I'm sorry if I've stepped on anyone's toes

As a reaction to a post a couple of weeks ago from a woman who was having a hard time eating her double cheeseburger from MacDonalds, I recently posted about a resource book called "Before and After" by Susan Maria Leach. It was one of the books highly recommended not only by my surgeon's office, but also by a friend back east who had WLS 5 years ago, and calls it her "Bible". I've been researching the RNY prodecure since Carney Wilson had it years ago, reading everything I could get my hands on. At 55 years and 312 pounds (with many rounds of Weight Watchers, Dr. Atkins, South Beach, NutriSystem and other programs beneath my belt), and with painful osteoarthritis in my knees and hips, I finally decided this summer that quality of life was much more important than the unhealthy diet I'd been consuming and the way I was living. I attended a seminar given by the surgeon (who works with Rose Hospital Bariatric Center of Excellence in Denver - and has done over 2000 surgeries), talked with some of his patients, began going to support groups ad nutrition classes, and jumping through the insurance hoops I would need in order to get approval. I had two options - a 6 month physician-supervised weight-loss program with documentation, or a three-month "fast track" where I saw both my PCP and the dietician for three months and began an eating plan mandated by the dietician. I chose the fast-track option, and have been eating a normal post-op diet since then - six small meals per day, each one about 200 - 250 calories, and 75% protein and 25% carbs, as her plan recommends, with no more than 25 carbohydrates per day post-op. They prefer that I get my carbs from vegetables and fruit. I never said I was not eating vegetables and fruits (I know all about "good carbohydrates" and "bad carbohydrates"), however, with the other carbs I need to work in (like ground flax seed, and other fiber) - it's not easy to get a lot of vegetables and fruit in there and still stay under 25 carbs per day. Heck... a quarter cup of sliced peaches is 4, a quarter cup of brown rice is 11, a half a cup of chopped broccoli is 6, and a half a cup of mashed potatoes is 18.5. According to both the surgeon and the dietician (who works with him) - sugar and too much fat will almost invariably cause dumping syndrome (something so unpleasant you don't EVEN want to go there), but if for some reason it DOESN'T cause dumping syndrome - it still isn't something that should be included in your post-op diet because of the way it creates an insulin loop with high-and-low-blood-sugar levels. And I was told that refined WHITE carbohydrates, including potatoes, rice, pasta, bread, popcorn and chips, were also to be avoided like the plague in the post-op period after you get to the "normal food" stage. However, they DID say that whole wheat pasta, whole grain breads, and brown rice were okay in very limited amounts - but they still preferred that I eat protein first, then if there was room, vegetables or fruits, and finally, the whole grain carbs. The nutritional notebook they gave me is very specific on what I should eat, and in what amounts and what order. I ordered a beginners kit from one of the bariatric eating sites, with samples of Nectar Protien, Matrix shakes, sugar-free puddings and other things, and have been trying them out. It also contained the "Before and After" book. I read it in about 3 days. Almost without exception, her book echos everything my surgeon has told me, and also the bariatric center at the hospital where they hold support groups, nutritional classes, and exercise classes. YES, I understand that I will have to take nutritional supplements for the rest of my life. I also understand that there are many options for "snack foods" like the high-protein soy chips from SmartForme and stuff like that. But as I said before... we have ALL OF US - EVERYONE ONE THIS BOARD - worked so hard to have this opportunity to turn our lives around, that I don't understand why someone would be eating a MacDonald's double cheeseburger, or challenging their pouches by deliberately eating sugar, drinking carbonated drinks, or eating refined carbohydrates in place of their protein just "because they are able to without feeling bad! We've all been given a second chance at life, and I want to see all of us succeed. So, once again, I apologize if I came off too pompous or "know it all".... and I wish the best of luck to all of us.

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