1 week post-op and worried that I'm screwing everything up. Why is it so easy to get protein...

(deactivated member)
on 5/10/15 10:21 pm
RNY on 05/04/15

Hi everyone, it's me again. I'm starting to get really freaked out. Mainly, I'm worried that I'm overeating/overdrinking at a week post-op (halfway through the full liquids stage) and, subsequently, I'm wondering why that's even possible and what it means for the future.

I got some great feedback from the vets (thank you!!) when my calories were topping 700 per day a couple days post-op, so I cut out strained soups, popsicles, and things that are probably recommended by my plan for those who are having trouble getting fluids in but weren't really necessary for me since I wasn't having any issues. I tried to prioritize protein instead -- the thing is, now I'm taking in way too much protein! My plan says to aim for your weight times 0.3 in protein grams a day, and my NUT also said most people can't get that much in right away. Well, my goal is 65g, and today I hit 104! I'm sipping fluids constantly and only aiming for a protein shake or high-protein/low-sugar yogurt when I'm hungry, so I'm pretty sure I'm not confusing thirst for hunger. Fluids have been strangely easy for me to get in too. I definitely can't drink as much as I could pre-op...I make an 8 oz. protein shake and sometimes have to save half for later, but then I'm hungry again fairly quickly.

I'm also freaked out about feeling hungry this soon out, period...how in the world are people able to stick to 300-500 calories a day immediately post-op without being absolutely miserable? My protein shakes alone are 200 calories apiece if I make them with skim milk; 240 if I make them with 2% (which is recommended by my plan), and I would be so miserably hungry if 2 shakes a day were my only source of nutrition. I know I have a fast metabolism (144% of predicted energy expenditure for my age and sex)...does that play a role?

I spent so long preparing to get this tool, learning everything I could from those who have been there, and getting myself as healthy as I could for surgery, but now I'm legitimately afraid it somehow just won't work to help control my hunger and portions. I've also only lost a pound this first week and feeling really disheartened seeing posts from people losing 10+ at the same mile marker. Am I totally messing this up? What am I doing wrong? I felt so prepared before my surgery, and now I feel like I have no idea what I'm doing.

mlg21
on 5/10/15 11:12 pm

I am a bit worried too!  I just started eating puree's and the recommendation is 1-2 tsps. at first.  I don't feel any restriction even when I eat more.  I don't feel restriction when I drink.   My plan suggested No protein drinks.  I am bypass.   It is hard meeting protein goal without them.  In fact I was not given a goal and just try to have what I can.   Not sure how smart that is!   I have snuck in a drink here or there using almond milk to get my numbers up though.   I very much feel like I am on a diet.... not a lifestyle change trying to eat only until I am full... but I am not getting that 'full' feeling.     What is the carb content of your shakes?   Carbs for me really slow weight loss down ( they did pre surgery).    How much h20 are you drinking?

 

    
mornings
on 5/11/15 2:24 am - Canada

hello  im from alberta  so im unsure of the ways your nurse plans your  daily meals  I know they don't want you to drink  protein drinks here they want you to  eat your protein ,  and  when I used to speak of not feeling full  the first thing my doctor then said to me was why are you trying to  get a full feeling ,   you don't need to eat till you feel full you eat what is allowed for your pouch so if its 1/2 cup or 1 cup then don't exceed that he said ,   that  not everyone gets that full feeling , you need to perhaps mentally look at your portion size and  forget the waiting on the full feeling  another thing I was told is  , if your still hungry after you eat and chew slowly   then wait 30 mins to see if that passes , sometimes it can be head hunger ....   never drink with your meals either  wait that 30 mins so it wont flush out what you did eat and cause you even more hunger  ,   hope they may help   but sometimes you also can get powered protein like beneprotien to help till  your able to eat foods that are high in It  

christinerocks
on 5/11/15 3:39 am - AZ
RNY on 04/06/15

Teaspoons? Or Tablespoons? 

I know every plan is different but mine called for 1/4c puréed protein at a meal I was also instructed to eat just 3 meals, plus 1 or 2 preplanned snacks.  I couldn't always get it all in but 2 tablespoons was my minimum.  The other 2 tablespoons could be a snack, several hours later.  

________

137 pounds lost - from a 24/26W to a size 8/10!

 

(deactivated member)
on 5/11/15 9:36 am
RNY on 05/04/15

Wow, I don't know what I'd do for my liquid stage if I couldn't have protein shakes! With milk, mine have 18g carbs; 2g if I make them with water.

christinerocks
on 5/10/15 8:31 pm, edited 5/10/15 8:32 pm - AZ
RNY on 04/06/15

104 g of protein? I am still having a morning shake and most days it's a struggle to get to 70.  Not sure how you're getting that number 1 week after surgery.  Are you still eating every hour?  If so then you're basically eating around the restriction so that could be why you're not feeling it.  Also, soft foods like yogurt and such mostly slide through.  When you have puréed and solid protein, you will really start to feel it.  Trust me on that. But if you're still eating every hour... I think you need to call your NUT today and make sure 104 g of protein at 1 week is ok according to his/her plan. I'm no expert but that sounds high. Since you are having no issues with food and drink maybe your NUT will have you start eating just 3 meals plus 1 or 2 snacks. 

If they agree that 104 is too much at this point, or if you decide to get into the habit of 3 meals plus 1-2 pre planned snacks, you may want to set a daily plan ahead of time so you can be sure to hit your target without going so far over.  This practice is really helping me make sure I hit my minimum and stay in a healthy range. Check out the daily post on the RNY board called What's on your Menu Today.  (You will see it on weekdays.). This will show you daily food and exercise plans of many other people, and should give you an idea of portions and foods. Granted you may not be cleared to eat these foods yet -- at 5 weeks out I am still on limited soft proteins and no fruit, for example -- but it will show you portions and counts of people at various stages of the RNY journey.    

I am experiencing some hunger, not as bad as I used to have but it's certainly there.  One of the vets (Rocky) often says "Hunger is not an emergency."  I try to remember this.  If I'm a few hours from a meal and I've already had my ore-planned snack and am still hungry, I go do something to distract myself until the next mealtime.  Or drink some water.  A bit of chicken broth often quells the hunger if I'm really struggling, but most of the time I can just wait it out. I'm a terribly bad snacker/grazer so I really try to stick to my pre-planned snacks.

You've lost a fantastic amount of weight pre- surgery and you're basically a lightweight now.  That's pretty awesome!  But it also means you may be smaller than the patients your program is used to counseling and therefore you may need to push back on some of their direction so you can be sure you're losing at a healthy rate.  You may also lose weight a little bit slower than those of me (like me) who had a small pre-surgery weight loss, or at least, that's what I have read on here. 

As for your 1 pound loss at 1 week, remember that you may have gained 15 pounds in fluid in the hospital so your body is still losing the fluids. Don't compare your loss to others.  Read about people who didn't lose in the first few weeks and are now a size 4.  There are a lot of those stories on this site.  And also... How much weight did you lose before you hit the operating room?  That's right, you totally ROCKED your pre-surgery program so you're going to KILL it in the end, girl!  Believe it and be it.

________

137 pounds lost - from a 24/26W to a size 8/10!

 

(deactivated member)
on 5/11/15 9:47 am
RNY on 05/04/15

I gave up the "1 oz every 15 mins" when I realized I could get more than an ounce in. Now I'm aiming for 3 "meals" and 2 "snacks" per day, sipping constantly. Yesterday my mom and I went to a movie and I didn't have anything but tea and water between 3pm and 9pm, and I was STARVING when we got home! A protein shake worked well to dull the hunger though. Maybe it's all in my head. Portion control has always been a problem for me -- even when I was losing pre-op, I'd sometimes have 1200 calorie meals. I think I'm learning that I wasn't as prepared as I thought I was; I was just able to hide behind my metabolism.

Here's how I got 104g of protein yesterday (can you tell I LOVE milk?):

B - protein shake w/ 2% milk; 32g

S - sugar-free Jello; 0g

L - protein shake w/ skim milk; 24g

S - cup of 2% milk; 8g

D - protein shake (different brand) w/ skim milk - 40g

I love Rocky's "hunger is not an emergency" line. And I agree; the hunger I feel now is nowhere near as urgent-feeling as it used to be. But I still get "hangry" and grumpy when I'm hungry, although I think the mood swings I'm having in conjunction with my pain meds are contributing to that (I'm trying to wean myself off as quickly as possible).

I think you're right about my program not "fitting" my anymore. Thanks for the insight. I made my protein shake w/ water this morning since I know I'll get my protein in just fine (all through my book, it says things like "add milk for extra protein"). I sure hope to rock it, but this is certainly a curveball I wasn't expecting!

Ashley in Belgium
on 5/11/15 3:39 am - Belgium
RNY on 08/08/13

Okay, Deep Breath.

You are so early post-op, it's normal to feel overwhelmed and worried about doing things "right" and knowing just what in the world "right" is anymore as a post-op.  

Your nerves were cut - your tummy isn't sending you the same signals as before.  You can only measure and weigh out your portions and try your best to get that small amount in.  If it's easy for you to do it, then slow down, or just be glad that you aren't struggling!  I have never had to go slow or chew to excess - I was lucky I guess.  Follow your plan, fluid intake is as important as protein at this stage I think.  I ate 6x a day tiny amounts (still do in fact) and I am never hungry.  Things will settle out as you get to 2 or three months out.  It does get easier and more comfortable.  Just relax and go with it.  You've got this!  

As a vet on here often says - Hunger isn't an emergency.  Sometimes stomach acid and dehydration makes us feel hungry.  In my experience it isn't the total amount of fluid I drink in a day that matters the most - it is that the fluid was consumed throughout the day.  I get dehydrated quickly - like not drinking for 2 hours will make me feel nauseous and ill.  And please don't get hung up on other folks weight loss - you may be retaining tons of fluid from surgery, or be a stair step loser. It's a journey, not a race and we all get there if we stick to plan and are diligent.  Some just get there faster than others, but it's staying at goal that matters most!

Good luck!

Revision Band to RNY 8/8/13 5'4" HW 252 Lbs / SW 236 Lb / GW 135 lb / CW 127

(deactivated member)
on 5/11/15 9:51 am
RNY on 05/04/15

Thank you, I think I definitely do need to calm down! I think you're right about the signals not being the same either. I'm going to start making my protein shakes with water instead of milk since I clearly don't need the extra protein. I've also been suffering from really miserable and uncomfortable gas that my NUT thinks might be lactose intolerance, so maybe I can knock out two problems at once.

selhard
on 5/10/15 9:21 pm, edited 5/10/15 11:01 pm - MN
RNY on 11/26/12

Instead of sounding like you are messing up, you sound overwhelmed.  Kinda like when bringing home the first baby; you stare down at this little human wondering what to do with it.  Overwhelmed, yep, pretty sure you need to cut yourself some slack, do the best you can with what you know, use all the support you can grab onto to, and let WLS do it's magic.  

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