carbs and protein

I am 14 weeks post r n y.  I have lost 53 lbs, my bmi is 32 and would like to know what you recommend that I eat for breakfast.  I was doing the carnation instant sf breakfast with skim.  I would like a protein bar because I leave my house at 6 am, and that would be easier.  Also, I find sometimes it is not easy getting full, what do you suggest?  Another question...carbs....how many carbs a day should I eat, and what do you recommend?   Thanks for your help. Elizabeth

You are on a regular diet by now so if you prefer to use protein bars, that's fine.   It's not unusual to have different feelings of fullness as your body adjusts to the surgery.  The fluids that you sip, sip, sip between meals should help with this.  It is important to stop at about 1/2 cup of food no matter what, due to the size of your pouch.  Your stretch receptors, which tell your brain that you are full, have been annihilated by the surgery.  You need to chew thoroughly, take your time eating, and try to help your body remember to feel full at some point in your meal.  This might take time so be very conscientious in your portion sizes! Regarding carbs - I'm not as worried about adequate carbs as I am about your getting adequate protein.  Your body is still recovering from a major ordeal and protein is the building blocks that will support your healing.  Worry about adequate protein (at the level your MD suggested) and meeting the fluid requirements.  Carbs are important for energy, but your body has the ability to work on alternative fuels - such as ketones which are a by-product of fat metabolism.  Protein is irreplaceable and if your body doesn't have enough from your diet it will scavenge from your own tissue.  This may result in poor healing, a weakened immune system, and other unpleasantries. Oh, and take your supplements! Danielle Halewijn RD eNutritioncare.com