Water is much more important than you know. Fact. We sit through patient aftercare classes and just nod about drinking all that water. It's just water... right? Wrong. Dehydration is the leading cause of hospital readmission after bariatric surgery. The level of sickness caused by post op dehydration can be even worse than the surgery itself.

Come on... how serious can it be? True Story!

My friend JoAnne was dancing and singing show tunes in her first days home from bariatric surgery. I smiled when I saw her name on my phone, but was stunned by a small weak voice crying that she was dying. I called 911 en route. Her lips were cracked, tongue swollen, she was confused and crying without tears. She was only in the hospital for two days for her RNY surgery but readmitted and spent ten days for dehydration and cardiac complications. I have never seen anyone go from great to gravely ill in so a short a time.
This is a largely preventable complication due to patients not believing that drinking water could possibly be that important. After a few bags of IV fluids Jo told me that the water was making her feel sick so she stopped drinking it entirely.
Immediately after surgery, it is nearly impossible to drink 64 ounces of water, but you must quickly work up to it and sip sip sip as it if it your full time job! Follow these tips for help with hydration:
1. Understand.
64 ounces is just 8 cups. Surely we can all drink a measly cup of water every hour. A Big Gulp is 64 ounces.
2. Calibrate.
Using a glass measuring cup, pour 8 fluid ounces of water into your favorite glass to see just how little an amount it really is. When we were slugging back orange juice from huge cups all those years, we did not know we were drinking 32 ounces as if it were nothing. A Venti Iced Coffee is 24 ounces.
3. Plan.
We are awake and moving through life at least 12 hours a day. Pick 8 of those hours and drink a 1/2 cup of water every 30 minutes. Using your glass measuring cup, see the small dribble that four ounces of water represents. A 1/2 cup is nothing. Small sips complete a goal.
4. Remind.
You are holding a phone in your hand, correct? There is an app on it that can play a tune or ring a bell to remind you every hour, every 30 minutes, every 15 minutes. Its easy and it's free. You don't need a $40 musical water cup.
5. Temperature.
If water is making you feel NAUSEOUS, try hot, warm and cold. Then try icy cold nearly frozen. Room temperature. Warm and comforting is the winning temp for many as it relaxes the inflamed newly operated on tissues and soothes all the way down.
6. Flavor.
If water is making you feel NAUSEOUS, try light flavors. Use a pitcher to make tasty naturally flavored water - use 5 strawberries, 5 slices of orange, or 5 slices of cucumber. Think outside the box and use fresh dill with cucumber, fresh ginger with pear (for nausea!). Adding a slice of lemon to either HOT or COLD water makes a big difference. Keep a pitcher in the fridge filled with water and a handful of frozen strawberries to flavor.
7. Broth.
Think Chinese Takeout Wonton Soup and when you order it, say that you would like BROTH ONLY. Nothing in it, no wontons, no greens, no pork. The warm broth is familiar and soothing. You can also get plain Chinese Chicken Broth, NOTHING IN IT, what they would use for Egg Drop Soup. Chicken or beef broth works too - using your glass measuring cup, heat 12 ounces of water and add a chicken cube.
8. Tea.
Make Celestial Seasonings Herbal Tea. If you don't have a tea pot, measure and heat 4 cups of water in a regular pot, remove from the burner and add tea bags to steep for one minutes. Remove teabags and pour some into your mug to sip. There are special blends to calm a tummy like Chamomile, Mandarin Spice, Chai Spice, Green tea with Lemon. Sometimes hot, sometimes cold, sometimes room temperature.
9. Ice pops.
Flavored ice pops count as water too. Not Frozen Fruit Bars, Not No-Sugar-Added, Not Fudge Pops, Not Klondike bars with no added sugar... we are talking about old fashioned Sugar Free Ice Pops. Period. Eat them end to end if you would like. A box a day even. It's fine. Avoid rehospitalization with SUGAR FREE ICE POPS. It's cool!
10. Prioritize.
Fluids, protein and vitamins are all important, but WATER is more important than protein or vitamins in early weeks. Some doctor's teams will have you starting on vitamins immediately and this is what is causing your nausea. Back down to one tablet a day instead of the full dose. If still nauseated, try half a chewable. Once you get used to that crumb of vitamin for a week, then move up to a little larger piece. Make sure you drink some broth or eat a spoonful of smooth yogurt before you chew up the vitamin tablet so it is not in the pouch by itself. Vitamins are the cause of the nausea in many instances.
Bariatric surgery is not easy nor is it the easy way out. It takes time to get used to these changes and it takes strength and dedication. A post op I knew once said that bariatric surgery will slap a backbone in you. True words. Drink your water.
June 28, 2023
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