What could this be? With an introduction.

To give you a little background as to how I got here.......

I had a two level lumbar fusion 1/26/2013. Lots of pain and it really never healed right. I was left physically disabled. My weight ballooned from 320 to 425 due to a now (forced) sedentary lifestyle. Every doctor, PA, nurse, and family said I needed to consider having some type of bariatric surgery. 

So in June of 2016 I had the initial consultation for RNY. I was apprehensive. I went to the pre-surgical group meeting in October. I started the dietician monthly appointments that month as well. Due to some other medical issues, I had to undergo more testing to get clearance for surgery. Medicare was waiving the 6 month supervised diet and exercise due to my physical disability. I called the office on 12/13/16 to confirm that I had completed all of the steps required. I was told that she would get it submitted to insurance (Medicare) and I would be able to get it scheduled after the holidays. 

To my surprise I received a call the next day wanting to know if I would want surgery on 12/20 (so 6 days later) due to another person cancelling at the last minute. I said yes after it sounded like I wouldn't be able to schedule it for the end of January like I hoped for. (Note: When I talked to the PA in the hospital, that was the case as the busiest time of the year is right after the holidays)

So I had six days to learn about everything I needed to know, prepare for after surgery, get rid of any food I couldn't have, and buy anything that I needed. Dietician appointments up until then were going over what I was eating then.

Everything after surgery is pretty much going fine. I am following the diet. I did forget about one thing though. Back in November I scheduled my colonoscopy and as luck would have it, it was one month after I had RNY. Surgeon said that it would be fine to have it done. Since I was on a full liquid diet at that point, I figured that it would be best if I did have it done then.

I was very hungry when I got home from being Roto-rooted. Nothing to eat or drink since the night before was tough for some reason. I finally got home and made my bowl of cream of wheat and decided to have four ounces of fruit juice with it to take my morning medicines.

Now the fun part. Later that day I had diarrhea. Just like the time before when I chalked it up to my body not liking a certain brand of grape juice. There is no warning and no other symptoms. Just diarrhea. 

Could this be dumping? I can't figure it out. The juice is 100% fruit juice with no added sugar. Before the colonoscopy, I drank 8 oz of it a day without issue. Now I can't have any.

Fruit juice and fruit are pure sugar. It doesn't need added sugar, because the sugar was already there. You may as well have a candy bar as far as your RNY is concerned.

Outside of a few berries here and there, you'd do better avoiding fruit, at least until you hit maintenance.

It wasn't dumping, but between the carbs in the fruit juice and the carbs in the cream of wheat, it was your body telling you to cut it out.

Protein, protein, protein.

Believe it or not, the juice was on the clear liquid phase of the diet for the first two weeks. The cream of wheat is also on the list for the full liquid diet that I have to follow until Feb. 2. It is the whole grain one.

I had no problems with this brand until Monday.

I believe it, because I have seen some REALLY horrendous advice for post -op...  What Grim just advised you is correct.  Cream of wheat and juice are solid sugar.  Your focus must be on protein.  I defy you to find any successful vets on here that will tell you that grape juice (one of the highest, if not THE highest sugar juice) or cream of wheat was on their post op menu.  

What has worked for me -- until maintenance (and I don't even eat/drink these things at THREE YEARS OUT) -- no juices, very few fruits (perhaps a couple of berries) and NO PROCESSED CARBS (i.e.: cream of wheat).

I'm still new to all of this, but I do know that protein is where you want to be. It's harder when you are first starting on soft/mushy foods, but turn to things like cottage cheese, low sugar/sugar free (greek) yogurt, hummus, soft cheeses, etc (look up eggfaces baked ricotta, you can google it)... a lot of the nutritionists don't understand exactly how our new pouches work (they are only trained in Nutrition, not RNY, usually).

Ditch the fruit juices. try the no calorie water flavorers, there are a TON of flavors. 

The idea is to eat protein 90% of your meal. Then NON STARCHY veggies if you have room.

I am 8 months out. I measure out 2.5-3 ounces of dense protein, then add whatever veggie I'm having to make my plate 4 ounces total. at 6 weeks out, I was lucky if I ate half of the plate.

Also, check out the Daily Menu posts... they are PRICELESS in helpin you to find things you can eat that will maximize your weight loss. You only have 12-18 months to get the weight off, use it to your advantage.

And welcome to OH 

OMG stop!!!!  NO juice!  No Cream of Wheat!  You are basically taking your surgery and tossing it down the drain.  And any dietician or doctor who tells you to eat that sh*t so soon after RNY should be sued for malpractice... they are blatantly ignoring the dietary recommendations of the American Society for Metabolic and Bariatric Surgery!!!!!!!

Protein, healthy fats, maybe a green veggie if you have room.  Maybe. That is all you should be thinking about right now.  And if you don't believe me, believe the experts.  https://asmbs.org/patients/life-after-bariatric-surgery

Fruit sugar is still sugar.  Dairy sugar is still sugar.  "Natural" sugar is still sugar.  "No Added Sugar" can still have sugar.  Take charge of your health and your life.... and please realize I am not mad at you AT ALL... I am just incredibly mad at your surgical team for leading you astray.

Audrey

For now, I have to follow the diet I was given. I am still at the full liquid phase. Anything that can be pureed, greek yogurt, SF pudding, SF jello, 1% or skim milk, 100% fruit juice (only 4 oz. per day).

My diet right now:

Puree's once per day, 16oz. max with at least 3oz or chicken, meat, or fish in the 16oz. Over the course of 1 hour.

Whole Grain Cream of wheat 2tbsp with 2/3 cup milk. Once a day. I am allowed to have grits but hate them.

Greek Yogurt 5oz plain. Once per day. (I usually have this for lunch.)

Pudding 4 oz. for snack.

Water 64oz

Protein shakes. 2 per day. 28g protein in each one. Made with 1 cup milk and 1 scoop protein powder. 1 after breakfast and one with snack.

The purees have been chicken or beef with broth. Maybe some milk. 

I lost 30 pounds in the first two weeks after surgery and 50 pounds in the first month.

You mean I should have lost more? Everyone has seemed very happy with what I have lost.

You lost a lot of weight because you started at super morbidly obese.  I know -- I was also super morbidly obese -- it's almost impossible not to lose a lot of weight right after surgery. 

 I also did a full liquid phase and a pureed phase -- I didn't have cream of wheat nor juice.  My stomach also didn't hurt. I never had diarrhea.

You can ignore those who have already done this successfully.  It's totally up to you. 

You have done great.  You should be incredibly proud of yourself.  

But everyone loses at first.  The key is to keep it off.  Right now your re-arranged and shortened intestines and stomach cannot absorb calories or nutrients properly.  As someone here once said, you could eat a box of candy bars and a dozen bagels a day and still lose weight in the weeks and months after RNY (if our poor stomachs had room for them lol).  Especially with a higher starting weight like you or me... we lose more faster, in the beginning.

But then after the malabsorption goes away in a year or two as the intestines repair themselves and the stomach expands a bit, you realize the folly of high carb, high sugar post-RNY diets.  Newer research suggests we have messed up our metabolism so much thanks to super morbid obesity, that unlike "regular folks" we have to completely rethink the idea of calories vs. carbs vs. fat for the rest of our lives.

Greek yogurt (in fact all yogurt) has more sugar than you might think.  Puree a hard boiled egg with some mayo and you get the same protein bang for your buck, and almost no sugar or carbs.  

Two cups of milk (whether skim, whole or otherwise) is 24 grams of sugar.  Replace it with heavy cream for similar protein levels and again, almost no sugar.  

And read the labels on your protein shakes.  What brand are they?  What is their sugar/carb content?  What kind of protein?  Can you make up any of that with the sugar free jello, pureed tuna salad, other meats, broth, etc?  Many of us need protein shakes after surgery, don't get me wrong... but two a day is a lot.

2 tbsp of Cream of Wheat may not seem like much, but even that small amount provides about 8-10 g of carbs that could be replaced by a protein, healthy fat or non-starchy veggie instead.

And vitamins, vitamins, vitamins.

You will find many, many people on this board who choose to follow research and evidence-based nutrition practices instead of what their surgeon or dietitian (who often have never been super morbidly obese themselves) tells them.  That of course is up to you... and I am certain that there are some here who would disagree with some or all of what I just wrote.  But I am speaking from a position of successful long-term weight loss maintenance.... and I want others to be successful too.

Audrey

You don't HAVE to follow a crappy plan. And that is a really, really crappy plan they have you on.