Advancing to the mushy stage early??

[JillianMarie 0]

Now i made a big mistake last night- or at least i think i did- and caved in and ate 2 Protein bars. I'm at day 11 post op and am to the point where liquids no longer fill me up (the swelling must really be going down because i can just keep on chugging shakes all day long and they go straight through me). Fudgcicles no longer fill me up, two days ago i went through an entire 24 pack in one day of sugar free fudgecicles! Many people were concerned about me losing too much weight with this surgery, but now i am concerned about not losing anymore because it is so easy to get my calories in. I wanted to experiment with something solid (even though i know it is too soon) to see how it would sit on my stomach. I got two low carb Protein Bars, each was 2 ounces. They didn't have anything crunchy like nuts in them, and they are sweetened with splenda. They also contain 7 grams of fat each, but the healthy fat that helps keep you full longer and helps with your hair and nails. I started by taking a few tiny bites of the bars, chewing VERY well, and slowly. I would take a small sip of warm broth in between each swallow. Before i knew it, both bars were gone, and my stomach didn't get upset whatsoever, and i laid on my back flat all night with no pain or nausea. I woke up today feeling great, no stomach upset or heaviness. I think i will go ahead and start with my mushy stage now, even though it is 3 days early, and see how it goes. I dont want to push my stomach too hard too soon, but right now i am able to get an easy 1600 calories a day on light yogurt, Protein Shakes, etc... and right after surgery i could hardly get in 300 a day. I'm thinking that if i advance to the mushy stage, less food will be required to fill me up and it will sit with me longer. It's getting far too easy for me to go overboard now on calories when drinking the shakes and puddings. I really look forward to adding vegetables and oatmeal in the coming weeks (blended of course), as those foods sound incredible to me right now! lol!!

Oh- and chewable cherry Rolaids have been my lifesaver!! They cure stomach pain better than Nexium or Prilosec, and give you your dose of Calcium in one. You can also get the tropical flavored chews, that are an antacid and anti-gas in one. Don't care for that flavor as much but they both work great.:biggrin0:

[deletedsally 8]

Jillian, it's hard to know what to say at this point because I don't know anything about the dietary guidelines you were given by your doctor, and I don't know how your surgeon approached the construction of your sleeve given the small amount of weight you had to lose. With respect to your food choices: I can only tell you that I was instructed to stay on Clear Liquids for 4 days post op and on full liquids for 4 weeks before starting the mushies. On the full liquid stage I was able to have pureed and strained foods only. Cream soups--strained. Baby food meats mixed with Soup. Protein Shakes. The only foods on my list with any texture at all were cottage cheese and cream of rice Cereal. For me, the mushies started 4 weeks plus four days after surgery. If you are having this much hunger, you may want to check with your doctor about how to approach this, so that you protect your sleeve.

[Devo 0]

I am 4 weeks out but started with full liquid diet for the first 2 weeks and then progressed to soft diet (per dr's instructions). Full liquids included Protein Shakes, crystal light, Soups (low fat meat & milk based - I love low fat cream of chix Soup and add more chix broth for a little more flavor), cooked cereals (cream of rice or wheat, which I did NOT like!), mashed potatoes (absolutely love). Also, strained pureed vegies, unsweetened applesauce, skim milk, sugar free Jello (a life saver for the munchies!) and puddings. The first time I tried a sugar free pudding for a treat, I could only eat half of it and I was absolutely stuffed for like 3 hours! That was about 4 days in...I am really surprised with your calorie intake...most folks here, me included, only get about 600-800 calories daily. Now I eat Subway Breakfast sandwiches (minus the bread) for breakfast, very satisfying; usually a cup of soup (any low fat, low sodium) healthy choice is good, for lunch and either soup or soft Protein with a few well cooked veggies for dinner. I will occassionally have a handful of nuts in the evening, without any issues, or sugar free pudding. Life is Grand!! Hope this is helpful. Have a great day!

[JillianMarie 0]

Katt- my Dr., although a fantastic surgeon, has provided no follow up care and i have no method of contacting him. They sent me home with paperwork, basically 2 days after surgery i was able to have Jello and broth, and when i got home i was able to have yougurt, pudding, cottage cheese, etc... (so they allowed me to have full liquids once i returned home). The only thing he stressed was eating small portions at a time and chewing well to make sure food is digested. He never stressed staying on "clear liquids" or "full liquids" for a certain amount of time. The only period of time that i was required to be on clear liquids was the day of surgery and the day after. I know that the lady that i went with that owns the Medical Tourism company, had just had the sleeve surgery 3 weeks prior, and she had just started eating full foods, and while we were there she ate heavy food- half of a big enchilada, tacos, etc.... but broke it up into small bites because she got full very fast. 3 weeks out and eating mexican food? It was at the Dr's recovery house too, and he was there and saw her eat it. So i don't think he is very strict with his guidelines. That is why i am asking the opinions of you all, because i want to be safe with what i do eat, but i do feel like im ready for something with more consistency and thickness now, as I am not yet exercising and it would be easy for me to actually gain weight consuming Protein shakes all day long. I need something to sit in my stomach longer so i go longer without eating. I have noticed that if i eat something, as long as it is soft or at least chewed until soft, nothing sharp, and nothing heavy or fatty, and i follow with liquids, it eases right through me. I tried baby food last night- mixed the turkey with turkey broth baby food with some low sugar ketchup (yes i know that sounds terrible) and ate it with measuring spoon 1/2 tsp, slowly. Tasted WONDERFUL. I did notice i felt full MUCH faster than i do on the shakes. A few bites and i felt full. So i stopped, then after a little bit i ate a little more, and did the same again. I feel like i wont have a problem with the baby food as long as i dont eat it too fast, and fast eating has always been a problem of mine because i was a compulsive eater. But i am terrified of vomiting so i take it slow.

I'm just a little concerned at this point. Liquids go down too fast and now i am left feeling hungry easily. The normal foods that i would typically eat that are lower in calories and dense in nutrition (grilled chicken, steamed veggies, canned tuna, oatmeal) would easily fill me up in very small portions and be able to reduce my calories quite a bit. But i am not sure what stage i should introduce those things back into my diet, i am not concerned so much of getting sick, as i would chew very well and even puree them, i just dont want anything to get lodged where the internal incisions are. Do you know how long they take to heal? Are there staples inside the stomach?

I'm going through some big food withdrawals- as most people probably do after surgery- and the things i miss most are broccoli and oatmeal. I am wondering how much longer i should wait before adding them back in small amounts. I'm willing to blend them if i have to! lol!

Sorry for such a long post!!!

[Devo 0]

Jillian, I noticed you mentioned drinking liquids after eating...most of the guidelines I have read say to wait 30 minutes after eating before drinking. It does push the food right thru your sleeve. If you wait, you won't get hungry again so quickly. This has been a challenge for me but I am working on it and getting better at it....

[deletedsally 8]

Hi Jillian,

The nutritional guidelines from my surgeon are not available online, but lots of others are. I printed out multiple guidelines that were online prior to my surgery. They were all fairly similar, but I got different ideas from each one that helped me. Try these links and see what you think.

Also, I found that if I had some form of pureed Protein, I stayed full for hours. I used baby food meats sometimes for convenience, but I preferred the taste of fresh stewed chicken that I cooked with onion and carrots and fresh herbs--pureed it all in my food processor. I also cooked fresh steamed broccoli and pureed it in the food processor. I did really well with that.

http://www.cornellweightlosssurgery.org/pdf/dietary_guidelines_sleeve_gastrectomy.pdf

http://www.hopkinsbayview.org/bariatrics/docs/nutrition_sleeve.pdf

http://www.bethesda.med.navy.mil/patient/health_care/surgery_services/bariatric_surgery/bariatric%20nutrition%20guide-sleeve%20gastrectomy.pdf

http://www.iabsobesitysurgery.com/Media/Forms/SleeveDietGuide.pdf

[deletedsally 8]

Jillian, I noticed you mentioned drinking liquids after eating...most of the guidelines I have read say to wait 30 minutes after eating before drinking. It does push the food right thru your sleeve. If you wait, you won't get hungry again so quickly. This has been a challenge for me but I am working on it and getting better at it....

I agree with this, and some guidelines even say that you aren't supposed to drink fluids for an hour after eating.

[Tiffykins 672]

You should be able to contact your coordinator to get some guidance for your specific situation.

The sleeve is not about just restriction. They operate on our stomachs not our brains, and if patients aren't willing to changes habits and make better food choices then none of us will lose the desired weight. It's just a fact of weight loss surgery, not just the sleeve. All of the weight loss surgeries can be cheated. Without changing your relationship with food, you won't lose weight, or you're going to be dieting. It's just a fact of weight loss surgery.

The basic eating "rules" of the sleeve are no more than 4ounces of mushies at each meal. Most surgeons recommend no more than 3-4 meals per day, no Snacks. Once you get to solids, dense Protein, restriction is usually different, but I'm not sure if your surgeon made any concessions in your stomach size due to you only wanting to lose 30lbs, but most of us experience major restriction with solids. It takes some of us 6+ weeks to be able to eat more than 1oz of chicken breast or ground beef.

Very basic sleeve rules are do not drink any liquids for a minimum of 30 minutes after you consume food. If you do drink, it's just liquefying the foods you put in there and flushing them into your intestines. You won't get any satiety in doing this with each meal.

Also, try to remember, not all sleeve patients lose hunger. You have Ghrelin still floating around your system as well, so you're going to be hungry. It's not out of the ordinary.

Tums/Rolaids are Calcium carbonate and not even recommended with the sleeve.

I'm not even going to try to suggest when broccoli or oatmeal is "ok" to add back because I wasn't able to have mushy/puree food for 3.5 weeks once I started my post-op diet. Other people's diets are more strict, and others are more lenient.

You're going to have to take care of your new stomach. You'll have to give it some time, and try to not only stay within the guidelines, but really work on your relationship with food. That's what all of us have to do for us to be successful.

This probably comes off harsh, and those aren't my intentions. I hope you are able to get some answers from someone. I know that Dr. Almanza does give his coordinators information, and since you paid them, you should be able to get some assistance from someone on his staff. They have several patients that have been able to get help from them post-op, you should be able to get the same courtesy.

[JillianMarie 0]

That is probably true, that because i am drinking with my food it is moving through far too fast, I'll back off on the liquids around the time that i eat. Your idea of stewed chicken with broccoli and carrots in the food processor sounds wonderful! I will have try that!

Thank you for adding a link to those files, i'll print them out and read them! Thanks so much for your help!! :biggrin0:

[JillianMarie 0]

Thanks Tiffykins, I did email both the coordinators for Dr. Almanza but have not gotten responses from either of them.

Dr. Almanza did tell me to "graze" throughout the day, instead of 3 tiny meals, have maybe 5. He said i would get hungry frequently, but could only eat about 1/3 cup of food at a time, so to space those meals out every few hours, and avoid drinking with the food.

I'm aiming for about 1000 calories a day, not 500. 1000 is still a drastic reduction from what i was used to taking in. (3000 prior to surgery)

I'll stick to the guidelines that others have gotten from their doctors, stay on my full liquids for the full 2 weeks, then in a few days (3 days away!!) i'll start the mushy/blended stage, and stay on it for about 3 weeks. I see a GI doctor next thursday, hopefully he can give me some advice as well about when it is appropriate to introduce new foods, and which ones to avoid. You are very right about taking care of the new sleeve, i don't want to push it or risk complications.

Thanks!!

[wannalise 15]

Jillian,

I would continue to measure and be very careful. Even with your liquids. The nerves in your body were just severed and you may not feel the signals of full or not. I know there is no way I could have gotten down the quantities you are eating, in fact I'm two months out and two Protein Bars would be my day. Please be careful, it would be very sad to have done something so drastic as surgery and to damage your stomach. I would recommend getting in touch with a NUT who specializes in bariatric surgery and getting some advice. Even a GI doc will only be able to tell you about the structure of your body, not how to feed your new stomach. Good luck.

[MlkPas 5]

Jillian, are you still planning to see a therapist? It really does seem that you may have issues that go beyond the physical -- particularly eating 24 fudgesicles in a day, so soon after your surgery. And I'm concerned because your posts seem kind of, well, frantic. I really think a good therapist would be able to help you find some peace around this whole thing.

[Devo 0]

Tiffykins, I know Calcium Carbonate is not good with the sleeve, but do you know why? I have some chewable Previcid but it has calcium carbonate in it. I have taken a few of them, probably stupid. Hopefully I have not done any damage.

[kalew 0]

Good rule of thumb, is 60 grams of Protein a day, and 60 oz of liquids. kind of the KISS method (keep it simple) Eat the protein first, then veggies, then carbs if you are still hungry. I did 2 weeks of full liquids then start soft diet for 4 weeks: eat about 1/2 cup at a time for breakfast, lunch and dinner, for extra protein you can have Protein Shakes or drinks (I used Isopure zero carb from the Vitamin shoppe)

avoid fresh veggies, corn, asparagus, tomatoes, lettuce, celery, fresh fruits (except for bananas); no bread, rice, Pasta. you can have about 1/2 slice of toast or about 4 crackers. good protein sources (3-4 oz) are lean chicken, lean hamburger, pork, beef, fish, etc. eggs, egg whites. The thought with the bread, rice, pasta as it tends to just ball up in your stomach and sit there, you may get nauseated or vomit. Look at labels and make sure that a sugar is not one of the first 3 ingredients listed. Made a mistake once with carnation instant breakfast (thought it was no sugar added one but it wasn't) had a bunch of strange noises then my bowels were overactive. If you want I can fax you my guidelines.

Edited May 31, 2010 by kalew

[wannalise 15]

My understanding with the Calcium carbonate is that it is an effective temporary acid reducer, then your body realizes you don't have enough acid and to compensate produces too much. Its called acid rebound.