A sleeve gastrectomy removes about 80% of the stomach, reducing the capacity for food in one sitting to about four ounces. Intended benefits of a gastrectomy include weight loss and remittance of diabetes. Short-term complications can include bleeding, pain, and blood clots while long-term complications may include failure to lose weight, the eventual regaining of weight initially lost, intolerance to certain foods, dyspepsia, addictions (believed to be transfer reaction from overeating), GERD, abscesses or ulcers, gallstones, diarrhea, and, believe it or not, divorce. Some studies have shown that over 80% of marriages end in divorce after gastrectomy surgery.
Nearly 68% of gastrectomy patients have regained all or nearly all weight lost by five years post-surgery.
My wife had laparoscopic sleeve gastrectomy surgery performed in the summer of 2014 by Dr. Lisa D. Brostrom, Chief, Plastic and Reconstructive Surgery, Brooke Army Medical Center in San Antonio, Texas.
Pre-surgery, her weight was 234 pounds and she was a diagnosed type 2 diabetic. Her body mass index (BMI) was over 36. Six-months post-surgery, she weighed 145 pounds. Her fasting blood sugar levels and A1C (average blood sugar levels over three months) were normal. By the middle of May 2020, six years post-surgery, her weight remains 145 pounds with a BMI of less than 23 and there is no sign of the return of diabetes. She has had no gastric distress or problems of any kind, with the possible exception of a small but noticeable increase in stomach gas, which has not caused her any distress. To this non-medic, the operation seems to have been successful and well worth the cost and healing required.
During the pre-discharge briefing, Dr. Brostrom stressed that with her decreased stomach size, it was essential that we modify her diet to ensure that she got sufficient protein. After discharge, she was to be restricted to a liquid diet for a few weeks. After that she was to eat six to eight very small meals per day, and also ensure adequate water for hydration.
Considering her need for protein and her newly-limited stomach size, we determined that a protein supplement may be helpful. As she was on a liquid diet, at least short-term, we decided that making her a morning protein shake would be a wise thing to do. After some thought and research, I decided that just dumping a package or scoop of protein powder into some water or plant-based-milk would not provide the optimum solution (no pun intended). Accordingly, I developed the following recipe.
1 package* Carnation Instant Breakfast Light Start™ (Sugar-Free)
¼ cup raw rolled oatmeal
1 20-gram scoop of no sugar added whey protein powder*
1 medium not over-ripe banana
3-4 ounces unsweetened plain yogurt
3-4 ounces in-season fresh berries
6 ounces of unflavored, unsweetened soy or almond milk
I place the dry ingredients into a blender, add fruit, yogurt, and plant-based milk then blend until smooth and creamy. This makes about 22 ounces of creamy shake which she enjoys through a straw for breakfast, mid-morning snack, and (most days) lunch. She generally snacks on fruit and/or whole-wheat toast in the afternoon and we enjoy a normal dinner with a protein entrée (which may be fish, poultry, meat, or vegetable protein such as lentils or beans), a vegetable side or salad. An evening snack often consists of about 2 ounces of ice cream or some buttered popcorn. I have observed that she normally drinks about 48 ounces of water per day. She does not drink coffee, beer, liquor, or caffeinated tea. A sugared soda is a rare treat – her preference is ice-cold root beer.
Here is something that is probably key to her success: she has stayed active. She normally gets about 40 or more minutes per day of light exercise, either in the community pool or walking. Her balance and vision no longer allow bicycling, but we have added some 1- and 3-pound weights and some stretchy bands to her routine for arm and wrist resistance work and a large body ball for balance.
Making the shake is quick and simple, but it does require some time and effort and some planning for shopping to ensure ingredients are always on hand. To me, it would be inconvenient to try to carry the ingredients and a blender for travel, so we rely on products like Boost™ or Ensure™ for times of travel or if I were to be unable to prepare her concoction.
The table below presents the estimated representative nutritional values for the morning shake. In compiling this table, I noted that the amount of total sugars is higher than I expected, and exceeds the recommended daily allowance for sugars. We are using no-sugar-added and unsweetened products where possible; the largest contributor to the sugars is the banana. In defense, those sugars are ‘natural’ and mostly in the form of fructose. Less-ripe bananas have lower sugar content.
Values are approximations
(a) 0.8g per Kg body weight
Oh, and did I mention: We are still married. We will celebrate our 52nd wedding anniversary on August 16, 2020.
For more information on sleeve gastrectomy surgery, see the World Journal of Gastrointestinal Surgery, April 27, 2017, National Institutes of Health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406732/ .
DISCLAIMER: I am not a physician and this article is not providing medical advice. I am simply relating our success story with my wife’s gastrectomy. Always seek competent medical advice from a licensed professional before selecting any course of action regarding your health.
*She prefers chocolate