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I don't know how to eat...


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This sounds like such a stupid question... I should know this.. but I don't. And my NUT is useless... 

 

So, I'm in week 2 post surgery. I know what I can eat. Here is a brief list:

 

protein shakes

clear fluids like jello, popsicles, broth

yogurt

thin cooked cereal (like cream of wheat)

unsweetened applesauce

fat free sugar free pudding. 

(you get the idea). 

 

So, I don't know if I am just supposed to eat when I feel like it?  or if I should schedule meals at this point?  and if so... how many? 

 

 

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My thought is to schedule. Often this close to surgery you don't always feel hunger. So scheduling gets around that problem. 

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so... 3 meals a day?  And how much?

 

For example. tonight I had 1/4 cup of yogurt for dinner. Just because I didn't want to overstretch my pouch. But.. if I apply that to my other meals.. that's only 3/4 cup of food a day. That's not very much food. And what about shakes now?

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Even though you may not be hungry schedule the meals to establish the habit. I eat every 2-3 hours, 5x a day. my NUT recommended this and it has worked well for me.

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And yes, protein shakes count. Early on I counted 4-5 ounces of a protein shake as a meal. Now I drink the premier 11 oz shake every morning.

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Do the best you can, get your fluids in, the early days are rough.  I still have trouble some days (after almost 2 years) -- one day at a time. I would NOT want to go back to pre-WLS.

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Scarlett,

During all your preoperative meetings were you never given a manual. One which outlined what you were to eat during each phase and how often?

That is the plan you should be following - it was developed by your surgeons practice to address such questions. In the event you did not receive one you should call them tomorrow and ask for it.

Plans vary greatly - mine was 3 meals a day with no snacks others were told 5 meals a day. The variances are so great the the only way for you to know what yours should be is to ask Your practice.

Edited by WorkinProcess
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Scarlett,

During all your preoperative meetings were you never given a manual. One which outlined what you were to eat during each phase and how often?

Of course.. I have a 40 page manual. which I have read 5 times from front to back.. highlighted, and reviewed... But, for the post op phases it only lists acceptable foods.. not how/when or what quantities to eat them. that's why I asked the question here. 

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Quantity - as in "it would only equate to 3/4 total a day" doesn't matter so much right now while you are healing.  You basically do what you can until the stomach heals well enough to allow something more "normal" to be consumed.   As long as you are getting the protein and fluids in, that is enough to sustain healing and a modicum of energy at least until such a time.

 

My program also suggests bypass eats 5 small meals a day, this is assuming they are eating 2-4oz total at each small meal.  (and not 8oz 5x a day in other words) Protein shakes also count and suggested as snacks inbetween - taking an 8oz shake and splitting into 2 snacks (as an example).

Edited by Jolls
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Good to hear you have the manual, I couldnt have imagined that you hadn't been given one.

 

At this stage of your recovery, I'm pretty sure they didnt think in terms of how much you could eat -- that is the stage where they tell you "try to get in your protein and fluids" rather than specifying the size portions at mealtimes...

 

I could not have imagined doing anything but liquid protein at that point, and 1/4 of a cup of anything like yogurt at that time would have been completely impossible.

 

3/4 cup of food is actually a LOT of food if you consider the size your stomach is now, vs the size it was prior to surgery.

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Through my second week out, I was still on full liquids, at 2 ounces every 15 minutes, with a protein (Isopure, shake, broth) at the top of each hour, and water, tea, or other liquid the other times.  However, at three weeks I started adding semi-soft foods.  It sounds like what you are eating is similar to week 3 for me.  That being said, I have attached a sample schedule for my week 3.  I can't say whether this is appropriate for you or not.  You should check with your surgeon to be sure.

 

I have been extremely pleased with the amount of guidance I received from my surgeon and nutritionist, and recommend them both very highly.  (This may be because the nutritionist is associated with my surgeon's office, and I assume handles only bariatric patients.)  We were required to see our nutritionist for a session on how to eat post-op before adding anything other than full liquids, and it was very helpful.  semisolid-schedule1.jpg (JPEG Image, 451 × 516 pixels).pdf 

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I did 2-4 oz, usually 2. I scheduled it 3 meals a day. And whatever I "ate" I didn't drink the 30 min before or after. I can't stand hot cereal but thinned down malto meal cocoa wheats with a little milk. I used a 2 oz shot glass to eat yogurt, sf pudding and jello. I put a dab of Greek yogurt on top of the pudding and jello.

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I'm with NotGoingThere, we have the same surgeon's office but different surgeons. Excellent resources and information on what to do post-op.

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Scarlet

Starting week 3 when transitioning to foods like yogurt, I became symptomatic with hypoglycemia because I wasn't hungry and not eating often enough. With the approval of my NUT who is excellent(only does bariatrics) I began eating something protein every 3 to 4 hours. Like 2-3 ounces of yogurt, and later on 1 cheese stick, 2-3 ounces of tuna etc. I still stick to this plan and have been successful.

I do not graze but eat at regular intervals to keep my body fueled. For the first 9 months my first meal was a protein shake that I drank on the way to work. This plan might not work for you but it did for me.

Best...

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 It sounds like what you are eating is similar to week 3 for me.  

 

I have been extremely pleased with the amount of guidance I received from my surgeon and nutritionist, and recommend them both very highly.  (This may be because the nutritionist is associated with my surgeon's office, and I assume handles only bariatric patients.)  We were required to see our nutritionist for a session on how to eat post-op before adding anything other than full liquids, and it was very helpful.  attachicon.gifsemisolid-schedule1.jpg (JPEG Image, 451 × 516 pixels).pdf

 

I think the difference may be due to the different proceedure. (sleeve vs. rny). that being said.. I've gone a bit slower than my doc recommended. I could have started "full liquids" (which includes yogurt, etc) on Monday... but I'm waiting till today... So, I'm close to the same schedule.  

 

As for my NUT.. he is also associated with my surgery center, but I don't think he likes his job. He is all about spending as little time as possible with the patient.. checking off his questions.. then bolting. HORRIBLE!

 

 

 

 I have attached a sample schedule for my week 3.  I can't say whether this is appropriate for you or not.  You should check with your surgeon to be sure.

  attachicon.gifsemisolid-schedule1.jpg (JPEG Image, 451 × 516 pixels).pdf

 

HOLY COW!!  That is a LOT of food!  I'd be behind schedule in about 1-2 hours of the day. It takes me an hour or more just to get my herbal tea in, in the morning. But, it is good to see that you could eat anytime, through the day... and varied food. 

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I did 2-4 oz, usually 2. I scheduled it 3 meals a day. And whatever I "ate" I didn't drink the 30 min before or after. I can't stand hot cereal but thinned down malto meal cocoa wheats with a little milk. I used a 2 oz shot glass to eat yogurt, sf pudding and jello. I put a dab of Greek yogurt on top of the pudding and jello.

 

Now, on the opposite spectrum.. that is VERY little food. did you continue to drink shakes?

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HOLY COW!!  That is a LOT of food!  I'd be behind schedule in about 1-2 hours of the day. It takes me an hour or more just to get my herbal tea in, in the morning. But, it is good to see that you could eat anytime, through the day... and varied food. 

Those are goals - no one expects you to achieve that straight out of the gate.

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Your program's nutritionist is probably spread pretty thin covering all classes and individualized counseling he does. If you have additional questions for him, ask for an email address so that you can send questions to him and he can answer them without the pressure of the deadlines for all the other patients he works with.

You mentioned something about not following their timing for food phases - try to stick with their plan so they can better assist you.

As we suggested to you months ago, you need to learn to not sweat every detail or you will drive yourself crazy

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I lived off of yogurt for the first few weeks after the liquid phase. I could not tolerate shakes and have just now gotten to where I can drink them without vomiting. 

 

This is the website for my surgeon office. Under forms section there is the nutritional packet and the food plan that you might find helpful. I am only allowed 3 meals a day and no snacks. http://www.carolinasurgical.com/forms-resources/forms/ 

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If it's ok, I'd like to post my food for the day, and maybe one of you could look at it and see if I'm ok. I want to make sure I'm ok on nutrition. Everything listed is on my "plan"

Today I had:

Herbal tea with benefiber

2 oz cream of wheat with a splash of skim milk to thin.

1 10 oz shake made with half skim/half almond milk. 2 scoops EAS lean 15, and I Tbsp genepro (45 grams protein) divided into 3 snack size shakes

2 oz light and fit vanilla yogurt

1/2 of a SF jello cup

1 sugar free fudgesicle

For the day I came in at 326 calories, 54.5 grams protein, 3 grams fat, 41 grams carbs.

I'm not happy with the carb count, but everything I'm allowed right now has carbs.

Do you think that I need to make any adjustments?

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I know.. the carbs are high. But everything on my "list" has carbs of some sort in it. even my shakes have carbs. If I get in all my shakes.. that's 30 grams of carbs right there. hopefully once I have more food choices, I'll be able to lower my carbs. 

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If it's ok, I'd like to post my food for the day, and maybe one of you could look at it and see if I'm ok. I want to make sure I'm ok on nutrition. Everything listed is on my "plan"

Today I had:

Herbal tea with benefiber

2 oz cream of wheat with a splash of skim milk to thin.

1 10 oz shake made with half skim/half almond milk. 2 scoops EAS lean 15, and I Tbsp genepro (45 grams protein) divided into 3 snack size shakes

2 oz light and fit vanilla yogurt

1/2 of a SF jello cup

1 sugar free fudgesicle

For the day I came in at 326 calories, 54.5 grams protein, 3 grams fat, 41 grams carbs.

I'm not happy with the carb count, but everything I'm allowed right now has carbs.

Do you think that I need to make any adjustments?

 

 

I'd add protein powder to that cream of wheat, that will make it worthwhile eating then.  But really what you are doing is fine.  Protein and fluids protein and fluids -  only worry about those things.  Do not worry about calories or carbs - they will fall into place if you just focus on protein and fluids.   You are healing and do not need to stress over every number right now.

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OH.. that's a great idea!  I can add the protein to the the cream of wheat.. and maybe the yogurt as well.... 

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