1st two weeks post op diet in MEXICO

I am having surgery in mexico (RNY) in march. I am not sure what to expect as far as my post op diet is concerned. My biggest question is: is it generally clear liquids only and if so, should I or can I use protein powder to up the nutritional value. If I know that this is okay, I will take some protein powder with me, as it may be difficult to find in Mexico. I thought I'd take some crystal light also. I am worried if I am taking in only clear liquids with no protein that I won't feel well enough for the 18 hour drive back. we are planning on splitting our drive up over 3-4 days with frequent rest stops but I want to feel as good as I can.

I was really worried about my first two weeks as well. Now mind you I am only 3 weeks post-op and so am definately not a pro. I went to a nutritionlist and support groups before my surgery, and tried to get as much info as I could, but let me tell you I am still learning. Now my doctor stated, in the hospital after the surgery that when I left on Day 3, I had to go on a liquid diet, but it didn't have to be all clear. She was firm that I had to get in 60 grams of protien a day. She stated that because my body would go in starvation mode if I wasn't getting the protien and would hold onto that fat for dear life. So now I look at food as calories and protein. I found some fruit drinks on this site that are low in calories and HIGH in protein and not gritty or thick. I have found this better then the protein powder because it had some flavor and was actually better in calorie to protein ratio. Now for the first couple of days in the hospital I was on clear liquids. BUT I could only have 1 ounce of water an hour at that time. Reason was because I had the RNY and that was pretty complex abnominal surgery. The doc said that even though I may have felt fine on the outside (I had laproscopic) that inside thmy stomach and intestines were VERY sensitive and very inflamed. So anything more than the water may have made me sick. On the second day it was broth, an ounce of yogurt, crystal light, and water. On the third about the same. After that it was important for me to keep up the water. (ALWAYS have water with you, I don't know why but I am dehydrated if I don't have water for more than a half hour. So in essence, I would probably start the protein on day 4 or 5 because you don't want to chance getting your newly created stomach (pouch as they say) and intestines blocked. Trust me, you really will need that time to let them heal a little. When you get out of surgery it will be different because you will feel tender on the inside, if that makes sense. Iwas on oxycodone for a couple of days after the surgery, because it is extremely painful as the stitches inside heal. Also, make sure that you have prescriptions from them or talk to your primary for the vitamins, b12 sublingual, and calcium. If I don't take those myself I feel a bit lightheaded and also for actigall (sp) and pepcid (20 mg). Reason for those is that your body willbe adjusting to produce the correct amount of acid, and those are needed so that your pouch heals correctly. Also, I wish you the best and please post to let us all know how you are doing after your surgery. Jessica

PLEASE PLEASE take these months to get a seducated/informed as you can! http://www.sabariatric.com is a good one for diet info! I send this to many preops: join: http://health.groups.yahoo.com/group/GastricBypass-InfoCentral/ http://health.groups.yahoo.com/group/OSSG-Protein/ http://health.groups.yahoo.com/group/OSSG-Nutrition/ *best luck to you!) Deciding to have WLS is a major, life-changing event and shouldn't be made on impulse (I am not saying this is you I am saying this for anyone thinking about it!). I recommend anyone be 110% sure this is what you want to do because it is PERMANENT! Things to think about: · How long have you been researching WLS?**Hopefully at least a good 6 months or so****for many it is years! · Do you understand the procedure, I mean really understand the nitty gritty of what they are going to do to your intestinal system! Not just it will help me lose weight but that they are going to cut your stomach in 2,make a small pouch, the old stomach hopefully is transected from pouch by staples and surgically cut in 2! Then the intestines are cut a few feet or so down and rerouted so you lose weight because the tummy is restrictive and bypassing the intestines decreases absorption....Know the risks involved with this!!!***(nutritional/metabolic/physical/psychosocial): ex B12 and vitamin deficiencies/protein deficiency/hernia/adhesions, risk of depression post op related to grief over loss of food and hormonal surge of estrogen/trauma of surgery, marital/relational difficulties/high divorce rate)... · Surgical risks: (not all inclusive.. Bleeding · Complications due to anesthesia and medications · Deep vein thrombosis/clots · Wound Dehiscence · Infections · Pulmonary problems · Spleen injury · Stenosis · Hernia · Depression possibly related to grieving the loss of food, decreased metabolism, and hormonal surges from estrogen being released into the body from rapid wt loss/fat breakdown.... · Gallstones.... · Long-term osteoporosis, vit./mineral deficiencies · hair loss (temporary due to anesthesia, trauma of surgery but will continue if you are protien/vit and mineral deficient!) · Food intolerances (possibly meats, esp. red meat, lactose intolerance, sugar, fats, fried food) · Dumping syndrome (Nausea/vomiting/diarrhea/chestpain/palatations/sweating/tiredness for minutes/hours/days) · EXCESS SKIN....OK my philosophy is you fit in your skin or you don't...Do say you don't want to feel bad after, ask yourself do you feel bad now? If yes are you healthy now as a MO person? Yeah many insurance companies pay for some plastic surgeries if medically necessary it may be a fight, but you can get some of it removed possibly....If though this will deter you I say the chances are great you will have some amount of excess skin, no one knows how much...Age, gender, prior diet/weight changes, pregnancies all affect this and the best chance on has to control this is (although limited) exercise, water and protein....So if this is a huge issue don't have surgery.....Perhaps join : http://health.groups.yahoo.com/group/ossg-plasticsurgery/ a great site and look at before pictures and after....Excess skin may be by far the most distressing side-effect for people as we already come with altered self-esteem/body image!!! · What type of research have you done? (Internet, in-person support group meetings, talking with others who have had surgery, surgeon consult, surgeon seminar, articles, books?????)***Knowledge is power and is the best tool we have for success and happiness afterwards**** · What are your present support systems? Friends, Family, co-workers.....**Although not 100% necessary if others are on board it sure as heck makes the ride all that much easier!!!*** · What are your current stressors? ***WLS is a time when you need to be as stable as possible, going through a divorce, bankruptcy, death of a close relative, job loss...well WLS may be a good option but pick the optimal time as it is stressful enough if everything is good, when you are going through something extra stressful you are hampering your success possibly and not having the old standby of food to rely on can be HELL!***This is not to say there ever is a right time and things can happen post-op but be kind to yourself and do what's best for you, waiting 3 months may make all the difference in the world! After all this is about forever!!! · What is your nutritional/obesity/diet history?***WLS is not for everyone, it is for the Morbidly obese (BMI above 40 or 35 with major comorbdities such as sleep apnea, Coronary disease, Diabetes....)This should be no ones first attempt at dieting (*I know this is not yours again just general guidelines)...Anyone who says this is the easy way out, KNOWS NOTHING about the surgery or the struggles you will endure and lifestyle changes necessary post-op for success! They are usually ignorant, jealous or both! Again your education and knowledge here goes a long way...Everyone seems to know someone who 'died' or had a 'terrible experience' with WLS...BUT no one seems to have a name or number to call that person!!! It is again based on hearsay alot of the time and their own fears and insecurities...You are doing this for you remember that, it is nice to have support, so educate friends and family, bring them to a support group!!! It can only help! Many programs require wt loss preop...I know many people disagree with this or don't understand why..IMHO I think it is a generally good idea to start instilling dietary, exercise and overall lifestyle changes preop, there is nothing magical about the surgery that makes u wake up and think like a thin person (*I WISH!!!!) So making small changes are helpful pre-op...EXERCISE is one of the biggest keys to success (IMHO again) and anything you can do preop will help you keep up with this and be healthier for surgery!! (and a better surgical risk!)...Start eating smaller portions, it is hard if you go from eating super sized fast food today to clear liquids for 2 weeks (*this is my equivalent of psychological hell/torture!!!) Start slowing down when you eat, put that fork down in-between bites, cut up your food to small pieces, stop drinking and eating at the same time (cant do it or shouldn't postop so start now!) Start taking in 64 ounces of fluid a day if u aren't already, will need to postop! Cut out carbonation, caffeine, sugar, alcohol and chocolate (these are 5 recommended things to avoid postop for many esp. in the first year) again make postop life easier on yourself not harder start ahead!!!!Try on new coping skills for size, they wont miraculously appear postop! Stock the house with clear liquids, crystal lite, diet kool-aid, broth, diet jello etc so u are ready when u get home!!!!Try and avoid the 'last supper syndrome' you will eat most everything again eventually, perhaps in smaller quantities, so don't have a feast each night of things u think u will never have again! · Ask yourself: What is my ability to make lifestyle changes? Be compliant with post-op recommendations??? This is only a tool....(*sorry can't say that enough!).... a. Need to exercise daily for health/wt loss and help with excess skin b. Need to supplement with B12, multivitamin, folate, Iron, Zinc, Calcium citrate, protein shakes possibly give or take things. c. Need for LIFELONG FOLLOW UP!!!! · Know that extended release medications may not be as effective or absorbed well (**esp. birth control pills in woman of childbearing age use alternative form of BC) I could probably ramble on all day about this..I hope some of this helps you! Any specific ? email us or me offline! Take care and good luck it is an awesome journey!! *not perfect and a positive attitude helps! DO this for you and only you!!!!Start journaling now www.obesityhelp.com is a great site, start your own profile there! Also if you haven't seen this document (pouch rules) print and read! A good basic guide to things that will help you use the tool and be successful as possible (*for most of us!!!) http://www.digitalhorsewoman.com/pouchrules.htm Take Care, Jamie Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"

Follow your doctor's instructions. If he doesn't give you enough, perhaps you could use the following site as a guideline... http://www.misila.org/Misi/FAQ.asp If I had to do it over again? I would keep my volume of intake less than 1/4 cup AS LONG AS I COULD... up to about month 5 When you are NOT hungry ... don't eat. If you try to squeeze in all that protein in the beginning... I personally feel (for some) it can cause a pattern of eating when you are not hungry... The following is a repost: There is a protein pudding out by Sylvester Stallone... you can read about it at http://www.fitflex.com/instone-protein-pudding-review.html or http://www.instonenutrition.com/ But they have the same kind of thing at GNC and Bariatriceating http://store.bariatriceating.com/proteinpudding.html Or why not buy some tasteless protein supplement and make your own? Add it to anything, really. http://www.bodybuilding.com/store/opt/any.html By the way... protein requirement? http://www.unjury.com/reg/calculator.shtml I'm not promoting the BARIATRICEATING.com site, but did find these and thought I would share: When winter comes.. http://store.bariatriceating.com/neelpr.html Cookies http://store.bariatriceating.com/sufrpi.html Chocolate craving? I used this even BEFORE surgery when I catered. You can buy it and similar products in regular grocery stores. http://store.bariatriceating.com/sasusufrmomi.html Later, when you can visit the grocery store... Grocery food list link and other information link http://www.misila.org/Misi/FAQ.asp First month: During the first month after surgery, your stomach and the opening into your intestines are swollen and very small. You will be able to eat only very limited amounts of food. It is important that you concentrate on eating the most important foods for healing: PROTEINS. All proteins must be very soft, moist, and well chewed in order to pass through your new little stomach successfully. If you eat too fast or too much, it will feel like heartburn and may cause you to become sick, so be careful. Grocery list of Protein Foods: 1. Cottage Cheese (low-fat or non-fat). 2. Yogurt (low-fat, non-fat, plain, or artificially sweetened). 3. String cheese 4. Eggs (any style, limit yolks). 5. Tofu 6. Refried beans 7. Lentil or black bean soup 8. Fish (soft and moist). 9. Small amounts of cooking spray 10. Small amounts of non-fat mayonnaise or mustard to moisten food. Just for good measure, I included this too... The link is http://www.misila.org/Misi/FAQ.asp How do you create your own Protein Supplement Recipes? With flavorful additions like: Sugar-free drinks--any Kool-aid or Crystal Light flavors Extracts - imitation flavors and real flavor extracts also bolster supplement taste. However, if you use extracts that contain alcohol, limit the amount you use to 1 1/2 teaspoons per beverage because alcohol contains wasted calories. Remain limited to the following low calorie extracts (calories per teaspoon): Black Walnut - 4 Chocolate - 7 Coconut - 8 Vanilla, imitation - 3 Pineapple - 6 Vanilla - 8 Maple - 6 High Power Pudding - mix one small pack of sugar-free pudding (chocolate, vanilla, or pistachio) to 2 cups of skim milk and 1/2 cup of non-fat dry milk and chill. One 1/2 cup serving provides 9.5 grams of protein and 120 calories as mixed. Protein Pudding - mix one vanilla protein supplement with approx. two ounces less liquid than directions call for. Next, add three tablespoons of your favorite sugar-free, fat-free instant pudding and five ice cubes. Blend at high speed for 60 seconds and enjoy. Orange Pudding - 3 ounces of boiling water, 1 1/2 teaspoons (2/3 envelope) orange flavored sugar-free gelatin, 7 ounces of sugar-free TANG and your protein powder. Mix well and chill. Fruit Cubes - 1 cup of heated diet soda (not boiling) to one envelope of unflavored gelatin. Then mix in your protein powder and 1/2 cup of cold diet soda and pour into an ice tray and chill. Eat all the cubes as one serving. Slush Recipes Designing your own -- Mixing instructions 1. Pour 3 ounces of fluid into a measuring cup. Add ice until fluid line reaches 12-ounces. 2. Pour ice mixture into blender. 3. Add flavoring and protein powder. 4. Blend on low speed 2 to 3 seconds with quick pulses, then blend on high speed until mixture is the consistency of slush. Raspberry Slush - 6 ounces of sugar-free raspberry flavored fruit tea and ice to 1/2 teaspoon of rum flavoring and protein powder. Blend and serve. Hot Beverages Designing your own -- Mixing instructions 1. Mix dry ingredients together. 2. Hea****er until steaming, either in a saucepan or microwave. Do not boil. 3. Add 9 fluid ounces of ho****er to the dry ingredients. 4. Immediately mix with spoon until powder is completely dissolved. 5. Do not use a blender or shaker as hot liquids may splash and burn. 6. Do not mix protein powder and water prior to cooking in microwave as this will cause lumps to form. Coca - mix 1 teaspoon of cocoa to 2 packets of Equal sweetener, a dash of cinnamon and 9 ounces of water to chocolate or vanilla protein powder. Peppermint Coca - 1 teaspoon of cocoa, 1 teaspoon of chocolate flavoring, 1/8 teaspoon of peppermint extract, a dash of cinnamon and 3 packets of Equal sweetener to 9 ounces of water and vanilla or chocolate protein powder. Mousses Designing your own -- Mixing instructions 1. Mix 1/2 cup boiling water into gelatin. Stir vigorously with wire whip until dissolved. 2. Add remaining ingredients to gelatin mixture. 3. Mix well. 4. Pour into container with tight fitting lid. 5. Put in freezer until set and very cold, but not frozen. 6. Mix with electric mixer on high speed until peaks form and mixture is lightly fluffy. 7. Serve at once. 8. Due to the increased caloric content of these mousse recipes limit to one per day. Chocolate Mint Mousse - 1/2 cup boiling water, 1/2 envelope (1-1/8) Knox unflavored gelatin to 2 packets of equal sweetener. A dash of cinnamon, 1 teaspoon of creme de menthe extract to 1/2 cup of water and chocolate protein powder. Chocolate Almond Mousse - 1/2 cup boiling water, 1/2 envelope (1-1/8) Knox unflavored gelatin to 2 packets of equal sweetener. A dash of cinnamon, 1 teaspoon of cocoa, 1/4 teaspoon of pure almond extract to a 1/2 cup of water and chocolate protein powder. What about the exercise? (If I could only jump like that!) Begin exercise program at 6 weeks after your operation. Perform exercises 5 days per week and resting 2 days every week. 1st thru 3rd week: Brisk walk for 15 minutes on first day. Increase by 2 minutes per exercise day until after 2 weeks you are walking for 35 minutes. 4th thru 6th week: Continue brisk walking 5 days per week for 35-40 minutes per session. 7th thru 10th week: Begin resistance training using bands. Perform upper body training for 15 minutes 3 days per week and lower body resistance training for 15 minutes 2 days per week. Follow resistance training with 15 minutes of brisk walking (or some form of cardiovascular exercise). 11th week and Beyond: Alternate 2 weeks of cardiovascular exercise (brisk walking, jogging, or biking) for 35 to 40 minutes (exercise 5 days, rest for 2 days) with 2 weeks of combination training (15 minutes resistance training and 15 minutes cardiovascular training).