Jiff!!!!
 

Hi girl. I know you are a busy bever these days but i have a question for you. I ran into some one today who just had her gastro done about 2 months ago or less has lost about 40 so far but can not manage to keep any foods down that has any consistancy to it. what did you eat then and do you have any reccomendations?? I gave her a copy of all my recipies for shakes but she is concerned that would be too much. she is only ablt to stomach just a bit of mashed potatoes!!!and even that sits too heavy in her stomach. from the brief enconter she is not taking in any protein!!! So needless to say I have gobbled her under my wing but would like yor input as to what could help her eat a bit more. and better!!!!!

thanks tons girl. And i am soo proud of how great you have done. I did mention how well a "friend has done" and she was very impressed!!!!!! so KUDOS to you from a stranger!!!!

Debkay if you are there pop in and send in your thoughts too.

ay yi yi!!!! that chickie sounds like she's in trouble, and she's going to lose her hair!!!!

but first things first. how is she doing with the water? if she's having trouble keeping water down, she might have a stricture and she needs to tell her doc.

has she tried posting questions on the surgery support group at spotlighthealth.com's obesity section? debkay told peachie to tell me about it, and it's been a big source of advice.

ok. let's assume she doesn't have a stricture. and before i go any further, from what i've seen on spotlight health, docs really differ in their recommendations, especially very early post op, but i can also tell you that i've had far fewer problems than many of the patients with less-permissive docs.

so, having said all that, i can tell you that i've been doing exactly what my surgeon told me to do:

80-100 grams of protein per day. those with less than 150 pounds have goals of 60-80 grams per day. i was special because i had so much more to lose.

at least 64 oz water.

a wide variety of foods, always eating protein first

introduce new foods one at a time, and if something doesn't sit well, leave it alone for a week or two, and then try again

little or no carbs [like no mashed potatoes!!! but for some reason, potatoes in any form come right up]


and here's how i've been doing it.

20-30 gram protein shakes morning and evening in about 6 oz of milk. this is essential. i will always take a protein shake even if it means i can't eat a meal.

now, some of these are very hard to choke down. from the beginning, i couldn't drink them without gagging. very very heavy on the poor little pouch. so, i started sipping them with a spoon. it worked much much better, and i highly recommend trying it this way. they STILL hang up on me sometimes, even at 4 months out, so i haven't given up the spoon, and i don't have to!!!!

after about a month, in order to meet the protein needs, i knew i'd have to make sure i ate more than 1-2 meals a day. we were told to eat 3 meals a day plus one or two shakes. and believe me, that was nearly impossible for the first month or so.

and every time i spaced actual food more than 5 hours apart, it hurt like HE** and i was miserable, but i also noticed that if i ate more regularly, like about every 4 hours, it didn't hurt nearly as much, and stayed down better.

i decided that maybe not eating was allowing the pouch to contract too much, and since it doesn't really heal until about 12 weeks out, it was simply too painful as it stretched out again. now, please notice i'm talking about very small amounts of stretching. i'm NOT talking about a stretched pouch due to OVEREATING.

think about what happens if you have a large, deep cut on your hand. as it heals, it gets stiff if you don't move it. that's what i decided was happening. and it's been working great for me..

but, on those days that NOTHING would stay down, i pureed things like chicken just to get down protein.

and one of the absolute best things was progresso chickarina soup!!!! all those adorable little ground chicken meatballs, with 18 grams of protein per can. and all we were allowed to do was to fish the meat and vegs out, after draining the broth.

and i highly recommend that she simply take some high-protein soup, like chickarina, or lentil, or black bean, and puree it. then put a couple of tablespoons of it in a cup, sprinkle some cheese on it, and nuke it.

it should work. one can lasted me for 6 meals! but it stayed down reliably.

some people in my group resorted to baby food. i didn't. but some have had good luck with it.

i also decided to eat through the pain, so to speak, if i'd only eaten a tiny couple of mouthfuls. if i hadn't eaten 2 tablespoons of food at that point, i simply waited until the discomfort passed, and then continued eating. the reason i did this was because i KNEW i had to get the protein in, and that according to the surgeon, and both of his nurses that had had the surgery and were at goal, i should be able to tolerate 2 tablespoons of food.

she HAS to stop with the mashed potatoes, and go into the soft pureed food: cottage cheese, soup, scrambled eggs [they still come up on me, but some people do well with them], low-carb yogurt, even small amounts of hummus. but just to show you how perverse life is, deviled eggs made with pickle relish or hot chili sauce are working just fine!!!!

and the doc also recommends canned tuna, canned chicken, deviled ham, but i didn't try them. i went for the extremely thinly sliced [read shaved!!!] deli turkey. we were allowed to have other deli meats as well, but ham smelled and tasted rotten, roast beef was too chewy and came up, and bologna, and things like it were so fatty that they made me queasy.

i'm just grateful that deli turkey comes in so many yummy flavors!!!

and fish is a wonderful thing, especially those nice soft flounders, soles, salmon. shrimp is better left for later, and there's no way mussels or clams are going down. they're bigger than the outlet and i won't suffer.

and just to finish off this long, extremely boring post [apologies to all of you, but i figure if you've read this far you're actually interested in the topic!!!], let me give you the handbook information for months 1-3.

it's titled: SOFT DIET

protein: 70% of your intake. always eat your protein first. low fat deli meats, canned tuna, eggs, canned turkey, cottage cheese, tofu, canned chicken, low fat yogurt [but watch the carbs!!], low fat cheese [i ignored this, and ate whatever cheese i wanted. i quickly found that very thinly sliced american cheese was my friend, especially on difficult days, when i would melt it into tomato soup for at least SOMETHING]

vegetables: must be well cooked, canned, frozen, or steamed. peeled: tomatoes, lettuces, cucumber, salad, carrots, green beans, squash, beets. [i didn't eat any raw vegs, like shredded carrots, until about month 3, but i did try to eat some cooked vegs every day, with mixed results]

fruit and carbs: use these sparingly, they should be a minimal part of your diet. canned, light and rinsed. fresh, peeled and sliced thin or mashed. yams. minimal amounts of pasta or rice. avoid bread/rolls.

soups: bean, turkey vegetable, lentil, minestrone, chicken vegetable, vegetable [i always add cheese to soup to add more protein.]

sample meals: 1 slice deli meat with 2 tb melted cheese on top

2 tbs scrambled egg with 1 tbs grated cheese, 1 tbs mild salsa, deli ham

2-3 tbs cottage cheese with 1 tbs canned fruit

2 tbs boiled chicken breast, 1 tbs broth to soften chicken, 1 tbs spaghetti squash

and i'm here to tell you i ate very little of this stuff. as i've mentioned before, mom's great joy is going out to eat, so even at week two, i was off to restaurants. i ate small amounts of fish most of the time.

boston market chicken is my friend. it's nice and moist and the kids meal lasts me 2 or 3 meals.

and, one last thing, the way i handle my food is this:

one of my sisters, the other one, not peachie, was kind enough to find me some small plates and cups. the cups hold 8 oz at most. i put a small amount of carb on the bottom [if i have some leftover rice, that is], then about 1 tbs cooked vegs, and whatever amount of cooked protein i can handle. and i add a small amount of very very very thinly sliced cheese [usually munster or american] to the carb and the veg layers.

then i nuke it. if i get through the protein, that's fine, if i get through protein plus vegs, that's GREAT. and the carbs, if i get to that layer, i'm just plain lucky and probably didn't eat enough protein!!!

i hope this gives her some ideas.

and i really hope debkay shows up. she's doing fabulously well too, and i'd be interested in hearing how, especially since she's still rehabilitating....

let me know what else i can do. this is such a drastic step that it's tragic to be having trouble as well. very very discouraging

Ditto to what Jiff wrote!!!
 

nasus, I'm so sorry your friend is having trouble. I hope she can turn around soon, and start feeling better.

I can't add anything to what Jiff said, she did a wonderful job, just wanted to let you know I was thinking about your friend.

Debbie

Thanks girls I knew you would help!!! Now just to get a hold of her!!!

Gosh you girls have really gone through the ringer!!! Do not let anyone say you have taken the easy way out!!!! I will let you guys know how she is doing. Thanks again.

WAIT!!!! there's more!!!
 

i forgot the refried beans/mashed beans and cheese thing!!!!

it's another life saver.

oh drat. there was more i wanted to say but it flew right out of my poor brain. it'll come to me later... i'll let you know...

i finally remembered!!!
 

i wanted to say a few words about the vomiting. so all of you with sensitive stomachs can leave now.

ok. are only the strong ones left????

90% of people who have this surgery vomit if they eat too fast, eat too much, or if something fibrous gets caught in the outlet [which is the size of a nickel... just try swallowing a centrum and see what happens!!!!!], or if something just doesn't set right.

it's not the most pleasant thing in the world, and it's certainly something to be avoided if at all possible, but, IT HAPPENS. and the world doesn't collapse or end. fortunately, vomiting also makes every single one of us feel better, since we wouldn't do it if our stomach pouches felt OK.

i vomited almost daily for month 2 and into month 3. and things that were just fine one meal came right up the next. in fact, there were entire days where nothing stayed down [hence the tomato soup and american cheese emergency food supply]

and i checked with the doc. and he said that some people just have what he called 'twitchy stomachs,' and it would last about 6 weeks.

and then, and these are just about his exact words... "God has mercy on you, and it stops." he told me to just keep trying to eat, and it would be fine.

he was right. it was almost like someone flipped the OFF switch!!

and life got much easier.

and the more active i got, the greater the risk of throwing up in restaurants, other people's houses, work.

i've done it all!!!! and again, the world doesn't end. if anyone notices [and believe me, that's a BIG IF!!!!!], they're concerned rather than grossed out.

of course, i'd rather not do it, but it happens. and trying to avoid it will only result in problems because you won't be eating and getting your protein and other nutrients.

i' know this person who's having problems is afraid of throwing up. no one enjoys it... and if they did enjoy it, they'd probably fail the psych evaluation anyway and couldn't have the surgery!!!!

it's part of learning to live with this.

and it's all really ok. i promise.

JIFF
 

Are you really only 4months out? Did I read that right? You'v lost over 200 pounds in only 4 months? WOW !!!

I'm impressed and excited. My DH has been exceedingly lucky. He has only vomited one time, and all we can figure out is he had too many carbs. That's what they call "dumping" right?

A typical day for him is a protein shake for breakfast. I also take all of his regular pills and smash them and add to the shake.

Lunch is egg, tuna or ham salad Made with protein ran through the mini food processor and add a little mustard, mayonnaise, or salad dressing, not much, just enough to moisten it. Other things for lunch is cottage cheese and fruit, or pimento cheese.

For dinner I've been fixing regular meat, but again running it through the food processor. and some soft veggies.

He said today that he's getting tired of the nighttime meal and would like to start trying some different things like veggie casseroles, or something less boring, but to save me I can;t think of anything to fix. Maybe baked squash with cheese?

He has not been able to weigh since his surgery, because he does not know of a scale that goes high enough except the hospital. What did you do to weigh before you lost a lot. If you have lost 200, have another 100 to go, you must be close to what he was (is?) He has the imfamous honor to be the largest that the doctor every operated on.

He goes back to the doctor for his 6 week checkup Friday. I can't wait to see what he has to say.

oh dear, barb... sorry to have confused you. the 200 pound loss started early last september. i started at 506 during a 5-week stay in the hospital followed by 3 weeks in a nursing home.

the obesity center where i had wnated to have the surgery wouldn't take me unless i weighed under 475 because the OR table had a load limit of 500 pounds and they had to account for the weight of the equipment.

when i showed up for the surgery consultation in early novembe,r i weighed 425, and nearly fainted!!! you see, the docs had FINALLY corrected my severe sleep apnea, and, according to the smart docs, not the stupid ones, now that i was getting oxygen into my system, i actually had a metabolism...

at the surgery on january 29, 2002, i weighed 409. this morning, i weighed 307, so i've lost 199 pounds total, but 'only' 102 directly related to the surgery. not that i'm complaining.

but i certainly don't want to mislead you or anyone else.

as for meal ideas... what about fish? lots of protein [more than chicken, more than meat]. he's still early post op, avoid shrimp, mussels, clams, shrimp, oysters, and 'hard' fish like swordfish. but sole, flounder, canned salmon, fresh salmon, cod, are all fine. [flounder stuffed with seasoned ground crab??? yummm]

tofu. lentils. chicken sausage. meatballs made without breading [but you can add eggs to it]. crabcakes made without breading. i found a recipe for ricotta gnocchi somewhere. i'll try to find it for you. something like minestrone with lots of legumes in it, but he can't have the broth with it. just enough liquid to moisten it.

pot roast. any kind of meat stew. as long as it's soft, and lightly gravied/sauced/brothed, it'll be fine.

and i'm really interested in trying the ricotta pancakes that nasus posted yesterday... they sure sound like a good choice!!!

what about some veal cutlets? expensive but since he can only eat a few bites, it shouldn't be too costly.

unfortunately, although a veg casserole makes a great side dish, his priority MUST be the protein.

i've been making deviled eggs with a little pickle relish or chili sauce and they've been great.

and it's great about the vomiting, but a word of warning: i didn't start until month 2!!!!!

let me know how he's doing... it 's a long, hard road, but i think everything will be fine...

I felt SO dumb..
 

...last night after I went to bed and was thinking about all I had read. Like a light blub turned on I thoughtNo way she's only 4 months post op!!! She meant that the foods she was talking about were for use by people starting at 4 months.

Anyway Alvin goes to the doctor for his 6 week checkup tomorrow and I plan to go with him, to clearify the food thing. I feel he is not getting enough protein, but I'm at a loss as to how to get it down him. [i] if you haven't notices MEN can be so stubborn[/] But if we all three (me hime & doc) talk about it together maybe we can get it together.

Also when did you start exercisieng? Alvin has never been tested for sleep apena, but he hasn't slep in the bed for about 10 years now. He has a chair he sleeps in. He has extermely bad circulation in his legs and can't walk but a few feet without getting out of breath. He's supposed to start a water aerobic class expecially for his doctors' patients Tuesday night, but he said this morning that he's not sure if he's going to go!!! We'll talk about that at the doctors tommorrow, too.

Thanks again for all the info. It really helps to "talk" things out with someone who's been there.

yikes, barb!!!!!
 

ya gotta read slower!!!!!

i AM 4 months post op. the foods i listed were what we were told to eat at months 1-3.

and frankly, i'm not eating much differently than that right now, except that i'm FINALLY tolerating salads and tiny amounts of fruit now. [and it's almost strawberry season!!!]

as for alvin, you can't force it down him. he MUST become responsible for his own food. and he MUST do the low carb protein shakes.

as for the apnea, i'm surprised his doc didn't require a sleep study before the surgery, but it would sure be a good idea for him to have one!!

and walking. yes. well. it can be difficult. the surgeon said that i could start exercising after week 3. but right after the surgery, we were expected to get up and walk, even if we just marched in place for a few minutes several times a day. it was emphasized that we COULD NOT sit around all day.

i started off doing one of those exercise shows [i chose gilad's bodies in motion because it's done in hawaii and gilad is quite cute!!!... hey, i may be overweight but i can still LOOK]

and it was very very hard at first, but it got easier as time went on.

would it help you if i started posting what i eat every day? i think it's boring, but if it would help you and ole alvin, i'd be happy to.

and willchange sent me a pm. and i answered it... i hope he comes around here and posts.. these ladies are all so very very respectful of this decision, even if it's not the right one for them.

keep me posted!!! i'll be very interested in how things are going. and i'll be happy to put in my two cents.

Yes Jiff I'd love to know what you eat. Today Alvin had a protein shake for breakfast. For lunch he has som crab meat, and some Tomato Bisque soup. Tonight it was stuffed green peppers and mixed veggies in lowfat cheese sauce. I made I stuffed pepper and he got about 1/8th to 1/4 of it.

He goes to the doc tomorrow and I plan to go with him, he asked WHY? and I told him that I wanted to know as much as he does (since he's not that good about talking about it) and alson I want to make sure the doc emphases that he needs to go to the wateraerobic class.

I found out today that the instructor he will have is the one I like the very best. She is great. She is a physical therapist as well as an aerobic instructior and she's super. ( I go to the health club that is associated to our area hospital)

I'll let you know how it come out.

barb... didn't your doctor tell alvin not to mix liquids and solids??? or not to drink 30 minutes before and 30 minutes after eating????

this is not a good practice, the soup and meat at the same meal!!! the liquid is washing the protein right out of his pouch!!!

you're right. he needs more protein.

here was my 'exciting day'

7:00-8:15 am
16 oz water
30 gram protein shake [25 g protein powder plus 1/2 c skim milk]

9:15

a deviled egg

10 am... hot tea

then iced tea

then water

3 pm [a tough day at work]

2 oz veal stuffed with shrimp, spinach, and cheese.
1 tbs [or less] rice [this was a doggie bag from a restaurant]

1 tbs shredded carrot, 1 cherry tomato, 2 bites black bean salad

6:45

20 gram protein shake

8:30

2 oz chicken
1 tbs rice
4 cherry tomatoes
2 bites black olive slices
1/2 oz munster cheese on chicken

that's about 55 grams of protein shake, plus 28 grams meat protein and 5 grams of cheese for a total of... of.... 88 grams of protein. not great, but not bad. oh. and forgot the 10 grams of protein in the egg... 98 grams... right where i should be!!!

and more water, too... and iced tea.

as i've said at some point, the only real reason i forced myself to eat at first was to be sure to meet my protein goals.

the water aerobics shoudl be great... and i'll be interested in hearing what the doc said. and what alvin said the doc said!!! [it can be SOOOO different, can't it???]

I am a little scared for Alvin..

Jiff. God Bless you! :)

The doctor said...
 

That Alvin ws doing great. I did go with him He said he did need more protein for the long haul, but at this stage he just needed to be really concerned about eating when he knew he should and keeping hydrated. He said as he gets farther out op he will want to eat more, the the body takes time to adjust and it's hasn't been that long. He said that I was worring too much.

And yes Jiff he told us about the drinking and eating, but I never considered the soup a drink!!! But he did eat all the soup first then eat his fish.

Also today he's talking about joining my health club after he goes to the class Tuesday night. It's a different world every day:dizzy:

wonderful news, barb!!!!
 

so glad to hear that the doc is pleased, and that ole alvin is showing some interest in exercise. it really and truly does make a difference.

we were told that this next year or a little more was kind of a honeymoon period, in that we really could do just about anything, and still lose. BUT, we also needed to develop certain habits that would last a lifetime, which means the protein first, the vitamins and the exercise, so that when we reallly needed the discipline, we'd have it.

this isn't a reason to go do anything we want, though. as someone pointed out to me at our last support group meeting, the people who do really well on this are those who don't eat the carbs [pasta, bread, rice, potatoes, chips].

so, onward and downward!!!! and don't worry, i've noticed you've been doing very well too. so both of you, get on those swim trunks and keep it going!!!!!