SummerTimeGirl
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Update On Me (Surgery: 5/19/21)
SummerTimeGirl posted a topic in General Weight Loss Surgery Discussions
Just wanted to fill people in on what my experience has been like thus far since surgery. If you want to know something I forgot to mention, please don't hesitate to ask. HOSPITAL STAY: So I had my surgery May 19th around 10:30 am. I was in recovery and waking up by 11:45 am. All that went smoothly. The first day I was so dang tired that I drifted off and on while sitting in the chair in-between walking around and drinking. I felt bad for my husband who stay with me all day. He was totally content and happy to be there but I knew he too was tired so about 7pm I made him go home (visiting hours ended at 8 anyway). LOL When I first got to my room I was like, OMG I have HORRIBLE burning like heartburn and even complained about it. They gave me some sort of Gas chew and it didn't do jack. It wasn't until I got up and walking around that I figured out it was NOT heartburn but related to that gas inside and the walking helped that feeling subside. They gave me nothing but water or Gatorade Zero while there and I was totally fine and content with that. They mentioned medicine if I was nauseous but I never was. I felt totally fine and normal but for the one incision site that's to the right and up from my belly button. Doc said that's the typical complaint spot and where he pulls the extra stomach through so that's to be expected. But it hurt like hell when first standing from sitting and also wiping after peeing. Uggghhh. I slept in a chair sitting up that night when I could sleep which really only amounted to 3 hours total. I was given Tylenol for pain and an Oxycodone once on that first night. They sent me home with the Oxycodone too for pain and so far I have only taken it once at night to help with that pain while sleeping. The next morning they took more blood work and everything came back good and they allowed me to go home by early noon. Mostly because my pain was managed by meds and because I was easily able to get enough water down and I was not sick. Also, I did not pack much but I did pack my cell phone, charger, kindle, Biotene, Chapstick, brush, toothpaste and toothbrush, extra underwear and that was it. I did not use ANYTHING but for my brush and, right after surgery, put on my own undies and a pad since I got my period the day before surgery. I did not even use my cell phone (maybe once to post here) cause I was just so dang tired (plus trying to get my liquids in and walking) and hubby did all the updating to others for me. I mostly watched TV as it was on for background noise more than anything. MOVING AROUND: Every day is getting better but this dang incision spot is a ******!!! Can't wait for it to stop hurting cause I'm really tired of sleeping sitting up. I tried every way possible to lay down and it's just not possible! The dang area feels like it's burning and tearing apart when I do. Otherwise I'm following orders and walking around. I do not feel I still have a lot of gas issues but I most definitely feel like I am swollen about my stomach area for sure. APPEARANCE: I was actually surprised at how weird my stomach looked after surgery. Normally my stomach is smooth/one size all over and flat/round-ish (except for my little fat pouch right under my left breast that's been there forever). But upon looking at my stomach after surgery, I feel like some spots are like poofed out and others dented in, if that makes sense. Especially the bad incision spot. Strange. Not sure how else to explain it. Today is day 4 and it looks like I'm starting to bruise around most, if not all, incisions. Just slightly. FOOD/WATER: So my after diet consists of 2 weeks FULL LIQUIDS, followed by 1 week PUREE, and 2 weeks SOFT FOODS, then finally normal foods. Strange enough, I have had NO problem getting in 64 oz of liquid at all. I've had no chest pain, full feeling or sickness. A few times I had what feels like if you drink too much how it creates a sorta air bubble that hurts for a split second but then it passes. Otherwise, no issues. In fact, a few times after trying to drink/gulp like I normally would, I had to stop and remind myself that I no longer could do that. So weird cause I feel, aside from the incision pain, I would never know I even had surgery. So right now since all I've been able to ingest is liquids, I'm not sure if this is gonna be a blessing or an issue. On one hand I'm glad I can seem to "eat" and drink normal and also have had no aversions to taste. But on the other hand, I worry that will not help me in the long run to lose weight. This remains to be seen but I am scared I won't lose for this reason. So far I've had protein shakes, water, Gatorade Zero, the broths from creamed soups, sugar free popsicles and that's it. MEDICINE: I was told I wouldn't be able to swallow anything bigger than a tictac. That was a lie. I have been able to swallow all my pills, even the big ol Metformin, with no issue. POTTY: Had my first BM on my second day home. Had several a day since. No problems there either. WEIGHT: Not that I expected anything yet but, I have gotten on the scale and it's the same as it was the day of surgery. I think that's it. Can't think of anything else right now but if you have any questions please ask. -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
UPDATE: It's been a while since I've been on and posted so I figured I'd so so quick. ABSOLUTELY NOTHING has changed for me!!! Still stuck at 235-ish (and have been since the end of last Oct) and can't seem to lose anymore no matter what the hell I do!! I did start Rybelsus a few months ago and made it through a month of the 3mg dose and a month through the 7mg does. Then, when my doc put me on the final dose of 14mg a few weeks ago, my insurance suddenly decided it was no longer gonna cover it!! Not sure why the allowed the other doses/months and not the new one. Doc and I are trying to appeal it (cause it costs about $1300 out of pocket a month without insurance and has no generic). Their one reason was that I was NOT a uncontrolled Type 2 Diabetic. They also said I needed to be in a weigh loss program or seeing a weight loss doctor in order to have it approved for weight loss reasons. I asked my family doc if my surgeon qualifies as that and so he sent him a messaged asking the same thing. Just wondering if it is a matter of the surgeon prescribing it vs. my family doc. Who knows. Anyway, just waiting on hearing back about that. Not even sure that will help me either. Don't know what else to do and just trying to accept the fact that I most likely will be at this weight forever. Which SUCKS!!! I wanted to get down to at least 180. I'm swimming damn near 4 hours every day or walking for at least an hour and of course depending on who, doc wise, I speak to they each have something different to say. Walk less, walk more, walk slow, walk fast, do weights, don't do weights......UUUUUgggggggggggghhhhhhhhhhh! I've tried it all. Upped water, lowered water, ate more protein, ate less protein, ate more food, ate less food, just don't know what else to do so pretty much just been living my life doing whatever. Haven't been logging my food for months but not doing anything really different food wise than I was when I was logging. Just wondered if being so strict and regimented was maybe causing the stall so I stopped but I guess that wasn't the case either. Anyway, that's that. -
May Surgeries - check in!
SummerTimeGirl replied to ChunkyCali's topic in Gastric Sleeve Surgery Forums
WOW! You all are doing AMAZING and I'm so proud of you all!! Congrats!!! I on the other hand will hit my 1 year anniversary on May 19th and still have at least 50-55lbs MORE to lose! However I HAVE lost about 74 since surgery and about 94 since last March. As most of you know I have been stalled since about October. No real new weight loss since then. So about a week, week and a half ago my doc took me off Metformin totally and onto Rybelssus. Just had my yearly check up with my surgeon yesterday and he agrees with this new change. Despite all of that, my surgeon reminded me that their goal, around the one year mark, for me was to be between 201 and 234. So, I'm not far off from that I guess technically. Just sucks that I've been stagnant for so long despite all the different things I've tried as per my dietician and eating correctly and exercising. Anyway, hoping this Rybelsus kicks me out of this stagnant phase and I too can see numbers under 200! Congrats again!! -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
I have been lucky with the fact that I have NOT had issues eating at all. I also haven't had any sort of aversion to any foods. My frustration with it all comes with the fact that even way before surgery foods that normal dieting people would eat like brown rice, sweet potatoes, whole grains, fruits, stuff like that, would stall me or make me gain weight. I expressed those fears to the nutritionist before surgery and now after. But she keeps suggesting I add and have those things in my diet and that there is no reason why I shouldn't. I guess I'm just trapped in my old bad ways of thinking and my bad habit of trying to omit them and it gets to my mind at times. I'm always like, it must be nice to be normal and not have to think of every morsel of food you're about to put into your mouth. Or worry over it and how it's gonna make you stall, not lose, gain, etc. My long stall also has me wondering if my PCOS and IR may still be causing me issues when it comes to my hormones and inability to lose due to it. I've been looking into supplements for it but have yet to bite the bullet. The one that seems to come highly recommended by many docs is kind of expensive but I hear great things about it. I am wondering if that coupled with the Rybelsus will help get my hormones and stuff in check IF that is or may be what's stalling me? -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
Thanks. Yeah, my husband asked me the other day if I thought having the surgery was still worth it. In a sulk I told him I wasn't sure and maybe not. At the time he asked me (I was already in a rant about not losing) I was just feeling so tired of always having to log every bite I take (in hopes of figuring out what the hell is wrong with me), constantly thinking about stuff I'm about to eat.......even when it's good healthy foods and healthy carbs, worrying what it will or won't do to me/how my body will react, going out on a date with him and not being able to eat and drink normally......having to either eat first or drink first and then having to sit there for so long to do the other either way, etc. But then on Sunday he took me kayaking for the first time in my life!!! I had always been afraid to do so due to my weight. I loved it so much. All the way there I worried and wondered if I looked small enough now to NOT be questioned about my weight before renting one. He asked if I was excited and I was like, not yet, then expressed those fears. But once we got there we rented them without me even getting a second glance from the guy renting them and we had a blast! Then afterwards I noted how I was also dressed in all black (t-shirt and leggins) and how that day it was sunny and 83* and not once did I sweat, get hot, out of breath, flush, get tired, winded, NOTHING!!! So then I thought YES, YES it was still worth me getting the surgery even if I never lose another pound. -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
UPDATE: Another quick update since it's been a while. Well, I tired my old dose of Metformin for over a month and it did nothing for my weight loss. I was really hoping that the cut in dose was the issue/reason for my stall since October. But I'm still stalled despite still eating right (and logging everything) and exercise. So I contacted my doc through the patient portal and told him it wasn't making a difference and he switched me to Rybelsus. He said I DO NOT need it for my blood sugar as it's been great, but he feels it may help with the weight loss as it has done so with many of his other patients. It's also supposed to be good for those with PCOS and Insulin Resistance. He told me I am doing everything humanly possible to lose weight on my own and he doesn't know what else I could or should do otherwise so we both agreed I'd give this a shot. I will have to give it a good three months to see. I will be on the 3mg for 30 days. Then 7 (or 8?) mg for 30 days. And finally, the highest does of 14mg for at least 30 days. We will reevaluate after that. He also talked again about how he believes some bodies/people just may be predisposed to a set weight and that there may be nothing you can do to change that. I get where he's coming from but I'd hate to think my body is done losing and I'll be stuck here still at least 50-60 lbs overweight (from MY goal......which is still an overweight number wise by normal standards). I have a meeting with my surgeon in a week or two. I think by their standards I will be on target (although I feel like a failure) because he told me before that he expects me to be between 201 and 234 at a year out. Well my lowest weigh in has been 235 but that was weeks ago (March 16th). Haven't lost more since and, once again, I am hovering around 241 and 245. Sighhhhhhh Still have til May 19th (my surgery anniversary) to lose more but I am doubtful that will happen. Anyway, that's that and I feel so defeated. Of course I'd be the freakin' oddball that would STILL have problems losing weight even after surgery. -
Burning/Tearing Sensation 8 Months Out
SummerTimeGirl posted a topic in General Weight Loss Surgery Discussions
Let me first start off by saying yes, I DO plan on running this by my doc and/or my surgeon soon. But, a few weeks ago I sorta took a deep breath, held the air as I filled/ my abdomen, then sorta pushed my stomach out (think lower stomach area), if that makes any sense, and immediately got this tearing/burning sensation to the right of my belly button. It sorta reminded me of that feeling most of us got/had shortly after surgery. I had not felt this feeling since then until now. But yeah, every time I would breathe deeply, hold my breath, then push my abdominal cavity I would feel this. So I stopped doing it, of course. I remember this similar feeling after surgery and even mentioning it to the surgeon and was told it was just due to sutures and whatnot inside and possibly the nerves healing and that it would go away. Anyway, I was feeling ok since I stopped doing that and it didn't give me any further issues until today when I bent over to give the dog some water and my fat roll/stomach kinda scrunched up between my upper thighs and my upper stomach and again, I felt immediately that sharp, burning/tearing sensation to the right of my belly button. Not sure what to think about it. It does not hurt when lifting anything heavy and so far my husband and I cannot seem to feel a lump/bulge or anything when palpitating the area. I do not feel nauseous, fever, nothing off that would indicate a hernia or some similar problem. HOWEVER, having said that, when I did have my surgery my surgeon did say he saw a small hernia in that are but said that he did not think it would be a problem so he didn't do anything with it. But now I half wonder if its that, or is it a muscle tear? I just don't know. Has anyone experienced something similar? Again, I am 8 months out now so I'd imagine all healing inside should have been completed LONG ago. -
Burning/Tearing Sensation 8 Months Out
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
A muscle pull. So they believed. Went away after several weeks and I haven't felt it since. -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
Thanks so much! Glad you found it helpful. I use it as kind of a log for myself too so that I can look back and see what happened and when. That's so funny with the Liverwurst. LOL As I said before, I don't usually like it but every now and then I get a taste for it. LOL -
Still pain at incision site
SummerTimeGirl replied to Ccosta0425's topic in POST-Operation Weight Loss Surgery Q&A
Curious if that pain has finally gone away for you? -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
UPDATE: Just wanted to give ANOTHER quick update to my situation. LOL So as you may know I met with my dietician on March 3rd and we discussed my food logs and exercise and how it appeared I was doing everything right. Also told her that the only new different thing that happened back when my stall started was the fact that I halved my Metformin. She didn't seem to think that was the issue. But for sh*ts and giggles I started myself back on my old dose the next day. So guess what, on March 4th I weight in at 243.2. But then two days ago I weighed in at 235.4!!!! Pretty much an 8lb loss in only 12 days!!! Coincidence or what? I did NOTHING else new or different. All I know is that the scale has NOT moved like that in like 5 months!!! I also had my doc appointment today and we discussed what happened and he said if I feel like it's helping my weight move again then to stay on it. Otherwise, if I stall again, we can then discuss some other medicinal options to possibly help me start losing again. Overall he is happy with my progress and tells me to just keep doing what I've been doing. I HOPE the Metformin was the issue all along but I'm not getting too happy just yet. I'll keep updating periodically. -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
UPDATE: I go in this week for another regular check up with my family doc and so today he had me get my cholesterol and my A1C done again. My LDL was 137 which is weird cause it was 135 in September. I would think it would have improved and gone down more. NOT go up.....even if it isn't up by much. My A1C was 5.6 down from 5.8 in September. I would have thought that would have gone down more too. Especially since last March it was 6.7 and went to 5.8 in September last year. BIG difference in just 6 months. So why was this last 6 months not so good? Also been stalled for about that same amount of time. These things make me think even more that maybe I should have stayed at my normal Metformin dose so I'll definitely be talking about that this week with my doctor. As much as I wanted to come off the meds it just may have been too soon. EDITED TO ADD: So even though I have an appointment with him this week he called me to go over the results already. He said my sugar numbers are excellent and responding well but the cholesterol isn't responding as well but it isn't terrible. Anyway, he mentioned Metformin and my weight loss and stuff and then I briefly said that I wanted to discuss it and why and he then mentioned that there are better medications than Metformin that accomplish the same stuff for my sugars but also help with weight loss so we'll talk about that this week too. Not sure what medication he is thinking about but I guess I'll see. -
Post op day 4 complications
SummerTimeGirl replied to gabbykittyvsg's topic in Gastric Bypass Surgery Forums
So very sorry to hear this. I hope they get things figured out for you soon and you make a full recovery with no further issues. -
Post-op Diet: First Few Weeks
SummerTimeGirl replied to cgp1204's topic in POST-Operation Weight Loss Surgery Q&A
So pre-op diet for me was 11 days of 4 shakes a day and 4, 1 cup servings of non starchy veggies. Then of course the day before was just clear liquids. That was it. Then AFTER surgery it was 2 weeks Full Liquid then 1 week Puree then 2 weeks Soft Foods and then finally, regular foods after that. As more people post you will see some of our plans vary greatly and some are very similar. Strange how that is. LOL -
What are you treating yourself with?
SummerTimeGirl replied to Summermoose's topic in General Weight Loss Surgery Discussions
I can't say that I have "treated" myself with anything when it comes with food. I mean, if I feel like having something I just do if it's let's say, a cookie or two (an actual true serving size or less). Like the dietician says, it's not like you're sitting down eating an entire bag/box/etc. of said "bad" food 'cause now I have limits and stick to them. Anyway, that doesn't happen often anyway as I really haven't felt the desire to have such things. Haven't treated myself to clothes yet either because I can't see wasting money if I could potentially still lose weight (I have about 50-60 lbs to go). BUT, what I WILL FINALLY treat myself to soon, now that I lost the weight that I have, is a kayaking trip with my husband!! I was always worried about my weight before and would never give it a try. Was also always embarrassed to ask about weight limits when it came to it before too so I just never did. So now, within the next month or two when it opens, my butt is gonna be out there on one! LOL THAT will be a real treat for me. Would also like to eventually get on a jet ski. Another thing I always avoided due to my weight. Haven't been to an amusement park in decades either. Something my husband and I used to always love to do. But of course I have avoided it due to my weight but now, unfortunately, he can't really do it either due to some heart issues he has. So, not sure I'll ever get back to one of those but we'll see. He said he'd still go with me even if he can't get on anything so maybe one day I'll take him up on that. -
May Surgeries - check in!
SummerTimeGirl replied to ChunkyCali's topic in Gastric Sleeve Surgery Forums
Awesome progress! Congrats to you!! So jealous!!! I have lost like 73. Slow going due to my long a** stall! But I'm working on it (along with the dietician). Trying to figure out why this stall is even happening and why so long. But still sticking to plan and doing well when it comes to my diet and exercise. -
Still pain at incision site
SummerTimeGirl replied to Ccosta0425's topic in POST-Operation Weight Loss Surgery Q&A
Yes, I'm thinking it should be gone soon. I wasn't able to bend over or anything for that amount of time either due to the pain in that spot. I remember reading about others who had the surgery done close to my date were able to lay down no problem from day one. I was so jealous. LOL But yeah, one day you'll just notice it no longer hurts. -
Still pain at incision site
SummerTimeGirl replied to Ccosta0425's topic in POST-Operation Weight Loss Surgery Q&A
Yup. I had that stupid pain at that location until about week 3 or 4! Up until that time I had to sleep semi sitting up in bed because I dare not lay down flat or on my side cause if I did, YIKES, that pain! LOL Anyway, it was a pain in the you-know-what but it should be giving you some relief soon, I'd say. -
A shameless plea for support
SummerTimeGirl replied to NolaJay's topic in Gastric Sleeve Surgery Forums
Interestingly enough, I had an appointment with my dietician today and we spoke about portion sizes. Oh, I also had my surgery last May (19th). Part of the reason for the appt. was due to a VERY long stall I've been in. Anyway, one of my concerns was whether or not I was eating too much at each meal and she assured me I was not. And I'm typically eating around 3-4 oz of meat and 2-4 oz of veggies. She said at this far out we should be eating around a cup's worth of food. Of course this may change due to the type of foods you are eating. She said you may be able to tolerate a little more or less than that depending on the type of food. Of course her answer was to STOP eating when you start to feel full regardless of the amount you started with. So, if you measure out 4 oz of chicken and 1/2 cup of veggies but get full after the chicken or after the chicken and SOME of the veggies (but not all), then just stop, of course. Anyway, I was worried about the stretching out of the stomach too since I can eat more now and told her as much and she said no, based on my food logs I was NOT eating too much for where I am right now post surgery and that a cup was a normal amount. So, I doubt you are either. -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
UPDATE: So I had my meeting with my dietician this morning. She said based on the log I provided her from the Baritastic app for the last two months she did NOT see that I was eating anything that I shouldn't or in quantities that I shouldn't. She still seems to think I was/am still being a little inconsistent when it comes to protein. She said that based on a few missing days and some days where it may have been lower. But I tried to tell her overall, I think I HAVE been pretty consistent regardless of those few days/logs. Anyway, she said at one time the 800 calories a day was probably good enough for me but now that I'm working out more regularly that maybe now I should up my calories and protein. Calories to around 1000 to 1100 and protein more than 80/90. I feel like she's guessing, in a way, on what could be wrong too because of the fact that she said she does not see anywhere in my food logs or workout routine where I'm doing anything wrong. She also mentioned body composition. She said maybe I have actually gained more lean muscle over fat and whatnot and that I should pay more attention to that. I told her I DO have a scale like that and, even though I weigh regularly, I DO NOT log the actual weigh ins unless there is a loss so I can't or haven't seen if there has indeed been a change because it doesn't log it on the app unless I allow it to. So, I need to start logging those slight gains too in order to MAYBE get a better idea of what is going on. My husband and I were talking last night and we still think that my cut in Metformin dose still may be playing a part in this long stall. I had my dose cut in September and October was my last real loss. Also the last time my period was normal. So, I brought that up to her and she doesn't seem to think that's the reason. She said it was right that my dose was cut because my sugars have been improving and warranted it. Like the doc said, she also said the weight loss itself could be causing the irregularity in period and stall. That there is no way to know for sure if it's due to the weight loss in general or the Metformin. But I don't know. Just awfully funny that it was cut down and suddenly I stop losing weight and my period has been jacked since too. Anyway, I think I'm gonna go back to my old dose for the next few weeks and see if anything changes. If it does I will then discuss that with my family doc who I see in two weeks. Because, if the scale starts moving again, then just maybe I need to go back on it for now. I know my goal and point of having the surgery was to GET OFF this medicine but who knows. Maybe I still need it for now. I still feel so confused. She said she understood but that I DO seem to be doing everything right and that I should stay the course. Anyway, that's that. -
how does sleeve gastrectomy affect your appetite?
SummerTimeGirl replied to bombshellocks's topic in POST-Operation Weight Loss Surgery Q&A
At almost 10 months out I feel myself feeling hunger again like I used to before surgery. Maybe in part too because I NEVER had one issue after surgery when it came to eating and drinking. I did both just fine with no gagging, no sick feeling, etc. I also knew when to stop and never pushed my limits. I just think now that I'm naturally able to eat more since I am this far out, the hunger feeling is like it was before when it comes to it being time to eat and whatnot. Having said that, I also notice that if I have a good meal full of lots of protein I tend to stay full and satisfied MUCH longer and sometimes don't even feel hungry come my next meal. This is especially true at breakfast. I'll eat an egg and two pieces of turkey sausage, or two eggs and one piece of turkey sausage and I sometimes am not even hungry come lunch. And most times I don't even fully finish that breakfast. So yeah, pay attention to protein. -
Laparoscopic Sleeve Gastrectomy
SummerTimeGirl replied to GodsManna4Life's topic in Gastric Sleeve Surgery Forums
Yay! Excited for you! Congrats!! -
ONE-DERLAND!
SummerTimeGirl replied to GummyBearQueen's topic in POST-Operation Weight Loss Surgery Q&A
Congrats!!!!!! -
Update On Me (Surgery: 5/19/21)
SummerTimeGirl replied to SummerTimeGirl's topic in General Weight Loss Surgery Discussions
Thank you so much! -
Lunch idea after gastric bypass
SummerTimeGirl replied to Jennifer ortiz's topic in General Weight Loss Surgery Discussions
A combo or anything below......... Tuna with some crackers and cheese, hard boiled eggs, rolled lunchmeat, chicken salad, egg salad, slices of spicy salami or pepperoni and some cheese slices/cubes, left overs, grape tomatoes, cucumber slices, cottage cheese, low fat yogurt tubes, nuts, sandwich roll ups on low carb tortillas, shrimp, etc. I also suggest visiting Bariatric Queen's website. https://bariatricqueen.com/tag/bariatric-meal-prep/ She lists her meal plans at all stages and has lots of great ideas for breakfasts, lunches, dinners, etc.