Yesterday I had my NUT and Pulmonary appointments at the hospital and then my PT appointment. The NUT one I’ve really been looking forward to as it seems like each surgeon’s NUT here has different plans for patients to follow, so I was anxious to see what my diet would be (some NUT’s diets here seem a little crazy to me). I’ll have to tell you that I came away VERY happy.

Here are the basics of my plan:

PHASE 1 (1-2 wks) Goal is hydration (64oz fluids). Clear sugar-free liquids, skim milk, fruit & vegetable juice (all these count toward liquid ttl). Start chewable multi-vitamins. NO protein goal (she says you have enough nutrients stored that you’re fine for a week or two), NO protein shakes.

PHASE 2 (about wks 3-4) Goals to transition to food, increase nutrition. Use all phase 1 foods (64oz. liquids) plus mushies. Eat 6 small meals with portions ¼-1/2 C, and only eat for 30 min. No liquids 1 hr. before, during, and after meals. Protein – at least a few Tbs-up to ¼ C/meal, then other mushies. NO protein shakes.

PHASE 3 (about wk 5 or 6) Goal adequate nutrition and weight loss. Continue liquids rules/amounts, 3 meals no snacks, <1200 cal, <1.5 C ttl. per meal. At least (per day): 6-9oz (about ¾-1C) protein, 1C Vegetables, 1C fruits, 1.5C grains/starches, 3tsp Fats. NO protein shakes (not expected to meet all these amounts/goals until about week 5). Avoid: high fat/sugar (in moderation and add to cal. for the day), stringy/tough/course foods you can’t tolerate (may be able to eat if you chew very well).

So here’s why I’m so happy with it. I’m basically following the new food pyramid (with smaller amounts/cal. to lose the weight) so it’s a very balanced diet. Basically no healthy food is completely off limits unless you can’t tolerate it (i.e. Raw celery may be too stringy, untoasted bread may be too doughy, but some CAN tolerate/eat these). I hate most low-fat condiments so I just need to use less and figure the cals into my daily totals. Did you get that I don’t HAVE to drink Protein Shakes…EVER, and she said even though they’re protein, they are high in calories compared to the satiety you get from them…they are sliders so you will feel hungry way sooner than with a food protein (I couldn’t understand why people are still drinking these years later, but whatever works for them). So far, this was the diet I was hoping for. Just healthy eating in smaller portions! We’ll see about the pre-op diet when I go to the pre-op class.

Pulmonary was simple as I’ve been to this Specialist before. I have Adult-onset Asthma and found out at the same time that I am very allergic to everything environmental (diagnosed with both in ’07 after 12 weeks of bad coughing...more debilitating than you think) and after several misdiagnosis’. My lungs have been so much better with my daily meds. Sleep lab is a pre-op my surgeon requires. My PCP had already sent me this past fall to the sleep lab as I was having a lot of trouble sleeping and my Dad has very bad sleep apnea (apparently I just snore a little, no apnea). Once I started the next month on meds. for my chronic migraines one of the side effects from that drug is deeper sleeping, so that’s helped me a lot with getting back to sleep (I think the back/shoulder problems I have wake me up, so maybe the PT I’m doing will help as well).

So two more pre-ops down, and only the Cardiologist visit next week and then my Pre-Op class left in April!

Oh, I got my neck and shoulder x-rays back before going to the PT yesterday...small amount of arthritis/degeneration in my shoulder, no problems with the shoulder blade, and the PT was right, the main issues are in my neck right where she thought (C5,6,7). I have arthritis, bone spurs, degeneration, one bone that has slid back a little and disc space narrowing which is pinching the nerves...that's what gives me the pain in my shoulder, down my arm and the numbness in my hand. The neck...which doesn't really bother me...who knew?