Search the Community

i have struggled so much this year!! we lost my father in law in february to alzheimers. i had my band surgery in may. then in july i lost my only sister. we were twins. she was a recovering alcoholic and was bipolar. it's been very very difficult for me. ok it's been diffcult for everyone who lives in this house. the kiddos weren't dealing well with anything at all so i have them both going to therapy. my youngest has adhd and they wouldn't give him meds without him seeing a physcartic and she suggested he go for therapy. my oldest is angry at everything. my hubby also goes to therapy due to the fact he has anger probs and it's hard for him to cope with it somedays. i suspect his has ptsd and we found out this past week he also has mild sleep apnea. i am seriously dreading the holidays this yr. i was happy we made it through thanksgiving lol. now gearing up for christmas. it's just not in me. i thought decorating would help and i went overboard on lights and garland in this house. we could land a 747 in here lol. but it is very pretty!!! i put on my happy face and smile and it does help- to a point. i figured there are less fortunate people in this would then me and i should just pick myself up and move on. i have my health, my family and i am still alive and breathing. so instead of looking at all the negative in my life i am trying to look at the positive things.Worry is like a rocking chair--it gives you something to do but it doesn't get you anywhere." same this for negativity and feeling blue. sure in the world doesn't get you anywhere...

I still think I have my same food obsession, just can't eat as much of it. I feel like I have done okay shopping, only once half way I splurged on a spring suit (300) that is now too big I'm sure. Regret that! I don't like to overindulge on senseless things like that, but I did look great that one night. At least I sort of made sure it was things that could be altered like a straight skirt, etc. and I do plan to do that. But the blazer that goes with it....I don't know if it can be altered. I hate that feeling of waste. I will say my culinary skills are improving post sleeve.. I seem to be in search of that "perfect bite" and get really pissed if I get a bad meal since I can't eat much anyway. I'm more interested in recipes and novel tastes and things cooked to absolute perfection. Like this morning I made a small Breakfast for my family, and was overjoyed that I finally did not waste food, but I was so happy each and every item tasted perfectly. It has been hard to not cook too much and I still tend to fall into that. My dog has eaten very well this past year b/c I basically need to stop wasting ingredients. We have two children (step kids) that moved out too recently so I think I was used to cooking too much bc they would eat it eventually and now there is no one to eat the extra for the most part as my 12 year old only likes certain things and not others and my little guy does't eat much (he is 3.5 years). My husband rarely eats leftovers. As for shopping, there are so many things to buy once you lose the weight bc NOTHING in a closet or drawer fits, not even your shoes as I went down a size and a half. I am so sad I have wasted so many clothes and shoes b/c I either give them away or they just sit there not being worn. I gave so much away and recently did a garage sales. But it is just waste everywhere!! I did wear 3" thin heels to a special event the other night. I have not done that in years and I was very uncomfortable (my feet seem very bony now with not much pad on the heel). But heh, I made it standing up a couple hours on and off throughout the evening. I cannot believe how uncomfortable heels are, but I couldn't even try before so it was fun to just wear them to look cute which was not an option for me before. But will I wear them again?...that is the thing. I don't like to waste. I tried so hard to find a pair of comfortable heels but I tried on a million shoes and these were the most comfortable I could find. My foot is so damn tiny and small now and the heels just swallow me and I couldn't find narrow size shoes that were cute and comfortable. I'd rather buy a pair of comfortable shoes I wear every day than buy fancy things I hardly wear - especially right now bc I always need clothes for work. Before I would have worn dressy flats so I wouldn't have made that extra purchase which is what I'm talking about. THose one time purchases to look extra cute are killers. Like I bought some expensive jeans in Vegas that are so fancy I've actually never found a place to wear them. Once again, regret. I could spend all my time just buying and returning, buying and returning. One purchase that worked out was some cute straight jeans from banana Republic (8P) and some Ann Taylor jeans (8p) and some tall black boots with a heel which are extremely comfortable. I don't think I've EVER had the nerve to have tall boots b/c a short fat girl in tall boots is well, not real nice. I bought a sweater dress too to wear with them but haven't done so yet. Still might return that. I spend a lot of time questioning my purchases and if it is expensive it is even worse. I don't have endless time to shop so that makes it more challenging. But definitely no matter how many clothes I buy now I need something else because I have nothing old to fall back on in my closet. I feel like I've overdone it and yet I just wear the same things over and over again. So that is what I've struggled with, not an obsession, but I have definitely struggled with waste - buying/cooking too much food/clothes/making senseless purchases. It is like a new door has opened and for some reason it has led to me feeling like I overspend on groceries, restaurants, and sometimes shopping. I can't tell you how many times I have wasted money/food at restaurants bc I overorder. It is all so overwhelming and then in a couple hours just hungry again. I try to save and eat again but sometimes it isn't what I want. I am a bit fickle with everything now. We are going on a cruise this summer and I've been shopping already for that and have really picked up some bargains off season. We are going to DIsney World, then beach/fishing for a few days, then a short cruise. This trip would have been way to much for me before...whereas I'm really looking forward to it. But all this extra activity leads to a lot of extra spending for my whole family, not just me. It is hard to define, but sitting at home was just cheaper. As for alcohol, I've never had an issue bc I can take it or leave it. I had a full glass of champagne at the party and never felt it for some reason, but it didn't make me sick or anything. I think one thing is as you are losing, and as the surgery is new, you get used to a lot of attention from it and when people get used to you thinner and they don't say anything you are like !!!???!!! I do I not look good? But hopefully eventually I won't be looking for that constant feedback. BC people just get used to you thin and don't mention it anymore. My husband is tired of me saying" feel this bone ", etc. One day he even said he wanted his fat girl back b/c I get annoying to him sometimes stressing over how I look, trying to get noticed, etc. It is kinda weird that I would be that way bc I'm not a teenager. Some days I feel so damn cute, but other days feel the same as before. Like when I needed a dress and couldn't get in the small sizes (I had to buy a 12P) and I felt so fat. For some reason my rib cage and breast area is still kinda thick and fitted dresses do not fit extremely well and I was kinda embarrassed that I popped a zipper b/c I tried to wear too small of a dress. It is all just weird. Thanks for listening.

That's a lot of wine. The recommended amount of alcohol for women is 2 drinks or less per day (a 6 oz glass of wine would be an example of a drink). Lots of empty calories, too. A 6-oz glass is about 120 calories, so 3 glasses add up, plus there's zero nutritional value to those calories. I say, post-sleeve would be a great time to cut down on alcohol. You can't drink for a while after the surgery - this is surgeon-dependent, but I've seen guidelines that range from 1 month to 6 months of abstinence from alcohol - so it'd be a good time to kick the habit. You can have alcohol once you're all healed up. I've never been much of a drinker, so I can only speak to being able to have 1 drink without consequences. I usually have mixed drinks - I never liked wine much before, but now it makes me very nauseous after just 2-3 sips.

Bob, you've been my role model here since I first found this place. I am immensely proud of you and what you've accomplished in such a short time. I'm finally being banded the day after tomorrow, so am where you were a year ago. I hope I can report such an excellent journey as yours a year from now. I wish you nothing but continued success and a rapid, painless healing from this latest surgery. Good luck! As for the cigarettes, if I can offer my personal experience: I quit smoking eleven years ago after more than thirty years as a heavy-duty 2+ pack a day smoker. I had quit a hundred times before then, for varying amounts of time, from a few minutes to as long as seven months. But I always went back to them. I finally realized I had never felt like an ex-smoker, always that I was in-between packs. I always felt when I'd stopped smoking that I'd be smoking again at some point. And I always did. The turning point for me came the day I came to the thundering conclusion that I didn't have a smoking habit. I realized I was a nicotine addict. Just as bad (to me) as a heroin addict or being an alcoholic, and I was just as addicted. And just like that, I quit. I ddn't STOP smoking, I QUIT. And I haven't lit one since. I have absolutely zero desire, because I know, just like an alcoholic or a heroin addict, that I can't have just one cigarette, or I'll be back at it. Changing my frame of mind from thinking of myself as a smoker to accepting that I was a nicotine addict completely changed my entire attitude. No drug was going to control my life, and that was that. I've never looked back. Good luck with all of it! Dave

thanks for the suggestions ajames and cindy, milkshakes do sound way better then just drinkins, and im sure after 5 days of sweets a soup will taste like a god-send. Where is everyone getting unflavored Protein powder? i looked in 2 places today and couldnt find it and think it will be necessary for my week of clears. loralee- i too am scared of the anesthesia, but they do have stuff to reverse it and having talked to an OR nurse about 1 in 20 people do have a reaction and they just give this med, reverse it, and try another sedation method. I also talked to my ER doc who did a surgical residency and he said that without family history or previous reaction your chances are very slim, just dont drink alcohol or smoke the week before and make sure they know ALL of your meds, otc and scripts, and the chances decrease even more. Most of the time someone does not tell them about a heart problem or their lungs are so fibrotic from smoking/aspestos/ect. that they get the tube in and start to give meds and the person's lungs cannot handle that, just be honest and you will be fine =). That helped me relax a little about it, but i doubt i will be turning down the pre-anesthesia sedation iv meds the day of. What is everyone bringing to the hospital? I have to stay overnight per the doc, all his pt's do, and since i have only worked nights, never been a pt, im not sure what to bring...i have chapstick, change of clothes, magazines, ipod, slippers, and a robe packed already (yup, all set!) what else would you bring? Here we go everyone, 10 days till a new you =)

I am glad I am not alone. @Mommy (and man, that is weird calling you Mommy), I think if you scroll down, there is a box called Meta, which has two links for Entry RSS and Comment RSS. That should allow you to add it to your blogroll @NBFlo, I believe it is about the fresh surgical wound and caffeine, which can cause ulcers or so? Same for alcohol and I believe I am supposed to stay away from both for 3 months. @Tiff, when did you pick it up again?

Ideas for portable protein: cheese sticks greek yogurt Protein bars (be careful about ingredients, calories, carbs, sugar alcohols, etc.) hard boiled eggs protein shakes RTD (ready-to-drink) beef Jerky (again being careful about nitrates, sugar added, etc....I usually make my own) cottage cheese ( you can buy little individual cups or just use your own tupperware and fill it and keep it in a cold pack) I hope you actually get a BREAK ...you SHOULD be having a snack at 10am ...esp. if you are feeling hungry. I think they are legal rules that employers must follow in regards to working x number of hours and getting x number of breaks per hours worked. I think .5 hour lunch is fine, but then again I'm a contractor (I work for my former employer on a contract basis...no benefits, or legal lunch breaks, etc.) and I used to work 10 hour days and take only .5 hour lunch. It seemed like more than enough time. Now when I work, I never take a lunch break but hardly ever work more than 8 hours in a day. I eat at my desk, because my job is in front of a computer so it's not a big deal to eat and work at the same time. I don't take a lunch because I only get paid for the time worked, so I would rather get in, do my work and get out than take any type of unpaid break.

Hi...again have no freaken idea....how to navigate this site....and no time to fiddle with it....so sorry everyone for the typical font and reply style. lol so unlike me which is the reason for the apology. Its been a week since posting and well.....it hasnt been a great week for food, exercize or Water....but am getting back on the saddle tomorrow AM....rather the seat of the cycle at the gym. Foods havent been horrid just eating Proteins and shakes and not enough vegetables and water.....Ive been so busy running around buying presents and supervising that I have no idea if im coming or going.....I thought this would be the easiest holiday to deal with but......I realize its so much easier to shop, cook and have off from work but nooooo going to work run around after looking for presents in a million different places and going to one party and celebration at this ones house or that ones...or dinners out etc has taken its toll and im just plain tired!!! Of course its a wonderful holiday...but all the running....and partying and its only just begun...eight more nights!! I am just thankful there is school all day otherwise...in addition to busy and tired Id be totally broke with a babyisitter in addtion to all the presents and goings on...lol This weekend we are going to our synaguage for chanuka dinner tomorow night....that should be fun and nice. Sat lunch is at another shul. That should be fun too....if course this means I wont have anything to eat good for me....but I have prepared one of Phyllis what I call famous BBQ chickens!! Thanks again..saving me. So at least I know ill go home and eat if there is nada...and I know what shabbos dinners are about soooo I know there wont be anything for me. Sat night im the car pool mom, my turn to drive to and from Bat Mitzvah about 45 min away....where I will be twiddling my thumbs wating around for three hours....probably go shopping for more presents at that time.... Sunday is our family chanuka party at my brothers house....I am hoping for some serious alcohol or other to help with the drama that im sure will happen at that party! Of course its all in the spirit of chanuka ....so im sucking it all up and running, running, running!!! I see everyone is getting ready for Christmas....and I love reading about all your plans....jealous of the great decorating and table settings and the gettings ready....cant wait to hear about all the fabulous christmas eve and morning stories with everyone and their families.... well... must run its late and exhausted.....welcome to the newbys....and have a great holiday...and remember WHEN YOU FAIL TO PLAN YOU PLAN TO FAIL (like me this week) Okay....have a great night...... Jodi

I've not been maintaining for a year, but I've been at goal for nearly a year. I continued to lose past my goal weight and have been easily maintaining for the last 7 months. I still love my sleeve, and do not diet at all. I indulge with sweets, alcoholic beverages, and even white carbs weekly. The difference is that I don't overindulge, and I have realized that my body runs better on mainly protein first, but I eat a very balanced, healthy diet. I do not deprive myself of anything, I just don't eat in large quantities anymore. Do I sometimes splurge a little much? Sure, I do, but I also know that splurging leads to me feeling fatigued, and I just don't "feel good". It's just how my body works. Food is an afterthought, I eat because I have to eat, and yes, I have cravings, but the sleeve makes managing those cravings much easier, and obviously I can't binge out anymore. Plus, I have zero desire to get that overly stuffed, busting out of my pants feeling anymore. Food is just fuel. I've learned to eat to live instead of living to eat, and it would not have been possible without the sleeve.

Hi 2steps! Well, I think you have already explained your problems. Now only to fix them. You have to leave the alcohol and corn puffs alone until you reach goal. I know, easier said than done... but just remember - it's not forever! Or at least until you fit your Christmas gown. It's only 7 Lbs.. you can definitely still get into it by Christmas. Also, you do need to change up your workout. Our bodies get acclimated to the same workout, especially if it's all we do every day. Try some new workouts, integrate some weights and more cardio. You will do fine. Sometimes we just go through these crazy stalls. Also, remember you are a lightweight. You lost incredibly fast in the beginning, your body may just be playing catch-up right now.

I waited a month before I had any alcohol.

I'd ask your doctor this question, but off hand, I'd suggest waiting until you are at least on full solids before doing so. You want to be healed up before adding alcohol to the mix.

How along after surgery are you able to drink Alcohol again?

Some things I brought to the hospita were... -my own slip on slippers for walking & flip flops for the shower -chapstick -a smal mirror (so i could look at my belly easier, hehe) -sugar free Vitamin C drops *ok'd it w/ my RN before I took and only took them to try to get my bowels to start waking up (bc the sugar alcohols start to get the bowels up and running.) And it worked. I had about 4 Vit C drops before I went to bed and the next day everything cam out fine, - Gas X disolving mouth strips. I read they can help with the gas they fill your abdomn up with, Seems like it works for some but not for others,, I'm over 1 week out and I still have pain in my left sholder from the gas pressure, -my own Vitamins, the did supply all but didn't have some of them, but I made sure I was ok to take them. - A comfortable! bra! I got one at Kohls.. it's more of a sports bra but kinda loose and comfortable, I wore that everyday I was there, because you have to walk so much and for me I deff needed some support even thou it wasn't much it was better than nothing, -cell charger a few pairs of undies Bring your own deoderat. I used the toothbrush, toothpaste & mouthwash. I

You might want to cut your calorie intake a bit. You seem like you are eating a lot. I generally consume about 500 calories a day-maybe 750 on a rare heavy day and I am about a week and a half behind you. Definitely cut the sweets and alcohol.

Hi peeps! Whew! I had four g-kids today 6,2, 18mos, and almost 3 mos. I did something in my lower abdomen when I got up with the little one. I just hope it is a catch. It is right where I had my last surgery four years ago. Hopefully it is just scar tissue. Anyway, we had a good time with the kids. Then my DS came over and finally picked up the rest of his clothes. He still did not get the deer head. UGH! I guess this girl is a keeper. Being a major in the Air Force she is keeping my DS in line. He is crazy about her. I know they are talking marriage. LauraK.....yep it was a good day with the kids. Three in diapers made for a poopie day too! lol Nope, didn't get the decorating done. My granddaughter that helps was a no show......she is coming tomorrow to get the stuff out of the attic. I can do it now, but why take the chance of pulling something when a 16yr old has offered. Cheri, thanks for sharing about your family. It is interesting to watch how those characteristics run throughout the family. We have lot of ADD in the family. From you talking about it I have been able to notice those symptoms in my ADD kid and now in one of my grand. I even see it in me. No one in my family ever sought help for alcoholism. They just got old and quit drinking. Joyce, the weather is pretty now so your DD will be able to enjoy a little of it before it gets nasty in a couple of days. Water aerobics is the only thing that does not hurt my back. I love it. You are so limber. It won't take long till you have a trainer. I even forgot you had a knee replacement because in Vegas you never favored your knee. Melissa, Zumba sounds fun, but I would have to borrow it before buying. I have so much exercise crap I have never used. Glad you found something to make you sweat. lol Okay gang, I am going to go soak in the tub then watch a little TV.

Charlene, one of my uncles who wasn't there is an alcoholic and a number of us think my aunt has a problem. My uncle who died could also drink large amounts of beer, but I only saw him at big gatherings so I don't know what he was like on a day to day basis. They're all huge men (6'5"-6'7")and that makes a difference in alcohol metabolism. I actually participated in my alcoholic uncle's intervention. He's still very active in AA. I never see my youngest uncle who was 4 when I was born. He lives in Montreal and hasn't been out here in years and years. He's in his 60's and still competes in decathlons. My aunt ran until her joints wouldn't let her anymore. The uncle who was there at the party has also always prided himself on staying in shape. The other two uncles, the alcoholic and the deceased uncle, were more massive, like football players not basketball players, and developed guts. My brothers are also very tall and one has the massive build and struggles more with his weight, and the other is more like a basketball player and has continued till recently playing basketball and swimming and has had less trouble. I noticed he's finally getting a gut. I've got the bigger frame of me and my sisters. They are taller than me and have the leaner frames. I am the shortest (5'9") of all my aunts and uncles and my mom and I'm the shortest of my siblings. My mom got the heavier frame but my dad who was 6'3" before starting to shrink has a very lean build. All big people but all highly coordinated and athletic. Huge ADHD tendancies running through us all. Very restless, unable to sit unless focused on a project. I find family characteristics to be fascinating as you can tell from all I've written. I've noticed a lot of similarities in what goes wrong with us as we're aging as well. Laura, sad news about your dad but not unexpected on your part. I'm glad you were able to have such a great Thanksgiving with them. Had trouble viewing your pictures when I clicked on them because they more than filled my computer screen. What's up with that? But you all looked so happy. Nels looks like he could be you and your husband's physical child. I have to go trim back all my geraniums which are currently in my basement. I keep them all alive in my living room windows all winter. Keeps my living room amazingly cheerful. But right now they're full of dead leaves since we left them out until frost. They're messy but worth it. Cheri

Janet.......have a great vacation with the family. We will miss you! Cheri......sound like you had an awesome Thanksgiving with the family. My extended family is full of dysfunction.......mainly alcoholism. I still love to see them and remember good times as children. Apples, have a great time at your Christmas get- together with the family. Laura.......so sorry about your dad. It is so hard to watch our loved ones suffer with so much pain. I know you are such a comfort to them. HUGS! and Prayers for you and family. Chris......I hope your DW is bettter today......scary! Sham......It is hard to make that guess on your dress size. I think you go down a size every twenty lbs. Be sure you get a dress that can be altered several sizes. Kelly.....congrats on the first meal. If you felt full for several hours it sounds like you may be just where you need to be. Okay gang, I offered to babysit my two granddaughters while DD and her husband go do some shopping. I will be busy today. I am back to journaling, and looking forward to a fill on the 9th.

I'd say no alcohol until you are at goal....and up your protein. My surgeon has had me at 60 grams since I left the hospital. I don't know about the Snacks you are eating, but look at the sugar content with any protein or power bars you are eating. Good luck.....I think if you just make a few changes, mainly with the alcohol and making sure you up your protein, you'll kick start your weight loss again! My protein intake is 60 - 75 grams a day! Good luck!!!

Leigha, you'd think a fellow bandster would know to leave you in peace, right? She probably felt like she'd found a kindred spirit. At least your day was memorable! I got stuck the other night. We had lasagna, which is always dicey for me. The odd thing was that while I was sliming, I got extremely nauseous. That doesn't normally happen when I am stuck. So, up it all came. Then yesterday, the back end exploded. I am blaming it on the underdone turkey at MIL's. Elfie, I had egg nog yesterday. All 8 bagillion calories. Yummy. Gave me a whopping headache, as almost any alcohol does these days. Our chicken came out excellent! Yay!

Thanks LowCho. I guess I just hoped that since my problem was always with volume eating, the fact that I can eat so little now would mean that I would lose. My dietician and surgeon's guidelines only said to use moderation where alcohol is concerned, and to ensure I take Vitamins. There was no 60g Protein, 40g carbs etc rules. I do think I am following a fairly healthy diet though, and really didn't want to cut out all treats and deprive myself. If I felt I was over indulging then I could understand, but in my opinion I am not. But in all fairness I asked you for suggestions on how to break my stall, which you have done. So I guess I am just being childish and stamping my feet about these little treats which I might have to give up, but didn't think I would have to

Definitely drop the alcohol and your carb count. Too much for where you are, right now. I had to sign a document with my surgeon that I would not have alcohol, caffeine or starches until after 12 months. During the first 12 months, the honeymoon period, I can only have up to 40 carbs per day.

I replied 24 hours later and told her I forgive her. She wanted to get a rise out of me, and I am not going to give her what she wants. I told her that i was forgiving her for ME. Then I gave her the Mayo clinics definition of forgiveness. Here it is... What is forgiveness? Generally, forgiveness is a decision to let go of resentment and thoughts of revenge. The act that hurt or offended you may always remain a part of your life, but forgiveness can lessen its grip on you and help you focus on other, positive parts of your life. Forgiveness can even lead to feelings of understanding, empathy and compassion for the one who hurt you. Forgiveness doesn't mean that you deny the other person's responsibility for hurting you, and it doesn't minimize or justify the wrong. You can forgive the person without excusing the act. Forgiveness brings a kind of peace that helps you go on with life. What are the benefits of forgiving someone? Letting go of grudges and bitterness makes way for compassion, kindness and peace. Forgiveness can lead to: ■Healthier relationships ■Greater spiritual and psychological well-being ■Less stress and hostility ■Lower blood pressure ■Fewer symptoms of depression, anxiety and chronic pain ■Lower risk of alcohol and substance abuse

Thanks so much for the info... Can you please email ctdgamez@yahoo LAPAROSCOPIC GASTRIC SLEEVE DIET Joseph E. Chebli MD FACS Introduction The following information provides guidelines for you to follow before and after Gastric Sleeve Surgery and for the rest of your life. Gastric Sleeve Surgery is a weight loss tool. After surgery, you will be required to make lifelong changes in your eating habits and to exercise on a regular basis in order to achieve and maintain your weight loss goals. Gastric Sleeve Surgery reduces the size of the stomach which restricts the volume of food that you can consume at one time. This means that you will feel full after eating a small amount. The surgery also induces hormonal changes which help prevent you from feeling excessively hungry. You should avoid drinking liquids with meals. This is to prevent overfilling of the stomach. Frequent snacking or grazing must also be avoided as this contributes to excess calorie intake and can slow weight loss or cause you to gain weight. Exercise is an important component of weight loss success. Exercise is recommended before and after surgery in order to maximize the amount of weight that you lose and keep off. If you have not been an active exerciser, always consult with your physician for clearance and recommendations before beginning any exercise program. It is important to follow the lifetime Gastric Sleeve diet rules, supplement guidelines, and exercise recommendations in order to achieve and maintain optimum weight loss success. In order to begin preparing for surgery, start implementing the pre-surgery diet goals listed on the next page. Pre-Surgery Diet Practice Tips 1. Choose low-fat foods, and avoid fried foods. 2. Stop using sugar. Use healthy sugar substitutes. (T) 3. Decrease intake of desserts and candy. 4. Stop drinking sugar-sweetened beverages such as regular soda and sweetened Kool-Aid. 5. Start weaning off of caffeine and carbonated beverages. 6. Start cutting back on fast food and eating out. Begin making healthy meal choices when eating out and at home. 7. Eat 3 meals a day. Do not skip breakfast. 8. Start decreasing portion sizes. 9. Eat more fruits and vegetables. 10. Practice drinking Water and other fluids between meals, not with meals. 11. Drink 64 ounces water a day. 12. Practice sipping liquids. 13. Avoid alcohol. 14. Begin some form of exercise. 15. Review the following information on the gastric sleeve diet. 16. Practice chewing foods thoroughly, 20 - 40 times or to paste consistency. 17. Purchase your Protein drinks or supplements. 18. Purchase your Vitamin and mineral supplements. 19. Begin planning a schedule for mealtime, fluids and vitamin and mineral supplements. Post Gastric Sleeve Surgery Diet Important Diet Guidelines: 1. Eat 3 meals per day. Avoid snacking and grazing. 2. Eat small amounts. Initial portion size should be no more than 1 - 2 ounces - approximately 2 - 4 Tablespoons - of food per meal for the first month. At first you may not be able to tolerate this amount. Over time, you will slowly tolerate more volume at each meal. Long term, the stomach will eventually hold about 4 - 8 ounces (1/2 - 1 cup) of food per meal. 3. Eat protein foods first. 4. Do not try to eat food and drink liquid together. • Consume liquid 30 to 60 minutes before and/or 30 to 60 minutes after eating meals but not during meals. 5. You are required to take a multi-vitamin with minerals for the rest of your life. 6. Eat slowly! • Each meal should last 30minutes or longer. • Avoid gulping foods and drinks. • All foods must be well-chewed to a paste consistency. • Using a small fork or spoon (i.e. baby utensils) can help control portion sizes. • Have one place to eat (such as at the table) and avoid reading or watching TV while you eat. This helps you to enjoy your food, concentrate on eating slower and to realize when your stomach is full. 7. Drink plenty of calorie-free, non-carbonated, caffeine- free fluids between meals. • Drink slowly-sip fluids, never gulp. • Calorie-containing beverages should be limited to skim milk and protein drinks. • Limit juice to no more than 4oz. per day. • Consume zero-calorie beverages throughout the day. Diet Progression After Surgery The diet after gastric sleeve surgery progresses through several stages. Your surgeon will let you know when it is okay to progress to the next stage. Day 1 - 2 after surgery: Clear liquid diet The clear liquid diet means fluids or foods that are liquid at body temperature and can almost be seen through. You will be on a clear liquid diet while you’re in the hospital. Examples of Clear Liquid Diet (No Added Sugar/ Sugar Free): • Clear (diluted) fruit juices without added sugar: apple, grape or white grape or diet cranberry • sugar-free Crystal Light drink mix or popsicles, Sugar-free Kool-Aid. (T - careful, usually sweetened w/Aspartame) • Herbal tea, caffeine-free tea • flat soda • Sugar-free Popsicles • Sugar-free Gelatin • Clear broth • Water �� It is best to dilute juices by 50% with water. �� Avoid citrus juices (orange/grapefruit) and tomato juice for the first three weeks. �� coffee and de-caffeinated coffee contain acids which are irritating to the stomach lining and should be avoided for the first few weeks for healing. Day 3 through Week 2: Full Liquid Diet The next stage is the full liquid diet which consists of sugar-free, low-fat milk products and the clear liquids listed above. You will need to supplement with protein (drinks or powder) after surgery. Remember to sip liquids, do not gulp. Examples of Full Liquid Diet (No Added Sugar/Sugar-Free, Low Fat): • Skim Milk or Lactaid milk • Soy Milk (non-fat) • Low fat, thin, strained cream soup (smooth, no pieces of food) • Sugar-free instant breakfast • Protein drinks – Start daily when you get home from the hospital. (See section on protein and protein drinks) • Plain or “light” (no sugar added) yogurt with no fruit pieces • Sugar-free pudding or custard • Thinned cream of wheat or rice cereal Week 3 through Week 8: pureed Diet You may now begin a pureed diet. This includes all items listed for clear and full liquids, and the items listed for the pureed (blenderized) diet. • Eat PROTEIN foods first • Make sure foods are well blended. • Start slowly. If you do not tolerate pureed foods go back to the liquid diet and try again in a few days. • Remember to drink liquids between meals, not with meals. • Continue protein drinks or protein supplements every day. Examples for the Pureed Diet (Sugar-Free/No Sugar Added, Low Fat): eggs cheese Pureed or blenderized scrambled eggs or egg substitute or cheese omelet; melted low-fat cheese, low-fat or non-fat cream cheese, ricotta cheese, very smooth/mashed soft cheese such as mozzarella, string cheese, low-fat or non-fat smooth or small curd cottage cheese meat, Fish, Poultry, Baby food meat or pureed meat or poultry moistened with broth or low-fat gravy Blenderized shrimp, scallops or fish Pureed tuna or salmon (canned in water) or pureed egg salad with low-fat or non-fat mayonnaise Potted meats thinned with broth; smooth deviled ham Starches Unsweetened instant oatmeal (strained), cream of wheat or rice cereal, mashed potatoes or sweet potatoes, smooth polenta, hummus, refried beans; low-fat or baked crackers or chips Vegetables Baby food vegetables or pureed cooked vegetables (no corn or peas) Mashed winter squash, tomato juice or sauce, pureed salsa, marinara Soup Strained, low-fat cream soup made with skim milk; fat-free broth Blenderized lentil or split pea soup or chili Fruit Baby food fruits (bananas, pears, applesauce, peaches, mango, etc) Unsweetened applesauce (smooth) Unsweetened canned fruit – blenderized Unsweetened fruit juice (diluted, no sugar added) Remember: IF YOU CAN CHEW IT, DON’T DO IT! Tips to Get Started Everything that you eat on the pureed diet should be sugar-free or no sugar added, low fat and blended to the consistency of baby food or smooth applesauce. • You will need a blender or food processor or you can purchase baby food. • Start with 1 ounce (2 Tablespoon) portions - no more than 4 Tablespoons at the most. Listen to your body and stop eating as soon as you feel full. • Eat protein foods first. Then if you are not too full, try vegetables or fruits. • Continue protein supplements (80 g protein per day from supplement). Helpful Hints for Blenderizing • Cut foods into small pieces before putting into the blender or food processor. • Remove seeds, skins and fat. • Add liquid for ease of blending. Add enough liquid to cover the blades. Options include skim milk, broth, strained low-fat cream soup, low-fat gravy, low-fat or non-fat sour cream or fat-free half & half. • Blend the item to a smooth, applesauce consistency. • Make sure there are no particles, seeds or lumps remaining. If so put through a sieve or strainer. • If you have leftover blenderized foods, try freezing in single serving portions in ice cube trays and put the frozen cubes into plastic freezer bags. Meats – Very lean and dry meats puree better by adding a small amount of fat (margarine, oil, light mayonnaise, gravy, etc.) Fish also tends to be dry. Improve the texture by adding small amount of lemon juice, light mayonnaise or strained low-fat tartar sauce. Starches – Try pureed peas, canned Beans, sweet potatoes. Starches puree better when hot. Rice and potatoes tend to puree into a gummy paste and are not recommended. Substitute cream of rice cereal prepared with a flavorful broth and seasoned with margarine. Pasta or noodles are not recommended as they are not well-tolerated. Vegetables – Cook vegetables until soft. If using canned vegetables, drain first. Add melted margarine and puree. Add a small amount of liquid until it reaches the smooth applesauce consistency. Fruit – If using canned fruit, drain first. Add a few drops of lemon juice to help prevent them from discoloring. Begin to take advantage of your favorite leftovers before surgery. Process these foods, and freeze them in an ice cube tray. (Each cube is approximately 1/2 to 1 ounce). When frozen, pop out into Zip-lock bag; label and date, and freeze cubes until needed. Meal Guidelines for the Pureed Diet (See Sample Pureed Meals listed in the Appendix) Once you begin to eat pureed foods (which are considered solids) you will want to start differentiating between liquids and solids – meals should include pureed foods, and so liquids (including protein drinks) should be taken separately from your meals. • You should eat 3 meals a day with protein drinks between meals. • Protein drinks containing at least 20 grams of protein per serving should be consumed as needed to meet 80 g/day goal. • Start with a portion size of 1 to 2 tablespoons of pureed food for the first month. At first you may not be able to tolerate this amount. Eat your protein source first, and then if you have room a small amount of fruit, vegetables or other foods may be consumed. Hints for Measuring Foods: Liquids or soft/pureed foods are best measured in measuring cups or spoons; they can be measured in ounces, Tablespoons or mls. 1 cup 8 Fluid ounces 240 ml 16 tablespoons 3/4 cup 6 fluid ounces 180 ml 12 tablespoons 1/2 cup 4 fluid ounces 120 ml 8 tablespoons 1/4 cup 2 fluid ounces 60 ml 4 tablespoons 1/8 cup 1 fluid ounce 30 ml 2 tablespoons 1 Tablespoon = 3 teaspoons 1/2 Tablespoon = 1-1/2 teaspoons Week 9-12 After Surgery: Soft solid food Diet If you have been tolerating pureed foods, you may now begin a soft diet. This includes all items listed for clear and full liquids and pureed diets plus items listed for the soft diet. Try 1 to 2 new foods a day. This will help you to learn what foods you tolerate. • Remember your stomach pouch empties more slowly with more solid or dense foods than with liquids, so you will be able to tolerate a smaller quantity of food than you could with liquids. • Go slowly. If you do not tolerate the trial of soft foods, resume pureed foods and try again in a week. • Eat protein foods first • Avoid foods high in sugar and fat. • Space meals 4-5 hours apart • Continue your protein drinks between meals • Drink other fluids constantly between meals Examples of Soft Diet (No Added Sugar/Sugar-Free, Low Fat): • Baked fish (no bones) • Imitation crab meat, baby shrimp • Bananas • Canned peaches or pears in water or juice • Well-cooked vegetables without seeds or skin (no corn or peas) • Scrambled, poached or hard boiled eggs • Tuna or egg salad (no onions, celery, pimientos, etc.) • Finely shaved deli meat • Baked, grilled or rotisserie chicken o Moist foods will be better tolerated. Moisten meats with broth, low fat mayonnaise, or low-fat gravy or sauce. o Fish and seafood Proteins are softer and easier to break down than poultry or red meat proteins. o Reheating foods tends to make them dry out and hard to tolerate. Common Problem Foods (Avoid for 3 months after surgery) • Red meat such as steak, roast beef, pork. Red meat is high in muscle fiber, which is difficult to separate even with a great deal of chewing. Avoid hamburger for one month after surgery. • Un-toasted bread; rolls, biscuits. (Toasted bread may be better-tolerated.) • Pasta • Rice • Membrane of citrus fruits • Dried fruits, nuts, popcorn, coconut • Salads, fresh fruits (except banana) and fresh uncooked vegetables, potato skins. Month 4 After Surgery: Regular Diet • Problem foods as listed above can now be tried. • Rice, pasta and doughy bread may not be tolerated for 6 months or more. • Try fresh fruits without the skin first. If tolerated, the skin can be tried the next time. Salads are generally well-tolerated if chewed well. • Go slowly. Try a small amount to see how you feel. • Avoid high sugar and high fat foods to avoid a high calorie intake. Foods to Avoid: Hard/crunchy foods may always be poorly tolerated. Nuts and seeds are difficult to break down. Fried foods/greasy foods are hard to digest and are very high in calories. • Corn chips, potato chips, tortilla chips, hard taco shells • Nuts and seeds • Fried foods and greasy foods Points to Remember: • Solid foods will fill your stomach pouch more than liquids so you will be eating smaller quantities of foods versus liquids. • If you don’t tolerate a food the first time, wait a week and try again. • You may find that you tolerate a certain food one day and not the next. It is normal for this to happen. • If you don’t tolerate certain foods or notice nausea, vomiting or diarrhea during or after eating, ask yourself the following questions: o Did I chew to a paste consistency? o Did I eat too fast? o Did I eat too much volume? o Did I drink fluid with my real meal or too close to my meal? o Did I eat something high in sugar or fat? o Was the food moist or was it too dry? Steps for adding solid foods: • Try only 1 small bite of the new food and chew well. Wait awhile and if there are no problems, take another bite. • If at any time you feel too full, nauseated or vomit, stop eating and rest. Take only clear liquids at the next meal and add blended foods and liquids at the following meal. Try one solid food again the next day. PROTEIN Protein is the most important nutrient to concentrate on when resuming your diet. Because the volume of your meals will be limited, you should aim for a minimum of 80 grams of protein per day – this needs to come from your protein supplement. Why is protein important? • Wound healing • Sparing loss of muscle • Minimizing hair loss • Preventing protein malnutrition Remember to eat protein foods first at each meal, followed by vegetables and fruit. These are some good sources of protein: Protein Sources Serving size Protein (g) Skim or 1% milk 1 cup 8 Evaporated skim milk (canned) 1 cup 19 Soy milk beverage 1 cup (8 ounces) 7 Non fat dry milk powder 1/3 cup powder 8 Nonfat, sugar free yogurt 1 cup (8 ounces) 8 Nonfat or low fat cottage cheese ½ cup (4 ounces) 14 Nonfat or low fat cheese slices String cheese *1 ounce/ 1 slice 6 LEAN meats – skinless chicken or turkey breast, fish, beef, ham, Deli meats *1 ounce 7 Egg or Egg substitute 1 egg or ¼ cup subst. 7 Peanut Butter (creamy) 1 Tablespoon 5 Tofu ¼ cup 5 Legumes; dried beans peas or lentils Chili, bean soup ½ cup cooked ½ cup 7-9 6-7 Soy/vegetable patty (like Gardenburger) 1 patty 8 - 10 Hummus ½ cup 6 Measuring Hints: *1 ounce of meat is equal to about 3 – 4 Tablespoons of chopped or ground meat. 1 ounce of grated or cottage cheese, tuna or egg salad is ~ 1/4th cup (4 Tablespoons). A 3-ounce portion size of chicken or meat is about the size of a deck of cards. High Protein Ideas Chicken or Turkey Pureed – Use baby food or make your own. Try mixing it into strained low-fat cream soup. Breast – baked or grilled Thin-sliced/shaved deli slices Ground – meatballs, meatloaf Canned – works great for chicken salad Strained out of canned soup – tends to be very moist Fish (avoid bones) Baked, broiled, poached, or grilled fish Shrimp Imitation or regular crab meat Fresh or canned

Dawn, I just copied down this list of changes that someone posted to deal with their gas problems. Maybe one of these will help you! Here's the list: I was taking Gas-X. He told me to stop taking it and to use Maalox Maximum Relief. • I was drinking a Protein shake called ENS chocolate Milk. I would mix it up thin but as it would sit it would get very thick. He asked me to stop drinking it for a while. • i was taking my multi-Vitamins in the morning. He said that they can sometimes cause gas/bloating/nausea so he asked me to take them at night before bed. • I was using soy milk for my shakes. He asked me to use regular milk for a while and see what happened. • I was taking one or two SF mints daily for my breath. The contained sugar alcohols so he asked me to stop.