Michael King Oxford, MS
Hello everyone-
I will be having my surgery on the 13th of May w/Dr. King. And was wondering on his lap patients if he does a drain? Or have you wear a binder? And was also wondering how long the stages are? Like the clear liquid stage? The full liquid? Pureed stage? Soft stage? Then I know u can eat regular food. I'm just asking because I will spend a few days after surgery up in a hotel hopefully just one! And I kinda needa know what food or liquids I will need. I know I need to bring alotta water. Thanks!!!
~April~
May 13, 2005 surgery scheduled!!!
Hey April, 
I had Dr. Byars, but they have the same "follow up" and
Diet Advancement protocol.
I went looking for my old diet sheets
But couldn't find them.
Try contacting King and Byars Surgical Clinic
And having them e-mail you the whole thing.
Just google-
surgicalclinic.ms
And you'll go right to it.
If not that,
Then Contact Becky Wilson at Liv-Lite and ask if she'll e-mail you one.
They are really good about helping out with anything.
If not e-mail
Ask if they'll fax you one.
I'm sure they would.
In the meantime, I'll try finding my "lists"
They were all "hard copies"
But maybe I can scan them in and send them as "Photos."
Here is a "Big Ole" Stack of info-
And while it's not King's protocol,
It's pretty darned close.
I think the "Weeks" to advance
And what you can add are a little more conservative than this
But It will give you an idea until you can get your hands on a copy
Of the "Real Thing."
Hope this helps--
THE GASTRIC BYPASS DIET
~~McFarland Clinic, PC
~~Ames, IA
Gastric Bypass surgery assists in weight lo by restricting the amount of food that can be eaten at one time. In order for this procedure to be a success, you must abide by the limits of the amount of food allowed per hour, coupled with good nutritious choices. Because you are limiting the amount of food and fluids you have at a time, it is important to drink enough water to prevent dehydration, by having some every hour you are awake.
Following surgery, no oral intake is allowed until bowel activity resumes and some healing of the pouch occurs. During this time, your fluid requirements are met with I.V. fluids.
GUIDE FOR MEASURING FOODS:
1 Cup = 240 cc = 8 ounces
1/2 Cup = 120 cc = 4 ounces
1/4 Cup = 60 cc = 2 ounces
2 Tablespoons = 30 cc = 1 ounce
1 Tablespoon = 15 cc = 1/2 ounce
THE FIRST STEP IS WATER
About day 3-4 post surgery, you will begin taking water in sips of 50 cc per hour.
Sip this 50 cc slowly, and stop if you feel uncomfortable. Limits are placed on the hourly amounts taken to avoid stretching or rupturing the small gastric pouch. Early after surgery, the emptying of the pouch may be slow. The feeling of fullness may be different from the feeling you had before surgery. Get to know what this feels like. A sheet for recording your water intake will be provided. Record the amount you take accurately to help gauge your tolerance.
CLEAR LIQUIDS
After tolerating 24 hours of water, the diet is advanced to clear liquids, at a rate of 75 cc per hour.
The following foods are provided on a clear liquid tray in the hospital.
~~Water
~~Broth
~~Diet Gelatin
~~Tea
~~Coffee (caffeine-free)
~~Clear juice (diluted)
You may have the clear liquid tray for two hours. Choose foods from the tray so that you can eat 75 cc each hour for the two hours. The tray will have more on it than you can finish. Once the two hours are up, put the food tray away and switch back to having water at the rate of 75 cc per hour.
FULL LIQUIDS
After a day of tolerating clear liquids, the diet is advanced to full liquids at the rate of 100 cc per hour. Once again, meals last two hours, with water taken in between meals.
The following foods are provided on a full liquid tray at the hospital:
~~Cream of Wheat
~~Soups (strained, creamed soup, broth)
~~Desserts (custard, diet gelatin, sugar-free frozen yogurt, sugar-free pudding)
~~Beverages (coffee, tea {caffeine-free})
~~Seasonings (salt and flavorings in moderation)
~~Pureed fruits
~~Sugar substitutes
~~Skim milk
~~Juices (diluted)
**********By now you should be tolerating 100 cc per hour of full liquids.
**********Patients usually go home after tolerating a day of full liquids.
**********Be sure you plan ahead and think of foods in this category that you can have at home.
**********Again, be sure to drink 100 cc per hour of water in between meals. Do not exceed the 100 cc per hour limit. If you take sips of water during mealtimes, count the amount sipped in your 100 cc per hour total.
SAMPLE MENU FOR TWO WEEKS AT HOME:
Breakfast:
~~100 cc NSA Carnation Instant Breakfast (made with Double Milk) (OR)
~~1/4 Cup SF/NSA yogurt (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk)
Lunch:
~~1/4 Cup cream soup (made with Double Milk) (OR)
~~100 cc NSA Carnation Instant Breakfst (made with Double Milk) (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk)
Supper:
~~1/4 Cup cream soup (made with Double Milk) (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk) (OR)
~~2 Tbsp. puree fruit
**********Double Milk Recipe**********
1 Cup FF Skim milk
1/3 Cup non-fat powdered milk
Drink a total of at least 1000 cc (4 cups) of water, broth, diet soda, unsweetened tea or coffee during the day, between meals. Stick to the restriction of 100 cc per hour of full liquids for three weeks after surgery.
PUREED DIET
This diet begins three weeks after your operation.
Take 15-20 minutes to eat one ounce of food. STOP DRINKING 30 MINUTES BEFORE EATING AND WAIT 45 MINUTES AFTER EATING THE MEAL BEFORE HAVING WATER AGAIN. Chew foods well. Be sure to have protein foods at each meal.
PUREED MENU EXAMPLES:
Breakfast:
~~1 scrambled egg (OR)
~~1/4 Cup cereal (OR)
~~1/4 Cup yogurt
Lunch:
~~1/4 Cup pureed meat (OR)
~~1/4 Cup mashed potatoes (OR)
~~1/2 Cup cream soup (made with Double Milk)
Supper:
~~1/4 Cup pureed meat (OR)
~~1/4 Cup pudding (made with Double Milk) (OR)
~~100 cc NSA Carnation Instant Breakfast (made with Double Milk)
To puree meat:
1/4 Cup broth
1/4 Cup meat, poultry or fish, cut against the grain
Blend in this small amount to achieve desired consistency.
Clean blender after each use to avoid food borne illness. (Use within 24 hours, unless frozen.)
Freeze:
Place extra blended food in plastic freezer ice cube trays. When frozen, transfer to freezer bags and write date on the bag. Use within two months, or throw away.
MECHANICAL SOFT DIET
This diet begins four weeks after surgery. Be sure to chew well and take 15-20 minutes to eat one ounce of food.
Begin to slowly add soft foods, such as:
~~Fat free or 1% cottage cheese
~~Low-fat cheese
~~Scrambled eggs
~~Hard cooked eggs
~~Unsweetened dry cereals
~~Crisp toast
~~Non-fat crackers
~~Tuna salad (water packed)
~~Baked fish
~~Ground chicken or turkey
~~Low-fat refried beans
~~Canned vegetables
~~Baked potato
~~Watermelon
~~Bananas
~~Low-fat casseroles
SOFT DIET MENU EXAMPLES
Breakfast:
~~1 scrambled egg (OR)
~~1/4 Cup cooked cereal (OR)
~~1/4 Cup low calorie yogurt
Lunch:
~~1/4 Cup baked fish (OR)
~~100 cc NSA Carnation Instant Breakfast (made with Double Milk) (OR)
~~1/4 baked potato
Supper:
~~1/4 Cup ground meat (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk) (OR)
~~1/4 Cup fruit
GENERAL DIET
Begin this diet after tolerating a soft diet. Add foods gradually and remember to chew well.
GENERAL MENU EXAMPLES:
Breakfast:
~~1 scrambled egg (OR)
~~1/4 Cup fresh fruit (OR)
~~1/2 slice toast, SF jelly
Lunch:
~~1/4 Cup tender meat (OR)
~~1/4 Cup yogurt (OR)
~~1/4 Cup cooked vegetable
Supper:
~~1/4 Cup tender meat (OR)
~~1/4 Cup raw vegetables or salad (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk)
DO NOT EAT BETWEEN MEALS. DRINK ONLY NON-CALORIC FLUIDS.
THINGS TO REMEMBER:
Be careful eating red meat for the first four months.
Be careful with white bread for the first four months, unless toasted.
PROBLEM FOODS TO TRY WITH CAUTION:
Beef, orange membranes, skins and seeds of fruit and vegetables, corn, celery, sweet potatoes and fresh breads.
PROBLEM FOODS
The ability to tolerate certain foods depends on teeth condition and thoroughly chewing the food. Keep a written (or mental) list of foods difficult to eat.
Some problem foods are:
**********Tough meats, especially beef. Buy lean hamburger, marinate meats, use a tenderizer.
**********Membranes of oranges. Remove membrane, used canned sections or canned mandarin oranges.
**********Skins and seeds of some fruits and vegetables. Peel and seed fruits and vegetables.
**********Fibrous vegetables (corn, celery and sweet potatoes). Blend, puree, mince or strain to break down fiber.
**********Fresh bread. Toast white bread; use day-old whole grain wheat bread.
FLUID INTAKE
**********Fluids will be provided through an I.V. (intravenous feeding) after surgery. The I.V. will be continued until adequate fluids are taken by mouth.
**********Do not drink fluids with meals. Avoid drinking fluids 30 minutes before meals and 45 minutes after meals.
**********Sip beverages slowly. Let them linger in your mouth before swallowing.
**********Select no-calorie beverages, such as water, tea, SF Kool-Aid or SF lemonade.
**********Limit use of fruit juices to 1/2-1 cup per week.
**********Pay attention to signals of fullness.
**********Drink 4-6 cups of no-calorie fluids daily.
**********Drink a total of 7-9 cups of fluid per day.
**********Drink enough water to urinate four cups per day.
PROTEIN INTAKE
It is important to eat protein at each meal. In order to get 40-60 grams of protein each day, eat the protein foods first, and have skim milk or yogurt daily.
SIGNS OF INADEQUATE PROTEIN:
~~Hair loss
~~Brittle nails
~~Slow healing
INCREASING PROTEIN
**********Use Double Milk
**********Add low-calorie Nestle Quik, low-calorie cocoa, Alba or low-calorie instant breakfast to skim milk.
**********For Lactose intolerance~~~Put Lactaid or Dairy Ease in milk or use soy milk if lactose intolerance is a problem.~~~Choose lactose-free low-fat milk available in the dairy case of most grocery stores, If not available, ask for it to be stocked.
**********Eat an omelet, scrambled egg or low-calorie fruit-flavored yogurt.
**********Combine cottage cheese with canned fruit.
**********Spread tuna or chicken salad, made with low-calorie mayonnaise, on low-fat crackers.
FAT INTAKE
Keep total fat intake below 30-40 grams per day.
**********Read labels~~~To identify hidden fats.~~~To identify unrealistic portion sizes.
**********FAT-FREE is not CALORIE-FREE.
**********Too many calories, no matter the energy source, will slow weight loss.
Calorie per gram of energy nutrients comparison:
Carbohydrate = 4 calories/gram
Protein = 4 calories/gram
Alcohol = 7 calories/gram
Fat = 9 calories/gram
CHEWING
Swallowing food without chewing adequately causes pain, discomfort, nausea, or vomiting. It is possible to stretch the pouch and disrupt the staple line.
Guidelines are:
**********Do not skip meals.
**********Take 30-60 minutes to eat every meal. At first, take longer.
**********Chew each bite 20-30 times until the food is of pureed consistency.
**********Use a dessert spoon or long-handled baby spoon to better control bite size and speed of eating.
**********Savor the flavor and texture of each bite of food.
**********See the dentist, if your teeth are in poor condition.
**********Explain the reason for eating slowly if asked.
VITAMIN AND MINERAL SUPPLEMENTS
Vitamin and mineral deficiencies of iron, calcium and B-12 can occur following a gastric bypass surgery (Roux-en-Y). To avoid this complication, discharge recommendations are chewable Tums to provide 1000 mg elemental calcium (2-5 tablets, depending on amount per tablet) and chewable multiple vitamins daily. Daily supplements of B-12 (500 mcg) and iron are necessary after your first post-op visit. Tums will be replaced with Calcium Citrate at your six week post-op visit.
Calcium and iron should not be taken at the same time (at least four hours apart). Take iron with high vitamin C foods (citrus fruits, strawberries, tomatoes, mango and papaya, kiwi, cantaloupe and cabbage family vegetables), but not with milk or antacids. Do not take with yogurt, cheese, tea or coffee. Do not crush or chew extended release iron preparations. If a dose is missed, do not double the dose.
Use one bottle of chewable multiple vitamins with iron, then use any brand multiple vitamin with iron. If using large Centrum-type, break in half.
Do not eat rhubarb and spinach, or bran and whole grain cereals, when taking a calcium supplement. These foods contain oxalic acid or phytic acid and may interfere with calcium absorption.
CONSTIPATION
It is typical to have a bowel movement every 2-3 days following a gastric restriction procedure. Constipation sometimes occurs after surgery. If constipation occurs, include high fiber foods in your diet.
Additionally, increase no calorie fluids from six to eight 8-ounce glasses daily. Colace, an over-the-counter stool softener, is available if high-fiber foods and fluids do not relieve constipation. Metamucil may be used to increase finer intake.
High Fiber Food Examples:
~~1/4 Cup Kellogg's All Bran (with extra fiber)~~7 fiber grams
~~1/4 Cup Fiber One~~7 fiber grams
~~1/4 Cup Nabisco 100% Bran~~5 fiber grams
~~1/2 Cup Prune juice~~3 fiber grams
~~2 Tbsp. Mashed Peas, Pinto beans or Kidney beans~~1 fiber gram
~~2 Tbsp. Fresh fruits/Vegetables
If I can find my paperwork from their office,
I'll pass it on.
Best Wishes-
Dx
I had Dr. Byars, but they have the same "follow up" and
Diet Advancement protocol.
I went looking for my old diet sheets
But couldn't find them.
Try contacting King and Byars Surgical Clinic
And having them e-mail you the whole thing.
Just google-
surgicalclinic.ms
And you'll go right to it.
If not that,
Then Contact Becky Wilson at Liv-Lite and ask if she'll e-mail you one.
They are really good about helping out with anything.
If not e-mail
Ask if they'll fax you one.
I'm sure they would.
In the meantime, I'll try finding my "lists"
They were all "hard copies"
But maybe I can scan them in and send them as "Photos."
Here is a "Big Ole" Stack of info-
And while it's not King's protocol,
It's pretty darned close.
I think the "Weeks" to advance
And what you can add are a little more conservative than this
But It will give you an idea until you can get your hands on a copy
Of the "Real Thing."
Hope this helps--
THE GASTRIC BYPASS DIET
~~McFarland Clinic, PC
~~Ames, IA
Gastric Bypass surgery assists in weight lo by restricting the amount of food that can be eaten at one time. In order for this procedure to be a success, you must abide by the limits of the amount of food allowed per hour, coupled with good nutritious choices. Because you are limiting the amount of food and fluids you have at a time, it is important to drink enough water to prevent dehydration, by having some every hour you are awake.
Following surgery, no oral intake is allowed until bowel activity resumes and some healing of the pouch occurs. During this time, your fluid requirements are met with I.V. fluids.
GUIDE FOR MEASURING FOODS:
1 Cup = 240 cc = 8 ounces
1/2 Cup = 120 cc = 4 ounces
1/4 Cup = 60 cc = 2 ounces
2 Tablespoons = 30 cc = 1 ounce
1 Tablespoon = 15 cc = 1/2 ounce
THE FIRST STEP IS WATER
About day 3-4 post surgery, you will begin taking water in sips of 50 cc per hour.
Sip this 50 cc slowly, and stop if you feel uncomfortable. Limits are placed on the hourly amounts taken to avoid stretching or rupturing the small gastric pouch. Early after surgery, the emptying of the pouch may be slow. The feeling of fullness may be different from the feeling you had before surgery. Get to know what this feels like. A sheet for recording your water intake will be provided. Record the amount you take accurately to help gauge your tolerance.
CLEAR LIQUIDS
After tolerating 24 hours of water, the diet is advanced to clear liquids, at a rate of 75 cc per hour.
The following foods are provided on a clear liquid tray in the hospital.
~~Water
~~Broth
~~Diet Gelatin
~~Tea
~~Coffee (caffeine-free)
~~Clear juice (diluted)
You may have the clear liquid tray for two hours. Choose foods from the tray so that you can eat 75 cc each hour for the two hours. The tray will have more on it than you can finish. Once the two hours are up, put the food tray away and switch back to having water at the rate of 75 cc per hour.
FULL LIQUIDS
After a day of tolerating clear liquids, the diet is advanced to full liquids at the rate of 100 cc per hour. Once again, meals last two hours, with water taken in between meals.
The following foods are provided on a full liquid tray at the hospital:
~~Cream of Wheat
~~Soups (strained, creamed soup, broth)
~~Desserts (custard, diet gelatin, sugar-free frozen yogurt, sugar-free pudding)
~~Beverages (coffee, tea {caffeine-free})
~~Seasonings (salt and flavorings in moderation)
~~Pureed fruits
~~Sugar substitutes
~~Skim milk
~~Juices (diluted)
**********By now you should be tolerating 100 cc per hour of full liquids.
**********Patients usually go home after tolerating a day of full liquids.
**********Be sure you plan ahead and think of foods in this category that you can have at home.
**********Again, be sure to drink 100 cc per hour of water in between meals. Do not exceed the 100 cc per hour limit. If you take sips of water during mealtimes, count the amount sipped in your 100 cc per hour total.
SAMPLE MENU FOR TWO WEEKS AT HOME:
Breakfast:
~~100 cc NSA Carnation Instant Breakfast (made with Double Milk) (OR)
~~1/4 Cup SF/NSA yogurt (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk)
Lunch:
~~1/4 Cup cream soup (made with Double Milk) (OR)
~~100 cc NSA Carnation Instant Breakfst (made with Double Milk) (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk)
Supper:
~~1/4 Cup cream soup (made with Double Milk) (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk) (OR)
~~2 Tbsp. puree fruit
**********Double Milk Recipe**********
1 Cup FF Skim milk
1/3 Cup non-fat powdered milk
Drink a total of at least 1000 cc (4 cups) of water, broth, diet soda, unsweetened tea or coffee during the day, between meals. Stick to the restriction of 100 cc per hour of full liquids for three weeks after surgery.
PUREED DIET
This diet begins three weeks after your operation.
Take 15-20 minutes to eat one ounce of food. STOP DRINKING 30 MINUTES BEFORE EATING AND WAIT 45 MINUTES AFTER EATING THE MEAL BEFORE HAVING WATER AGAIN. Chew foods well. Be sure to have protein foods at each meal.
PUREED MENU EXAMPLES:
Breakfast:
~~1 scrambled egg (OR)
~~1/4 Cup cereal (OR)
~~1/4 Cup yogurt
Lunch:
~~1/4 Cup pureed meat (OR)
~~1/4 Cup mashed potatoes (OR)
~~1/2 Cup cream soup (made with Double Milk)
Supper:
~~1/4 Cup pureed meat (OR)
~~1/4 Cup pudding (made with Double Milk) (OR)
~~100 cc NSA Carnation Instant Breakfast (made with Double Milk)
To puree meat:
1/4 Cup broth
1/4 Cup meat, poultry or fish, cut against the grain
Blend in this small amount to achieve desired consistency.
Clean blender after each use to avoid food borne illness. (Use within 24 hours, unless frozen.)
Freeze:
Place extra blended food in plastic freezer ice cube trays. When frozen, transfer to freezer bags and write date on the bag. Use within two months, or throw away.
MECHANICAL SOFT DIET
This diet begins four weeks after surgery. Be sure to chew well and take 15-20 minutes to eat one ounce of food.
Begin to slowly add soft foods, such as:
~~Fat free or 1% cottage cheese
~~Low-fat cheese
~~Scrambled eggs
~~Hard cooked eggs
~~Unsweetened dry cereals
~~Crisp toast
~~Non-fat crackers
~~Tuna salad (water packed)
~~Baked fish
~~Ground chicken or turkey
~~Low-fat refried beans
~~Canned vegetables
~~Baked potato
~~Watermelon
~~Bananas
~~Low-fat casseroles
SOFT DIET MENU EXAMPLES
Breakfast:
~~1 scrambled egg (OR)
~~1/4 Cup cooked cereal (OR)
~~1/4 Cup low calorie yogurt
Lunch:
~~1/4 Cup baked fish (OR)
~~100 cc NSA Carnation Instant Breakfast (made with Double Milk) (OR)
~~1/4 baked potato
Supper:
~~1/4 Cup ground meat (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk) (OR)
~~1/4 Cup fruit
GENERAL DIET
Begin this diet after tolerating a soft diet. Add foods gradually and remember to chew well.
GENERAL MENU EXAMPLES:
Breakfast:
~~1 scrambled egg (OR)
~~1/4 Cup fresh fruit (OR)
~~1/2 slice toast, SF jelly
Lunch:
~~1/4 Cup tender meat (OR)
~~1/4 Cup yogurt (OR)
~~1/4 Cup cooked vegetable
Supper:
~~1/4 Cup tender meat (OR)
~~1/4 Cup raw vegetables or salad (OR)
~~1/4 Cup SF/FF pudding (made with Double Milk)
DO NOT EAT BETWEEN MEALS. DRINK ONLY NON-CALORIC FLUIDS.
THINGS TO REMEMBER:
Be careful eating red meat for the first four months.
Be careful with white bread for the first four months, unless toasted.
PROBLEM FOODS TO TRY WITH CAUTION:
Beef, orange membranes, skins and seeds of fruit and vegetables, corn, celery, sweet potatoes and fresh breads.
PROBLEM FOODS
The ability to tolerate certain foods depends on teeth condition and thoroughly chewing the food. Keep a written (or mental) list of foods difficult to eat.
Some problem foods are:
**********Tough meats, especially beef. Buy lean hamburger, marinate meats, use a tenderizer.
**********Membranes of oranges. Remove membrane, used canned sections or canned mandarin oranges.
**********Skins and seeds of some fruits and vegetables. Peel and seed fruits and vegetables.
**********Fibrous vegetables (corn, celery and sweet potatoes). Blend, puree, mince or strain to break down fiber.
**********Fresh bread. Toast white bread; use day-old whole grain wheat bread.
FLUID INTAKE
**********Fluids will be provided through an I.V. (intravenous feeding) after surgery. The I.V. will be continued until adequate fluids are taken by mouth.
**********Do not drink fluids with meals. Avoid drinking fluids 30 minutes before meals and 45 minutes after meals.
**********Sip beverages slowly. Let them linger in your mouth before swallowing.
**********Select no-calorie beverages, such as water, tea, SF Kool-Aid or SF lemonade.
**********Limit use of fruit juices to 1/2-1 cup per week.
**********Pay attention to signals of fullness.
**********Drink 4-6 cups of no-calorie fluids daily.
**********Drink a total of 7-9 cups of fluid per day.
**********Drink enough water to urinate four cups per day.
PROTEIN INTAKE
It is important to eat protein at each meal. In order to get 40-60 grams of protein each day, eat the protein foods first, and have skim milk or yogurt daily.
SIGNS OF INADEQUATE PROTEIN:
~~Hair loss
~~Brittle nails
~~Slow healing
INCREASING PROTEIN
**********Use Double Milk
**********Add low-calorie Nestle Quik, low-calorie cocoa, Alba or low-calorie instant breakfast to skim milk.
**********For Lactose intolerance~~~Put Lactaid or Dairy Ease in milk or use soy milk if lactose intolerance is a problem.~~~Choose lactose-free low-fat milk available in the dairy case of most grocery stores, If not available, ask for it to be stocked.
**********Eat an omelet, scrambled egg or low-calorie fruit-flavored yogurt.
**********Combine cottage cheese with canned fruit.
**********Spread tuna or chicken salad, made with low-calorie mayonnaise, on low-fat crackers.
FAT INTAKE
Keep total fat intake below 30-40 grams per day.
**********Read labels~~~To identify hidden fats.~~~To identify unrealistic portion sizes.
**********FAT-FREE is not CALORIE-FREE.
**********Too many calories, no matter the energy source, will slow weight loss.
Calorie per gram of energy nutrients comparison:
Carbohydrate = 4 calories/gram
Protein = 4 calories/gram
Alcohol = 7 calories/gram
Fat = 9 calories/gram
CHEWING
Swallowing food without chewing adequately causes pain, discomfort, nausea, or vomiting. It is possible to stretch the pouch and disrupt the staple line.
Guidelines are:
**********Do not skip meals.
**********Take 30-60 minutes to eat every meal. At first, take longer.
**********Chew each bite 20-30 times until the food is of pureed consistency.
**********Use a dessert spoon or long-handled baby spoon to better control bite size and speed of eating.
**********Savor the flavor and texture of each bite of food.
**********See the dentist, if your teeth are in poor condition.
**********Explain the reason for eating slowly if asked.
VITAMIN AND MINERAL SUPPLEMENTS
Vitamin and mineral deficiencies of iron, calcium and B-12 can occur following a gastric bypass surgery (Roux-en-Y). To avoid this complication, discharge recommendations are chewable Tums to provide 1000 mg elemental calcium (2-5 tablets, depending on amount per tablet) and chewable multiple vitamins daily. Daily supplements of B-12 (500 mcg) and iron are necessary after your first post-op visit. Tums will be replaced with Calcium Citrate at your six week post-op visit.
Calcium and iron should not be taken at the same time (at least four hours apart). Take iron with high vitamin C foods (citrus fruits, strawberries, tomatoes, mango and papaya, kiwi, cantaloupe and cabbage family vegetables), but not with milk or antacids. Do not take with yogurt, cheese, tea or coffee. Do not crush or chew extended release iron preparations. If a dose is missed, do not double the dose.
Use one bottle of chewable multiple vitamins with iron, then use any brand multiple vitamin with iron. If using large Centrum-type, break in half.
Do not eat rhubarb and spinach, or bran and whole grain cereals, when taking a calcium supplement. These foods contain oxalic acid or phytic acid and may interfere with calcium absorption.
CONSTIPATION
It is typical to have a bowel movement every 2-3 days following a gastric restriction procedure. Constipation sometimes occurs after surgery. If constipation occurs, include high fiber foods in your diet.
Additionally, increase no calorie fluids from six to eight 8-ounce glasses daily. Colace, an over-the-counter stool softener, is available if high-fiber foods and fluids do not relieve constipation. Metamucil may be used to increase finer intake.
High Fiber Food Examples:
~~1/4 Cup Kellogg's All Bran (with extra fiber)~~7 fiber grams
~~1/4 Cup Fiber One~~7 fiber grams
~~1/4 Cup Nabisco 100% Bran~~5 fiber grams
~~1/2 Cup Prune juice~~3 fiber grams
~~2 Tbsp. Mashed Peas, Pinto beans or Kidney beans~~1 fiber gram
~~2 Tbsp. Fresh fruits/Vegetables
If I can find my paperwork from their office,
I'll pass it on.
Best Wishes-
Dx 
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