Dietary Stages After the Gastric Bypass

I had my surgery 18 days ago, which feels like almost a lifetime when you're really not eating. I was looking ahead to see what will most likely be approved for food for me to eat as of Tuesday, which is when my appointment with my nutritionsist is. First, let;s go over what is allowed when a patient first comes home from surgery. The following list was provided by UMasss Memorial in Worcester and could vary in different parts of the US depending on the program you are on. This is just what you may be able to expect. ALWAYS follow what your doctor gives for orders and never vary.

1. 4 Ounces of a sugar free nutritional supplement every 2 hours, 8 times a day. (Carnation Instant Breakfast - No Sugar Added is recommended) with milk.


2. Water


3. Sugar Free Beverages such as Crystal Light or Sugar Free Kool-Aid


4. Coffee or Tea (preferrably decaf)


5. Bouilllon or broth (no salt added is best)


6. "Flat" diet soda (preferrably decaf)


7. Tomato or V-8 Juice


8. Sugar Free Popcicles (less than 20 calories each, limit 2 per day)


9. Fruit Juice without added sugar (no more than 4 ounces per serving with a total of 8 ounces per day.)


10. Gatorade (no more than 8 ouunces per day)


11. Sugar Free gelatin

I have been

2 Weeks After Surgery

Last night marked two weeks after surgery. Today I weighed in 30 pounds less than I did 2 weeks ago.

I had my doctor's appointment today. Actually, I saw the Nurse Practitioner. She removed my staples, thank God. She went over a few questions about how I was feeling and stated that everything was looking good. My one concern, infection in the largest incision, did not occur. It was still open, by that, I mean, the incision was very deep and that was still evident by the gap between my skin. It is not fully closed. She put some steri tape on it, which should stay on there for 1 week and that should help close it. She advised that if I used cream on the other scars it would help to soften the skin and clear up the scar tissue.

I have been cleared to go to the beach and in the water for short periods, but I cannot swim in pools for another week until that one incision is closed completely. The reason for that is the high concentration of bacteria in pools is too high. The ocean is fine because the water is moving and dissipating the bacteria and is not in such a high concentration in one area. The heat wave is over now and there is a hurricane coming up the coast this weekend so the beach is out. Next week will be in the high 70's only so we may have to forget that for this year unfortunately.

I am looking forward to a great night sleep tonight without the staples in. I am currently lying on my side as I type this. I feel much more comfortable.

I visited work today. I originally had 4-6 weeks approved for recovery. The nurse said I was doing well and as long as I can increase my protein grams per day from 30 up to 40 I shouldn't be as tired and can go back to work as early as next week. My mother thinks I'm crazy because I have all that time approved, but I'm not doing anything with my time at home. At least if I start out early with half days it won't be such a shock to my system when I go back full time. I'm just lucky I like my job. I wouldn't recommend that everyone do this. If your job is a very stressful one, take the time to take care of yourself and get used to the diet before going back. Some jobs are just too stressful to do both. I am able to drink and have food at my desk so if I need to, I am still able to take care of myself there. Starting off with half days will give me the ability to see where my body is at as well. I am still VERY tired and need to take a nap during the day. This way I will know how much my body can handle as time goes on but still get the rest I need in the beginning.

DON'T OVERDO IT!

I made the mistake of overdoing it yesterday and was worn out by 12. I had run many errands and spent too long registering my son in an overheated high school. By noonish I was drained and my incision was burning. I had spent too much time in the car as well. Sitting in this position had my incision folded into itself and the staples were rubbing against the skin, irritating the area around it. I was exhausted but couldn't sleep, and I didn't feel like drinking anything. It was 96 degrees outside and that was not a good way to be feeling. I knew I needed all the liquid I could get. As a result of this 4 day heat wave, I drank more water than protein, trying to not get dehydrated. This just exhausted my body. It was nice to be able to visit my parent's during this time. They have a fabulous A/C. It was a savior. So was the company. Try not to spend a lot of time alone. Not only is it important to be able to talk with others, but you can also have them remind you to drink if you're struggling with it.

Listen to your body if you have had the surgery. Even if you haven't for that matter. You have to be aware of what you need or you could find yourself in a dangerous situation.

FOOD CRAVINGS

A few days ago I had a food issue. I wanted it. I was near a Subway and they were baking fresh bread. The smell was intoxicating. Of course, after that, I noticed EVERY fast food place for the rest of the day. But what I really wanted was a piece of buttered toast. I have also wanted the end triangle, the first bite of a piece of pizza. No more than that, just that bite. Even though the desire is there, the temptation is not. I am very secure in the fact that after this long, if I tried to eat anything like that, I will become violently ill. No thank you. Nothing is worth that at this point. I had a Tic Tac Bold yesterday and as soon as the taste of peppermint hit my stomach I had to spit it out. It was too powerful and my stomach didn't approve.

I have noticed my bad food habits as well. I have this voice inside that tells me when to stop, or what would be good at a given moment. I didn't realize how many times a day this voice kicks in and how often I had listened to it in the past. If I don't give in to it, it keeps going with the next suggestion like a sabotaging enemy. I just acknowledge it now for what it is and keep going. It's nice to recognize what it is with the tool of the surgery behind me so that I can't give in.

I have one week left before I start eating foods besides the liquid. I'm very nervous about it but I think I will be fine because I am very mindful of what my body can handle. I'm hoping it will be easier to get all the protein in then. A bite or two of chicken sounds like something I could really look forward to.

Surprise Weight Loss

I woke up this morning and got dressed in my usual clothes. I was swimming in them. So I made a trip to my closet and pulled out a bag of clothes that I have not worn in 2 or more years. I couldn't believe that, not only did they fit me, but they were also too big. I was excited to know I have clothes for my new smaller size, but now I still need to go down one more size. All this in 11 days!. I didn't expect things to be going this well.

I went and got weighed the other day, Wednesday and found, that one week out of surgery I had lost 10 pounds. I was impressed. I added that to the 30 I lost before the surgery and was very happy. But today, I was shocked. It is Saturday, just three days later and I have lost 12 more pounds since Wednesday. I was astounded!

I've started noticing encouraging things about my body. I have ankles now, for one, and feet! They have been bloated for so long, holding on to water weight. They are thin now. My face is starting to change. starting to slim down too. My eyes are more prominent now and, as a friend pointed out yesterday, less pain is visible in my eyes. There isn't a part of me that isn't smaller, including my wrists. It's refreshing.

I've said it before, it's not ALL about the weight loss for me. It is about my health and how I feel. As I tell everyone who asks, each day is better. I am no longer taking my antidepressants and I am off my blood pressure medication and my sleeping pills. (I'm not sure if it's too early to be off the sleeping pills though.) I slept on my side last night and actually got more sleep. I woke up with no discomfort. I am still irritated by the staples but they will be gone in a few days.

I am concerned about the heat wave coming up. I can't get dehydrated and with the small amount that I am drinking I really have to stay cool (without being able to swim). Just something to watch.

A friend shared a bit of her story with me the other day. The results from this surgery never seem to amaze me and she is one with another inspiring story. Each story I've heard is so different from the one before. Joy has lost 160 pounds since the middle of December. How truly amazing! I am so truly inspired and proud to have people like Joy to be able to turn to for advice I know I'll need. Thanks Joy, for being there and opening up to me.

The First Week Out of the Hospital

I have been home from the hospital now for a full week. The first two days were the most difficult but with each passing day it gets easier.

Friday and Saturday were the toughest. I was still in a great deal of pain and it was difficult to move around. I don't like asking for help when it comes to moving on my own but I had to a few times. My husband was here and I had my two teen-aged boys willing to assist as well.

The most difficult thing for me was dealing with guilt. I was struggling with getting in enough liquids and feeling that if I didn't get more in that I would end up dehydrated. I was sipping as often as I could but could only partake of one or two sips at a time. My stomach was upset every time I took more than a sip, which was very frustrating. This led to me becoming emotional about the situation and feeling depressed.

Taking the pain pills was getting to be more of a hassle than something that was helpful. I had to crush them up and they were very hard to swallow with one sip of water so I stopped taking them on Saturday, the day after I got home. I had moderate pain but it was manageable. All other pills need to be crushed up before taken as well. I am taking a chewable vitamin, calcium (Tums), Vitamin B12 and Ranitidine to coat the stomach.

I spoke with the Doctor's office on Monday. As long as I was no longer taking the narcotic pain pills I was allowed to drive but also told to take it easy. I don't recommend planning on going far if you do drive the first week home. It is still very uncomfortable going over bumps. It is nice to know you have the option to go out instead of being couped up in the house for days on end.

There were food obstacles the first week. I know better. I knew I wouldn't eat anything, even taste anything off the diet. I am so afraid of getting very sick. But my husband wasn't thinking and made turkey club sandwiches for himself and the boys one night and fried up the bacon in a pan on the stove. I had to leave the house for a while until it was vented out a bit. I had the recurring image in my head of me standing over the stove one and consuming half od what I cooked. Bacon and sausage are two of my biggest downfalls. I kept dwelling on this image as long as I could smell it.

The second issue was when Mike cooked one of my favorite meals for dinner, pasta with ground sausage and garlic Texas toast. It was the smell that bothered me. I just went upstairs and relaxed up there until the family was done eating.

My old habits have not died yet. Dinner is my hardest time. I still want to ask what is for dinner and look forward to the meal. I also found that when I'm out of the house, my mind tells me to stop for certain foods. It's not a cravings that I have, but a habit that is embedded deep in my subconscious. That's going to take some time to get rid of. It makes me realize why I have failed in the past. Physically not being able to have these foods has obviously made me more aware and I cannot give in to ideas like this or I would end up sick and back in the hospital.

I have woken up hungry in the past few days. It's not that hunger I used to feel where I'm desperately in need of something. If I take a couple sips of water it goes away. I am still on the same diet, Carnation Instant Breakfast - No Sugar Added Drink, chicken broth, Jell-o, water - flavored of unflavored, flat diet cola (which I stay away from) and an occasional Popsicle (I am allowed no more than 2 a day of the 20 calorie or less type.) I does get a bit monotonous but I don't think about it.

I had 5 incisions. They are healing nicely, except for one. I hate my largest incision. It is a bit larger than an inch in length with two staples on one side and three on the other side with a hole in the middle. I'm not sure why they did not staple the middle but it leaks on occasion, especially after I shower. I spoke with the Surgeon about it and he said that is normal. He would have been concerned if it was accompanied by a fever, redness or swelling and I did not have any of those. It is not pleasant to look at though.

I have this weird feeling in the center of my abdomin like there is a incision there with staples. It must be where the new pouch is.

I couldn't stand the not knowing and by Tuesday I made a trip to my primary care physician's office and asked if I could use their scale to weigh myself weekly. Thankfully, they did not have an issue. I have lost 10 pounds in the first week. I was a bit surprised because my body seemed to be in starvation mode, holding on to all the liquid I put into it. My ankles were swollen and I felt bloated. It wasn't until the end of the day that I noticed that I was starting to go to the bathroom every hour or so. I was finally flushing it out.

My stomach feels like it sets differently on my body. I'm not sure how else to explain the feeling. I guess it sort of feels smaller (the outside). It has been in the past two days, (days 9 and 10 after surgery) that I can actually start to see a difference in my body. It is refreshing.

I still do not have a lot of energy because my intake is still not entirely where it should be, but I make sure I more around as much as possible. I want to start walking more today. I have only been walking short distances this past week.

As I mentioned, there are improvements with each day in the level of discomfort, the amount I am able to consume easier and the way I move.

In closing, I would like to mention the gas. With every sip it seems, I have the urge to burp but it doesn't always come up. This makes my stomach uncomfortable and it is bothersome. Moving helps to get that out, but it can be painful at times.

The Surgery and Hospital Stay - 8/4/09 - 8/7/092

On Tuesday morning, we arrived at the hospital for our 10:45 AM appointment and we were immediately put in a prep room and told that they were already ready for me upstairs in surgery. I said goodbye to Mike and he left with my clothes and shoes.

They wheeled me down a few halls on a bed and into a large open room with curtain separters. It took them several tries to get an i.v. in. They were warned in advance that my veins rolled, and that's exactly what happened. The Surgeon came by as well as each member of the team and introduced themselves to me and asked if I had any questions. It put me at ease a bit.

I was in that room for about 20 minutes while they prepped me for surgery. I remember being wheeled down a few halls and going into an elevator. I don't remember much after the elevator doors opened. I was given anesthesia at some point in the room downstairs but I don't remember. The time was about 11:30am.

At 6:20 PM I caught myself arguing with someone. I was trying to get off the bed to go to the bathroom. I couldn't understand where I was and why this felt real but felt like a dream. I was coming out of anesthesia. It took me a few minutes to understand where I was and what had happened and to completely get my sight back enough to focus on anything. Everyone kept telling me I had just come out of surgery and that I had a catheter in. You can't imagine the releif I felt knowing the surgery actually took place this time.

I was still very groggy when they wheeled me into my room about 30 minutes later. I was told the surgery lasted 4 hours and I was in recovery for 3 and half hours.

I was on a morphine drip which I was in control of. I was able to push a button to release a dose every 6 minutes, which, I was always pushing too soon. The pain was manageable but I was very loopy. This was confirmed later as well, by the guests who were there to visit.

I had four incisions with staples. One was just above my belly button, another about five inches above that, one on the center far right of my stomach, and the last one was about two and a half inches from the top center one, to the left. This was the worst one. It was the largest and I can't remember if there was something there, but it was never stapled all the way. There was a hole in the center of it. I also had a drain tube coming from my left side which was draining blood from the surgerical site. I had a catheter which had been placed in while I had been under anesthesia before the surgery.

After my visitors left I just wanted to sleep. I remember feeling like I had been asleep for hours when a nurse had come in to check my vitals. I had only dozed about 20 minutes. The first night was vey busy. I was checked on often. My morphine bag needed to be changed, the drain tube adn catheter needed draining, my incisions were tended to and redressed, my vitals were taken and my C-PAP machine was hooked up and oxygen was filtered through the mask when I was trying to sleep. I had "boots" on my calves. They were like blood preassure cuffs. They would pump up every couple of seconds, (not as tight as a blood preassure cuff though), one leg at a time to keep the circulation going until I was able to walk. I also had fluids being pumped in my system because I hadn't had anything to drink since Monday night. Needless to say, it was a non-productive night of sleep, just dozing. If I rememeber correctly I was able to have water after I was in my room. A styrophome cup with ice was on my tray table at all times with one once measuring cups from which I sipped only.

In the morning I was able to eat. I wasn't really hungry though. They brought in a one ounce cup of Carnation Instant Breakfast - No Sugar Added Chocolate drink. I had to sip that. It took me a while to get that down. Most of the day was the same as the night before, trying to sleep as much as possible in about 20-40 minute increments. I noticed that my pain had increased a bit and they gave me an additional pain reliever. I was high at that point. I don't know really what I was saying. No one else could understand me very well either from what they said. My voice was also still very horse from the breathing tube that was down my throat during surgery (which I never knew about until later.)

I remember trying to call work. I work in a call center and for the past year and a half I have probably given out our phone number over 150 times in one day. But because I was under so much pain medication, I kept getting a sex line when I dialed our number. It happened twice.

Later in the day I was talking to one of the nurses about being a DJ. I had my laptop there so I could work on my music data base and was getting ready to do so. I told him I'd play him a song. When I tried typing in his request, I couldn't. I tried several times and was not able to find my hand-eye coordination needed to type the proper characters. I was pretty amused but frustrated.

Later in the morning, still the day after the surgery, they had me go for a short walk around the halls to increase circulation. I was able to roll onto my side and push up to get out of bed. It was a bit tough and it did hurt, but with a push of the morphine button I was back on track.

They removed my catheter on Thursday I believe. It was like being 3 again, everyone was praising me for peeing in the potty! There was a plastic bed pan like catcher that fit on the rim on the toilet which meassured how much urine was excreted. This was to be sure I wasn't getting dehydrated.

They started bringing me "meals" on Thursday. They consisted of 1/4 cup of sugar free Jell-o, about 1/2 cup of broth and 4 ounces of the Carnation Instant Breakfast. I never could finish it all before they brought the next meal. It was way too much.

The nurses would scrub my back and they left a basin of soapy water with a wash cloth and towel in order to give myself a sponge bath. That was refreshing. I was able to change into my own pajamas as well, a bit of home. This started on Wednesday. I remember that it took a while but was not as uncomfortable as I imagined it to be. I do have one regret. I did not wash my hair while I was there. There was a sink in the room but it did not occur to me to wash my hair in the sink because my balance wasn't where I'd wanted it to be in order to do that. By the time I left, my hair was embarrassingly greasy.

Here comes the funny part... When they set me up to give myself a sponge bath, they also gavc me a banana boat basin, a cup of water, a small tube of toothpaste and a little toothbrush. Day one was fine. I had no problem handling such an easy daily task. Day 2, however, was a different story. I started brushing my teeth and thought to myself, "Why can't I taste the toothpaste? It's not foaming in my mouth like it usually does. I kept brushing. Then I put more on my toothbrush. Just before putting the tooth brush back into my mouth I looked at the tube. I had brushed my teeth with Vaseline. I felt like a moron. I had to ask for a new toothbrush and water. The staff got a good laugh out of that. Thankfully, I didn't swallow anything, gross.

There was a television in the room that worked but I had found a chanel that had soothing pictures and soothing music. I kept it there most of the time. I didn't have the attention span to watch anything until Thursday because I was just too tired.

On Thursday, the Surgeon came in with his surgical team and went over what I should be looking for and concerned about after my release. I was released on Friday around noon.

Tonight was my "Last Supper" and I'm regretting it. My stomach is upset from what I ate and I don't blame it. We went as a family to Texas Roadhouse. Their rolls were to die for, well, I shouldn't put it that way. I could have had just rolls and peanuts and been happy, but I ordered a burger too. I can't stand feeling this way.

From here forward I am on liquids only. Tomorrow is the day before the surgery. I am able to have some regular liquids in the morning, but after 12:00 it can only be clear liquids. I'm not worrried about it. I plan on picking up an extra large bottle of water in the morning and refilling it at lunch time. I may also buy a V8 Fusion for breakfast.

It will be a very busy and fast day at work tomorrow as I prepare for someone to take over for me while I'm gone. When I get home I wanted to steam clean the hallway and pack. Depending on what time I have to be at the hospital will force my early or late bead time.

I can't believe it's almost here!