biginjapan

Protein Prioritized Dirty Keto

It wasn't solid at all! It was baked ricotta - very light and fluffy, which made it all the more easy to overeat. I did have the feeling, about halfway through eating, that I should stop and keep the rest for leftovers, and I did pause for a while, but I still felt good and ended up finishing the entire portion. But of course I paid for that not less than an hour later!

@FluffyChix Unfortunately here in Japan low-fat cheeses are very hard to find. At the moment I have a bunch of cheeses in my fridge but I think if I just use a little in different recipes, then I might be okay.

I'm not a huge fan of Premier - they seem a little more chemically than the protein shakes I make myself. I only use Syntrax protein powder - it's the only one I found that blends well and has no aftertaste. However, everyone has different tastes when it comes to shakes. If you like PP, stick with it!

When I had my sleeve done back in 2017 I was eating a lot more than that at 4 months. Probably a cup to 1.5 cups, although it would depend on what kind of protein I was eating. I was sticking to all the recommended daily macros/calorie recommendations, mostly eating protein (fish or chicken or tofu) with veggies on the side. Some people can't get to where I was at 4-6 months until 1-2 years after surgery - everyone is different, and handles food differently.

You know, I did ask my surgeon about my gallbladder and he said it was fine, but it is something that I will have to keep an eye on as the months and years progress. The only truly high fat thing that I enjoy eating is cheese, but we'll have to see how well my body reacts to it.

I'm struggling with this. I have no sensation of being full, even when I've overeaten. I do get some burps and gurgles when I've drunk too much too fast (especially protein shakes), but no real signals for food. But in the past three days I've had two episodes of dumping syndrome, the last one definitely because of overeating. It took over 8 hours for me to feel decent enough to be able to start drinking water again, after being up all night in pain. I had the ricotta bake which I used to eat after my first surgery no problem, but in this case it was a disaster. 😞 I definitely need to portion out everything to stop this from happening again since I can't rely on my body to stop eating. I did eat a small portion, but I guess it was still too big for someone only 2 weeks out from surgery.

I think for the most part, the diet we follow post-surgery (whether sleeve or bypass) is what is known as protein-prioritized keto (there's a FB group if you are interested). Keep protein high, fats low to moderate, and carbs low. In fact, I really don't understand the (traditional keto) focus on high fat since the reason most people lose weight is because of low carbs. And of course protein is better for you than fat. That said, some people may be more sensitive to fatty foods after bypass (I just had a bypass revision myself and this is something I'm concerned about). I would talk to your doctor/nutritionist to see what they think.

I'm also short (5'3") and for my first surgery was 150 pounds overweight, for my most recent revision, 100 pounds overweight (which put me at 41 BMI). I had no other co-morbidities at the time of either surgery. However, I was self-pay for both, so did not have to go through insurance at all. Unfortunately I think insurance companies have more say than doctors do, but if you meet the minimum requirement I can't see why they wouldn't accept you for surgery. Just don't lose any weight until you get approved!

I was released from the hospital day 3 post-op and since then I've been walking between 10-20,000 steps a day (I did the same when I had the sleeve). I do get a little tired sometimes, but then I'll go home and have a big rest. FWIW, I was doing 20,000 steps because I was in Paris and did a lot of walking there - I'm sticking closer to the 10,000 mark now that I'm back home. I don't make it to 10,000 everyday, but I feel better getting out in the fresh air moving around that just sitting at home. To be fair, this is in line with what I was doing before surgery, so it's not like I'm pushing myself more than usual. This is usual for me. However, as other people have said, everyone is different. It's important to listen to your body. If you feel tired or are in pain, then maybe dial it back a bit. If not, keep going!

@asnirak I had bypass as well (revision) and I also question why it’s so easy for me to drink liquids! That said, I know from my last surgery that liquids go right through you, but also in the first weeks after surgery your stomach is quite swollen and sore, so it may not be able to indicate to you if you are having too much. Which is why it’s important to try to stick to recommended doses if possible. Another reason to do so is to prepare us in getting used to eating smaller portions, and to eating and drinking more slowly. Interestingly, my program has a more realistic liquid intake progression - 1.2L the first two weeks (about 5 cups), then 1.5 the next two, and then 2L (64 oz) once one month post-op hits. I found no problem getting my liquids in in the beginning, but now that I’ve added purées and soft foods I find it a bit more challenging.

I've been on liquids and purees since I left the hospital, in two days I'll officially move on to the soft foods stage. When I had my sleeve done 3 years ago I remember cooking whatever meat or fish I had in a broth (either chicken or beef or vegetable - Better than Bouillon is great for this). It's not sous-vide as that takes ages - I wasn't hard boiling it, but since it was so little meat it cooked pretty quickly. Meats tend to be more tender this way and can be easier to eat at first if other methods (oven baking, grilling, etc) are not as successful. Poaching eggs the traditional way (right in the water) is another option. Personally I love Shelly's egg bites recipes on theworldaccordingtoeggface.com - I've tried quite a few, and am already planning which ones I'll eat this week. I've done the ricotta bake before but it's hard to find ricotta in Japan so I'll have to see if I can source some tomorrow. She also has a lot of other recipe ideas for different stages, it's worth taking a look if you haven't already: http://theworldaccordingtoeggface.blogspot.com/2007/08/pureed-foods.html

Fortunately, (or not), I don't drink coffee so this isn't something I've had to deal with. That said, I found it interesting that I was allowed to have coffee on my surgery day, as well as immediately post-op! Even if I did drink it I find the thought of doing so so close to surgery to be off-putting.

@MaineDoc - have you tried some savory hot drinks, like bone broth or miso soup? I found them both really helpful when I couldn't stand another glass of water or protein drink. What kind of protein drinks are you drinking, pre-made, or ones that you mix yourself? The only protein powder that I really like, pre- and post-op, is Syntrax. The juices taste like the juice, and the chocolate/vanilla flavours are good and don't seem as false to me as others. That said, with other brands, like Premier Protein, I find the pre-mixed drinks tolerable, but the powders to mix were absolutely horrible - I had to throw out the entire container.

No one knows about this surgery. I did tell a couple of people about my first surgery back in 2017 just in case something happened to me, but none of them live in Japan. For this surgery I told no one. Luckily I'm on university holidays (which will now be extended until May, due to Covid-19) so I haven't had to miss work for any reason. Most people, including my students, won't have seen me for 3+ months by the time school starts again, so I'm sure people will notice some of the weight loss by then. But since I've done this before, and was very focused on my diet, I think most people will assume that that's what happened again this time.

From what I understand, dumping can be caused from a variety of factors - food moving too quickly into the intestine, or something that your stomach/intestines do not like - it's commonly sugar, but not necessarily. Nausea, bloating, vomiting, diarrhea, and abdominal cramping are all symptoms of early dumping syndrome, and I'm pretty sure that's what happened to me. I did think about lactose intolerance, but I've been drinking yogurt drinks and eating other kinds of yogurt all week (since the first day post-op - given to me by the doctor in the hospital). I had no issues with those, so it's curious that I had a problem here in Japan. That said, I'm laying off any dairy for at least a week just in case. I think it may be because I ate it too fast, or my body didn't like the mix (I added some protein powder to the yogurt). When I was feeling horrible I also had a little bit of a herbal tea popular here in Japan (that I've been drinking for 6+ years) and that just made my symptoms ten times worse. I didn't know if it was because it just inflamed the problem, or added to it. But today I tried it again and within moments of drinking it my stomach was not happy. So the tea (an oolong blend) was definitely another issue. Luckily I only had a couple of sips and did not eat or drink anything else for the rest of the day (other than water), so although I was uncomfortable for a while, it was nothing like the 5 hours of pain I had last night. I'm disappointed though - one thing I love about Japan is all the non-black teas that are available to drink everywhere (this is definitely not a soda-type of country), but if I can't drink them that will lower my liquid choices down to water and herbal teas I can make at home.

Yeah, I spoke too soon (that's karma for you). My last meal of the day was some low fat yogurt with extra protein and OMG - now I know what dumping syndrome is! I felt horrible for about 5 hours, nauseous, gas (stomach abdominal area was very distended), etc - it wasn't until I was finally able to vomit that I felt better and could actually go to sleep. Even then I had to lie on my back since lying on either side brought back those symptoms (but less). I certainly learned my lesson! I think I'll take it easy and just do liquids today.

I find it interesting how different doctors recommend different post-up eating regimens. When I did my sleeve back in 2017 I was the same as the rest of you - clear liquids, then full liquids in the first 2 weeks post-op. But on this revision surgery I've been on full liquids and purees since the day I left the hospital (day 3 post-op) and I haven't had any issues since. I've been tired of drinking of my protein so tonight I tried some tuna with a little shredded cheese and it went down no problem. Still not sure how this is working considering my stomach is about the size of my index finger. But, no pain, no dumping. I'm still going to do liquids tomorrow but I may try another small meal with soft food/mushies (maybe scrambled eggs, or mashed carrots, or tofu) - it's a few days too early, but we'll see how it goes. If I have to be honest, I'm kind of upset that nothing has bothered me so far - I really would prefer some pushback from my stomach, or dumping, or something! because I don't like being able to eat and drink what I want. I know that in the long run it will make it that much harder to stay motivated and on track.

Like the others have said, there's nothing you can do about it. However, I do think that having long hair makes the hair loss look worse than it is - maybe you might want to consider a shorter hairstyle (not short, just shorter) while you are in this stage. It doesn't last forever and the only person who will notice is you. My first surgery was 3 years ago and I have very fine hair, but I did go through a couple months of hair loss like yours - no one noticed. I took extra biotin every day (including a couple months before surgery), used biotin shampoos and conditioners, etc. - I don't know if it helped or not. Remember - it won't last much longer, and no one will notice except you.

I'm doing ok with liquids and purees. I can eat more than the recommended amounts though, so will need to be more strict about portion size. I'm back in Japan as of today so am hoping to get away from the high carb foods I've been eating (pureed fruit, yogurt, etc) and into healthier stuff like miso soup and proper protein shakes (I ran out of protein powder while travelling). I noticed today that I'm not quite hitting my protein goals, so that (and water of course) will be my goal until I get to soft/mushy food next week, which will open up a lot more options I think. I'm definitely recovering faster than I did my first surgery, which is good. It makes me feel like I could progress faster in my food goals but I'm going to stick to the plan. Question: how's everyone doing with bowel movements? I've been pretty good (I was worried right after surgery of constipation but that passed (!) quickly enough) but the colour of my stool is a bit off - hoping it's just the effect of surgery/meds/food going through the digestive track too rapidly.

I had the sleeve done in Mexico in 2017 and am now ten days post op on a revision to bypass (which I got done in Estonia). I had no problems with either and in fact I think I’m doing much better this time around. Gas pain gone in a day, all scars healing very rapidly, I’ve been walking over 10,000 steps a day since day three post op (sometimes over 20000), and haven’t had any food issues yet (still on liquids/purées) v However, I’ve been on this site long enough to know that it’s not the norm. It’s kind of strange, since I don’t do well with pain in my everyday life, but seem to recover quickly from surgeries.

I’ve been on purées since I left the hospital, but only eat them once or twice a day (yogurt, hummus, cottage cheese, purred fruits (like for babies/kids). It’s all been going well so far. In the beginning I ate a very specific amount as I didn’t want to hurt my stomach, but I have absentmindedly eaten an entire pot of yogurt (for example) and haven’t had any issues yet, which is kind of disappointing, since I really need to be more attentive to portion size, and am somewhat upset that the foods with sugar in them (yogurt, fruit) are not affecting me negatively, which is one thing I had hoped for by getting bypass. I know i shouldn’t be having any sugar, but here in Paris/Europe there aren’t a lot of high protein foods that don’t have them (or high fat, like hummus). Anyway, once I’m back home I plan to be much more strict about what goes in. I haven’t had foamies but I will say that if you are experiencing small burps or gurgles, that’s also an indication that you’ve had too much. I’ve had that a few times - it doesn’t hurt or seem serious, but it’s a good reminder to slow down and eat less. I tried my first multivitamin yesterday but had some pain/weird feeling about an hour or two later, so I think I’ll wait another day or two before trying again.

Where are you getting it done? I live in Japan so looked around for a lot of international programs that weren’t Mexico and ended up getting my revision surgery in Estonia. I had a great experience there - no liquid pre-op diet, great doctor and staff who came to see me at least twice a day while in hospital, and my scars have been minimal and healing nicely (compared to my first surgery where it took a few weeks for the biggest ones to stops oozing). As this was a revision (and therefore a final) surgery I won’t be looking for any others, but it would be good to know for others searching this site who want some ideas besides North America. in any event, good luck with yours!

I walked over 20,000 steps yesterday and felt good until the early afternoon when it was clear I should probably rest a bit. But the first week is done! I can’t wait to get home so I can eat properly and check the scale. I’m in Paris at the moment, and it’s hard to find protein based foods that I can eat/drink that aren’t extremely high in sugar or fat. I’ve been making do with soups and yogurt, plus my own protein drink and water.