Out With the Old--In With the New!

[FluffyChix 17,418]

4 minutes ago, Biddynz said:

Well, @FluffyChix I am in New Zealand, and it seems more common here to have practically no food plan. They are much more relaxed here - but I suspect a quirk of NZ law might be a GREAT reason for this.

Here it is, my US buddies. We have full, universal tax-paid no-fault accident insurance - so if something goes wrong (with anything - surgery, a ladder, a car crash) every single NZer gets full medical care free on the state and (more importantly) in return no-one can sue anyone. We have no courts full of people suing each other. None.

So maybe our Doctors ar a little less nervous? Anyway- my food plan was this.

1. Start with mush until you can eat harder foods, then progress as you are able. Don’t drink when you eat, for now. I was on puréed chicken and Beans before I left hospital.

2. Start with bites, then 1/4 cup, then 1/2 cup. Your max will be 1 cup but you might not get there.

3. Strictly 3 meals a day, no snacking. Protein first helps some people so feel free to give that a go, but don’t panic about 60g every single day because your liver will make you Protein.

That is it. My meal plan.

My surgeon has a longitudinal study of 1700 patients going back, some nearly 20 years. The average calorie intake after 5 years is 900-1000. And he has a huge no-regain success rate too (but he does the no-stretch, double walled stomach with the silicone ring embedded - Fobi Pouch).

Wow!!! That's amazing about the no tort law suits! And about your medical coverage! And holy cow on getting to eat solids so quickly!

Thanks for sharing your food plan! That's also incredible on the 5 years out at 900-1000cals with a high NO-Regain Success Rate! Aren't you glad? Do you also have the Fobi?

Are you watching Big Ward? I LOVE the doc on there!

[Biddy zz 🏳️🌈 1,004]

Yep, I have the fobi. I loved the gastric band when it worked, so am very comfortable with having that wee ring in there (a little boy’s urinirary catheter, with a suture throug the middle tying it into a 6.5cm circle).

My Pouch is long and narrow (most are more like small round balloons - mine is the long thin party balloon). And when he rejoins it to the intestine, he takes several inches of intestine up and uses it to surround the newly cut edge of the pouch - so most of my new pouch is stomach wall plus intestine wall double-thick. This almost eliminates post surgery leaks. Also - in a few people, the cut away stomach migrates back to the new Pouch and rejoins which makes the cut away stomach get food again (isn’t THAT amazing!) but having that intestine over the incision line stops that..

The downside - surgery is expensive because it takes 5 hours (including band removal and scar tidying - maybe 3 usually). Also, my guy hand sews rather than staples, hence 100% open surgery.

Edited March 10, 2018 by Biddynz

[Apple203 1,314]

Ha -- I binge-watched the season of Big Ward on Netflix this week -- I loved it, too!! I have never really liked My 600 Pound Life -- I just can't relate to their situations. First I ever heard of Fobi. Is there a risk of erosion like with band?

[Biddy zz 🏳️🌈 1,004]

21 minutes ago, Apple203 said:

First I ever heard of Fobi. Is there a risk of erosion like with band?

No, none at all. It is more to retain pouch shape than to cause restriction. It is very loose - held in by a loose suture either side. In almost 2000 ops, the surgeon has twice (I think he said twice) had to do laparoscopic surgery to remove it in people whose swelling didn’t go down the way he expected and so it was restrictive. It is near the bottom of the pouch, too, so no ‘tissue up through the band’ issues if you vomit either. Thankfully.

Edited March 10, 2018 by Biddynz

[Miss Topaz 300]

7 hours ago, Biddynz said:

Yep, I have the fobi. I loved the gastric band when it worked, so am very comfortable with having that wee ring in there (a little boy’s urinirary catheter, with a suture throug the middle tying it into a 6.5cm circle).

My Pouch is long and narrow (most are more like small round balloons - mine is the long thin party balloon). And when he rejoins it to the intestine, he takes several inches of intestine up and uses it to surround the newly cut edge of the pouch - so most of my new pouch is stomach wall plus intestine wall double-thick. This almost eliminates post surgery leaks. Also - in a few people, the cut away stomach migrates back to the new Pouch and rejoins which makes the cut away stomach get food again (isn’t THAT amazing!) but having that intestine over the incision line stops that..

The downside - surgery is expensive because it takes 5 hours (including band removal and scar tidying - maybe 3 usually). Also, my guy hand sews rather than staples, hence 100% open surgery.

The whole process is fascinating!

[frust8 963]

Isn't it just! I can now see his rationale for it needing to be open. He is truly a magician with his hands. I never thought to ask but do you live on the North or South Island ?? At any rate I think you had the best surgeon in all of New Zealand!

Sent from my VS880PP using BariatricPal mobile app

[Biddy zz 🏳️🌈 1,004]

I was living in the north, Auckland, the biggest city, but now I live right down south. Slower, gentler pace of life!

The Fobi Pouch was invented by a US surgeon - my guy trained with him.

As well as the open surgery, it is also very expensive - equivalent to a year’s salary at job that pays at the lower end of the wage scale. Or 1/10th of an average house in my city. Lucky insurance paid for 1/4 but still...

No regerts, as they say.

[FluffyChix 17,418]

19 Days Post Op - 211.8lbs (-10.6lbs from SW-222.4lbs)

Ok, so I have things to discuss. ROFLMAO. Let's talk Celebrate Vitamins. I chose to go this route because my RD and doc highly recommended them as giving good labs down the road. So that means, they are easily and well absorbed. To me, that's like a life insurance policy geared toward success.

I also chose them cuz I got samples from several companies and these had (IMHO), the best tastes overall, and the most choices for types of Vitamins (i.e. capsules, chewables, chewy bites, drink mixes, sublingual tablets, etc). So now I want to report on what I got and how I love them/tolerate them.

I got 2 different kind of Multi-Vitamins because I was afraid that I would get to hate the drink mix if I had to have it 2 times a day. Here are my 2 multi-vitamins to take care of my daily bariatric needs:

Essential 3-in-1 Multi Drink Mix in Citrus Splash and it's the 60 serving tub.

So I use 1 scoop a day in Water with ice. And what I get for that is: 1/2 of my Multi-Vitamin needs + 500mg of calcium citrate + about 3g of benefiber stuff. And it tastes like Tang! I'm a Tang kid. I loved the stuff growing up, just as I loved the instant Lipton Lemon Iced Tea. LOL. So I look forward to having my big glass of this stuff, 30 minutes after Breakfast or morning snack time. YUM!!! I thoroughly recommend it. I love that I don't have any gross burps or nausea after it and it tastes yum. And I don't have to swallow a bullet sized multi-vitamin. The tub will lat me 60 days cuz I'm having it one time a day. The other multi is a chewable orange tablet that I take with dinner.

Chewable Tablet Multi-Vitamin in Citrus.

I like this Vitamin. I let it kinda dissolve like a huge sweettart. It does have a mild vitaminy taste, kinda like the old chewable vitamins or baby asprins we took as kids. I like it, tolerate it and best of all don't get burps or nausea behind it. If only taking this vitamin, you need 2per day. But I take 1 at the evening meal and the drink mix for the other half of my vitamin. The drawback with this chewable is that it does not contain the 500mg of Calcium citrate like the drink mix contains. So that means I require 1000mg of calcium citrate from another source which means more cost. But it gives me the greatest flexibility.

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Calcium Citrate Chewy Bites - 1000mg/day (1500mg actual, but I get 500mg from my drink mix multi above--so I only need 2-500mg chewy bites)

I love these chewy bites. I have to take 2 that are separated from my any other big vitamin source of calcium or Iron by 2 hours. I take 1 at noon and the other right after dinner.

Watermelon Chewy Bite - 500mg calcium citrate + D (love to take this in the afternoon)

Chocolate Chewy Bite - 500mg calcium citrate + D (love to take this after dinner kinda like a sweet touch finish to the meal)

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Thiamine 100mg Capsule.

Nothin' amazing to report here other than that it is small and easily swallowed and digested! I take it in the morning since B1 thiamine is an energy vitamin!

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Vitamin D3.

I don't have to take an extra supplement because between my 2 multis and the calcium citrate chewy bites, I meet my 2000mg D3 requirements each day. Score! And a money saver!

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B12 500mg/daily or 1000mg/every other day Sublingual Soft Melts in Wild Cherry.

This is so easy to take. I dissolve it under the tongue. It dissolves quickly is faintly wild cherry. And I take it every other day with my Thiamine and Multi Drink Mix. YUM! And pretty cheap!

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Iron 18mg (from iron fumerate) + C (for better absorption) Chewable Tablet-Tangerine Flavor (every other day at bedtime cuz I'm post-meno and only need about 10mg/day).

This is another big chewable tablet that I let dissolve. It's not bad. Doesn't have an aweful taste and is the best choice so far for flavor and lack of after taste. It doesn't make me sick to my tummy either. Big score! I tried others that sent me praying to hurl! I only take it every other day at night. I separate from any other vitamin or tummy pill by 2-4 hours so that it will absorb.

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Notes:

And that is it. That's my vitamin regimen. I think the cost over time was about $35/mo? Or something cray like that? Bariatric Pal has these in their store at the same price as direct from Celebrate. I do love the customer service at Celebrate and work with someone there personally. So I do use Celebrate. But they are the same price and I'm sure you could get great service from Alex's crew.

I don't know if I will continue doing the chewables and drink mixes over time. What I don't like is that rather than pills or capsules, I have 55-60 calories from VITAMINS!!!! and have about 10-12g of sugar alcohols (I subtract about 8-9 grams of fiber/sugar alcohols as a guestimate). So they could potentially impact your weight loss. I don't like to thing that right now, they represent about 10% of my daily caloric intake! Whoooooooaaaaaa Nelly!

But I'm willing to suspend disbelief and continue to take them in the hopes that they will be well-absorbed and will keep my labs beautimous and also because I don't have to swallow huge ass pills right after surgery!

OK, so there you go! Vitamin Central. LOL. More later...

Edited March 11, 2018 by FluffyChix

[FluffyChix 17,418]

For those of us who can't have real cheese yet, I resurrected a very ancient Weight Watchers solution for a modern problem. LOL. Cheese is high binding and may cause some of us newbs to have Constipation or occasional irregularity. My surgeon told me for the next few weeks, that I should not eat it. Ok. So I won't. Cuz I don't want to end up in the ER again. Horrors!

Enter 2 playahs!

1. Red Star Large Flake Nutritional Yeast.

If you squint real hard and cock your head to the side, this parmesan cheesy/ breadcrumby food looks kinda like old, golden Parmesan cheese--the kind from a green can. And it tastes vaguely cheesy. It's a favorite of vegans the world around. And it's available in the bulk isle and also in a jar in the health food section of most groceries. Also Bob's Red Mill carries it as well--that's on the baking isle with the rest of his stuff. Or online...

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2. Greek Fat Free Yo-Cheese (FCC recipe)

Makes a little over 1 cup--about 267g after straining--about 75ml of whey from it).

Serving size: 1/8th of recipe = about 34g

1 1/2c Greek fat free yogurt, plain (HEB)

1 clove garlic, peeled and pressed

1/2 tsp minced dehydrated onions (Tones)

1/2 tsp parsley flakes

1/4 tsp Kosher salt

Variations:

1/2 tsp lemon zest

1 tsp fresh lemon juice

fresh herbs to taste

Using a coffee filter placed inside a small mesh strainer, add yogurt and place strainer contraption over another small bowel or measuring cup. Cover and place in fridge. Allow yogurt to strain for 12-24 hours.

Transfer strained yogurt to a bowl and add remaining flavoring agents. Make any kind of cheese you want! It mimics "boursin" or soft farmer's cheese.

Nutritional Information Full Recipe*: 204 cals; 35g protein; 0g fat; 14g carb; 0g fiber; 14g net carbs; 11g nat sugars

Nutritional Information 1/8 Recipe*=about 34g: 26 cals; 4g protein; 0g fat; 2g carbs; 0g fiber; 2g net carbs; 1g nat sugars

*About the carb/sugar count of this cheese: There is no way to know what the true carb count is once this cheese is drained and the whey discarded. The whey is the element that contains most of the sugars and carbs. So by discarding about 75ml of this drained whey, this cheese is almost certainly lower carb and lower sugar than the original Greek yogurt I used. But to be as close as possible, these nutritional counts are derived only from the original ingredient prior to draining.

I use this because it's filled with Probiotics, is super duper low fat, flavorful, acts like a soft whipped cheese and won't stop me up or set my trains off schedule on the #2 track.

I love it stuffed inside an omelet, mixed with lots of overcooked veggies, and smeared inside slices of deli meats. I also love it (down the road) as a veggie dip flavored with Ranch mix.

Enjoy!

Edited March 12, 2018 by FluffyChix

[MrsGamgee 756]

Thanks Fluffy! I had been wondering about your yo-cheese.

Sent from my SM-G920W8 using BariatricPal mobile app

[frust8 963]

And I love Laughing Cow and those kinds of cheese, it does sound so good.

Sent from my VS880PP using BariatricPal mobile app

[FluffyChix 17,418]

I'm not allowed to have any cheese, especially since it was the generic laughing cow that pushed me to the ER.

[frust8 963]

You mean she moo-ooo-ved you there?

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[FluffyChix 17,418]

Day 21 - Week 3 Post Op - 212lbs (-10.4lbs from SW of 222.4lbs)

Good morning. So today is one of the milestones: Week 3 Post Op. Just wanted to make a couple of key observations and I will probably post my food log for a tiny bit.

It appears that the 3 week "stall" is alive and well perhaps? For the last 2 days, there really has been little scale love. It's been bouncing around between the same half pound--up and down. Yesterday I was up to 212.2lbs and today I'm back down to 212lbs. LOL. I realize that can be simple scale fluctuation. No scale is that accurate--even Tanita.

I do have a slight feeling that all the sugar alcohols from my Vitamins along with the 60cals/day that they provide is crazy making. And they may also contribute to the scale stuff. But I'm just gonna document and wait it out. It's not as if I have much option. LOL. I see the surgeon next week, and then see the RD right behind that appt. So I will def ask.

The other thing that bothers me is the lack of consensus about volume. I continue to fear that eating too much volume, too early will stretch out my anastamoses. Fact or crap? No idea. But from 5 different references, each gives a different volume amount for 3 weeks.

My RD (verbally at 3 weeks): 1/4c working up to 1/2c food + binder with diet--1-2oz Protein, 1/4c soft veg or soft fruit, 1/4c starch; 3 meals per day; 2-3 Snacks optional--1/4c-1/2c food depending on slider nature--1oz prot + soft fruit

**This equals: 1/4-1/2c protein + 1/4c veg + 1/4c starch or fruit = 3/4-1c of food!

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My Hospital RD (written diet) still alternates protein supplements with 6oz yogurt with a meal. Meal consists of 1oz protein + 1/4c soft veg on an alternating schedule.

**This equals: 1/4 protein + 1/4c veg = 1/2c of food!

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My Surgeon (verbally at beginning at 2 weeks) may advance to soft, fork tender foods stage, eating to tolerance 1-2oz protein + a couple bites of veg + a bite or 2 of soft fruits or starch.

**So that's about 1/2c of food at 3 meals. (Plus I can have a snack.)

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Obesity Coverage Website (thanks @Apple203)-Soft mechanical diet that actually per them begins week 4-5: (click to enlarge it)

**This fluctuates between 1/4-1c of food per meal.

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Big Ward: The doctor made a comment on I think Episode 7 that said up until about 3 months, you will be eating 1/4c of food at a time.

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Dilemma:

I don't really feel any restriction at 1/4cup. I can gulp (about 2-4 gulps before feeling a little discomfort and stimulation to slow down liquids). I can easily eat 1 large egg in less than 5 minutes! I do feel about 3 hours of satiety from 1/2-1c of food. But I'm only 3 weeks out!!!!

I can eat this meal easily in 20 minutes:

2oz pan sauteed chicken tender=1/2 cup of food!

1oz brown gravy=1/8cup of food

1/4c smashed roasted cauliflower=1/4cup of food

1/2oz green beans=1/8cup of food

This totals nearly 1 cup of food by volume!!!!

.

I can eat this meal easily in 15 minutes:

3oz Greek yogurt

3oz 2% cottage cheese

4g Peanut Butter slim powder

1/8c applesauce or 30g lite canned peaches

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I just don't know if I need to MAKE myself limit to 1oz=1/4c of protein as per the example in Obesity Coverage image. Or do I go ahead and advance THIS SOON to 2oz per meal? I limited food to 1oz protein per meal yesterday and felt hungry all day. My meals only lasted me about an hour or two.

Is it too early for me to feel satiety? Or do I have one of those cases where the surgery didn't help my hunger level? Do I have one of those stomachs that can handle eating more? I'm so scared of this! Yes, I'm having the crazies this morning. LOL.

I just flat out don't know what to do. And it looks like the 3 weeks stall is here.

Edited March 13, 2018 by FluffyChix

[newself 98]

ME TOO!!!!!!!!! AMEN SISTER! ME TOO!!!!!!

Here is my experience with volume (we had different procedures but close to same surgery date); some days I can eat close to 1/2 cup, other days I can barely eat a 6 oz light yogurt. It's weird and a little scary to me as well, but it is what it is, and I'm soooo thankful that I have felt great and have not had any of the uncomfortable side effects that others have suffered. Also, the very few extra calories give me the added energy to move well! I'm noticing my clothes are fitting properly vs being tight, so I figure I'm doing something right. Staying away from the scale bc of the 3 week stall.

On a happy note, I had to go to a dinner and literally the only item on the menu that was even a little bit appropriate was chili... I ate about 1/2 of the cup and I was very full but I did not feel cheated or left out. Pre surgery would have been a much different meal for me with feelings of shame and guilt afterward. So... even though it's only been 3 weeks I'm beyond happy with my choice to have this procedure, and I'm keeping a log of these happy victories for when I feel frustrated and upset.