anyone 3-4 weeks out?
Live, Love and Laugh
Kisses , Nanette 
Have you tried some other OH forums or some other WLS groups online? Such as:
http://www.obesityhelp.com/forums/RNY/
http://www.obesityhelp.com/forums/any_wls_regrets/
http://www.obesityhelp.com/forums/amos/
GBIC is a larger group more active and helpful I have moderated and participated in for 6 years.
http://health.groups.yahoo.com/group/GastricBypass-InfoCentral/
or this group (not sure how active check it out)
http://groups.yahoo.com/group/GastricBypass-PostOp/
At 3 weeks out I had just gotten off of a 15 day postop liquid only plan moved to soft mushies, this involved focusing on fluids getting in 64 oz as best I could of non caloried, non carbonated, non caffeinated fluid to avoid dehydration which can lead to sever Nausea and vomiting and even be fatal if not caught/treated.
Then I was instructed (6 yrs ago AlbanyMed program) to start 2tablespoons of things at a meal eaten over 20-30 min with a babyspoon/small dish/saucer like yogurt (Dannon fit and ligh****ch carbs/sugar in yogurts!), ricotta cheese, cottage cheese, moving slowly one food at a time to a cheese stick, wedge or two of laughing cow regular or lite cheese (on a wheat thin or two but many say no carbs this early!), tuna/chicken/seafood/shrimp//turkey/egg salad made like pate mixed in a minifood processor (again 2T only) use alittle light mayo to moisten.
Moisture is key here....
Some can work with scrambled egg/eggbeaters soft with cheese in them work to 1/4 cup at most now, depending on your healting and pouch/stoma size tolerance.
If protein is still too hard a protein shake a good whey protein with 20-23 g protein in a scopp of 90-120 cal and 0-3g fat, 0-4g carbs a serving mixed with water and ice only!
If they say and I would not do always oatmeal or cream of wheat add protein powder to it, same with brothed soups strained add potted meats to them or ground to oblivion chicken or such.
Exercise I started preop DAILY walking 2 iles (took 45 min at start woked to a 15 min ile as goal), then I added curves to that 3x week then 6x week then at 2 yr postop added the gym as curves not enough. Walking is a great exercise can be done anywhere (use Leslie Sansones walk off the pounds videos inside! when it rains no excuses!)..
For me the focus was on the process of developing a healthy lifestyle, learning to use my tool, enjoy each challenge and there were many! Find non food rewards, rethink my life using food as fuel and eating to live not lving to eat. Demphasizing food related activities, finding other ways to cope with emotions. Setting boundaries on my needs and doing things for myself and knowing it is not selfish. The emotional work now is of upmot important the honeymoon is sbhort and the guidlines and lessons and opportuities are best managed longterm if we utilize the first 6 mo postop to work on them to be healthy habits and work on reducing our lifetime of less helpful behaviors.
I saw choices as positive not negative, I had done this to limit myself and get healthy reminding self of that daily.......Be well!
http://www.obesityhelp.com/forums/RNY/
http://www.obesityhelp.com/forums/any_wls_regrets/
http://www.obesityhelp.com/forums/amos/
GBIC is a larger group more active and helpful I have moderated and participated in for 6 years.
http://health.groups.yahoo.com/group/GastricBypass-InfoCentral/
or this group (not sure how active check it out)
http://groups.yahoo.com/group/GastricBypass-PostOp/
At 3 weeks out I had just gotten off of a 15 day postop liquid only plan moved to soft mushies, this involved focusing on fluids getting in 64 oz as best I could of non caloried, non carbonated, non caffeinated fluid to avoid dehydration which can lead to sever Nausea and vomiting and even be fatal if not caught/treated.
Then I was instructed (6 yrs ago AlbanyMed program) to start 2tablespoons of things at a meal eaten over 20-30 min with a babyspoon/small dish/saucer like yogurt (Dannon fit and ligh****ch carbs/sugar in yogurts!), ricotta cheese, cottage cheese, moving slowly one food at a time to a cheese stick, wedge or two of laughing cow regular or lite cheese (on a wheat thin or two but many say no carbs this early!), tuna/chicken/seafood/shrimp//turkey/egg salad made like pate mixed in a minifood processor (again 2T only) use alittle light mayo to moisten.
Moisture is key here....
Some can work with scrambled egg/eggbeaters soft with cheese in them work to 1/4 cup at most now, depending on your healting and pouch/stoma size tolerance.
If protein is still too hard a protein shake a good whey protein with 20-23 g protein in a scopp of 90-120 cal and 0-3g fat, 0-4g carbs a serving mixed with water and ice only!
If they say and I would not do always oatmeal or cream of wheat add protein powder to it, same with brothed soups strained add potted meats to them or ground to oblivion chicken or such.
Exercise I started preop DAILY walking 2 iles (took 45 min at start woked to a 15 min ile as goal), then I added curves to that 3x week then 6x week then at 2 yr postop added the gym as curves not enough. Walking is a great exercise can be done anywhere (use Leslie Sansones walk off the pounds videos inside! when it rains no excuses!)..
For me the focus was on the process of developing a healthy lifestyle, learning to use my tool, enjoy each challenge and there were many! Find non food rewards, rethink my life using food as fuel and eating to live not lving to eat. Demphasizing food related activities, finding other ways to cope with emotions. Setting boundaries on my needs and doing things for myself and knowing it is not selfish. The emotional work now is of upmot important the honeymoon is sbhort and the guidlines and lessons and opportuities are best managed longterm if we utilize the first 6 mo postop to work on them to be healthy habits and work on reducing our lifetime of less helpful behaviors.
I saw choices as positive not negative, I had done this to limit myself and get healthy reminding self of that daily.......Be well!
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!"
Gastric bypass diet: Nutritional needs after weight-loss surgery
http://www.mayoclinic.com/health/gastric-bypass-diet/WT00007
Gastric bypass diet: Nutritional needs after weight-loss surgery
The gastric bypass diet outlines what you can eat and how much after gastric bypass surgery. Find out ways to establish new eating habits for successful weight loss.
What you eat, how you eat and how much you eat changes after gastric bypass surgery -- surgery that alters the anatomy of your digestive system to promote weight loss.
With your stomach pouch reduced to the size of a walnut, you'll need to follow a gastric bypass diet. This diet -- which your doctor or dietitian creates for you -- tells you what type and how much food to eat with each meal and the required consistency and texture of the food. The gastric bypass diet helps you maintain good nutrition while losing weight.
After surgery: The first three months
You won't be allowed to eat for one to two days after the surgery. Then you consume specific foods according to a diet progression. The purpose of the diet progression is to allow your stomach time to adapt to processing food and to allow you to lose weight while maintaining good nutrition.
The following are common phases in the gastric bypass diet progression:
Liquids. Foods and fluids that are liquid or semiliquid at room temperature and contain mostly water, such as broth, juice, milk and cooked cereal. In most cases, you stay on a liquid diet for two to three days.Pureed foods. Foods with a consistency of a smooth paste or a thick liquid. Pureed foods contain no distinct pieces. You usually eat pureed foods for three to four weeks so that your stomach has time to fully heal. Soft foods. Foods that are tender and easy to chew, such as ground or finely diced meats, canned or soft, fresh fruit, and cooked vegetables. You usually eat soft foods for eight weeks before progressing to regular-textured foods, as recommended by your dietitian or doctor.
During the diet progression, you eat many small meals a day and sip water frequently. You might first start with six small meals a day, then progress to four meals and finally, when eating regular foods, decrease to three meals a day. Typically, each meal includes protein-rich foods, such as lean meat, yogurt and eggs. Protein is important for maintaining and repairing your body after surgery.How quickly you move from one step to the next depends on how fast your body adjusts to the change in eating patterns and the texture and consistency of food. In most cases, people start eating regular foods three months after surgery.
Lifelong changes: New eating habits
After three months, expect to eat three small meals and three small, healthy snacks a day. Your meals typically include lean sources of protein (such as poultry without skin or low-fat cottage cheese) fruits, vegetables and whole grains. Limit or avoid high-sugar, high-fat foods, which provide many calories but few nutrients.The changes in your digestive system restrict how much you can eat and drink with each meal. To avoid problems and to ensure you're getting all the nutrients you need, closely follow these guidelines:
Eat small amounts. Just after surgery, your stomach holds only about 1 ounce of food. Though your stomach stretches over time to hold more food, you won't be able to eat more than 1 to 1 1/2 cups of food with each meal. Eating too much food adds extra calories and can cause pain, nausea, vomiting and abdominal cramps. Make sure you eat only the recommended amounts and stop eating before you feel full. Eat and drink slowly. Eating or drinking too quickly, especially high-sugar foods such as soda or ice cream, can cause dumping syndrome -- when foods and liquids enter your small intestine rapidly and in larger amounts than normal, causing nausea, vomiting, diarrhea, dizziness and sweating. To prevent dumping syndrome, eat your food and sip your beverages slowly. Take at least 30 minutes to eat your meals and 30 to 60 minutes to drink 1 cup of liquid. Chew food thoroughly. The new opening that leads from your stomach into your intestine is very small and large pieces of food can easily block the opening. Blockages prevent food from leaving your stomach and could cause vomiting. Take small bites of food and chew them to a pureed consistency. If you can't chew the food thoroughly, don't swallow it.
Drink most of your fluids between meals. Drinking beverages with your meals may cause pain, nausea and vomiting as well as dumping syndrome. Also, too many liquids at mealtime may leave you feeling overly full and prevent you from eating enough nutrient-rich foods. Expect to drink about 6 to 8 cups of fluids a day to prevent dehydration.
Try new foods one at a time. After surgery, certain foods may cause nausea, pain, vomiting or may block the opening of the stomach. To find out which foods are OK to eat and which cause you trouble, try one new food at a time. Foods that commonly cause trouble include dry tough meats, bread, raw vegetables and carbonated beverages.
Take recommended vitamin and mineral supplements. After surgery, your body has difficulty absorbing certain nutrients because most of your stomach and the first part of your small intestine are bypassed. To prevent a vitamin or mineral deficiency, take vitamin and mineral supplements regularly. These may include a multivitamin-multimineral, calcium, vitamin B-12 and possibly an iron supplement.
Weight loss and weight gain
Within the first two years following surgery, you can expect to lose 50 percent to 60 percent of your excess weight, if you follow the dietary and exercise recommendations. If you continue to follow these recommendations, you can keep most of that weight off long-term.However, if you return to your old eating habits, you may gain back any weight you've lost. People *****gain weight after gastric bypass surgery usually are consuming too many high-calorie foods and beverages and don't exercise enough. And rather than eating three meals a day and small snacks, some people graze -- eat food all day long. This eating pattern often leads to consuming too many calories, which causes weight gain.
If you aren't losing weight or are regaining weight after surgery, see your doctor. Your health care team can help reassess your eating and exercise habits and help you confront and overcome any weight-loss obstacles.Though weight-loss surgery helps you shed the pounds, its success depends on your willingness to adopt lifelong healthy-eating and exercise habits. What you eat and how you eat changes after surgery, but the benefits of weight loss and your improved health are well worth these efforts.
By Mayo Clinic Staff
Oct 14, 2005
© 1998-2005 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved
http://www.mayoclinic.com/health/gastric-bypass-diet/WT00007
Gastric bypass diet: Nutritional needs after weight-loss surgery
The gastric bypass diet outlines what you can eat and how much after gastric bypass surgery. Find out ways to establish new eating habits for successful weight loss.
What you eat, how you eat and how much you eat changes after gastric bypass surgery -- surgery that alters the anatomy of your digestive system to promote weight loss.
With your stomach pouch reduced to the size of a walnut, you'll need to follow a gastric bypass diet. This diet -- which your doctor or dietitian creates for you -- tells you what type and how much food to eat with each meal and the required consistency and texture of the food. The gastric bypass diet helps you maintain good nutrition while losing weight.
After surgery: The first three months
You won't be allowed to eat for one to two days after the surgery. Then you consume specific foods according to a diet progression. The purpose of the diet progression is to allow your stomach time to adapt to processing food and to allow you to lose weight while maintaining good nutrition.
The following are common phases in the gastric bypass diet progression:
Liquids. Foods and fluids that are liquid or semiliquid at room temperature and contain mostly water, such as broth, juice, milk and cooked cereal. In most cases, you stay on a liquid diet for two to three days.Pureed foods. Foods with a consistency of a smooth paste or a thick liquid. Pureed foods contain no distinct pieces. You usually eat pureed foods for three to four weeks so that your stomach has time to fully heal. Soft foods. Foods that are tender and easy to chew, such as ground or finely diced meats, canned or soft, fresh fruit, and cooked vegetables. You usually eat soft foods for eight weeks before progressing to regular-textured foods, as recommended by your dietitian or doctor.
During the diet progression, you eat many small meals a day and sip water frequently. You might first start with six small meals a day, then progress to four meals and finally, when eating regular foods, decrease to three meals a day. Typically, each meal includes protein-rich foods, such as lean meat, yogurt and eggs. Protein is important for maintaining and repairing your body after surgery.How quickly you move from one step to the next depends on how fast your body adjusts to the change in eating patterns and the texture and consistency of food. In most cases, people start eating regular foods three months after surgery.
Lifelong changes: New eating habits
After three months, expect to eat three small meals and three small, healthy snacks a day. Your meals typically include lean sources of protein (such as poultry without skin or low-fat cottage cheese) fruits, vegetables and whole grains. Limit or avoid high-sugar, high-fat foods, which provide many calories but few nutrients.The changes in your digestive system restrict how much you can eat and drink with each meal. To avoid problems and to ensure you're getting all the nutrients you need, closely follow these guidelines:
Eat small amounts. Just after surgery, your stomach holds only about 1 ounce of food. Though your stomach stretches over time to hold more food, you won't be able to eat more than 1 to 1 1/2 cups of food with each meal. Eating too much food adds extra calories and can cause pain, nausea, vomiting and abdominal cramps. Make sure you eat only the recommended amounts and stop eating before you feel full. Eat and drink slowly. Eating or drinking too quickly, especially high-sugar foods such as soda or ice cream, can cause dumping syndrome -- when foods and liquids enter your small intestine rapidly and in larger amounts than normal, causing nausea, vomiting, diarrhea, dizziness and sweating. To prevent dumping syndrome, eat your food and sip your beverages slowly. Take at least 30 minutes to eat your meals and 30 to 60 minutes to drink 1 cup of liquid. Chew food thoroughly. The new opening that leads from your stomach into your intestine is very small and large pieces of food can easily block the opening. Blockages prevent food from leaving your stomach and could cause vomiting. Take small bites of food and chew them to a pureed consistency. If you can't chew the food thoroughly, don't swallow it.
Drink most of your fluids between meals. Drinking beverages with your meals may cause pain, nausea and vomiting as well as dumping syndrome. Also, too many liquids at mealtime may leave you feeling overly full and prevent you from eating enough nutrient-rich foods. Expect to drink about 6 to 8 cups of fluids a day to prevent dehydration.
Try new foods one at a time. After surgery, certain foods may cause nausea, pain, vomiting or may block the opening of the stomach. To find out which foods are OK to eat and which cause you trouble, try one new food at a time. Foods that commonly cause trouble include dry tough meats, bread, raw vegetables and carbonated beverages.
Take recommended vitamin and mineral supplements. After surgery, your body has difficulty absorbing certain nutrients because most of your stomach and the first part of your small intestine are bypassed. To prevent a vitamin or mineral deficiency, take vitamin and mineral supplements regularly. These may include a multivitamin-multimineral, calcium, vitamin B-12 and possibly an iron supplement.
Weight loss and weight gain
Within the first two years following surgery, you can expect to lose 50 percent to 60 percent of your excess weight, if you follow the dietary and exercise recommendations. If you continue to follow these recommendations, you can keep most of that weight off long-term.However, if you return to your old eating habits, you may gain back any weight you've lost. People *****gain weight after gastric bypass surgery usually are consuming too many high-calorie foods and beverages and don't exercise enough. And rather than eating three meals a day and small snacks, some people graze -- eat food all day long. This eating pattern often leads to consuming too many calories, which causes weight gain.
If you aren't losing weight or are regaining weight after surgery, see your doctor. Your health care team can help reassess your eating and exercise habits and help you confront and overcome any weight-loss obstacles.Though weight-loss surgery helps you shed the pounds, its success depends on your willingness to adopt lifelong healthy-eating and exercise habits. What you eat and how you eat changes after surgery, but the benefits of weight loss and your improved health are well worth these efforts.
By Mayo Clinic Staff
Oct 14, 2005
© 1998-2005 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved
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!"
PS: Not sure if this post I had saved is any help...
Perfect recipe?? I was asked about postop food/cooking etc...
Hello, welcome and thanks for the topic! I can so appreciate & relate to your current issues. I hope in sharing my story it may help some (although in an indirect way perhaps). My experience was similar. I was THE BAKER, THE COOK in the family. I obtained great joy, satisfaction and self-esteem from these titles! I also obtained a morbidly obese body from tasting the fruits of my labor! It wasn't just the food for me, it was the psychological conceptual framework if you will that I operated from. This included Food=love, I cooked/baked to show others how I felt about them. I ate to feel loved as well! I cooked/baked/ate when I was sad, angry, bored, fearful (anxious) or lonely....I cooked/baked to fit in, hey if I was overweight I'd help everyone else be that too (subconsciously)! It lessened my shame so to speak. Many with eating disorders do this I find. The first 2 months were such a emotional challenge for me. Liquids for first 2 wks, then again at 1 month out for 2 more weeks after a second surgery for a stricture from adhesions that caused an obstruction. This was a time my food addiction was very apparent. I couldn't chew anything to soothe what I was feeling! So I switched to watching the Food Network (AKA food porn LOL!) really. I had to have it.....Now fast forward to 7 months out, I had lost all but 15# of excess wt, was feeling awesome no physical hunger, wt flew off etc but I was still the same person, yes I ate smaller portions and exercised as well daily (it became an addiction as well that I am still working on today at 5 1/2 yrs out) ~B~U~T~ I did not change my thoughts, my use of psychology so my hunger returned(from all the dreaded carbs I ate albeit in small quantities that bit me in the but!) I could eat a greater variety and quantity of foods so yikes, I worried about regain!!! The fear fueled my exercise compulsion I HAD to do it daily, I had to do at least 7 hrs cardio a week, I had to spend 10 hrs at least in the gym or else (I am not sure my world would crash?)...I refocused at 7-12 months out, I found that my sugar cravings were in addition to emotional cues to soothe/numb/avoid/pure habit so to speak a result of protein deficiency! I believed I could derive protein from skim milk; heck I drank 2 cups a day! I ate protein. I was deficient, low protein can in many trigger carb cravings! ESPECIALLY in many who are insulin sensitive/pre-diabetic.... I started the shakes as recommended, I looked to the south beach framework for a LIFSTYLE (not a diet). Here I found a marriage between my needs as a gastric bypass patient and satiety from my PHYSICAL HUNGER I seemingly created by eating all the refined carbs! (Bread/crackers and milk IMHO but thats another story).... My labs didn't lie my prealbumin was tanking, my albumin low as well...Eee gads! I did this to be healthy.
What I had failed to discover to this point at 1-2 yrs out was the enormity of the decision I had made, what effort I would need to make FOREVER to live a healthy life. One that was surrounded by support (online and in person), one that was full of my self-awareness, my personal consistent RESPONSIBILTY and ACCOUNTABILITY! So into therapy I went by years 3-4 the emotional toll was great. I had changed, I physically was close to 160# lighter but my brain was still as heavy as preop. Filled with old negative tapes, low esteem, codependent characteristics that I found I was grazing to feed/calm/soothe/avoid.
What I found is the little things I so worried about (such as what to bring, if I needed a fan, if I could bring extra pillows or having the perfect plan postop, the perfect recipe etc really were attempts to soothe my anxiety and fear of the unknown (death, would I succeed/fail!), now I see that but the lesson just keeps coming up until I master it, the lesson is acceptance, letting go, making a decision and being ok with the outcome regardless if it turns out as I hoped because my plan is not always what is best for me!
I became consumed with WLS in general so much I 'lost my life/identity' to that LABEL (I was a WLS person) when in fact I am much more than that. That despite the OPERATION the need for myself to do personal growth (therapy, 12 step work, develop supportive network, learn to take care of me FIRST) around my personality/character traits of codependency and how they are so intertwined into my obesity no tool can fix those (although I wi**** could of, that would of been magic as many of us hope WLS will be!). That in acceptance of myself at any moment, healthy boundaries, taking care of myself I could succeed or at least learn to reframe success as something more than a number on a scale or if I ate enough that day in protein or didn't eat too many carbs or drank enough fluid or got exactly enough exercise in etc.
Surgery was the easy part looking back although going through it I thought it was the hard part (ha how skewed that was!) living the lifestyle after in a consistent, self responsible manner is the most CHALLENGING thing I have ever chosen to do, I did not realize preop the immense effort it takes each moment to be healthy! It is so worth that energy though the freedom it brings!
Sometimes we consume our lives with food, thinking about what we can and can not have, when we can eat or should eat, how much, how often, how it should be cooked, when to buy it, how much, etc that we occupy so much time and do not even realize that we have no time left to feel (the point) in an addiction, it takes over us so we can forget us and what we are scared/fearful of feeling/being. I think the WLS lifestyle can be a sort of addiction and escape for a while ****il life overwhelms the beauty of the honeymoon!) and for myself exercise became an obsessive addiction as well.
I feel this is a courageous step we take, and it's not just about weight changing, eating the right food/recipe -- it's about life changing. This is why so many of us are challenged by the enormity of the decision.
Food cravings typically are in relation to or emotions. Different things signal different needs, as long as we focus on the gut to meet that need of the spirit/heart/head it will never be filled and instead we go around hungry still....I shifted my thinking and identity away from food altogether. I rarely bake as I once did. I decided I can be loved for and love others in ways w/o food. Society is so obese that I do not need to add to the epidemic by baking weekly and at holidays (I kid you not I made at least 14 batches cookies 5 batches of fudge and countless batches of peanut brittle around Christmas) Initially I wondered, what will people think if I don't? Well no one really noticed and hey I had more time. I discovered relationships are more important than the food. Eating out is about being with friends and family NOT the food. Reframing the importance of eating to live vs. living to eat is helpful for me. I can cook but it doesn't have to be the way I show love/care/concern or nurture those (kill them really!) I can now more than ever let go, accept what is, be in the moment with many uncomfortable feelings, not need to eat them down/away. I can listen to my body to tell me what I need really listen. I am not perfect (do not want to be) but this is my process, slow s it has been. So for me the recipe is self-awareness, self love, acceptance, letting go with a dash of friendship, a cup of support, and maybe a pound or two of therapy along the way! I couldn't change my life alone, I do not think anyone can. Together we can share our strength, hope and support and with that pay it forward. We cannot keep what we do not give away!!!
Ask yourself, what am I REALLY hungry for? Many of us find in the quietness of our mind the heart says it is not food.... We used to meet all our needs with food, now is a great opportunity to discover other ways to get out needs met w/o food, to realign food in a new way, refocus and reframe its place in our lives. Taking the emphasis off it we once had. In that we are free to be, discover and live fully!
I wish you well. Thanks for the topic again! I needed to remind myself how far I have come and how far I desire to go!
So my 'some more ideas' are not going to be recipe based, if you are not already consider some personal growth work (individual or/and group therapy, self help books such as those by www.geneenroth.com or Linda Spangle's Life is hard, food is easy etc, 12 step groups as indicated (CODA.org, OA.org etc).... I do cook and I do bake but they no longer define me, I define me and there is so much more I can give and be!
Perfect recipe?? I was asked about postop food/cooking etc...
Hello, welcome and thanks for the topic! I can so appreciate & relate to your current issues. I hope in sharing my story it may help some (although in an indirect way perhaps). My experience was similar. I was THE BAKER, THE COOK in the family. I obtained great joy, satisfaction and self-esteem from these titles! I also obtained a morbidly obese body from tasting the fruits of my labor! It wasn't just the food for me, it was the psychological conceptual framework if you will that I operated from. This included Food=love, I cooked/baked to show others how I felt about them. I ate to feel loved as well! I cooked/baked/ate when I was sad, angry, bored, fearful (anxious) or lonely....I cooked/baked to fit in, hey if I was overweight I'd help everyone else be that too (subconsciously)! It lessened my shame so to speak. Many with eating disorders do this I find. The first 2 months were such a emotional challenge for me. Liquids for first 2 wks, then again at 1 month out for 2 more weeks after a second surgery for a stricture from adhesions that caused an obstruction. This was a time my food addiction was very apparent. I couldn't chew anything to soothe what I was feeling! So I switched to watching the Food Network (AKA food porn LOL!) really. I had to have it.....Now fast forward to 7 months out, I had lost all but 15# of excess wt, was feeling awesome no physical hunger, wt flew off etc but I was still the same person, yes I ate smaller portions and exercised as well daily (it became an addiction as well that I am still working on today at 5 1/2 yrs out) ~B~U~T~ I did not change my thoughts, my use of psychology so my hunger returned(from all the dreaded carbs I ate albeit in small quantities that bit me in the but!) I could eat a greater variety and quantity of foods so yikes, I worried about regain!!! The fear fueled my exercise compulsion I HAD to do it daily, I had to do at least 7 hrs cardio a week, I had to spend 10 hrs at least in the gym or else (I am not sure my world would crash?)...I refocused at 7-12 months out, I found that my sugar cravings were in addition to emotional cues to soothe/numb/avoid/pure habit so to speak a result of protein deficiency! I believed I could derive protein from skim milk; heck I drank 2 cups a day! I ate protein. I was deficient, low protein can in many trigger carb cravings! ESPECIALLY in many who are insulin sensitive/pre-diabetic.... I started the shakes as recommended, I looked to the south beach framework for a LIFSTYLE (not a diet). Here I found a marriage between my needs as a gastric bypass patient and satiety from my PHYSICAL HUNGER I seemingly created by eating all the refined carbs! (Bread/crackers and milk IMHO but thats another story).... My labs didn't lie my prealbumin was tanking, my albumin low as well...Eee gads! I did this to be healthy.
What I had failed to discover to this point at 1-2 yrs out was the enormity of the decision I had made, what effort I would need to make FOREVER to live a healthy life. One that was surrounded by support (online and in person), one that was full of my self-awareness, my personal consistent RESPONSIBILTY and ACCOUNTABILITY! So into therapy I went by years 3-4 the emotional toll was great. I had changed, I physically was close to 160# lighter but my brain was still as heavy as preop. Filled with old negative tapes, low esteem, codependent characteristics that I found I was grazing to feed/calm/soothe/avoid.
What I found is the little things I so worried about (such as what to bring, if I needed a fan, if I could bring extra pillows or having the perfect plan postop, the perfect recipe etc really were attempts to soothe my anxiety and fear of the unknown (death, would I succeed/fail!), now I see that but the lesson just keeps coming up until I master it, the lesson is acceptance, letting go, making a decision and being ok with the outcome regardless if it turns out as I hoped because my plan is not always what is best for me!
I became consumed with WLS in general so much I 'lost my life/identity' to that LABEL (I was a WLS person) when in fact I am much more than that. That despite the OPERATION the need for myself to do personal growth (therapy, 12 step work, develop supportive network, learn to take care of me FIRST) around my personality/character traits of codependency and how they are so intertwined into my obesity no tool can fix those (although I wi**** could of, that would of been magic as many of us hope WLS will be!). That in acceptance of myself at any moment, healthy boundaries, taking care of myself I could succeed or at least learn to reframe success as something more than a number on a scale or if I ate enough that day in protein or didn't eat too many carbs or drank enough fluid or got exactly enough exercise in etc.
Surgery was the easy part looking back although going through it I thought it was the hard part (ha how skewed that was!) living the lifestyle after in a consistent, self responsible manner is the most CHALLENGING thing I have ever chosen to do, I did not realize preop the immense effort it takes each moment to be healthy! It is so worth that energy though the freedom it brings!
Sometimes we consume our lives with food, thinking about what we can and can not have, when we can eat or should eat, how much, how often, how it should be cooked, when to buy it, how much, etc that we occupy so much time and do not even realize that we have no time left to feel (the point) in an addiction, it takes over us so we can forget us and what we are scared/fearful of feeling/being. I think the WLS lifestyle can be a sort of addiction and escape for a while ****il life overwhelms the beauty of the honeymoon!) and for myself exercise became an obsessive addiction as well.
I feel this is a courageous step we take, and it's not just about weight changing, eating the right food/recipe -- it's about life changing. This is why so many of us are challenged by the enormity of the decision.
Food cravings typically are in relation to or emotions. Different things signal different needs, as long as we focus on the gut to meet that need of the spirit/heart/head it will never be filled and instead we go around hungry still....I shifted my thinking and identity away from food altogether. I rarely bake as I once did. I decided I can be loved for and love others in ways w/o food. Society is so obese that I do not need to add to the epidemic by baking weekly and at holidays (I kid you not I made at least 14 batches cookies 5 batches of fudge and countless batches of peanut brittle around Christmas) Initially I wondered, what will people think if I don't? Well no one really noticed and hey I had more time. I discovered relationships are more important than the food. Eating out is about being with friends and family NOT the food. Reframing the importance of eating to live vs. living to eat is helpful for me. I can cook but it doesn't have to be the way I show love/care/concern or nurture those (kill them really!) I can now more than ever let go, accept what is, be in the moment with many uncomfortable feelings, not need to eat them down/away. I can listen to my body to tell me what I need really listen. I am not perfect (do not want to be) but this is my process, slow s it has been. So for me the recipe is self-awareness, self love, acceptance, letting go with a dash of friendship, a cup of support, and maybe a pound or two of therapy along the way! I couldn't change my life alone, I do not think anyone can. Together we can share our strength, hope and support and with that pay it forward. We cannot keep what we do not give away!!!
Ask yourself, what am I REALLY hungry for? Many of us find in the quietness of our mind the heart says it is not food.... We used to meet all our needs with food, now is a great opportunity to discover other ways to get out needs met w/o food, to realign food in a new way, refocus and reframe its place in our lives. Taking the emphasis off it we once had. In that we are free to be, discover and live fully!
I wish you well. Thanks for the topic again! I needed to remind myself how far I have come and how far I desire to go!
So my 'some more ideas' are not going to be recipe based, if you are not already consider some personal growth work (individual or/and group therapy, self help books such as those by www.geneenroth.com or Linda Spangle's Life is hard, food is easy etc, 12 step groups as indicated (CODA.org, OA.org etc).... I do cook and I do bake but they no longer define me, I define me and there is so much more I can give and be!
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!"
From: http://www.sabariatric.com/keys_to_success1.htm
KEYS TO SUCCESS
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. There is an especially frightening change that takes place around 6-9 months after the surgery. 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. This page is about how to gain control of your weight using the stomach pouch "tool" and to keep control of the weight for life. The first thing to realize is that for the first six 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 stomach pouch could not handle enough calories to maintain weight for the first few months - we call this the "honeymoon" period after gastric bypass. 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. We describe the stomach pouch as a tool so that patients understand the necessity that you learn how to use it, and stick with the "rules of the tool" over time. Patients who are aiming for the best long-term success begin using these concepts and rules immediately after the gastric bypass. The time to really choose your new habits is during the early recovery after surgery - this is when your motivation is highest, and the rest of your life has been thrown out of kilter by the surgery anyway. Use this early recovery period to choose your new exercise and diet habits. And even though patients lose weight "no matter what" for the first few months, use of the concepts outlined below will also maximize the weight loss during the honeymoon period - take advantage of this time so that when appetite and capacity return there is not so much further to go in achieving a weight goal.
The "Rules of the Tool"
OK, here are the magic "rules of the tool" (are you ready?): Diet and Exercise. Seriously. The good news is that diet and exercise, supported by your pouch/tool, can help you achieve your goal weight with excellent energy and without uncomfortable hunger. The specific guidelines are below:
Exercise keys
Regular exercise is at least as important to success as following the diet recommendations outlined below. In this context, regular exercise means some kind of vigorous aerobic activity, at least 45 minutes in duration, at least 5 days per week. Patients who achieve this goal can reliably expect to have improved energy and improved weight loss.
Hibernation mode and Hunting mode
It appears easiest to understand these benefits by thinking back to the evolution of our ancestors. Back in "cave man days" starvation was a constant threat, and our bodies were evolved to store any extra calories in preparation for the lean times. During lean times, the body is programmed to do everything possible to hold onto the calorie stores. So the first response of the body when faced with starvation (during a drought for our ancestors, or after gastric bypass surgery for us) is to conserve all possible energy by turning down the "metabolic thermostat." This means that fewer calories are burned and the person feels like sleeping and being away from activity - they are easily fatigued. Some call this the "hibernation mode," and it is as if the long winter has come and the best adaptation is to go way back into the cave and wait until the weather (and the hunting) improve. (Note that the hibernation response can also lead to depression and difficulty interacting with others.)The role of exercise in this situation can be thought of as "fooling" the body into a different mode called "hunting mode." If the body is treated to regular vigorous physical activity during starvation, its interpretation may be that the person is foraging or hunting. The body (from an evolutionary standpoint) would be in favor of hunting because it could lead to more calorie intake, so it provides more energy to facilitate the acquisition of food - it turns up the "metabolic thermostat". This upregulation means that more calories are burned throughout the 24 hour period (besides the extra calories burned during the exercise) and the person has a significantly increased feeling of energy.
Note that this discussion about hibernation mode and hunting mode is written as a way of understanding the observed effects of exercise after gastric bypass - these are not scientifically established physiologic events.
The best time to begin your exercise program is before the gastric bypass. Again we're serious. Success in gastric bypass is all about choosing the right habits, with the support of the surgery to improve your success. If you exercise and diet before the surgery, you will have a strong impact on reducing your surgical risk. You will also benefit from having your plan in place, so you don't have to figure it out during the confused recovery phase after surgery. If exercise is not begun before surgery, then it should be started as soon as possible after surgery. Discuss details with your surgeon, but generally we advise patients to maximize their physical activity from the outset. This starts with walking on the same day as surgery, and should progress to more vigorous activity as the months go by. People who put off regular exercise until they feel "all recovered" or who try to start exercising when they realize they are not on course to reach their goal weight generally do not achieve or keep the new habit. Patients who work hard on exercise early after the surgery find it very rewarding. As the weight falls off, the capacity for exercise improves dramatically, with significant improvements on a week-by-week basis.
Two objections to the exercise program that we frequently hear are that the patient is too heavy, or too fatigued. The first of these is unfortunately valid in many of our patients who are extremely heavy - people with a BMI of 70 or more frequently cannot engage in routine exercise. The good news is that people with extreme weights burn a large number of calories by simply walking. The amount of physical work done (which translates into calories burned) comes from how much mass is moved and how far it goes. The message here is that the benefits of exercise can be realized in many ways - just work as hard as you can and do it frequently. Fatigue is the second objection. Patients sometimes tell us that they can't imagine walking to the door and back, especially in the first few months after surgery. Our answer is to do your best to exercise anyway. This complaint is likely to be a manifestation of hibernation syndrome, which can be shaken off by exercise.
Diet Keys
The goals of the long-term gastric bypass diet are:
consume minimal calories (promote weight loss)
consume adequate nutrition (achieve excellent long term health)
achieve the two goals above without undue hunger or cravings
These goals can all be achieved by using the pouch/tool with the right kinds of food, at the right intervals, and with appropriate management of fluids. The first thing to understand is that when the pouch is filled with food it sends signals to the brain that say that hunger is satisfied - no additional food is needed. This feeling is called "satiety." Any time a mature pouch is stretched by stuff inside it, the pouch will send a satiety signal to the brain, and (here's the cool part) the satiety signal will continue as long as the stuff is still in the pouch!
Therefore, keeping in mind the goals above, a patient should do the following:
Eat no more than three meals per day, with NO nibbling between meals. This will limit the volume of food and naturally limit the number of calories. One of these meals should definitely include breakfast - it has been shown that absence of nutrient intake causes the appetite center to "gear up" or become more sensitive, resulting in greater overall calorie intake through the day. This may work by means of an "ileal satiety feedback receptor" which (when exposed to nutrients several hours after they are taken in) may help suppress appetite.
Use solid protein (chicken, fish, etc) as the basis for each meal. It is OK to use some vegetables for variety. The solid protein will meet your nutritional needs, and it is the best food to "hang around" in the pouch to give a longer feeling of satiety. Many patients learn early on that they cannot hold nearly as much chicken as they can mashed potatoes - this is a GOOD effect. The effect exists because solid proteins do not pass out of the pouch too easily, resulting in less volume consumed. Simple carbohydrates (potatoes, pasta, rice, bread) should also be minimized because of their effect on blood sugar. Simple carbohydrates are close relatives of sugar, so that the calories in these foods are rather easily absorbed and they tend to "rush" into the system and drive the blood sugar up quickly. Because the amount of carbohydrate consumed was not very large the blood sugar soon begins to fall, but by this time the pancreas is pumping out large amounts of insulin (a hormone which pushes blood sugar down) and this combination causes the blood sugar to drop too low. At this point the patient is experiencing hypoglycemia, and the deep urge to consume food - if they consume a simple carbohydrate (such as juice, or a bit of potato) they will be back on the blood sugar roller coaster. A cycle of blood sugar highs and lows such as this leads to consumption of way too many calories, and the calories have no nutritional benefit. On the other hand, proteins take a while to digest, and so they are absorbed slowly. This provides a longer term steadier energy source for your body, avoiding the high/crash cycle.
Don't drink liquids with meals, and don't drink for at least two hours after your meal. Liquids taken after a meal will wash the food out of the pouch, releasing the tension on the walls of the pouch, and losing the feeling of satiety. In other words, consumption of liquids (with a mature pouch/tool) may be followed by a feeling of emptiness or hunger. Note that soup is a particularly poor food choice, because it is just like drinking with your meal. The liquefied food will pass quickly through the pouch, which allows more calories to be consumed and leaves the pouch empty. Note also that this part of the plan is not appropriate to begin practicing in the first three months or so after gastric bypass - in the early period after surgery it is enough of a struggle to get in adequate liquid (and hunger is not a huge challenge) that it is appropriate to begin drinking liquids about 30 minutes after you eat.
Pre-load with water. Just as you can avoid severe hunger with proper use of the pouch/tool, it is also manageable to avoid thirst and remain adequately hydrated. Beginning about 2 hours after a given meal, you should begin to drink (zero calorie) liquids aggressively. This brisk liquid consumption should finish with a "water load" about 15 minutes before you are to eat again. "Water load" means that you quickly drink as much liquid as you can hold, intentionally stretching your pouch. This maneuver serves to top off your hydration and to send satiety signals to your brain before you eat - this should moderate the pace and amount of your eating. Some allowance in this system must be made for the time of day. It is a good idea to get fluid in before breakfast, including the water load. It is also OK to wait longer after dinner (three or four hours) before drinking fluids.
It's a good idea to re-read this set of instructions each month until you've really "got it." It takes a lot of effort, determination, and practice to use your pouch/tool in the best way - the good news is that the results are worth it!
KEYS TO SUCCESS
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. There is an especially frightening change that takes place around 6-9 months after the surgery. 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. This page is about how to gain control of your weight using the stomach pouch "tool" and to keep control of the weight for life. The first thing to realize is that for the first six 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 stomach pouch could not handle enough calories to maintain weight for the first few months - we call this the "honeymoon" period after gastric bypass. 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. We describe the stomach pouch as a tool so that patients understand the necessity that you learn how to use it, and stick with the "rules of the tool" over time. Patients who are aiming for the best long-term success begin using these concepts and rules immediately after the gastric bypass. The time to really choose your new habits is during the early recovery after surgery - this is when your motivation is highest, and the rest of your life has been thrown out of kilter by the surgery anyway. Use this early recovery period to choose your new exercise and diet habits. And even though patients lose weight "no matter what" for the first few months, use of the concepts outlined below will also maximize the weight loss during the honeymoon period - take advantage of this time so that when appetite and capacity return there is not so much further to go in achieving a weight goal.
The "Rules of the Tool"
OK, here are the magic "rules of the tool" (are you ready?): Diet and Exercise. Seriously. The good news is that diet and exercise, supported by your pouch/tool, can help you achieve your goal weight with excellent energy and without uncomfortable hunger. The specific guidelines are below:
Exercise keys
Regular exercise is at least as important to success as following the diet recommendations outlined below. In this context, regular exercise means some kind of vigorous aerobic activity, at least 45 minutes in duration, at least 5 days per week. Patients who achieve this goal can reliably expect to have improved energy and improved weight loss.
Hibernation mode and Hunting mode
It appears easiest to understand these benefits by thinking back to the evolution of our ancestors. Back in "cave man days" starvation was a constant threat, and our bodies were evolved to store any extra calories in preparation for the lean times. During lean times, the body is programmed to do everything possible to hold onto the calorie stores. So the first response of the body when faced with starvation (during a drought for our ancestors, or after gastric bypass surgery for us) is to conserve all possible energy by turning down the "metabolic thermostat." This means that fewer calories are burned and the person feels like sleeping and being away from activity - they are easily fatigued. Some call this the "hibernation mode," and it is as if the long winter has come and the best adaptation is to go way back into the cave and wait until the weather (and the hunting) improve. (Note that the hibernation response can also lead to depression and difficulty interacting with others.)The role of exercise in this situation can be thought of as "fooling" the body into a different mode called "hunting mode." If the body is treated to regular vigorous physical activity during starvation, its interpretation may be that the person is foraging or hunting. The body (from an evolutionary standpoint) would be in favor of hunting because it could lead to more calorie intake, so it provides more energy to facilitate the acquisition of food - it turns up the "metabolic thermostat". This upregulation means that more calories are burned throughout the 24 hour period (besides the extra calories burned during the exercise) and the person has a significantly increased feeling of energy.
Note that this discussion about hibernation mode and hunting mode is written as a way of understanding the observed effects of exercise after gastric bypass - these are not scientifically established physiologic events.
The best time to begin your exercise program is before the gastric bypass. Again we're serious. Success in gastric bypass is all about choosing the right habits, with the support of the surgery to improve your success. If you exercise and diet before the surgery, you will have a strong impact on reducing your surgical risk. You will also benefit from having your plan in place, so you don't have to figure it out during the confused recovery phase after surgery. If exercise is not begun before surgery, then it should be started as soon as possible after surgery. Discuss details with your surgeon, but generally we advise patients to maximize their physical activity from the outset. This starts with walking on the same day as surgery, and should progress to more vigorous activity as the months go by. People who put off regular exercise until they feel "all recovered" or who try to start exercising when they realize they are not on course to reach their goal weight generally do not achieve or keep the new habit. Patients who work hard on exercise early after the surgery find it very rewarding. As the weight falls off, the capacity for exercise improves dramatically, with significant improvements on a week-by-week basis.
Two objections to the exercise program that we frequently hear are that the patient is too heavy, or too fatigued. The first of these is unfortunately valid in many of our patients who are extremely heavy - people with a BMI of 70 or more frequently cannot engage in routine exercise. The good news is that people with extreme weights burn a large number of calories by simply walking. The amount of physical work done (which translates into calories burned) comes from how much mass is moved and how far it goes. The message here is that the benefits of exercise can be realized in many ways - just work as hard as you can and do it frequently. Fatigue is the second objection. Patients sometimes tell us that they can't imagine walking to the door and back, especially in the first few months after surgery. Our answer is to do your best to exercise anyway. This complaint is likely to be a manifestation of hibernation syndrome, which can be shaken off by exercise.
Diet Keys
The goals of the long-term gastric bypass diet are:
consume minimal calories (promote weight loss)
consume adequate nutrition (achieve excellent long term health)
achieve the two goals above without undue hunger or cravings
These goals can all be achieved by using the pouch/tool with the right kinds of food, at the right intervals, and with appropriate management of fluids. The first thing to understand is that when the pouch is filled with food it sends signals to the brain that say that hunger is satisfied - no additional food is needed. This feeling is called "satiety." Any time a mature pouch is stretched by stuff inside it, the pouch will send a satiety signal to the brain, and (here's the cool part) the satiety signal will continue as long as the stuff is still in the pouch!
Therefore, keeping in mind the goals above, a patient should do the following:
Eat no more than three meals per day, with NO nibbling between meals. This will limit the volume of food and naturally limit the number of calories. One of these meals should definitely include breakfast - it has been shown that absence of nutrient intake causes the appetite center to "gear up" or become more sensitive, resulting in greater overall calorie intake through the day. This may work by means of an "ileal satiety feedback receptor" which (when exposed to nutrients several hours after they are taken in) may help suppress appetite.
Use solid protein (chicken, fish, etc) as the basis for each meal. It is OK to use some vegetables for variety. The solid protein will meet your nutritional needs, and it is the best food to "hang around" in the pouch to give a longer feeling of satiety. Many patients learn early on that they cannot hold nearly as much chicken as they can mashed potatoes - this is a GOOD effect. The effect exists because solid proteins do not pass out of the pouch too easily, resulting in less volume consumed. Simple carbohydrates (potatoes, pasta, rice, bread) should also be minimized because of their effect on blood sugar. Simple carbohydrates are close relatives of sugar, so that the calories in these foods are rather easily absorbed and they tend to "rush" into the system and drive the blood sugar up quickly. Because the amount of carbohydrate consumed was not very large the blood sugar soon begins to fall, but by this time the pancreas is pumping out large amounts of insulin (a hormone which pushes blood sugar down) and this combination causes the blood sugar to drop too low. At this point the patient is experiencing hypoglycemia, and the deep urge to consume food - if they consume a simple carbohydrate (such as juice, or a bit of potato) they will be back on the blood sugar roller coaster. A cycle of blood sugar highs and lows such as this leads to consumption of way too many calories, and the calories have no nutritional benefit. On the other hand, proteins take a while to digest, and so they are absorbed slowly. This provides a longer term steadier energy source for your body, avoiding the high/crash cycle.
Don't drink liquids with meals, and don't drink for at least two hours after your meal. Liquids taken after a meal will wash the food out of the pouch, releasing the tension on the walls of the pouch, and losing the feeling of satiety. In other words, consumption of liquids (with a mature pouch/tool) may be followed by a feeling of emptiness or hunger. Note that soup is a particularly poor food choice, because it is just like drinking with your meal. The liquefied food will pass quickly through the pouch, which allows more calories to be consumed and leaves the pouch empty. Note also that this part of the plan is not appropriate to begin practicing in the first three months or so after gastric bypass - in the early period after surgery it is enough of a struggle to get in adequate liquid (and hunger is not a huge challenge) that it is appropriate to begin drinking liquids about 30 minutes after you eat.
Pre-load with water. Just as you can avoid severe hunger with proper use of the pouch/tool, it is also manageable to avoid thirst and remain adequately hydrated. Beginning about 2 hours after a given meal, you should begin to drink (zero calorie) liquids aggressively. This brisk liquid consumption should finish with a "water load" about 15 minutes before you are to eat again. "Water load" means that you quickly drink as much liquid as you can hold, intentionally stretching your pouch. This maneuver serves to top off your hydration and to send satiety signals to your brain before you eat - this should moderate the pace and amount of your eating. Some allowance in this system must be made for the time of day. It is a good idea to get fluid in before breakfast, including the water load. It is also OK to wait longer after dinner (three or four hours) before drinking fluids.
It's a good idea to re-read this set of instructions each month until you've really "got it." It takes a lot of effort, determination, and practice to use your pouch/tool in the best way - the good news is that the results are worth it!
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!"
Check these out!
Roux-en-Y Gastric Bypass Diet and Nutrition Guidelines
http://www.obesityhelp.com/forums/nutrition/cmsID,10282/mode,content/a,cms/
http://www.endowsec.com/pated/edtgs22.htm
http://www.cornellweightlosssurgery.org/pdf/diet_guid_gas_bypas.pdf
http://www.lapsf.com/post-weight-loss-surgery-recipe-board.php
http://www.sabariatric.com/life_and_success/
http://www.sabariatric.com/life_and_success/diet
Great link to articles!
http://www.livingafterwls.com/Library.html
Roux-en-Y Gastric Bypass Diet and Nutrition Guidelines
http://www.obesityhelp.com/forums/nutrition/cmsID,10282/mode,content/a,cms/
http://www.endowsec.com/pated/edtgs22.htm
http://www.cornellweightlosssurgery.org/pdf/diet_guid_gas_bypas.pdf
http://www.lapsf.com/post-weight-loss-surgery-recipe-board.php
http://www.sabariatric.com/life_and_success/
http://www.sabariatric.com/life_and_success/diet
Great link to articles!
http://www.livingafterwls.com/Library.html
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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