My story is a horror story but it explains the major weight loss I had.
I lost 28 pounds (or more--I wasn't weighed until I had been out of the hospital a week) during the 6 weeks I was in the hospital getting my ileostomy.
Yes. 6 weeks. And yes. That is HIGHLY unusual.
The only reason I lost that much weight is because of my situation. If I had gone to the hospital somewhat healthy like a lot of people do for this surgery, I would not have lost anywhere near that much weight. Maybe just a few pounds from the initial fluid diet they had me on making sure my ileostomy worked correctly.
I went to the ER for bloody diarrhea Imodium wouldn't control nor would the meds my GI prescribed.
I was in the hospital for 2 weeks while they tried to treat me with the IV meds. Some of these meds required days of testing and shots before I could even have the med. Then my vitals were checked every 15 minutes after giving me the meds to make sure I was okay. The meds didn't work. None of them. I literally lost count of how many meds they tried on me during those two weeks.
When the bottom fell out, I almost bled to death. I was told by the doctors in simple terms I wouldn't live if I A. did not agree to accepting blood and 2. agree to the surgery. I had lost 1/3 of my blood. So they had to give me blood before surgery and again during and after surgery. The surgery had never even been discussed before and I only understood part of what the doctor said because of how sick I was. (I asked how he was going to cut me and he said "stem to stern". He wasn't kidding). When he came out of the OR, he told my mom that my colon fell apart in his hands and I had had only about
1 or 2 hours to live if I had not agreed to the surgery.
The next four weeks were getting healthy enough to come home. (oh yeah.. and two weeks after the surgery I blew 2 clots into my lungs and another one was in my leg obstruction at 100%--clearly that slowed down recovery..I still have a lot of that clot but it is improving.)
Like I said.. My story is a complete horror story. But it explains the massive weight loss I had (I started at 153 a couple of weeks before surgery, to 125pounds 5 weeks after surgery)
I have since gained 11 pounds back in the first 5 or 6 weeks or so I've been home. Granted... most of those pounds are gaining muscle back but still.. I'm gaining, not loosing.
The surgeon that will, hopefully--depending on scar tissue, give me my JPouch told me that to consider myself in training. I'm in training for surgery instead of a marathon.
But I'm to take it just as serious. Lots of exercise, Lots of protein to help healing and muscle development, and to come off as many meds as possible (including any and all pain meds, etc..).
The healthier I am going into the surgery, the better chance I have of a successful surgery and quick recovery.
That might be why your doctor is telling you to loose 20 before surgery. Get you as healthy as you can be and typically people will exercise and build muscle to loose the weight. The better your leg muscles are before surgery, the faster you will be able to get out of bed and walk yourself to the restroom (and then home!) after surgery. My hospital insisted on me walking 75 + feet or I couldn't go home. I could stay in the hospital getting no sleep while they take my vitals every hour or I could go to a rehab facility. But I couldn't go home if I couldn't walk 75 or more feet. I walked 90 one day and 120 the next. They let me go home.