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When should I start taking nutritional Suplementations (vitamins)?
You should begin to take your multivitamin supplements and calcium supplement at two weeks or unless specified differently by your surgeon.  Vitamins should be in a chewable form.  Adult forms should be taken as directed, usually one pill a day.  Child formulations such as the Flintstones Complete should be taken twice daily.

Do I need to take Iron?
Yes. Some multivitamins do not contain iron or do not contain enough to maintain appropriate iron stores and for this reason some patients will need to supplement with other iron supplements.  This is especially true for women that are still menstruating (having a period) on a monthly basis.  Many young women despite their weight are anemic (low blood count) prior to undergoing gastric bypass surgery. 

Do I need to take Calcium?
Yes. Calcium supplements are also extremely important, especially in women.  Calcium supplements should also have Vitamin D, a necessary component for the absorption of calcium.

Will I be allowed to drink alcohol?
You will find that even small amounts of alcohol will affect you quickly. It is suggested that you drink no alcohol for the first year. Thereafter, with your physician's approval, you may have a glass of wine or a small cocktail on occasion.

"Will I be able to eat ""spicy"" foods or seasoned foods?"
Most patients are able to enjoy spices after the initial 6 months following surgery.

Is there any restriction of salt intake?
No, your salt intake will be unchanged unless otherwise instructed by your primary care physician.

How can I be sure I am eating enough protein?
40 to 65 grams a day are generally sufficient. Check with your surgeon to determine the right amount for your type of surgery.

Why can't I eat red meat after surgery?
You can, but you will need to be very careful, and we recommend that you avoid it for the first several months. Red meats contain a high level of meat fibers (gristle) which hold the piece of meat together, preventing you from separating it into small parts when you chew. The gristle can plug the outlet of your stomach pouch and prevent anything from passing through, a condition that is very uncomfortable.

Why can't I snack between meals?
Snacking, nibbling or grazing on foods, usually high-calorie and high-fat foods, can add hundreds of calories a day to your intake, defeating the restrictive effect of your operation. Snacking will slow down your weight loss and can lead to regain of weight. Most patients find that keeping a bottle of flavored (non-sugar) water satisfies the need for snacking.

Is there a problem with consuming milk products?
Milk contains lactose (milk sugar), which is not well digested. This sugar passes through undigested until bacteria in the lower bowel act on it, producing irritating byproducts as well as gas. Depending on individual tolerance, some persons find even the smallest amount of milk can cause cramps, gas and diarrhea. Also, milk has a moderate ammount of sugar that makes for high calorie intake.

What is Dumping Syndrome?
"Eating sugars or other foods containing many small particles when you have an empty stomach can cause dumping syndrome in patients who have had a gastric bypass or BPD where the stomach pylorus is removed. Your body handles these small particles by diluting them with water, which reduces blood volume and causes a shock-like state. Sugar may also induce insulin shock due to the altered physiology of your intestinal tract. The result is a very unpleasant feeling: you break out in a cold clammy sweat, turn pale, feel ""butterflies"" in your stomach, and have a pounding pulse. Cramps and diarrhea may follow. This state can last for 30-60 minutes and can be quite uncomfortable - you may have to lie down until it goes away. This syndrome can be avoided by not eating the foods that cause it, especially on an empty stomach. A small amount of sweets, such as fruit, can sometimes be well tolerated at the end of a meal."

Why drink so much water?
When you are losing weight, there are many waste products to eliminate, mostly in the urine. Some of these substances tend to form crystals, which can cause kidney stones. A high water intake protects you and helps your body to rid itself of waste products efficiently, promoting better weight loss. Water also fills your stomach and helps to prolong and intensify your sense of satisfaction with food. If you feel a desire to eat between meals, it may be because you did not drink enough water. In addition, after the operation some patients will be quite fatigued. It is not uncommon that the cause is from dehydration. The importance of staying well hydrated cannot be over emphasized.

What are the best choices of protein?
Eggs, low-fat cheese, low-fat cottage cheese, tofu, fish, other seafood, chicken (dark meat), turkey (dark meat).

How long will I be off of solid foods after surgery?
Most surgeons recommend a period of four weeks or more without solid foods after surgery. A liquid diet, followed by semi-solid foods or pureed foods, may be recommended for a period of time until adequate healing has occurred. Your surgeon will provide you with specific dietary guidelines for the best post-surgical outcome. For more specific details see our 4 stages of eating after surgery.

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