Little Green

Man, solid food and pureed food are totally different As a quick background statement, I'm one month post-op and have had no issues tolerating food thus far. Never had any issues keeping stuff down, no nausea, no pain. Okay - so I started the solid, soft food stage a couple days ago. Nothing too impressive yet, some egg, some very tiny bites of chicken, 1.5 small potato wedges, half a small falafel. But tonight I finally had my first actual meal in a restaurant which was salmon and a couple bites of rice pilaf. Everything sat very well and was delicious (I posted a pic of the amazing grilled salmon in the Facebook group earlier if you want to check it out!). I ate maybe two ounces of the salmon. About 3 hours later - about two hours ago now - I had another small portion of the salmon. The only difference I could really tell is that I didn't reheat it, just ate it cold. Don't know if that makes a difference or not. Anyway, I ate too much without realizing it. One second I was fine and the next I had pain and cramping that made me need to lie down - sitting up was compressing my stomach in an uncomfortable way. No nausea, sweats, etc. so I don't think it was dumping. I had no warning - not that I could recognize, anyway. Over the last couple of hours it's gotten better, except now I can't drink water without getting the same pain again. I would think enough time has passed but I'm a total newb at solid foods, so I don't know. The salmon was very soft and flaky and I chewed well... I wouldn't think it would still be sitting in my stomach... Do you think something could be stuck? Should I just keep taking tiny sips to see if I can get things moving? I don't think I'm in an emergency situation or anything, and as long as I don't drink anything I am feeling pretty good. Just need some guidance from those who have walked this path longer than I have and might have some insight!

May 17th through June 17th update! I weighed 320 this morning - surgery morning I weighed 342. That brings my total loss for my first month to 22 pounds! It's still crazy to think I lost 19 pounds in the first 14 days and then took another 2.5 weeks to lose the next three pounds, lol... but since the scale is finally moving again, I ain't gonna question it! Going to try and wait until 6 weeks post-op to weigh in again, so that will be June 28. That seems kinda close so maybe if I can resist it I'll wait until July 5th.

After I woke up from recovery I had IV Dilaudid with a PCA (pain pump) as I was in tremendous pain post-op. After 24 hours of constant sleeping and almost no memory of my surroundings - the nurses had to remind me about my PCA when I would tell them I was in pain lol - I asked to switch to another kind of pain med so I could stay awake and they gave me liquid oxycodone which I tolerated much better and I was able to start making progress at that point. I had bad pain on the left side of my abdomen for about 9-10 days post-op so I took small doses of the liquid pain meds a couple times per day (usually in late afternoon and right before bed) that whole time. I had no pain pills at all, my prescriptions were only for liquids. No morphine or Tylenol in hospital as indicated by others... I mean there is no one protocol for all weight loss surgeries, it's going to depend on the hospital, the surgeon's orders, the pain level of the patient... so it's hard to say if your friend has a wonky regimen going on. I will say that on the evening of post-op day 3 I gave up crushing pills and just started swallowing them. I had no issues with it so that's not too, too surprising to me that she would have pills.

Four weeks post-op! I can hardly believe it! I'm going to slowly start introducing more types of food over the next few days. Technically I've already been eating "soft foods" since I decided not to puree some of my soups and such, but now I can add in certain whole fruits and steamed veggies along with beans that aren't pureed. The scale finally moved a bit! Down two pounds for a total loss of 21 pounds in the first four weeks. To keep it simple I'll go by the date for a true monthly weigh-in, so that'll be on this Sunday the 17th. Our pool should be ready for swimming soon and that will really help me get in more activity since walking longer than 15-20 minutes is still difficult for me. I still need to get a handle on my sleep and that might also help ramp up the weight loss - I've been sleeping 3-4 hours a night recently and I use the term "night" loosely since sometimes I can't sleep until after Mr. Green leaves for work! I know that's got my hormones all out of whack so hopefully that will improve very soon as well. I've been feeling great lately! Very happy and satisfied with my food and my stomach.

Sorry @Biddy zz! So glad to hear you're recovering well and not too much pain.

It's not like she's a trained medical professional in one of the best hospitals in the country who's done hundreds of cases under this protocol or anything, so obviously everyone should get an extra medical procedure that their insurance may or may not cover instead. Dude, you wonder why people don't react well to your posts You have a lot of good insight to share but you are not smarter or more knowledgeable than my surgeon for f-ck's sake!

No more feta, no more upset stomach. I miss it, though... SO GOOD. I wonder if I can have olives starting on my soft food week? (Which starts Friday!) That might satisfy the salty craving. Cravings for bad food continue. Today it was pizza and a Wendy's burger I wanted. I'm almost four weeks post-op, plus three weeks pre-op diet... Almost two months without access to my fast food fixes and I'm obviously going through withdrawal. It sucks but I know I can get through this. *positive thoughts* I also really want bread and tortillas, although I don't consider that a bad food craving. For example, I was going to eat tuna today but I just could not stop thinking about putting the tuna into a whole wheat pita. We don't have any pitas at the moment but we do have tortillas (used for Mr. Green's lunches) and I had to physically restrain myself from opening the cabinet where they are LOL so I just skipped the tuna altogether. Hopefully in another 2-4 weeks my stomach will be ready for that???? My weight has literally not moved at all in over 10 days. I kind of want to scream. I'm scared to stop weighing myself because what if I resist getting on the scale and I wait until the 17th and it STILL hasn't moved???? I don't really know what variable to change except I know that my sleep habits are a wreck right now. 24 days post-op... those are my rambles!

Thanks for the info, but I'll have to assume my surgeon knows what she's doing in recommending the medication.

Instead of broth, try straining soups. The flavor of the meat and seasonings stays behind and they are usually thicker than broth. Days 4-14 post-op I LIVED for strained beef stew/soups.

What's a carb to you? In the context of "avoiding carbs" or "low-carb" as a bariatric patient? Fries, pizza, ice cream, cookies, etc. - of course (although most of those foods are actually 50%+ fat so it seems weird to call them carbs). Bread? White bread seems obvious, but what about whole wheat? What about the gross, "healthy" kind with all the seeds and grains? Pasta? Again, refined white pasta seems clear enough, but how about the kinda gritty "meh" whole grain version? Potatoes? Beans? Oatmeal, rice, quinoa, corn... all whole grains, so which ones do you avoid? Thanks for any discussion you can provide! I'm just curious about how real life post-op folks make their decisions about what's acceptable to eat when it comes to carbs.

I made my husband throw away the rest of the feta after I snacked on it AGAIN just now. I neglected to say this in my earlier post but whether I'm not tolerating it period or just the amounts of it, it's not agreeing with me and gives me cramping nausea feelings. And yet despite that I haven't been able to stop snacking on it since last night when I bought it... whether it's the creaminess, the saltiness, the funkiness, whatever it is-- it's too much for my pleasure-starved brain AND for my poor little RNY. That's the only thing I've eaten in the last 22 days that's given me an upset stomach. So... bingeing (not really sure if "bingeing" is the right term) on feta cheese is a mistake. I'm glad I've learned that. I wish I didn't have to feel like garbage to have learned it, though. Trying to sip my water and deep-breathe through the bad tummy feelings. It just goes to show that WLS is NOT brain surgery... the desire to keep mindlessly eating something for the taste alone is still up there in the ol' noggin... d*mn you, dopamine!!! Hopefully this does not set me back in the eating department the way the hummus did. Crossing my fingers that after a good night's sleep I'll be ready for some more wholesome and less addictive food choices.

So this is what my 3 week post-op day of eating looked like today: The fiber number is very poor and can definitely be improved, but I chose grits for breakfast and snacked on cheese today (see above post regarding cheese cravings LOL). Doing oatmeal with peanut butter instead and switching cheese for potatoes would get fiber up to 15g or so without compromising protein. I can't wait to add steamed veggies soon! I'm honestly pretty happy about this - I plugged it into MyFitnessPal mostly out of curiosity. I haven't been focusing on food very much, not really measuring precise 1/4 cup servings or whatever, and I wondered if I was overeating. 750 calories seems reasonable to me?

Short answer: It's pretty much completely up to you. Long answer: "Keto" means almost nothing in the bariatric community anymore, I feel... in my pre-op phase I would tell my RD about my diet which at that time included things like oatmeal with berries for breakfast, tuna on whole grain bread for lunch, banana and string cheese snack, burrito bowl with rice or chicken with rice for supper, etc. Definitely protein-focused but not really low-carb and certainly not keto. She would nod and smile and encourage me and then my notes would say "Pt is following keto diet and will continue to do so." What????? LOL! Edit: I found the exact quote I was thinking of: "Commended pt on her weight loss, meal planning, and will continue to follow ketogenic diet." Yeah all that bread, oatmeal, and rice is really keto! A keto diet to me has a very narrow definition of restricting carbohydrate intake to fewer than 20-50g per day with an emphasis on high fat intake - 70% or more of the diet coming from fat. Most bariatric plans recommend moderate- or low-fat (20-35% of the diet) so to me they are inherently not keto regardless of the carbs. But the word is used generally in our community to mean low-carb, high-protein. High-fiber, complex carbohydrates - and fruit - are good for you. Period. They are healthy foods that support your cardiovascular health and protect you against cancer. Plenty of bariatric patients cut them out entirely in the interest of low-carb living so that's certainly an option and in that sense your diet can mirror a keto diet. Personally I'm not willing to give up the health benefits of carbs, so the "keto" guideline of 20-50g per day is not something I follow.

Holy guacamole! You poor thing. Did your surgeon have you on any preventative meds, by any chance? We're required to take an anti-gallstone med for six months and I'm hoping that as a result I can avoid this issue. *crosses fingers*

My puree instructions included an express approval for whole grains like oatmeal and grits as well as fruit like mashed banana. I personally find that banana is very stimulating to my digestive system so I'd see if you can tolerate that and maybe some oatmeal. Also if you like coffee, it can help get things going too. Good luck!

Woohoo! So exciting - I can't wait to be overweight! It'll happen right about the same time I hit onederland, too, so it'll be a PAR-TAY for sure!

It sounds like she's just recommending alternating your caloric intake which can be a good way to loosen up some extra weight - when I was calorie counting I often found that having a "cheat day," which was basically a day when I ate up to my maintenance # of calories (say, 2600 or so), I would lose more weight than sticking to 1500 calories for weeks on end. (Some people do the opposite for the same effect, by fasting for one day per week.) So if the regular diet plan is 1500 or so calories, the pre-op diet plan will likely be between 700-1000 calories. I don't think there's anything weird or unsafe about doing this. Go for it!

Thank you, sweet friend!

Oh, also! My blood pressure today was 109/75!

My appointment today went well! My surgeon seemed really pleased with my progress and how everything is healing up. The dietitian wasn't there so I didn't get to chat with her about food, but the surgeon said she would have her call me on Monday. I asked about why I haven't lost any weight in over a week and she said to wait another week and evaluate after that. She mentioned I could be eating too many calories but we both agreed that was extremely unlikely. I don't see how that's even possible unless I have some sort of freak metabolic issue post-op. Most days this week I could barely choke down a 160-cal PP shake plus maybe half a cup of soup. I'm not worried about the food, to be totally honest. I just need to get walking and keep hydrating. Today was probably my best food day yet although I admit I didn't eat anything until 2pm-- but after that, I had Panera broccoli cheddar soup (in two sittings), a strawberry banana Greek yogurt smoothie (over the course of 3 hours), and about a half ounce of feta cheese (allowed to melt down in my mouth before swallowing of course). I'm SO happy about the smoothie; I was really worried about dumping from high amounts of natural sugars but I had no problems and it tasted absolutely phenomenal. I got some bananas at the store tonight and I'm eagerly waiting for them to ripen! I went to the store on my own tonight and shopped for about 40 minutes. I was definitely shaky toward the end but I just sipped my water and took it easy. If we can manage to get up and out of the house before 8, tomorrow morning will be a good one for trail walking... but I don't have much faith in us getting up, haha. I need to go to Whole Foods soon to see if I can find soy-based products like yogurt that I couldn't find at Wally World or my grocery store, so that can be another indoor walk for me. Slowly but surely I will get there!

Yes!!!! Love that symbolism!

I gave up hiding in "fat clothes" in 2011 after a toxic relationship break-up. I wear bathing suits, sleeveless shirts, short dresses, whatever I want. I don't purposefully try to show off skin, but I just wear what I'm comfortable in. I figure if you don't want to see it, don't freakin look! I'm sure this trend will continue as I lose weight, lol...

Tomorrow (today) I have my rescheduled post-op visit with the surgeon! I have gone against my word and been weighing myself every day - that obsessive mindset is so hard to shake no matter how much I tell myself not to engage it. My weight has been bouncing around from 323 to 325 for just about 8 or 9 days now, so I'm still in the 17-19 lb range lost since surgery. Of course I would have loved another week of an 8-10 lb loss but so far things just ain't moving. I'm irritated but not concerned... I know it will move, and after tomorrow's appointment I'm going to try my damnedest not to get back on the scale until the 17th for a one-month weigh-in! I've been much happier since I started taking my vitamins earlier this week; I'm not exactly sure what could be in them that would boost my mood, but I'm all for it! I'm taking the Bariatric Fusion chewables. So far I like the tropical flavor and don't particularly care for the mixed berry. They are definitely a mouthful, regardless of the flavor! I'm still taking pantoprazole and just started actigall, plus my AD. So I have a very simple twice a day pill routine and I don't have to worry about spacing things or remembering to take pills at various hours, etc. I'm really pleased with this, so far! Belly pain is minimal, just a few zaps from around the numb area here and there. Bowel movements are easy to pass and regular. Eating has been getting easier as the days go by and to be entirely truthful I think it's because I'm not really following the puree rules. Unless the food is naturally pureed (mashed potatoes, applesauce) I'm either mashing with a fork (banana w/ peanut butter) or just mushing it to bits in my mouth before swallowing (potato soups, tuna). Maybe the puree texture was what was really messing with my mind. I still can't do the hummus ever since I had the meltdown that set off the eating issues. (Disclaimer: please follow your surgeon's guidelines instead of going off-track like me!) Possibly because of the added textures from the not-so-pureed foods, I've finally started feeling some feedback from my pouch here and there. I still haven't had any issues with what I'm eating, I seem to tolerate it all fine - but I do think I've been eating too fast because I definitely got some feedback after eating quickly, once yesterday and twice today so I'm going to work on "bariatric etiquette" including putting my fork down between bites and separating food and water. What I felt was mostly a weird, squeezing sensation (maybe a very low-grade pain) in my pouch with a very loud, overwhelming STOP! signal attached. It almost feels like a vagal response, like the first little bit of fuzz in your brain when you are about to faint. I don't actually faint or anything, though! And I'm still so happy that I haven't (yet) had vomiting, slimes, foamies, nausea, etc. or anything of the sort. I feel very lucky in that regard. I still don't have any sense of hunger or fullness. I'm eating because I know I should and stopping when my serving is gone. Maybe as I head into week four (can't believe it's been 3 weeks post-op today!!!!) I'll start getting some of those senses. I have had some cravings for gross, fatty food recently and I think it's because I've been eating a lot of prepared/purchased food, like beans from Taco Bell and mashed potatoes from Bojangle's. So I'm still keying into that "alone in my car going to drive-throughs" ritual that was such a problem for me. It also may be because I've chosen to reincorporate animal products, particularly cheese, in the soups and such that I've been eating. Because, to be frank, almost all the cravings I've been having are for products either made of or covered with cheese! Crispy melty mozzarella sticks, a Rally's burger dripping with cheese sauce, chicken fried rice from the local Mexican restaurant (which is basically just Spanish rice and grilled chicken with a crapton of queso blanco poured over it), a 5-layer burrito from Taco Bell... all have been on my mind lately. (Dr. Neal Barnard has some really interesting insights on cheese and addiction-like responses in the brain if you want to read more about why eating cheese might be making me crave cheese!) Right now I'm relying on my tiny pouch, lack of hunger, and a sincere desire NOT to harm myself by eating foods beyond the mushy/soft stage to overcome those cravings, but that stuff won't last forever. So in this last week of puree, I'm going to keep eating the foods that have been working for me, in the interest of calories and protein - but starting next week in the official soft food stage when I can experiment more, I'll be focusing on building back up a plant-based diet that helps my mind stay away from those types of cravings. Part of that will be planning meals and bulk cooking, and part of it will be rebuilding my cardio ability so that I have more energy for cooking! Well, I think this post is certainly long enough. One day soon I'll have to copy all this over to a word document so I don't lose any of my post-op journals if BP ever goes kaput!

Yes! That is so awesome. Hope you continue feeling better!