Hey guys
It me I am finally able to get on here for a few and let you know how I am doing!! I am back to work and I feel great.. I am suprised at how good i feel and how well eating in going since my gall baldder was removed. I am also supirsed at how much food I feel like I can eat.. I eat mostlthealth proyiens every now and again I treat myself to something good BUT Wow I really can eat at least 3/4 to 1 cup of food now is that normal?? From what i gather i guess so!! I am glad i really feel like I can handle this now!! I am glad to be able to enjoy certian things that i wonder if I ever would again LOL. I have lost 91 pounds I look and FEEL LIKE A NEW PERSON!!!! I havr benn at 155 for a few weeks now I guess i am at a little platue which is OK i am four months out that is to be excpected I guess . i hope all is well with you guys and i hope to see ya all at Saratoga metting in July. Please write me back if you think i am eating too much I am worried. My dr said back in May that my pouch was the perfect size i think i am being paraniod LOL. Big suprise i always am. Bridgit
Kristy 
Hello Bridgit, Miss talking/reading email/seeing you.
How is the lifestyle change coming? Getting away from emotional eating, avoiding snacking/grazing, not eating and drinking together? Avoiding caffeine, carbonation, caloried beverages? Exercise routine? Chewing well, eating slow?
These are the measures of long-term success as early on (before 6mo) we will lose wt even if we do not change these things..the honeymoon is glorious but sadly is gone fast!
I celebrate your journey and look to also the NSV (non scale victories you can share!)
I'd love for you to update your OH profile for yourself and others on your journey to date! It can be so helpful to self/others down the road! Your road has been bumpy also!
Food amounts vary postop in how much one can eat and when and changes as you go!
1 cup of salad is nothing but 1 cup of chicken is a different animal so to speak. When we talk about amounts we need to factor in density, lean protein typically is much more filling than 1-cup simple carbs or slider foods. Some days I can eat MUCH more than others. Sometimes I can eat 1/2 a meal others 3/4 or another day 1/4!? Stress plays a role too....What we can eat and what we should are 2 different things also, the goal of the pouch is not necessarily to eat until we feel full....but rather to learn to be satisfied with less.
Being wary now of those sliders (soup, yogurt, coral with milk, cottage cheese) they're ok once in a while but if a main staple you may have no satiety and be able to eat quite a bit.
Are you eating beyond full or up to it? Pushing limits frequently can lead to overstretching of the pouch and stoma, so best to not try that one more bite again and again.... Do you feel full? give me an example of a typical day amounts/variety/calories (go to www.fitday.com to see) that may be more helpful! SO learn the calories that you consume. Again, if you can measure it, you can manage it. Sometimes people are surprised by the number of calories in a given item, and the portion size.
Your pouch may be healed and less swollen than say mine was at 4 mo out that is expected and typical for us all to differ, remember don't compare of you will just go bonkers! LOL!
I can eat for instance 4 cups salad with 3-4 oz protein on it and raw veggies, but only 1 slice of pizza. I get full on 1 English muffin with 1 egg fried 1 slice cheese and sausage patty now but at 4 mo could only eat 1 egg and 1/2 English muffin if that, so it changes and evolves!
****************
This is from my PowerPoint presentation called
The first year after gastric bypass is usually very rewarding, but this time can also be confusing, frustrating and frightening.
The function of the stomach pouch "tool" changes almost continuously over the first six months, and continues to change periodically over the year or so.
Just when the patient feels they have begun to understand the stomach pouch/tool and how to use it, things change all over again.
WHAT DO I NEED TO CHANGE?
The first postoperative year is a critical time that must be dedicated to changing old behavior and forming new, lifelong habits.
~~~~~~~~~~~~
6-9 months after RNY surgery
Frightening CHANGES takes place.
The stomach pouch softens and expands slightly so that a patient regains a regular appetite and can "suddenly" tolerate a significantly larger amount of food.
Patients frequently worry that something has pulled apart or broken on the inside, though this is rarely the case.
This increased interest in food and increased capacity for food is a very natural and appropriate part of the recovery process after gastric bypass surgery.
The reason it frightens patients so much is that they had previously felt they had control of their weight for the first time in their lives, and the renewed appetite threatens that they are losing control once again.
You must realize that for the first 6 months or so after gastric bypass you did NOT have control of your weight.
The pounds were going to come off almost no matter what you did.
The pouch can't handle enough calories to maintain weight for the first few months.
The return of appetite and the increase in food capacity signal an end to the honeymoon period and a transition to the rest of life.
Your surgeon has created a stomach pouch that will be your tool to use to control your weight for life. In the beginning it worked 90% now you have to work 90%!
###################################
GREAT articles from Dr. Simpson's newsletters
(www.drsimpson.com to subscribe)
Monday, November 13, 2006 5:35 PM
It's not how much you can eat
Do not test yourself.
Control your portions.
Whether it is the RNY, LAP BAND, or DS -- there are myths that you can eat whatever you want and lose weight. That doesn't work. The other myth is that you eat until you feel full -- that doesn't work. The other one is that you will feel restriction -- and early on you do, but later you don't.
Weight loss surgery isn't about seeing how much you can eat, or what you can get away with -- weight loss surgery is about making better choices, a healthier lifestyle, and seeing how little you can eat.
Portion control is the key to all weight loss operations. Which means you determine the portions you eat before you consume them. Do not rely on your body to tell you when you are full, or stuffed. Instead, eat the portion your doctor recommends, and walk away from the table.
Do not test your stomach -- because you can fill it up more and more and stretch the nice job your surgeon did. With the band, that means you can slip the band -- by eating more and pulling stomach up above the band. But generally can be adjusted by deflating the band for a bit.
Bottom line-- it isn't how much you can eat -- it is how little you can eat.
It isn't six small meals a day. It isn't snacks - it is, two to three meals a day. If you find yourself hungry at a certain time of the day then figure out what you ate before-- was it soft food, was it something that lasted? Did you wash things out with water or some drink? Can you make a better choice.
Weight loss surgery is the marker for a new and healthier lifestyle. Here are some simple things to start or restart your surgery:
(a) Cut television time in half. Honest, the bad guys will get caught in CSI
(b) Spend 30 minutes a day doing some physical activity -- dedicated time to walking or swimming. More is better. If you need some help starting, see a physical therapist.
(c) Use smaller plates -- put your portion on the smaller plate
(d) Leave something on your plate-- always leave something to get rid of. What you leave should be starches -- what should not be left are vegetables. Leave the potatoes, eat the greens.
(e) After 30 minutes you are done eating -- stop there, and get rid of the excess food.
#######################
Friday, July 01, 2005 2:39 PM
Do not Fletcherize!
Do not chew your food to a pulp!
In early post operative surgery patients often go through a liquid phase then a puree stage. But, after the stomach, or pouch, is healed we want you off of the soft and puree foods. Soft foods (chips, breads, pasta) and pureed foods go quickly through a pouch and do not leave you satisfied. For those who have a DS, soft and puree foods go through the pylorus very quickly, with the same result -- you are not left satisfied. Chewing foods a lot (Fletcherization) has the same effect. If you overchew foods, you make them your own puree and the effect is that they zip through the stomach and do not leave you satisfied. Fletcher was a health nut from years ago, and one of the earliest diets. He had the theory that if you chewed your food long enough you would lose weight. The one thing we do not want is chunks of food stuck in the stomach, or anywhere. But we do want solid foods, not puree foods -- bottom line is this: do not put anything in your mouth larger than a piece of Chicklette chewing gum. Chew normally, do not overchew.
##########################
Friday, July 01, 2005 2:39 PM
Feeling full or feeling satiated
Do not fill up with carbs
It is solid foods that keep you satisfied, not liquid or pureed foods. Solid foods hang around for a while. There are two ways to feel full: one way is the "classic" way that we associate with big meals -- like Thanksgiving. After three plates of turkey, you have filled a stomach with turkey, potatoes, salad, and a lot of swallowed air. There is very little temptation to have a second piece of pie. This uncomfortable sensation is "abdominal wall stretching," not "satiety." The stomach is pressing against the abdominal wall -- there is also a lot of gas -- and you have to unbutton the pants. Satiety is a different sensation -- it isn't abdominal wall stretching, it is a sense that you are full. Do not mistake one sensation for the other. That is a mistake many post operative patients make. But satiety is very different. It is subtle, and often has to be learned. If you know your pouch size, then you should learn this feeling. In the early stages it might only be a couple of bites. That feeling -- that dims the appetite a bit, is satiety. After weight loss surgery you should not feel the abdominal wall sensation again. The reason satiety is important to feel, is because if you overfill your pouch you can stretch it, and while we expect some stretch in pouches, we do not want too much. Pouches are stretched by chronically overfeeding them. So learn what it feels like to be satiated (full). It is the key to using your tool for weight loss.
########################
Friday, February 17, 2006 5:19 PM
Portion Sizes
There is no doubt that eating smaller portions leads to weight loss. This is the basis of all weight loss operations today. When weight loss operations fail, they often fail because the amount of food a person can eat increases -- either the pouch enlarges, the stomach grows, or the band needs some adjustment. Look at portion sizes in America and see how they have changed over the last twenty years - then think about what brought you to surgery. It often was a small increase in a portion, which over time lead to an increase in calories that lead to obesity. Remember, 96 calories a day above the calories your body burns leads to 10 pounds in a year -- which, after ten years leads to 100 pounds. It also works in reverse. So, keep the portions under control -- don't stretch things out!
######################
Tuesday, August 22, 2006 4:00 PM
Not Restriction But Satiety
Learn the signals, and watch
the portions.
All weight loss operations work by what we refer to as "restriction." Sometimes, however, that word is overused a bit, because it really doesn't mean you will be restricted from eating more. Instead, think that you should feel satisfied with less food.
For patients who have the RNY or DS, they will recall early periods when eating one more bite brought on an unpleasant sensation of nausea and perhaps even vomiting. As the days went forward these became less and less, until several months after surgery when the stomach, or pouch, expanded to allow you to eat a small amount comfortably.
But "simply eat less" is not a successful post operative management plan. There are things that are tolerated well early on -- such as fish -- and it may take a bit of time before steak is tolerated. Besides knowing what protein sources are tolerated, the most important lessons to learn is that weight loss surgery is not about restriction -- weight loss surgery is about learning to feel the feelings of satiety.
For many this is a new feeling-- satiety -- or the sense that you are satisfied, not hungry, not stuffed -- but satisfied -- is something never experienced before weight loss surgery. But consider this: prior to weight loss surgery your stomach could hold between 40 and 50 ounces of food. Immediately after weight loss surgery the RNY patient holds 1/2 to one ounce, the DS patient about 4 ounces, and the LAP BAND patient generally can still use their entire stomach until the first adjustment. So it is quite a shock to eat less-- or, as one weight loss patient put it "your eyes are literally bigger than your stomach."
So learn the signals of satiety. Why? Because you can stretch out your stomach after weight loss operations, in fact, the one ounce stomach you start with the first day after an RNY is about 8 to 10 ounces a year later. That mild degree of enlargement is ok, but more than that and you can have a return of unwanted weight. Think about blowing up a balloon -- when you first try to stretch it, it takes a lot of effort, but the larger it becomes, the easier it is to stretch it with less breath. The same with your stomach or your pouch -- the more you stretch it, the easier it is to stretch it more.
The advantage here goes to the LAP BAND because if things stretch out a bit the band can be deflated and allow the stomach pouch to return to normal, but instead of challenging your stomach or pouch, learn the subtle signals that you are full.
If you cannot sense when you are full, or just are not "in tune" with your body (ok, I was a child of the 60's I can use that lingo) -- the most effective manner is portion control. Determine the amount you are going to eat, eat it and walk away. Do not eat more. The restaurant version of this is: when going to a restaurant, put most of the food -- immediately, in a "to go" box. At home it is hard to get a to go box, but have the food dished out onto your plate and then eat. That is, don't leave extra food on the table, serve the food first, in portions, then sit down to eat.
You will find that your portion sizes can be much smaller than you imagined, and that you are satisfied with less. Eating fewer calories is one of the only known anti-aging methods we know of -- so, don't worry about it. Enjoy less food, and enjoy good food.
SO YOUR POUCH MAY BE PEFECT BUT HOW IS YOUR HEAD IN USING THE POUCH?
How is the lifestyle change coming? Getting away from emotional eating, avoiding snacking/grazing, not eating and drinking together? Avoiding caffeine, carbonation, caloried beverages? Exercise routine? Chewing well, eating slow?
These are the measures of long-term success as early on (before 6mo) we will lose wt even if we do not change these things..the honeymoon is glorious but sadly is gone fast!
I celebrate your journey and look to also the NSV (non scale victories you can share!)
I'd love for you to update your OH profile for yourself and others on your journey to date! It can be so helpful to self/others down the road! Your road has been bumpy also!
Food amounts vary postop in how much one can eat and when and changes as you go!
1 cup of salad is nothing but 1 cup of chicken is a different animal so to speak. When we talk about amounts we need to factor in density, lean protein typically is much more filling than 1-cup simple carbs or slider foods. Some days I can eat MUCH more than others. Sometimes I can eat 1/2 a meal others 3/4 or another day 1/4!? Stress plays a role too....What we can eat and what we should are 2 different things also, the goal of the pouch is not necessarily to eat until we feel full....but rather to learn to be satisfied with less.
Being wary now of those sliders (soup, yogurt, coral with milk, cottage cheese) they're ok once in a while but if a main staple you may have no satiety and be able to eat quite a bit.
Are you eating beyond full or up to it? Pushing limits frequently can lead to overstretching of the pouch and stoma, so best to not try that one more bite again and again.... Do you feel full? give me an example of a typical day amounts/variety/calories (go to www.fitday.com to see) that may be more helpful! SO learn the calories that you consume. Again, if you can measure it, you can manage it. Sometimes people are surprised by the number of calories in a given item, and the portion size.
Your pouch may be healed and less swollen than say mine was at 4 mo out that is expected and typical for us all to differ, remember don't compare of you will just go bonkers! LOL!
I can eat for instance 4 cups salad with 3-4 oz protein on it and raw veggies, but only 1 slice of pizza. I get full on 1 English muffin with 1 egg fried 1 slice cheese and sausage patty now but at 4 mo could only eat 1 egg and 1/2 English muffin if that, so it changes and evolves!
****************
This is from my PowerPoint presentation called
The first year after gastric bypass is usually very rewarding, but this time can also be confusing, frustrating and frightening.
The function of the stomach pouch "tool" changes almost continuously over the first six months, and continues to change periodically over the year or so.
Just when the patient feels they have begun to understand the stomach pouch/tool and how to use it, things change all over again.
WHAT DO I NEED TO CHANGE?
The first postoperative year is a critical time that must be dedicated to changing old behavior and forming new, lifelong habits.
~~~~~~~~~~~~
6-9 months after RNY surgery
Frightening CHANGES takes place.
The stomach pouch softens and expands slightly so that a patient regains a regular appetite and can "suddenly" tolerate a significantly larger amount of food.
Patients frequently worry that something has pulled apart or broken on the inside, though this is rarely the case.
This increased interest in food and increased capacity for food is a very natural and appropriate part of the recovery process after gastric bypass surgery.
The reason it frightens patients so much is that they had previously felt they had control of their weight for the first time in their lives, and the renewed appetite threatens that they are losing control once again.
You must realize that for the first 6 months or so after gastric bypass you did NOT have control of your weight.
The pounds were going to come off almost no matter what you did.
The pouch can't handle enough calories to maintain weight for the first few months.
The return of appetite and the increase in food capacity signal an end to the honeymoon period and a transition to the rest of life.
Your surgeon has created a stomach pouch that will be your tool to use to control your weight for life. In the beginning it worked 90% now you have to work 90%!
###################################
GREAT articles from Dr. Simpson's newsletters
(www.drsimpson.com to subscribe)
Monday, November 13, 2006 5:35 PM
It's not how much you can eat
Do not test yourself.
Control your portions.
Whether it is the RNY, LAP BAND, or DS -- there are myths that you can eat whatever you want and lose weight. That doesn't work. The other myth is that you eat until you feel full -- that doesn't work. The other one is that you will feel restriction -- and early on you do, but later you don't.
Weight loss surgery isn't about seeing how much you can eat, or what you can get away with -- weight loss surgery is about making better choices, a healthier lifestyle, and seeing how little you can eat.
Portion control is the key to all weight loss operations. Which means you determine the portions you eat before you consume them. Do not rely on your body to tell you when you are full, or stuffed. Instead, eat the portion your doctor recommends, and walk away from the table.
Do not test your stomach -- because you can fill it up more and more and stretch the nice job your surgeon did. With the band, that means you can slip the band -- by eating more and pulling stomach up above the band. But generally can be adjusted by deflating the band for a bit.
Bottom line-- it isn't how much you can eat -- it is how little you can eat.
It isn't six small meals a day. It isn't snacks - it is, two to three meals a day. If you find yourself hungry at a certain time of the day then figure out what you ate before-- was it soft food, was it something that lasted? Did you wash things out with water or some drink? Can you make a better choice.
Weight loss surgery is the marker for a new and healthier lifestyle. Here are some simple things to start or restart your surgery:
(a) Cut television time in half. Honest, the bad guys will get caught in CSI
(b) Spend 30 minutes a day doing some physical activity -- dedicated time to walking or swimming. More is better. If you need some help starting, see a physical therapist.
(c) Use smaller plates -- put your portion on the smaller plate
(d) Leave something on your plate-- always leave something to get rid of. What you leave should be starches -- what should not be left are vegetables. Leave the potatoes, eat the greens.
(e) After 30 minutes you are done eating -- stop there, and get rid of the excess food.
#######################
Friday, July 01, 2005 2:39 PM
Do not Fletcherize!
Do not chew your food to a pulp!
In early post operative surgery patients often go through a liquid phase then a puree stage. But, after the stomach, or pouch, is healed we want you off of the soft and puree foods. Soft foods (chips, breads, pasta) and pureed foods go quickly through a pouch and do not leave you satisfied. For those who have a DS, soft and puree foods go through the pylorus very quickly, with the same result -- you are not left satisfied. Chewing foods a lot (Fletcherization) has the same effect. If you overchew foods, you make them your own puree and the effect is that they zip through the stomach and do not leave you satisfied. Fletcher was a health nut from years ago, and one of the earliest diets. He had the theory that if you chewed your food long enough you would lose weight. The one thing we do not want is chunks of food stuck in the stomach, or anywhere. But we do want solid foods, not puree foods -- bottom line is this: do not put anything in your mouth larger than a piece of Chicklette chewing gum. Chew normally, do not overchew.
##########################
Friday, July 01, 2005 2:39 PM
Feeling full or feeling satiated
Do not fill up with carbs
It is solid foods that keep you satisfied, not liquid or pureed foods. Solid foods hang around for a while. There are two ways to feel full: one way is the "classic" way that we associate with big meals -- like Thanksgiving. After three plates of turkey, you have filled a stomach with turkey, potatoes, salad, and a lot of swallowed air. There is very little temptation to have a second piece of pie. This uncomfortable sensation is "abdominal wall stretching," not "satiety." The stomach is pressing against the abdominal wall -- there is also a lot of gas -- and you have to unbutton the pants. Satiety is a different sensation -- it isn't abdominal wall stretching, it is a sense that you are full. Do not mistake one sensation for the other. That is a mistake many post operative patients make. But satiety is very different. It is subtle, and often has to be learned. If you know your pouch size, then you should learn this feeling. In the early stages it might only be a couple of bites. That feeling -- that dims the appetite a bit, is satiety. After weight loss surgery you should not feel the abdominal wall sensation again. The reason satiety is important to feel, is because if you overfill your pouch you can stretch it, and while we expect some stretch in pouches, we do not want too much. Pouches are stretched by chronically overfeeding them. So learn what it feels like to be satiated (full). It is the key to using your tool for weight loss.
########################
Friday, February 17, 2006 5:19 PM
Portion Sizes
There is no doubt that eating smaller portions leads to weight loss. This is the basis of all weight loss operations today. When weight loss operations fail, they often fail because the amount of food a person can eat increases -- either the pouch enlarges, the stomach grows, or the band needs some adjustment. Look at portion sizes in America and see how they have changed over the last twenty years - then think about what brought you to surgery. It often was a small increase in a portion, which over time lead to an increase in calories that lead to obesity. Remember, 96 calories a day above the calories your body burns leads to 10 pounds in a year -- which, after ten years leads to 100 pounds. It also works in reverse. So, keep the portions under control -- don't stretch things out!
######################
Tuesday, August 22, 2006 4:00 PM
Not Restriction But Satiety
Learn the signals, and watch
the portions.
All weight loss operations work by what we refer to as "restriction." Sometimes, however, that word is overused a bit, because it really doesn't mean you will be restricted from eating more. Instead, think that you should feel satisfied with less food.
For patients who have the RNY or DS, they will recall early periods when eating one more bite brought on an unpleasant sensation of nausea and perhaps even vomiting. As the days went forward these became less and less, until several months after surgery when the stomach, or pouch, expanded to allow you to eat a small amount comfortably.
But "simply eat less" is not a successful post operative management plan. There are things that are tolerated well early on -- such as fish -- and it may take a bit of time before steak is tolerated. Besides knowing what protein sources are tolerated, the most important lessons to learn is that weight loss surgery is not about restriction -- weight loss surgery is about learning to feel the feelings of satiety.
For many this is a new feeling-- satiety -- or the sense that you are satisfied, not hungry, not stuffed -- but satisfied -- is something never experienced before weight loss surgery. But consider this: prior to weight loss surgery your stomach could hold between 40 and 50 ounces of food. Immediately after weight loss surgery the RNY patient holds 1/2 to one ounce, the DS patient about 4 ounces, and the LAP BAND patient generally can still use their entire stomach until the first adjustment. So it is quite a shock to eat less-- or, as one weight loss patient put it "your eyes are literally bigger than your stomach."
So learn the signals of satiety. Why? Because you can stretch out your stomach after weight loss operations, in fact, the one ounce stomach you start with the first day after an RNY is about 8 to 10 ounces a year later. That mild degree of enlargement is ok, but more than that and you can have a return of unwanted weight. Think about blowing up a balloon -- when you first try to stretch it, it takes a lot of effort, but the larger it becomes, the easier it is to stretch it with less breath. The same with your stomach or your pouch -- the more you stretch it, the easier it is to stretch it more.
The advantage here goes to the LAP BAND because if things stretch out a bit the band can be deflated and allow the stomach pouch to return to normal, but instead of challenging your stomach or pouch, learn the subtle signals that you are full.
If you cannot sense when you are full, or just are not "in tune" with your body (ok, I was a child of the 60's I can use that lingo) -- the most effective manner is portion control. Determine the amount you are going to eat, eat it and walk away. Do not eat more. The restaurant version of this is: when going to a restaurant, put most of the food -- immediately, in a "to go" box. At home it is hard to get a to go box, but have the food dished out onto your plate and then eat. That is, don't leave extra food on the table, serve the food first, in portions, then sit down to eat.
You will find that your portion sizes can be much smaller than you imagined, and that you are satisfied with less. Eating fewer calories is one of the only known anti-aging methods we know of -- so, don't worry about it. Enjoy less food, and enjoy good food.
SO YOUR POUCH MAY BE PEFECT BUT HOW IS YOUR HEAD IN USING THE POUCH?
Take Care, 
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
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