Dietician Appointment - 3 month (14 weeks) post-op

I had my first visit with the dietician through the Ontario Telehealth Network (OTN) at my local hospital. I'm thankful that I don't have to travel to TWH and can do this from Orillia.

The visit was about 50 minutes and included a review of my blood work, general questions about how I am doing, what I am eating, how I am tracking, and what I am doing for exercise. There were, however, some aspects that I found to be quite confusing.

I am currently eating about 600 calories a day with 80 to 100 grams of protein a day and carbs that average around 40 grams. I'm eating two snacks and three meals. I'm still having a protein shake during the work week for breakfast, but eat protein rich morning meals at home. The eating plan does speak of having protein rich meals and the number you should be hitting daily, but does not talk about calories. I can eat between 1/2 to 3/4 cup of food within a 20 minutes (or so) time frame, then stop. Too fast or one spoonful too much makes me feel uncomfortable. No dumping, no vomiting and I read the labels to ensure sugar is under 5 grams and I seldom eat out.

I was told that my calories were too low and that I should be striving to hit 1000 calories a day (up to 1400 as I get further on). My protein should be 60 to 80 grams, and I need to incorporate more grains, fruits and vegetables into my diet.

I was also told that at 3+ months out, I have lost 53% of my excess weight, but that appears to be faster than normal. I was told that should lose 50% of my excess weight by 6 months. I told her that I am eating according to the plan, as much as I can comfortably do per meal, and am trying to walk 5 km. per day four days a week (still striving to reach that goal).

I told her I am eating my protein first (as directed) and am eating vegetables (cooked carrots and green beans, romaine lettuce, cucumbers, zucchini, sweet potatoes, peppers, onions, mushrooms), some fruit (unsweetened applesauce and berries), and have been avoiding starches and grains other than the odd Ryvita cracker with some laughing cow or other cheese.

She went over my vitamins and blood work. My B12 is high (reduce my 1200 mcg. sublingual to once a week), my calcium and Vitamin D were high (still take one tablet twice a day), and she advised me to take two of my multi-vitamin as I was only taking one (oops). Other than that, my levels were in the "high" range which I was really happy about and probably makes me a weird freak. Even my iron is still in the 200's, still coming down after being infused after surgery.

So, after such a long post, this is what I have learned:

• great to have the feedback and discussion with a member of our health team. So needed and so worthwhile (I had a lot of questions)
• I will make the suggested changes regarding my vitamins
• I will incorporate more vegetables and eat what I am able to without being concerned about calories.
• I will continue to eat protein first and still try to hit the 80 gram mark
• I will continue to track daily using MFP and again on the OH site
• I will still not eat starches (not interested, not helpful), but will incorporate more vegetables.
• I will continue to limit fruit to berries (high nutrition, low sugar variety)
• I have committed to not having any alcohol for a year, then revisit if I have the odd glass of wine or Caesar, but don't plan to drink my calories

Next comes my NP visit at the end of July. I KNOW that I am sticking to plan and KNOW that I am learning to use my new tool and benefit from the surgery. I haven't felt this good since my 30's and will continue to follow what has been given to me. If my weight loss is considered too fast (and I don't consider it to be), it is not because I am starving myself. I am fully satisfied and in control through better shopping practices, reading labels, meal planning, and mindful eating. I am doing what I have been told to do.

Happy Canada Day to you all. Keep striving towards better health; it's so worth it!

Congratulations on all your success so far! It sounds like you have an amazing plan in place. This is one post I can save for helping me plan my "how-to" post op. Tons of great advice and inspiration in here for me to live by once I get to where you're at. Thanks for posting in such great detail!!!

We're all at different stages and I am a newbie. I also get a lot from what I read and believe that sharing is a way of learning ourselves.

The only thing that concerns me about this post is this one statement:

I will incorporate more vegetables and eat what I am able to without being concerned about calories.

I am 14 months out and am in the 1000 calorie range. I guess you could say I'm in maintenance because my weight isn't really changing too much but I would like to lose a few more pounds. You can't lose your weight too fast, get it all of and then some to cover regain! Your menus and stats look awesome to me. I wouldn't change a thing. I just checked MFP for June last year and I was consistently between 600 - 800 calories. I think if you try hitting 1000 your loss will stop, or be very very slow.

You've been doing awesome Linda, keep up the great work.

Have an awesome weekend of camping, I'm looking forward to it too!

Thanks Ginnny. I always appreciate your advice.

To clarify, I will always be conscious of the calories I take in, but do look at the protein grams first. My comment was more about the fact that my calories are considered low, not high because of what I am able to take in so soon after surgery. I still have restrictions, still don't feel hunger (just know when I need to eat), and am following the plan. I just won't be striving to get to 1000 calories and will continue with my plan.

Have fun camping ... the only thing I will miss is that glass of wine! - lol

You're doing absolutely great, Linda; that was a fabulous Telehealth visit! 53% of your excess weight gone at 3 months out is wonderful.

I was down 45% of my excess at the 3 month point and they said the same to me; that I shouldn't be there so soon; they'd expect to see losses like that at the 6 month point. They told me to eat more carbs and increase my calories. I smiled, nodded, and went home and ate more carbs...healthy ones, too, but had a weigh gain within days. I went back to my normal eating and lost it again.

I think the problem is math; they look at averages but they are looking at average numbers, not people. We're all unique and lose at our own paces but they seem to forget that averages are just numbers. Averages are just stats; they just add up the weight everyone lost and divide it by the number of people losing weight and come up with the middle number. So if one person loses 20 Lbs, another loses 60 Lbs, they'd say the average weight loss is 40 Lbs...if I remember my stats class correctly, lol. Of course, they use a lot more than 2 people; they're going by all of their patients.

Anyway, I've always been awful at math, so I just decided I didn't want to fall in the middle because they think I should; I just want to do the best I can, whatever that turns out to be.

At my three month follow up they already considered me a success. I was 66 lbs lower than my starting weight. Imagine if I had stopped there. My goal was 100 lbs (at least) and here I am. Still working at losing a little more, but now I would even consider myself a success.

I agree Ginnny and we are successful, no matter what stage of the journey we're on. That's why I said the appointment was informative and confusing. I have at least 50 to go; no rush but sticking to the program.

Thanks for the feedback Kathy. I'm awful at math, but you can tell by the way I ramble on, I have always excelled at English (lol). And striving to be above average is a good thing!

Linda,

Congrats on your great appointmemt. I had mine yesterday too and was told the same thing about people not hitting 50% until about month 6. I am now at the 50% mark and feel great. She seemed yo be happy with what I am eating but just want me to have more foods high in vitamin A. ( darker green veggies or orange ones)

It's true not to focus on calories but eating a well balanced diet.

You are rocking it girl...keep it up!!

Laura