Post-surgery and I need help please


So, I had spinal surgery on 6/27 to remove and replace/fuse my cervical spine. Up until that day, I’ve been doing great on keto. 22# and 4-6" lost. I dropped 3 pants sizes and overall, love how I look and feel since losing weight. The day I was admitted for emergency surgery, I was 159#. After the surgery, I could only eat soft foods. My fiance went to the hospital cafe each day, trying to find keto things that I could eat, but sadly, there wasn’t much that I was able to swallow. The hospital nutritionist encouraged me to try some complex carbs, so I did. Wheat bread dipped in gravy. Some mashed whole wheat noodles. Sweet potato. Oatmeal. I couldn’t really eat much.

Fast forward to being released home, and she encouraged me to keep up with some carbs, lots of vegetables and fruits. So, basically she said that my body needs all things not keto for the nutrients, as bone repair and regeneration (my bone is now fusing to cadavar bone) is the most complex process in the body, and requires significant nutrition. I should also be eating an extra 500-800 calories per day.

Well, I’ve legit been ravenous since the surgery. I can eat every five minutes and not feel satisfied. Of course, stupid carbs are soft so mashed potatoes and gravy has been my go to. I tried mashed cauliflower and couldn’t get the texture down. So I switched to mashed sweet potato for the nutrients. Ugh. Pancakes are soft. So is bread. So are noodles. It’s a problem.

I dropped to 154 # right after surgery, even with the carb load. It’s been two weeks since the surgery and I’m 160.8 # this morning.

I feel like I do need to incorporate some fruits and vegetables into my diet to help with healing. I’m done with simple/non-keto approved carbs now that my throat has healed from the intubation and I can eat regular food. My question is, how high can/should I go on the carb count to incorporate some things I know my body needs, without gaining the weight back?

I"m sure there’s no magic answer, but any idea on what my diet should really look like right now?

I hope this makes sense. I’m not able to exercise yet, so I need to keep my diet in check to keep my weight under control, yet still need to give my body what it needs to heal. Should I incorporate ketones or any supplements?

Thanks for any ideas!

(It's all about the bacon, baby) #2

For bone growth, what you need is protein, not carbohydrate. Bone is calcium in a protein matrix, and without protein it will not grow properly. If you can find protein that you can manage to swallow (ground-up meat in gravy, perhaps?), that would be best. Fats are usually soft, so any fat you eat along with the protein should not pose a problem.

I know this is exactly the opposite of what the nutritionist told you, but she is operating on outdated, unscientific information. The minimum daily requirement for carbohydrate in the human diet is 0 grams, since the body is perfectly capable of making the small quantity of glucose it needs.

You will heal better and faster if you get enough protein and saturated fat, which will give the body enough amino acids to build new bone and enough saturated fat to provide material for cell walls and cholesterol for your immune system. The monounsaturated fat will provide energy for all these other processes.

Having gone through a spinal fusion myself, you have my sympathy and my very best wishes for a speedy recovery. It’s not fun. I was fortunate that the fusion was L4 & L5 to S1, so the other end of the spine, which was bad enough; neck surgery would probably have done me in. Keep calm and keto on! And let us know how you get on.

(Kristen Ann) #3

I don’t have much to add here, but I was just thinking that bone broth might be really good for recovering. I know it helps reduce my inflammation. Also what about mashed avocado, pureed soups, and chai seed pudding?

I don’t have an opinion on this because I’m not a doctor or nutritionist, but I would say do what you feel you need to do to heal.

that said, I have a hard time believing pancakes, bread, and noodles will help you heal.

(Jacqueline Porter) #4

I totally agree with @PaulL. Whenever someone has surgery the body uses a lot of available protein to repair the damage. This is reflected in a drop in blood proteins. In fact, patients can often “starve” post surgery if their appetite is low and they can require high protein drips or nasogastric feeds. This is extremely poor advice from a health care professional. Carbohydrates supply energy, not healing!
It is interesting to remember here that a ketogenic diet increases bone density!
You have a bit of catching up to do on the protein front. How about a nice soft chicken liver pate?
I wish you well🙂!

(Susan) #5

I am sorry for all the agony and pain you must be enduring at the moment, it is great that you have a supportive, helpful partner to help you through all this, at least.

I would agree with the bone broth, as @kaclp suggested. I would think there are still a lot of healthy Keto things you can eat, such as the avocado, scrambled eggs, ground beef (mince), some mashed up vegetables, cottage cheese, etc.

Take care and make sure you are getting enough rest and sleep as well, I hope you heal well =).

(hottie turned hag) #6

Yep. Protein is for tissue repair. Have never in my years in medicine heard what your dietitian advised, re: carbs.


Thanks, Paul. I’ve been slowly adding proteins back in now that I can swallow. Basically, if I go back to my normal keto diet, I should be okay? I did eat small amounts of berries, and lots of greens like kale and spinach before. Would you suggest any ketone supplements or collagen or anything?

It’s been interesting trying to remember NOT to turn my head! LOL


LOL, they didn’t. They were just super easy to swallow.


I think her suggestion on the carbs was more to provide options for things to eat since I could swallow those softer things. But she was more concerned that I add in like fruits and vegetables (gave me a hand out on them) into my every day diet. Sorry if there was confusion there. I ate the soft carbs because I was hungry, and let’s face it, they were delicious. :slight_smile:

I will get some bone broth today. I can’t believe I didn’t think of that. I’ll fry up some beef today and make a batch of soup, too. GOod to know I can get what I need from the keto diet without having to go crazy on adding in things that might send me back up 3 pants sizes.

(It's all about the bacon, baby) #10

I would expect so. If you’re grinding stuff up in order to make it easier to swallow, remember that the fiber gets destroyed in the process, so you need to count it towards your carb limit.

(Jacqueline Porter) #11

Poor you😌. I would say that a ketogenic diet is exactly what you need, with higher than normal levels of protein.
After my mum had her hemicolectomy (removal of half her bowel), I gave her a really high protein diet, took her egg or tuna sandwiches (she’s not keto!)to the hospital, and really gave her high protein diet for the few weeks I stayed with her afterwards. At 83 she healed so well that her scar is almost invisible!
She says I saved her life twice! Once for noticing her cancer symptoms early and then for her aftercare! I don’t like to blow my own trumpet but she’s probably right! Having said that she is pretty tough!

(Diane) #12

I worked in a hyperbaric unit for two years. A lot of our patients were diabetics getting treatment to promote wound healing. The biggest two pieces of advice were (if they were smokers) to stop smoking and to work with a dietician to make sure they got enough protein.

We also checked their vitamin D levels and had them supplement if their levels weren’t optimal.


Thank you. I did have my vitamin D level checked in the hospital and that was okay. I’ve never been a smoker, but apparently my bones were “soft” when they drilled the screws in. I’m waiting to hear what they’d like to do about that, if anything. Maybe some Fosamax or something. My calcium has always been historically low, even with supplements and until now, no one has looked into it.

(Diane) #14

Just found this brief article on about low diets and bone health.

(Susan) #15

Thanks for sharing that with us, Diane =). We just need salt so they don’t ache, hehe.

(CharleyD) #16

Sugar (whether complex or not) will only work to prevent inflammation from resolving naturally.

I think Carl’s liver pate might be just what the doctor ordered in this case :slight_smile:

(Diane) #17

My hips still get very achy at about day 3 to 5 of an EF. One of the (many) suggestions I’ve read as to why this occurs, is that fasting boosts your immune system and bone marrow in large bones (such as femurs and pelvic bones) is essential in producing white cells.

So, limiting fasting to less than 3 days can also help with less achiness!