovery time is determined by your progress and your doctor's assessment of your body's healing. Find out more about Gastric Sleeve recovery time.

12. How long will Jimmy be in the hospital after surgery?

A: The average hospital stay for laproscopic WLS is 1 - 2 days. Keep in mind that every person is different.

13. What food will you miss eating the most?

A: PIZZA! Although Jimmy will continue to be able to eat the cheese and the toppings, pizza just won't be the same so I know this is definitely the food he will miss the most.

14. Do people who have WLS have issues with excess skin?
A: Yes. Most people who have WLS have issues with excess skin. The amount of excess skin varies depending on age, weight (pre surgery), skin elasticity, etc. Find out more about excess skin issues.

15. What do you plan on doing while recovering at home?
A: Great question! Jimmy has been planning ahead for this one. I think that his major plans include starting a new TV series on Netflix, playing lots of Halo 4 & NBA 2K13, and finishing The Mark of Athena.

16. Other than food, what will be one of the biggest changes in your life after surgery?
A: This answer may surprise you--clothes. Jimmy is going to lose weight rapidly and so he is going to go through several wardrobe changes over the next year. Also, once he loses all this weight he could very likely be able to walk into places like Wal-Mart or Target and be able to buy clothes off their racks for the first time in many, many years.

17. Is it really important that I attend support group meetings?
A: Yes. It is important to get all kinds of support from your friends and family, but don't miss out on the support from the people who have been there and are waiting to meet you in the support groups which are often provided my your surgical group. Read about the importance of support groups

18. Is it true that you will have to take certain vitamins for the rest of your life?
A: Yes. Because the stomach is smaller after WLS, you have to take vitamins to help the body absorb all the nutrients it needs to keep you healthy. Some vitamins you may have to take include: B12, B Complex, a mult-vitamin with iron, and calcium citrate. Learn more about taking vitamins after WLS.

19. Are their side effects from WLS?
A: Absolutely! You may experience discomfort and gas from the surgery itself and then later you may encounter side effects such as nausea and diarrhea if you are not following your diet properly. Read more about WLS side effects.

20. If people could help you and Christiana in any way, what would it be?
A: Please keep us in your prayers. The liquid diet has not been easy. You feel hungry all the time and that makes things tense and stressful and we still have a few days left of that. Also pray that everything will go well with the surgery on Friday. Going under the knife is always scary no matter how safe the surgery is supposed to be. Also, please pray for a swift and easy recovery and adjustment period.

We really appreciate everyone who has already been supporting us and praying for us. We really and truly couldn't do it without you. Also a quick word of thanks to everyone who has been reading the blog and especially to those of you who have been commenting, it's really nice to know that all the work that has gone into this has not been in vain! Thank you all so much!

Jimmy and Christiana's 6th Anniversary in May 2012

Grace and Peace,