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I'm so confused-unclear diet plan from doc



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I'm 10 days post op and my surgeon isn't very helpful as to what my diet should look like. At my follow-up on day 8 he said I could move to a "transitional diet" and gave me a sheet of paper that says I can now eat things like eggs, refried Beans, tuna, chili, reduced fat cheese, anything that can be easily be broken up with a fork. His nurse said I don't have to "do" purees, per se, just to take my time getting to the soft stuff. 60g of Protein, no or low carb, less than 10g of fat per day, 64+ ounces of Water per day, okay.

So what could I do here? I've had zero issues getting my fluids in since day one. I've tried unsweetened applesauce, thinned out refried Beans, and refried beans with taco sauce (YUM!) with no issues. Are soy products okay, like tofu or meat substitutes? What about barley? As far as chili, I was under the impression that meats were pretty much verboten until the solid or "full" food phase, or am I mistaken? I thought I was prepared but he's really thrown me for a loop. My next follow-up appointment is a month from now.

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It sounds like you are allowed most of the things I was allowed during my soft foods phase. Ground meats, tuna, etc. were allowed during soft foods. Tougher, chewier meats were allowed later after my soft mechanical phase.

The food phases are based on texture.

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You're making safe choices so far. The meat in chili is fine because, after a fashion, it's pre-chewed.

I'm not sure what the nurse means by taking time getting to the soft stuff in place of pureeing.

Imagine the scary eyes of the cat in your signature photo staring right into yours to say, "Do not sit quietly until your next appointment. If you need clarification and have questions, call now." You're the customer and we're speaking about your well-being.

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I asked the nurse "So I don't have to do a puree phase?" and she said "You don't have to "do" purees but I wouldn't go home and eat chili, either. Just eat whatever you tolerate." So, yeah, not very helpful. It's kind of a theme with him, actually. What do I need to keep in mind as I progress? I'm aware of limiting to tiny portions and bites and no fluids 30 minutes before and after.

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Meal requirements can vary between surgeons post-op. In my case I was given substantial guidance of how much I could eat per meal and what I could eat. The reason why you might not want to transition too quickly to solid foods after RNY gastric bypass surgery is to allow the staple lines in your stomach to heal and to prevent nausea and vomiting. The other concern is that you need to limit your sugar and fat intake because the part of your stomach that normally processes sugar and fats has been cut away and it you take either of these in sufficient quantity, it can lead to dumping. So my direction was to start at 2 ounces of food per meal, 3 meals per day. Weeks 1-4 were full liquids, Weeks 5-8 were pureed foods, Weeks 9 and beyond were solids. So if you run into problems transitioning, there is nothing to say that you could slow down the transition until you feel more comfortable to move on.

The three most important elements after surgery is to meet your daily Fluid, Protein, and Vitamin requirements. food is secondary because your body is converting stored fat into the energy that drives your body. Thus you lose weight. Weight loss after RNY surgery is achieved through meal volume control. At 2 ounces of food per meal, it is almost impossible to meet your daily Protein requirements without relying on Protein shakes. So fluids are no problem. Good. Any issues with protein or Vitamins?

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I didn't technical have a pureed phase either. At 10 day follow up, my surgeon (actually my surgeons partner as my surgeon was out) said I could move to soft foods which she described as anything I could mash with my tongue. I struggled with things like fish because it was a little to dry. So start slow - soft cheeses, yogurt (w/ Protein powder added in), refried Beans, chicken or tuna salad (with mayo or Greek yogurt), Ricotta Bake, etc. Try that for a couple of weeks and see how it goes. If you tolerate it well, then move on to some more dense foods (like tender deli meat, baked fish) but always chewing well and with something to dip it in to keep it moist. I would also suggest finding a nutritionist that specializes in bariatrics if you can. The one I use does everything over the phone. Happy to give you that name if you need someone.

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@@Daisee68 and @@James Marusek got you covered. As they said take it very slow and try one food at a time. That way you will know what bothered you if you happen to get sick. It's also easier on your tummy.

Those first 6 weeks I lived on Greek yogurt, cottage cheese, over cooked soft carrots, ricotta bake, (9tried soft eggs but still can't eat them),

Cream of wheat with Protein powder, applesauce unsweetened, and of course Soups without Pasta (mostly creamed soups)

I had a minimum of 1 30 gram Protein shake but early on I usually had two so I got my Protein and liquids in.

Best of luck to you and congratulations!

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Vitamins are sorted. I take a chewable Multivitamin and various supplements, all of which were approved by my surgeon's nurse. For Protein, I have Isopure Protein powders I liked before surgery. He started me on Bariatric Advantage shakes post-surgery. I physically couldn't tolerate those at all no matter what I tried because of the texture and developed an aversion to shakes in general. I was able to tolerate an Isopure shake this morning so I'll do that for the foreseeable future. I also have the unflavored that I can add to whatever.

Three meals a day? Good to know. I wasn't sure how often we're allowed to eat puree/mushy stuff. I definitely want to avoid dumping, which is part of the reason I chose RNY over sleeve. As long as I have the 3x/day guideline I think I'm comfortable going with a puree/soft hybrid diet. I don't like seafood so that pretty much takes out a lot of the hardest-to-digest bits of the soft stage, if I avoid all other meats until later in the month. I'll give my doc a call about soy stuff and barley. I'll do a shake in the morning and evening, which will give me 50g of protein all on its own. Thanks so much for your help!

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Vitamins are sorted. I take a chewable Multivitamin and various supplements, all of which were approved by my surgeon's nurse. For Protein, I have Isopure Protein powders I liked before surgery. He started me on Bariatric Advantage shakes post-surgery. I physically couldn't tolerate those at all no matter what I tried because of the texture and developed an aversion to shakes in general. I was able to tolerate an Isopure shake this morning so I'll do that for the foreseeable future. I also have the unflavored that I can add to whatever.

Three meals a day? Good to know. I wasn't sure how often we're allowed to eat puree/mushy stuff. I definitely want to avoid dumping, which is part of the reason I chose RNY over sleeve. As long as I have the 3x/day guideline I think I'm comfortable going with a puree/soft hybrid diet. I don't like seafood so that pretty much takes out a lot of the hardest-to-digest bits of the soft stage, if I avoid all other meats until later in the month. I'll give my doc a call about soy stuff and barley. I'll do a shake in the morning and evening, which will give me 50g of protein all on its own. Thanks so much for your help!

post-295945-14682548358757_thumb.jpg post-295945-14682548400349_thumb.jpg

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Vitamins are sorted. I take a chewable multivitamin and various supplements, all of which were approved by my surgeon's nurse. For Protein, I have Isopure Protein powders I liked before surgery. He started me on Bariatric Advantage shakes post-surgery. I physically couldn't tolerate those at all no matter what I tried because of the texture and developed an aversion to shakes in general. I was able to tolerate an Isopure shake this morning so I'll do that for the foreseeable future. I also have the unflavored that I can add to whatever.

Three meals a day? Good to know. I wasn't sure how often we're allowed to eat puree/mushy stuff. I definitely want to avoid dumping, which is part of the reason I chose RNY over sleeve. As long as I have the 3x/day guideline I think I'm comfortable going with a puree/soft hybrid diet. I don't like seafood so that pretty much takes out a lot of the hardest-to-digest bits of the soft stage, if I avoid all other meats until later in the month. I'll give my doc a call about soy stuff and barley. I'll do a shake in the morning and evening, which will give me 50g of protein all on its own. Thanks so much for your help!

attachicon.gif20160711_123334.jpgattachicon.gif20160711_123258.jpg

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Thank you! That helps a lot!

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I hate that your surgeon's office is not as helpful as they should be! If you google "post operative diet for bariatric surgery" you will find plans from mayo Clinic and other prestigious hospitals. Maybe one of these will have a little more detail for you.

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I was given a manual created by the team at my Bariatric Care Center in our local hospital that spells it all out... Every stage of eating. There is a RD as part of this team and I take her advice over the office nurses, who don't have degrees in nutrition and give conflicting advice. For instance, Nurse said I could take all 4 Vitamins at once. Nutritionist said to take 2 in am and 2 in pm to get full absorption. See what I mean?

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