Hi all,

I'm 15 days post-op and am hoping for some insight into how others have transitioned through the phases of the post-op diet.

In phase one (liquid only), my materials from my bariatric program seemed to say not to follow the 30/30 drinking rule, but instead just alternate sipping Water and shakes all day. I found it much easier on my pouch to do it this way and not drink too much of a shake at once.

Now that I'm moving to purée foods, yogurt and such, it says to follow the 30/30 rule. Right now I can't seem to eat enough purée food to get even half my Protein in, so I've been mixing the two phases together. I'm still not following the 30/30 rule with shakes cause I find it difficult to get enough down that way. It's like once I'm full, I don't want anything for hours, so it's hard to have more than three "meals" per day.

How long did it take you guys to be able to eat enough to get your protein from food? Did that happen in the purée stage? If not, did you start following the 30/30 rule with shakes too? How did you make it work?

I am 4 months post op and still drinking at least 1 if not 2 shakes per day. Lots of people a year out drink at least 1 shake a day, so do not feel bad about still doing that. It takes a LONG time to get to where you need to be with Protein from food and very few get there during pureeds (I certainly didn't).

@@Daisee68 Did you follow the 30/30 rule with shakes? Was it hard at all to get enough protein doing that? Thank you!!

I'm just 4 months out but can not get all my protein in without shakes.

In the "Weight Loss" phase after RNY gastric bypass surgery, weight loss is achieved by portion control. You begin with an incredibly small portion of 2 ounces per meal (or 1/4 cup) and eventually after 18 months work your way up to 1 cup per meal.

In the beginning I was consuming 3 Protein shakes per day. I concentrated on consuming high protein meals and as time went on I was able to drop off one of the Protein Shakes and then another. But I wasn't able to get off all the protein shakes until I hit 1 cup per meal.

At 15 days post op, the most important (essential) elements of the program are meeting your daily protein, Fluid and Vitamin requirements. food is secondary because your body is converting stored fat into the energy that drives your body. Thus you lose weight.

So when did you guys start following the 30/30 rule? I find it impossible to meet my protein goal and follow it. Is it more important for later phases??

@@gpmed - I did find the 30/30 rule very overwhelming in the beginning but it does get easier. I did not follow it with shakes (per my NUT) though she did tell me to not mix the two. in other words, just drink your shake and then when you are done, have other liquids. Eventually I settled on not necessarily waiting 30 minutes after drinking before I ate. I always wait at least 15 minutes and sometime it is 30, but that one rule particularly overwhelmed me. (I am not saying do what I do, but that did help me relax.) I set a timer for 30 minutes on my phone after I finish eating and don't drink until the timer goes off, so I do stick with that rule. I probably only eat 3 to 4 times per day and have 1 shake per day. It is what works for me and I am able to get my Protein to at least 80 grams that way. I use Premier Protein ready to drink shakes or Precision Engineered powder both of which have 30 grams of protein so that helps a lot. (By the way, if you haven't read this yet - your body only absorbs 25g to 30g per hour so it won't do any good to add a bunch of protein or drink one of those protein shots.) If you can add unflavored Protein Powder to any of your food, that helps too (though I don't do that much anymore). If you like milk, you can also drink some skim milk in between meals which will get you fluids and protein at the same time. (Try Fairlife milk if you haven't. It is very good with more protein and less carbs.) I can promise your NUT nor surgeon expect you to get to your protein goals every day at this point. It will come in time. Just keep focusing on it.

Hope that helps a little. I have only recently sort of settled in to not being so overwhelmed with the rules so don't feel bad.

@@Daisee68 Thank you!! That was really, really helpful! It's nice to know others went through this and it gets better. I'm getting about 40g Protein each day as it is and was getting overwhelmed about how to follow the rules.

Meanwhile I keep dreaming I've eaten half of a huge brownie or bowl of Pasta and am panicked cause I'm not even supposed to be on solid food yet...haha!

@@gpmed - Glad it helped! I had a few food dreams too! Wake up scared to death I ate potato chips and drank a soda! Oh and once you get to solid food, the Protein gets a lot easier too, but again I just asked my NUT maybe 2 weeks ago, if it is was ok for me to still be drinking 2 shakes a day if I needed to get to my goal and she said absolutely and as long as I was still getting some protein with my food and not a lot of carbs.

I did not follow the 30/30 rule until I was eating solid foods. I am almost four months post op and I still drink a shake every morning because I cannot physically consume enough food to get all of the required Protein. I have had a really hard time with meat, so I am still eating alot of cottage cheese, cheese and yogurt. Just follow your body, it will tell you when you need to begin following the 30/30 rule.

@@gpmed I've posted this before, but maybe this might help you. I had my surgery at Mayo and these are the guidelines we were given for the different phases. I was able to get 60 grams of Protein beginning day 3 post-op. I'm almost 6 months out and average 110-120 grams at 800-850 calories per day. This includes 1 Premier Protein ready to drink shake per day. I use it in my decafe coffee and chai tea to make them into lattes. I don't know if you like quiche, but I have a great recipe for "Magic Crust Quiche" when you start your soft food stage. Once I began soft foods at day 15, I followed the 30/30 rule. I still make this quiche as it is a staple in my diet. I try to eat moist meats/foods to avoid any digestion problems. So far so good

@@beachgal2935 I would love your recipe for when I start soft foods in a week. Thank you!

@@gpmed Here's my FAVORITE recipe

Magic Crust Quiche - Ham

Ingredients

2 cups 1% Lowfat Milk

1/2 cup All-purpose flour

5 large eggs

1/2 cup 2% Reduced Fat Pepper Jack cheese shredded

1/2 cup 2% Reduced Fat Swiss Cheese shredded

1/2 cup 2% Reduced Fat Sharp Cheddar Cheese shredded

7 oz Ham diced small

1/4 cup Cooked red bell pepper diced small

1/4 cup Cooked Vidalia or sweet onion diced small

Preheat oven to 350˚. In a blender or NutriBullet, mix eggs, milk and flour until blended, season with salt, pepper, garlic powder or whatever you’d like. In a bowl combine all cheeses, cooked meat and cooked veggies. Now add blended mixture and stir to combine. Pour into an 8”x8” or 9”x9” square glass dish. Bake for 50-55 minutes. Let stand 5-10 before serving. You can add whatever cheeses, veggies or meats suit your taste. I steer clear of chicken as it seems to dry to me. The small amount of flour firms up the sides and bottom making the “magic crust” while saving tons of calories. The Nutrition Facts are based on recipe above. FYI - the heavier meats, like ground beef, tend to fall to the bottom. Serving size is approximately 2”x2 1/2”

Nutrition Facts

Servings 12

Per serving:

Calories 120

Protein 12g

Fat 5g

Cholesterol 94 mg

Sodium 253 mg

Potassium 59 mg

Total Carbohydrate 7 g

Sugars 2