Optimal Recovery, and Food Progression
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- Опубликовано: 2 ноя 2020
- This video is "homework" for Dr. Pilcher's patients who have just gotten home from the hospital after their Gastric Bypass or Sleeve.
Dr. Pilcher spends a few minutes reinforcing the key aspects of activity and hydration for recovery, then he focuses on debunking some old ideas about food and protein intake. This is a preview of the right way to start with food after your Thursday post-operative appointment.
I really like this doctor. He has the most material to prepare yourself for pre-op and post-op. Love the way he teaches.
Wow, thank you! Best of luck on your journey!
I like him a lot also! He seems to have a wealth of knowledge. His videos are giving me a lot of information to help as I get ready to have my surgery. DISCLAIMER: I follow MY surgeon and bariatric team.
I'm four weeks out from my bypass and my nutritionist just told me I need 121 grams of protein a day! This video provided a ton of anxiety relief. Thank you!
I'm in 5 week . Still have pain and weakness..how are you now ,?
I’ve learned more from watching your videos than from my program. You are wonderful. Thank you for all you do.
Thanks for watching!
I completely agree 👍 👏 💯
I guess im super lucky to have you as my surgeon!! You are a blessing!!
You are very kind. I'm looking forward to the rest of your (successful) journey!
Thank you for this video! A week out of VSG and was feeling lost and drown in protein. I appreciate your approach and it makes way more sense to me than forcing foods through the day just to hit a goal. Thank you for putting your work out here for all to see!!
Best of luck on your journey!
Precisely
Im getting my surgery soon, finding your videos was a plus. I have learned a ton here... thank you sir.
So glad these were useful, and best of luck on your journey!
Loved this video! It seems so logical and in my opinion, healthy on several levels.
Thank you, Dr. Pilcher for sharing.
Thanks for watching, and best of luck on your journey!
Headed into surgery your videos have been so helpful. Thank you for your time and sacrifice.
Glad this was helpful, and best of luck on your journey!
I went with a surgeon that my co-workers used. There is no real constructive program. Your videos have been a life save for me! I am almost 4 weeks post op gastric sleeve. Thank you for all the content you have created!
Thanks for watching, and best of luck on your journey!
I am 1 week post op and I appreciate your perspective very much!!! I have a hard time blindly following anything and in my research I came across your video. I'm glad I did. 😊
So glad this was helpful!
Thank you for your Awesome Videos..i am post Op 7 Years Post op lost 166 Kept it all off. I am Today age 64 ...North Florida!! Best thing I ever done for me and my Health!!
What have you been doing to keep it off so long? I wanna hear more from patients who have long term success! Everyone on YT is either one year out or 5/6 and gained it all back.
I have learned so much from your videos instead of my own surgical team! ❤️❤️ thank you for sharing.
I just had my gastric sleeve surgery on September 12th. In our program our first three weeks are all liquid. Our next three weeks are puréed. The next three are soft foods, then we move to mechanical and week 9 is when we can start eating regular foods again. Thank you for you very informative videos.
My program is the same. I didn't realize how different the programs are.
12 days post bypass here-Thank you doctor! I think it’s absurd that the nutritionists expect us to eat 3 meals a day!
So glad this feels right for you!
@@DoctorJP I am expected to drink 4 oz every hour it is exhausting and I feel like as if I have a stitch as well as stuffed
@@terrywnjoroge hows the recovery been for you?
Rtd blind man
@@DoctorJP what foods will make you physically sick after sleeve?
thank you Dr, im .having a very hard time drinking two protien drinks a day,im going to discuss this with my team. i really trust your advice, it makes so much sense.
What a relief, thanks, doc!
Happy to help!
Hi Dr Pilcher...just wanted to remind you how amazing you are...
I truly Believe on going Support is much needed.. i Even 7 years out follow Bariatric surgeon also many Bariatric Patients!! Thank You Doctor for your Awesome Educational Videos!!
I am so grateful for your video. I listened to my body and felt great. I listened to the "Program" and felt horrible post operative. You answered every single question without being your patient and without knowing what questions I really wanted to ask. THANK U!
So glad this was useful for you!
Doc you’re the best .!! Thanks you ❤
Thanks for watching. So glad this is helpful!
You are a good teacher and explain things clearly
Thanks very much - glad this was useful!
This made complete sense. Thanks
Thanks for watching!
Really appreciate this video!!
Glad it was helpful!
Thank you. Very informative!
So glad these are helpful, and best of luck on your journey!
Great information to get started on this amazing journey!
So glad it was helpful, and I wish you the best of luck on your journey!
I walk for excerise. I was using a cane and Walker before my sleeve..Today i don't use them.but keep them, as i am age 64.. today i keep my Walker and cane.. Best thing i did for myself!!
I go in to surgery this coming Tuesday to convert a 2013 gastric sleeve to a total bypass. Im 62 and have been quite anxious about going through this next surgery at my age. Your information has helped me to feel less afraid of the surgery, and confident that post-op, I'll have the right tools and mental approach for success. Thank you.
Thanks for watching, and best of luck on your journey!
This was very informative to me I will be having a gastric sleeve to bypass surgery on 6-10, thank you so much..
Best of luck on your journey!
I am 2 weeks out from gastric bypass and have started incorporating soft and puréed food. I was getting protein obsessed; staying up later so I could get that last 10 or 20g of protein in via a protein shake. This explanation was excellent. I’m listening to my body for cues in other areas (hydration) but not when it comes to hunger or protein?? Thank you. Much appreciated. I will of course bring up my protein intake with my surgeon at my next appointment. This video certainly eased my worries.
So glad this was helpful, and best of luck on your journey!
Amazingly helpful video.👍
Glad it was helpful! Best of luck on your journey!
I really appreciate this entire video. Really helps me understand the hunger and dislike of protein drinks. One thing I have and hadn’t seen info about are these little muscle spasms or cramp like waves I get since VSG it feels like pregnancy kicks and I am weakened in my stomach until it passes. As of today I’m 9 days post op so hopefully this will pass and not continue.
tbh the waves of cramping don't ring a bell for me
I have the same experience
Thank you!
You're so welcome, and thanks for watching!
Make my little stomach pissed off. 😂 Love your videos. Of all the info out here, I find yours most helpful.😊
Thanks for watching!
What an amazing video ty
Thanks for watching, and best of luck on your journey!
Great video!
Thanks for watching!
Brilliant 👏
Thanks for watching!
Timely video, Dr. Pilcher!
Again, I appreciate working with educators and your love of knowledge!
This definitely makes more sense to me. Thank you Dr.
@@amy4living1174 Glad it was helpful, but please check the ideas in this video with your main bariatric team.
@@DoctorJP I definitely will but thank you for your advice too because it's so stressful to think ONLY protein all the time. I want to think about nutrients too. 😂🤣😂🤣🙌👍
These videos are quite therapeutic for me
So glad this was helpful. Best of luck on your journey!
You are 100%. They found even long term fasters do not lose very much actual muscle. That autophagy primarily goes after detritus, cancer cells, inflammation FIRST before going after real muscle tissue.
love your input!
Everything you say makes sense.
Thanks for watching!
Watching to get ready for a revision. Stricture and hiatal hernia repair in a few weeks. I’m guessing I will need to refresh myself on post surgical progression with foods. I have had 3 previous perforations and have been told there is some concern about things, this being a rather complicated situation. He also said he believes this is the last time this can be done. Scary, but Refresh I will to try to be as prepared as possible. Original bypass 10 years ago.
Yes, revision surgery is a big deal. Best of luck to you!
@@DoctorJP thank you so much.
This sounds like a more sensible way of approaching a lifestyle change than the protein bulk
I hope it's helpful. Best of luck on your journey!
Thank you dr, all this information has been so helpful ,
My pleasure. Best of luck on your journey!
Thank you
Hi Doctor, thank you for your clips the information is helpful and encouraging, would you recommend IV therapy the 1st week to hydrate and give a boost of vitamins?
Thanks for your question Sandy. In our experience, IV treatment has only been needed in the small percentage of patients who struggle with sufficient oral intake of fluids/vitamins.
Thank you for your very informative videos. I'm pre-op and in the investigation and learning phase. What are your thoughts on drinks like Pedialyte in the first post-op week for hydration?
Thanks for your question. I think pedialyte can be useful. I personally prefer salty broth-type fluids because they contain more salt (a good thing) and less sugar.
Hi & thanks for your great videos! I’m scheduled for sleeve August 31st and learning all that I can to prepare. I take several supplements under endocrinologist recommendation ( we test quarterly to assess my levels and have healed exhausted adrenals & IR successfully via nutrition.) As to immediate post op time frame ( and even long term ), do you feel customized vitamin infusion / IV on a periodic basis isappropriate and helpful? Currently, we are working to improve my mitochondrial function, specifically low adrenaline & noradrenaline production, and have used NAD infusion successfully for this separate issue…Thus my questions around vitamin infusion and concerns about ingesting supplements daily once post surgery. Thanks so much!
These are pretty intense questions Amy, and I'm going to need to leave management to your endocrine doctor in partnership with your bariatric surgeon. I will say that, regardless of the starting plan, the team will want to follow your labs and clinical status and probably make modifications.
Dr I was wondering something I know nsaids are banned after RNY bypass what about a suppository for pain for a few days
Love this video. Thx dr p
Thanks for watching!
@@DoctorJP re-watched your video for the 3rd time last night and it makes complete sense. The idea of eating 5-6 times a day to hit a protien goal always seems overkill to me. I have done a bunch of fasting with one meal a day and alternate day fasting so I am comfortable with the concept you laid out. I am having my surgery in March and my question is this flys in the face of their advice. Do I bring this approach up to them or would they attempt to disqualify me from the program? Or is this something I keep to myself? Does your practice offer post wls counseling or coaching if we do not have the surgery with you?
@@driveneco I completely get your question, and I confess I don't have a really satisfactory clear answer for you. It's really important for you to maintain a good working relationship with your surgeon and their practice. Usually, that means completely open communication, but maybe not always. And unfortunately, I don't have a way to offer ongoing counseling for you, though I think you can find a lot of useful info on my other videos as well. I wish you the best of luck.
@@DoctorJP understood. I’ve watched all your videos. Very helpful. Thank you for the great content.
@@driveneco You are very welcome, and I believe that your investment in learning will pay tremendous dividends over time. Once again, best of luck!
Definitely different from the Mass general weight loss center in Boston.
They want you to have 30 oz of clear liquids. And 30 oz of full liquid which includes protein drinks. Two to three of them a day. Want you to stay with protein at least 60 to 80 g..
Just worked out beautiful for me. I don't know how these people can do it by having only a little bit of protein drinks and powders during those 7 days..
I'm glad Mass general allowed us protein drinks.. average about 600 to 800 calories a day.
We're also allowed to have Greek yogurt during those 7 days fat-free, skim milk, tomato juice, condensed tomato soup with skim milk in a pan. All types of broth.
I actually enjoyed this diet now that I'm on to starting to eat soft foods!!
So glad you're doing well! And yes, different programs do have different plans. "Many streams lead to the sea."
Hi doctor here a question: I have noticed in my personal life that protein makes me gain weight when I try to come up to the desired total number of protein. I am glad you bring it up here. I a having a bariatric operation next month, I found you here. I love vegetables and do not eat meats. Never been crazy about meats. Can someone survive with just vegetables & fruits?
Thanks for all your guidelines, I trust you already ❤
I have had numerous vegan or vegetarian patients and do well after bariatric surgery. I do think it takes more work with the dietitian, so make sure you work that situation before you have the surgery
I love your ideas. I feel like much of the medicine prescribed post surgery is meant to help you digest the food my nutritionist insists that I need. Just curious, do you prescribe omeprazole to your patients in the first week of gastric sleeve recovery?
I used to recommend routine omeprazole early after the surgery but it has not seemed very useful recently.
Thank you, I am in the third week after sleeve….and all I seem to be doing is eating and obsessing over grams of protein. I feel uncomfortably full for most of the day. My program had me on scrambled eggs, cottage cheese and tuna puree and pureed tinned chicken in the FIRST WEEK, with a protein shake on top of all of that. Too much. I am now going to relax and start listening to my body and trust myself, keep hydrating and keep on with the vitamins and stop with the overly sweet protein shakes recommended daily.
Glad this was useful for you. Best of luck on your journey!
Hi can anyone help or advise me. I had my sleeve 10 days ago in Turkey which went successfully. About 6 days ago I had a rash start on my thighs, it then progressed on to my stomach, back and arms. The surgeon I used said its likely a reaction to the antibiotics so I stopped them 3 days ago. The is still everywhere and the patches that started first have now calmed right down. I don't feel unwell at all but am just concerned if it's something more than an allergic reaction. Has anyone else experienced this? I did speak to a UK doctor who told me to go to A and E at hospital. I went there and saw someone I know who had been there 5 hours and was still waiting to be seen. I didn't want to take up resources from other really sick people so just left. I thought I would monitor from hom and see how it goes but its still very itchy. Would like to hear from anyone who has experienced the same issue.
Thank you for your informative video, how long is ok to go with food ?
Thanks for your question, and I think you are trying to ask how long it is OK to go WITHOUT food. The answer depends a lot on your actual clinical circumstances so it is not practical to answer that in general terms. You would need to coordinate with your bariatric team.
Hello doctor Pilcher. Excellent video. Would you say there is some nuance about this protein topic for individuals who are actively lifting and focused on muscle growth? I have my surgery soon, but thinking long term… a year or two out, I hope to begin building muscle again, as I have been the past few years. I only ask because I know as a lifter, I certainly eat more protein than the average person.
I think it's terrific that you're planning on working out and rebuilding muscle after your surgery. I agree that people in active exercise tend to eat a bit more; I prefer for your body to let you know what it needs rather than plan or push extra protein.
I have watched many of your great videos they have been very helpful thank you. Comparing your content on this video saying go easy on your stomach (so I am thinking I will be feeling weak) but then you also have a video saying many people can go on to be althetes. I am a competitive long distance horse rider, how many weeks after a gastric bypass surgery do you think it would be safe for my stomach to be able to horse ride again please - say for maybe just 1 or 2 hours riding?
A second question how many weeks after surgery would it be safe if I fell off my horse? Bit worried about popping my stitches and having an internal bleed or leak if I rode a more high risk horse. In one video you say the stitches are quite strong even after 2 days but that was in relation to just walking around getting mobile. I’m probably fitter than most patients, BMI 31.
PS the 7 day liver shrink with actual real clips of livers was perfect - just what I needed to see.
Thanks so much for watching!
I think it's awesome you are already athletic, and that you're intervening at an early stage to get the weight under control, while you still 'have' health.
Regarding the right time for resuming riding, I really need to refer you back to your surgeon because opinions vary substantially and because there is substantial medical responsibility associated with that advice.
Best of luck on your journey!
How do you feel about starting out with organic baby food when starting back on food since it's mainly pureed...
You should follow the instructions of your bariatric team, but in my experience it is not necessary to purée one's food after bariatric surgery.
I wish MY doctor had a website like yours..all i got was a 3 ring notebook and instructions so i have to search for the info by myself
You are super kind. Best of luck on your journey!
Dr. Pilcher..my daughter had the sleeve surgery 1yr ago...I am glad I found your videos..I have a question..What can she do to start gaining a little weight..I think she is loosing TOO MUCH WEIGHT. Please give a suggestion..if you may. Thank You.
It's a valid concern. I think she should visit back with the bariatric team for advice.
@@DoctorJP Thank you Sir
Dr Pilcher, I’m 2 and 1/2 weeks post op from RNY and I feel no restriction or fullness from my fluid and purée diet. Is this normal? It seems like everyone else post bypass is having a hard time getting food in and I’m not. I’m worried this surgery isn’t working! I’d appreciate your thoughts on this.
This is definitely normal! Your swelling is just a little less than other folks. I'm 13 days out from my sleeve and haven't had any issues with liquid. It's a good thing, we're lucky! Once you move onto soft foods you'll definitely feel the restriction, let me tell you!
You are such an awesome Doctor … I sure wish you were in Las Vegas Nevada 😊
You are super kind! In Las Vegas, you might want to check in on Dr. Punam Patel.
My personal experience hasn't been too comfortable. Surgeon, dietician, hospital dietician, nurse...all are on different pages when it comes to post op and pre op diet.
I must have been a rare case where day 2 post op I had hunger and day 4 I was dizzy almost faint and nauseous, I was able to eat an egg allowed by my surgeon and then he said because it sat well I was able to eat oatmeal and smoothies this early. No pain, I didn't over do it but I'm afraid this surgery isn't going to help as I want it. I feel like I can eat normally now and I'm only 11 days post op.
Sorry it's been a struggle so far. I recommend for you to stay in close contact with your surgical team.
Do you recommend any gallstones dissolving meds in the first 3 months after gastric sleeve?
That's a smart question, and meds to thin the bile can be useful, but those meds often give patients "tummyaches," so we have decided on balance they arent' worth it.
THIS makes sense. So much of what I’ve read about post surgery nutrition seems illogical and anecdotal
glad this was helpful
Please advise if cold water intake is harmful. I had gastric bypass surgery and cold or cool water causes discomfort.
Cold water is definitely not harmful, but for many people in the first few weeks after surgery the cold can cause a spasm and discomfort. If cold water causes pain at 2+ months from gastric bypass it could signify an ulcer. It would be smart to conned with your bariatric team.
@@DoctorJP thanks
Hi Doctor, thanks for the video. I'm 6 weeks post op (vsg). Surgery weight was 330, had a stall at week 3, started going down at week 4 and at week 5 im at a stall again. I was 301 on March 1...I'm 302 today. I am avg 700 calories a day. I am on ketosis. I am drinking water. What am I doing wrong? @johnPilcher
Thanks for the question Javier. With your very low calorie intake and your (appropriate) ketosis condition, I feel confident you are still burning fat briskly and that this will show up in really substantial weight loss over time. You may want to check this other RUclips of mine that explains the relationship of weight stalls with ketosis: ruclips.net/video/8L1SHIromvw/видео.html
Sir I have sleeve before four years ago but now I have a hard lump in my stomach it's pain full. What is this will you please explain?
The right thing is for you to get connected with an experienced bariatric team in your local area. Best of luck on your journey.
Hi Doc. Im 2 month out of surgery. But I eat healthy but im still hungry sometimes. Its like im not getting full. Why not?
Usually, that's a valid hunger that means your body needs nutrition. Still, useful to be sure you're avoiding carbs and sweeteners which can both stimulate hunger. And, also a good time to check back with your bariatric team.
My question is after the surgery, how weak do you feel days after surgery? Notice no one ever ask about this.
I was EXHAUSTED for like 2-3 weeks after. Could have just been the meds and not eating very much. It’s definitely not a small procedure.
Can I introduce solid foods after 4 weeks of sleeve?
please follow the instructions from your bariatric team
Are your in the NEW YORK area
Your videos are very informative and easy to understand. Thank you for sharing this information.
Doc, what if you don’t have hunger sensation at all?
This is a smart question. I can reassure you that I have never seen a patient fail to regain a healthy hunger level over time. I think I mentioned in the video, if a person happens to have complications that might lead to an abnormal delay in hunger return and might lead to malnutrition, but the complications are very much the exception.
@@DoctorJP thank you for your response. This has been helpful information.
I’m a 56 years old woman and I had gastric bypass RNY July 28th 2022 I was told by my nutritionist to take in 80 to 120 protein a day. I’m at 3 months & I don’t have any problem taking in food. I am slowly losing though. In fact I went through a stall at 3 weeks post surgery and didn’t lose for 3 weeks. I’m wondering if I’m taking in too much protein. I’m going to start trying to take in 60 instead. I’m afraid of my hair falling out though if I’m not getting enough protein. My hair has already got really thin a few years back due to my hypothyroidism so I’m praying I don’t lose a bunch.
I'm 5 days post op and my doc wanted me to start on soft proteins immediately. I've been having bad gas and I am glad for another perspective. I'm going to contact my doctor, but I think I should take a break on protein. I'm not even hungry, but I tolerate fluids well.
Thanks for watching. Best of luck on your journey!
M not your patient even from other continent Asia. M almost 2 months and 15 days post opp. After two months m feeling hungry every time. Plz make video how can I control.
Anna based on your other posts, it sounds like you had a variation on the standard gastric bypass and I'm not able to say what the best plan is for you. I strongly recommend for you to reconnect with your bariatric surgeon and their team.
Why can’t they use vitamin patches?
Also how to prevent nausea and dizziness?
Don’t we need the protein to prevent hair loss?
so far, there are no vitamin patches that reliably absorb through the skin.
What about 100% Apple juice and Orange Juice
Seems like you didn't watch the video
I feel like 60grams of protein is super easy to hit.
You probably have an Army of Bariatric Surgeons in your DM’s cursing you out right now lol.
ha yes, though so far I don't think they've caught up with how subversive I am
wierd no protien? almost no food? that sounds like the first couple weeks is just a fast lol. wierd wonder how would a fast work without surgery just eat 4 oz of protien for 2 weeks?
Thanks for your question. I'm not exactly saying "no protein." Just saying "don't force protein." Best of luck on your journey!
MMMMM Chicken cheesecake
lol
Sir, with all due respect you said that our bodies will use the excess stored protein, but you know that our bodies can't store protein and there is no way for our bodies to produce it, so we need to consume it daily.
I may need you to quote exactly the section you are referring to, for clarity, but the essence of the idea is that when you take an extra calories in any form, including protein, that is less fat that you burn in last week that you
@@DoctorJP Hello again, sir!
The section that I am referring to is starting from 15:00 to 15:53 where you said "our patients are coming into their surgery on a planned basis with fully normal nutrition and of course in a sense with extra nutrition **not just good protein stores** but lots of extra calories that's the fat stores that we want to get rid of and so at least philosophically or intellectually maybe it makes sense for patients to go intentionally on an under caloric basis over time or with an intentional calorie nutritional protein deficit for a little while to intentionally draw on the excess stores that are already in the body"
Pls don't get me wrong, I'm not here to argue nor am I a dietitian or a doctor. I'm here to learn after my VSG surgery, and just wanted to make sure that I understood what you meant.
All the best!