Full Liquid Recipes! Part Two

I did not get too creative on my own and pretty much stuck to basic foods or the recipes they gave me.  However, my husband just finished this phase, and he got a little more creative.  So I have included a couple of his favorite things to eat.

Protein Power Oatmeal - Serves 1

1/2 cup evaporated skim milk

1/4 cup quick oats

Add evaporated milk to quick oats.  Microwave at 50% for 3-4 minutes.  Nutritional info: Calories: 230, Protein: 11 g

I have not made this as I really like Quaker Oats Weight Control Instant Oatmeal.

And now for my favorite, the one I still make and eat several times a week.

Protein Power Pudding - Serves 4

1 package (4 serving size) sugar-free pudding mix, any flavor

2 cups skim milk

4 scoops Beneprotein unflavored protein powder

Put milk in blender.  Add pudding mix and protein powder.  Blend on medium speed for 45 seconds or until well mixed.  Pour into small bowls.  Refrigerate until set.  Makes 4 half cup servings.  Nutritional info per serving: Calories: 95, Protein: 10 g

I made it as specified the first time.  And it was pudding-y though a bit thick.  But it left a kind of stickiness on my teeth that I did not like.  So I modified it.  I used the following:

1 package (4 serving) sugar-free pudding mix, any flavor

2 cups fat free Fair Life Milk

1 scoop of Unjury unflavored protein powder.

I made it in a bowl with a hand mixer and mixed for two minutes as instructed by the package of pudding.  This version is creamier and there are no sticky teeth, so a winner in my book.  Nutritional Info:  Calories: 88, Protein: 12 g

Hubby's Favorite Creations:

Protein Power Malt-o-meal - 2.5 servings of .5 cup
3 Tbsp Malt-o-Meal
1/3 c dry nonfat milk
1 cup water
1 scoop of chocolate protein powder.

Prepare Malt-o-meal with dry milk and water.  Microwave as per the box instructions.  Stir.  Stir in the protein powder.  *Nutritional info will vary based on brand of protein powder used.  We use BodyTech's Whey Tech Pro 24.*  Nutritional info per serving: Calories: 132, Protein: 14 g


Protein Power Soup - 2 servings of 1 cup
98% Fat Free Cream of Chicken (or Mushroom) Soup
1 cup water
1/3 cup dry nonfat milk
1 scoop Beneprotein unflavored protein powder

Prepare soup with dry milk and water.  Heat via stove or microwave as the label on the soup instructs.   Strain soup to eliminate chunks.  Mix in the Beneprotein.   The Cream of Chicken is his most favorite of all the recipes.  * Nutritional info will vary based on flavor and brand of soup.  This was calculated with Great Value's 98% FF Cream of Chicken*  Nutritional info per serving: Calories: 128, Protein: 9.5 g


Protein Power Cream Broth - 1 serving of 1 cup
1 cup 99% FF broth (chicken or beef)
1/3 cup nonfat dry milk
1 scoop Beneprotein unflavored protein powder

Stir together the broth and dry milk.  Heat.  Stir in Beneprotein. *Nutritional info will vary based on what broth you use.  CollegeInn has zero protein, Swanson has 2 g protein.  This was calculated with CollegeInn because it taste better.*  Nutritional Info: Calories: 120, Protein: 14 g

NOTE: You could easily substitute any generic 80 Calorie skim milk for the nonfat dry milk and water in these recipes.  Nonfat Dry Milk was used in all of his recipes because that was all we had in the house except for Fair Life Milk.  He says Fair Life Milk upsets his stomach.  Fair Life is lactose free, but it taste sweeter than regular milk even though it has less sugar.  I am not sure what about it is upsetting his stomach.

First Medical Bill

Well, the first medical bill came in the mail this week.  On Tuesday, I believe, though I did not get the mail every day this week.  With the wrong address on it, I might add, so I suppose it is a good thing it made it to my mailbox at all.  It was from Radiology for my pre-op chest x-rays that I had done way back on 5/8/15.

The amount looked awfully familiar.  So I logged into out HRA account, and sure enough it had already been paid by the HRA earlier this month.  I though nothing of it really, things cross in the mail all the time.  Just to be sure, I thought I would call the Radiology Billing Dept to make sure things had been taken care of.

I got a very unpleasant person named Tiffany on the phone.  I explained to her unfriendly self what was going on and I was just calling to make sure they had been paid.  She proceeded to get even nastier with telling me that they had not been paid yet and would need me to make a payment or provide detailed documentation regarding the payment sent including proof they had deposited the money so they could look for the missing money.

At this point, my Dad knocked on the door.  So I told her I would call back and hung up on her.

I have never had such a bad experience when calling to make sure someone had gotten their money.  You'd think I was calling to tell her I had no intention of making good on my account.

After talking with my dad for a bit, I called the company responsible for managing our HRA.  Our HRA is a little funky.  It works differently than any other I've had experience with, and I used to work in medical billing.  After our insurance pays a claim, if we owe, the claim is sent directly from the insurance to the HRA company.  The HRA then makes payment automatically as long as there are funds in the account.  We never get a bill (until funds run out) and we don't use a payment card to make payments on our own.  All the bills have to be paid this way.  We have the option of making our own healthcare purchases using our own bank/credit cards and getting reimbursed if there are funds available.  It is weird, and every time I try to explain it to someone trying to collect money upfront they just don't get it.  In fact, when the Psychologist tried to collect their testing fee upfront (over $250.00) I tried to explain the HRA and told them I was willing to pay upfront, as long as when they received the HRA payment they would send me a refund.  They said no, no refunds.  So I said no, no prepayment.  Luckily for me, they still let me see the doctor.  I did later get a bill for my copay, but it was a lot less than what they wanted me to pay.

Back to my story though... So I called the HRA company.  I told the rep what was going on, and that I wanted to see if they had verification that the check had been deposited.  The rep looked into it and told me payment had been sent, but had not been deposited.  So I asked her to cancel the check and refund that amount back to the HRA, that I would just pay this bill myself.  She helpfully told me to be sure to save my receipt so I could file the claim to the HRA myself.

Then I called the Radiology Billing Dept back.  I was going to tell them what I did and give them my correct address.  I was on hold for a while when I noticed on the bill that I could pay online.  So I hung up and went online and paid.  They can figure it out for themselves when they try to deposit a cancelled check.  Hopefully, they will have no need of my correct address in the future.

Full Liquid Recipes! Part One

As promised, way back on 6/12 sorry, here are the Full Liquid Stage recipes I was provided with and my thoughts on them.

Protein Power Chocolate Milk - Serves 1
1/2 cup skim milk
1 packet of Swiss Miss Diet Hot Cocoa mix
1 scoop Beneprotein unflavored protein powder
4 ice cubes

Put all ingredients into blender.  Blend on high for 45 seconds.  Nutritional info: Calories: 95, Protein: 12 g

The first time I made this, I followed the recipe to a T.  It was okay.  Not enough ice to make it a true blended drink.  But also, it was frothy, so by letting it sit to defroth, most of the little ice bits were melted when I drank it.

Next time I made it, and I still do make it occasionally, I made the following changes.

1 cup Fat Free Fair Life Milk instead of 1/2 cup generic skim. (80 cal, 13 protein vs 45 cal, 4 protein)
No Ice.

This brings the Nutritional info up to: 130 Calories, 21 g Protein.  I find that it tastes richer, and has almost as much protein as a store bought protein shake powder but still tastes like hot chocolate.


Protein Power Crystal Light - Serves 1
1/2 cup Crystal Light (powder mixed with water)
1 scoop Beneprotein unflavored protein powder
2 Tbsp Cool Whip Free
4 ice cubes

Put all ingredients into blender.  Blend on high 45 seconds.  Nutritional info: Calories: 50, Protein: 6 g

I only made this once.  It was okay, but I didn't like it enough to make it again.  I had used Sunrise Orange made by Great Value.  The flavor was very weak.  I would rather just use half a packet of the Sunrise Orange and blend it right in my vanilla protein shakes.  It is like a creamsicle that way.


Peach Creamsicle Shake - Serves 1
6 ounces of Crystal Light Peach Tea
2 Tbsp Sugar-free instant vanilla pudding powder
1 scoop Vanilla protein powder
6 pkts Splenda
Ice Cubes

Thoroughly mix the ingredients in a blender.  Make sure to consume the shake over one hour.  Nutritional info will vary based upon what brand of protein powder you use.

I only made this once, and with changes.  I do not like peach anything... well except candles and lotion.  But I really don't like the taste.  So I substituted in Orange Sunrise.  I left out the Splenda as the Orange Sunrise has more sweetness to it than a peach tea would.  The taste was just alright.  Again, I would rather just add half of a single serve packet of the Orange Sunrise directly to my vanilla protein shake than to make it this way.

But, to have a little variety in my life, I do occasionally add 1 Tbsp of sugar-free pudding mix to my shakes when I make them.  I've added vanilla and butterscotch to my vanilla shakes and chocolate to my chocolate.  It makes the shake thicker and gives it a bit of a pudding flavor.  Which can be nice if you are getting tired of the same old shakes day in and day out.  I have a box of sugar-free cheesecake pudding that I want to try still.  I'm undecided if I should try chocolate cheesecake or vanilla cheesecake first.  Both have potential.

Two more recipes to go...

Unusual Infection, Zoo fun, and more!

Yesterday, was my follow-up appointment for my infected incision.  It appears to be doing well.  It isn't quite healed up yet so I am on a swimming restriction.  The infection appears to be gone now though.  He said it was unusual, but the culture they took of the pus came back as a bacteria they usually find in breast abscesses.  He said he had never seen that before in an incision infection.   I don't know how that happened either.  I don't have any breast abscesses.

After the appointment, we headed over to the Zoo.  We spent pretty much the entire day there.  I was so hot and worn out!  Yesterday was the first day, since I began tracking my steps, that I broke 10,000 steps in one day.  So, Yay me for that!  Now for some Zoo photos:

I was caught unawares by the sneaky husband here.

Argentine Tegu

Feeding time!

One of my favorite photos I took.

Then, I slept 9.5 hours last night.  I could just not wake up this morning.  When I finally managed it, I didn't let myself slack off.  I got right outside and walked my usual morning 1.5 miles.  I keep thinking I need to go that extra half mile and get up to two miles a day, but I just can't bring myself to do it.  The first half mile is good, the second half mile I tell myself I can't stop yet, by that third half mile I feel like I am going to lay down in the road and I have to argue myself into making it.  So I just don't see how I can add another half mile yet.

On the bright side, I don't know if it is the iron or the sodium, but I seem to be getting my energy back.  After a 45 minute break, I was up cleaning the house, paying bills, making phone calls etc.  I was going to volunteer at Church this afternoon.  However, I got an email telling me that due to an off-site meeting, nobody would be there to let me in.  So I rescheduled for next week.  Later this evening, I am going to babysit my nephews for the first time since I had surgery.  I am really looking forward to it, I've missed the little buggers!

Also regarding volunteering, we got an email on Monday asking us if we wanted to resume our cooking for church.  We are going to give it a shot.  We both really enjoy cooking and it is only one meal once a month.  We are planning on making some meals up ahead a time that will freeze well.  I have so many oodles and oodles of containers of shredded zucchini in the freezer that I know I am going to make something with that.  We are doing a dinner for July and a breakfast for August.  Maybe zucchini muffins?

My husband decided to go back to work today.  If he thinks he can handle it, more power to him.  Maybe he will have enough vacation days late fall this year for us to have a long weekend away somewhere.  That is a whole other kettle of fish!  We won't be small enough to do anything exciting like a roller-coaster park, nor will our bodies be remotely beach ready.  In the past, it galls me to admit, I have planned vacations around food.  Well, we can't do that anymore!  So I don't know what we will do.  But it is months away, so no need to stress yet.

Measurements

I updated the Progress Log as per my usual Monday routine.  It has been a month since I took measurements, so I went ahead and took those too.

They seem to indicate that I have been losing inches, except my arms.  Batwings, here I come!  But... can my measuring be trusted?  I seriously never know if I am measuring in the same place twice.  It must be nice for people who have a defined shape.  As for me, it is just all lumpy.    I am pretty sure I measure my hips and arms in the same place.  My hips definitely stand out as the widest part of my lower torso.  My bust though, as I lose weight, they will sag more and more.  So, do I continue to measure the fullest part, which may inch its way down my torso, or do I measure at the same place across my chest?  I'm not sure about the protocol for this.  That is one of the reason's I've never been that enthused about taking and tracking my measurements.

I know there will be time when my weight loss stalls and after a few weeks on a plateau, I may want to check my measurements to see if there is any change there.  Hence, why I took them in the first place.  I'm not good at this though.  I feel like I want to be excited by a 2 inch loss.  Then, I think I am just deluding myself and there is no way I measured correctly.  Maybe not the first time, maybe not this time, or both.

I know I can use my clothing as a reference.  I wore a shirt yesterday that two months prior I felt was too tight.  Was it two inches too tight?  I don't know, how do you tell that?  I can easily zip my size 36 jeans now, no sucking in at all.  They are not falling off me yet though.  I am not going to spend money to try a size 34 since I still have to order my clothes online at this point.  I do have a couple size 32 jeans in my closest that I bought a couple years ago optimistically.  I cannot zip those yet even when performing acrobatics.  So maybe I am at a tight 34?  Possibly.  I think I do see a slight difference in my face.  And my Mom tells me she can see a difference.  But would she tell me if she couldn't...

In any case, I will continue to take measurements, hoping that I am measuring close to the same place each time.

Exhaustion

I have been extremely exhausted since Friday.  I feel like a zombie walking around.  My husband keeps asking me if I am mad at him because it takes too much effort for me to talk to him.  He is not used to the silence from me.

I've taken a lot of naps.  I've been sleeping over 8 hours a night which is pretty unusual for me.  It's really screwing up my eating and pill taking time table.  I missed a meal completely on Friday.  I took at nap at 5:45 after I finished my 3rd meal of the day.  I slept until 10 PM.  So I got up, spent the next two hours taking the pills I considered most important, then went back to bed.  And I had no problem going back to sleep despite my long nap.

Maybe I am anemic as my first period since surgery started this past Wednesday.  I felt fine until Friday and nothing has changed except this.  I don't think I am depressed.  I'm not sad, angry, or even apathetic.  I care, I'm just too tired to do anything about it.  The past two days I've been hitting high iron foods hard.  Oatmeal, beef, beans, chicken, turkey.  Pretty much in that order.

Just this evening I started to consider that perhaps I am not getting enough salt in my diet.  Fatigue is also a symptom of hyponatremia (low blood salt).  I normally don't salt anything I cook.  That would be most of the meats I've been eating.  So using myfitnesspal.com, I looked at the record of my salt intake over the past 30 days.  It ranges from 850 mg to 1300 mg, with an average of 1070 mg for the past 21 days.  From Google:

The 2010 Dietary Guidelines for Americans recommend an upper limit for sodium consumption of 2,300 milligrams of sodium per day for adults. If you are African American, age 51 or older or have high blood pressure, diabetes or chronic disease, that recommendation is lowered to 1,500 milligrams per day.

So perhaps I'm too low in that.  I honestly don't know.  I just know I'm tired.  And when I get more talkative, I'm cranky.  My husband is not too please to be around me right now.

I don't have any blood work done to test my levels for 3 more weeks.  I guess I'll just hang in there for now.  Try to eat a little more salt and keep up on eating the iron-y foods. Now, I'm off to bed.

Bari Life Products Review

So do you remember the packets of samples I got from my sister's friend, Carrie?  Well, eight of them were samples of Bari Life products with some duplicates.  There were a total of six different samples.  Most of which I ate, one of which my husband ate.  This is my review of these products.

Chicken Bouillon Protein Soup:  Essentially chicken broth.  Microwave instructions were to mix contents of packet with 6-8 oz of water until smooth.  Microwave for 60 seconds.  It takes quite a bit of mixing and lump smashing to get it smooth.  60 seconds gets it warm enough, but I have a measly 700 watt microwave.  I imagine if you have a more powerful microwave it would have been a bit warmer.  It tasted like seasoned chicken broth.  I had no problems eating it all.  For 15 grams of protein, it's not bad.  But, I feel like I could add some unflavored protein powder to the chicken broth I like and have the same effect for less money.

Beef Bouillon Protein Soup:  This was by far the best of the products I tried.  It had a rich beefy flavor.  It was made the same way the Chicken Soup, but I microwaved it for 30 seconds more.

Cream of Tomato Protein Soup:  This is the only packet my husband ate as I do not like tomato soup.  So this is his opinion.  He said it was lumpy after he made it.  He said it was tomato-y and garlic-y, but that was about it.  It didn't actually remind him of tomato soup.  And it was much thinner than tomato soup.

Double Chocolate Pudding:  First, I could not find this exact product on the BariLife.com website.  All of their puddings are called Pudding/Shake, whereas this packet was clearly just marked as pudding.  Also, the chocolate sold on the website is called Swiss Chocolate, and this was called Double Chocolate.  I do not know if what I ate was discontinued, or if name and packaging were simply reworked.  That being said, I didn't like this.  You mix the packet with 4 ounces of cold water while stirring rapidly.  At first, it was a powdery mess, but then almost instantly it turned smooth and started to thicken.  So kudos for that.  The first bite was mmm chocolate.  But I noticed the more I ate, the more bitter it seems to me to the point where I was barely tasting chocolate at all.  I couldn't finish it.

Vanilla Pudding/Shake:  I was able to eat all of this, but I would not eat it again.  Like the chocolate, you simply mix this with 4 oz of cold water to have pudding.  To make a shake, mix with 8 oz cold water.  Since I have plenty of shakes already, I choose to make pudding.  The pudding was significantly thinner than the chocolate pudding.  It almost was the consistency of cake mix.  The first few bites actually reminded me of cake mix too.  But once my tongue was coated, the following bites were bland.

Hot Chocolate:  This was surprisingly good.  I admit I went in pretty leery due to my bad experience with the chocolate pudding.  First sip was hot chocolaty, and as I continued it stayed that way.  It tasted just like hot chocolate.  I don't think I will buy any though, I am not a huge fan of hot chocolate.  it is just something nice to have once in a while.

Bathroom TMI

I have been having acid reflux for the past two days.  Plus, my bowl movements have been green tinged for about a week now.  This means there is extra bile going through my system.  I am disappointed, because I was told having the gastric bypass should help with this.  I am worried the excess acid is going to give me an ulcer where the inside incisions are healing.  It got so bad last night I had to take 2 generic Tums.  Those hurt my stomach making it feel almost like it was too full of gas.  Then this morning, I had burning butt hole as the acid left me at the other end.  I'll be calling the doctor this morning as soon as his office opens.

Husband's turn

Today is my Husband's gastric bypass surgery.  We have to be there at 5;30 AM.  I am so tired.  But I am excited for him too.

ER visit

I had to go to the Emergency Room last night.

The entire day went fine.  In the evening, around 7:30 PM, I took a shower.  A couple hours later, we are talking about going to bed.  We are watching television and decide when the show is over it would be lights out.  I noticed I am having a little bit of pinching pain at one of my incision sites.  There are two incisions that are right where the waist band of my pants fall.  So occasionally the pants with elastic pulls on the steri-tape that is over the incisions.  So, not thinking about it, I pull my pajama pants away from my waist.  Ouch!  That hurt quite a bit!

I look and one of the incisions seems to have yellow pus coming through steri-tape.  My first thought was "Why did this have to be a Friday night?"  Seriously, it has all week for this to happen when I could just call the doctor's office, but no, now they are closed for the weekend.

My husband grabs the binder and we review the section on incisions.  I already knew what it said because I had just posted it in, but I really didn't want to do it, so we double checked.  Nope, still says I have to call the after-hours number right away.

I call and get an answering service.  I explain to her what is going on.  She says she will put me on hold while she tries to reach the on-call doctor.  She pops back on the line a couple times to reassure me it won't be long and please don't hang up.  I wait, finally the doctor comes on the line.  His voice is very low and scratchy, maybe he was a sleep?  Plus there was an accent of some sort, so I can barely understand him.  I explain what is going on to him.  He tells me to go to the ER.  But I didn't understand and had to ask him to repeat himself.  He told me again several times, so now it my turn to reassure someone.  I told him I would go as soon as we hung up.

In the meantime, my husband has been feeding the animals, letting Wren (our dog) out to potty, and getting dressed.  Once I hang up, I too get ready to go, because I'm not wearing my pjs to the ER.  By the time we leave, it is a bit after 10 PM.  It is raining and there is so much road construction so we have to detour.  What is normally at 20-25 minute drive took us 35 minutes.

Once we check in at the ER, I notice a sign above the check-in desk that says current wait time for adults is two hours.  I wish I had taken a book.  To my relief, five minutes later someone escorted us to an examination room.  A nurse took my vitals, reviewed my meds, I explained again what was going on.

Maybe twenty minutes later a doctor arrives to look at my incision.  He removed the steri-tape.  That was a bit painful.  Then I get to see a pink gash covered in yellow pus.  He cleans the site, but when he presses on my belly around the incision, more yellow pus oozes out of me.  So he does that for 30 seconds or so until there is no more pus.  He cleans it again.  I can see now that most of the incision appears to be healing except for a small hole where the pus is coming out.  He says I caught it pretty early, the skin isn't red yet, there is no inflammation, an antibiotic should be able to take care of it.  He took a culture to make sure the infection wasn't of an antibiotic resistant strain.  He dresses the wound and asks me to wait.

While the culture is tested, he will call my surgeon to make sure that he doesn't want anything else done.  So we wait.  I fell asleep sitting up.  So I laid the bed down and turned on my side and went to sleep.

At about 12:45, the nurse came back in.  She said the doctor couldn't get a hold of my surgeon.  So he wrote a prescription for the antibiotic and wants me to call my surgeon on Monday.  I was to be discharged.  I left with the prescription.  My husband drove me home.  I slept, and when I got home, I fell into bed.

My husband is awesome.  He drove me and waited.  He was awake that whole time.  He is such a amazing great man and takes care of me so well.  I do love him so.

Product Reviews: Fair Life Milk and Beneprotein

Fair Life Milk

I found this in the grocery store when I was looking for a milk alternative to skim milk.  I had read about Hood's Calorie Countdown milk and was searching for something similar.  Hood's products are unfortunately not available in my area.  I confirmed this by inquiring of Hood to which I got short but polite letter telling me so.  It advised me that I could request my store special order it in for me.

Anyway, in my search, I came across Fair Life Milk.  It is a Coca~Cola product.  That seems weird, but soda pop sales are in decline, so I guess they are diversifying.  It looks like this:

I bought the fat free.  But it also comes in 2%, whole, and chocolate.  As you can see, the label says it has 50% more protein and 30% more calcium versus ordinary milk.  The back of the label says it has 50% less sugar and is lactose free.  One cup has 80 calories, 0 g fat, 6 g carbs, 6 g sugars, 13 g protein, and 40% calcium.

There are multiple reviews on it online already going into technical stuff regarding it nutritional value and taste tests for it's taste bud appeal.  I am not qualified to go into technical stuff, and I have not tasted Fair Life Milk right out of the bottle.  I've only used it in shakes and recipes.

What I can tell you, is that for me, it's great.  For people needing to reduce their sugar (diabetics, WLS patients, ?) and those who need to increase their protein (WLS patients, vegetarians, ?)  it is awesome.

I don't worry about dumping so much when using it.  It is a big help getting in my required protein.  Plus, although it is not an issue yet for me, it has more calcium in which WLS patients are prone to having a deficiency.  All in all, I really like it.

The only down side is price.  The bottle is not quite a half gallon, with servings per container listed as About 7.  And it cost me $3.99 last week.  I bought it twice, the second time I got the last bottle of fat free.  The fat free must fly off the shelf.  This week, I was pleasantly surprised to find it on a price drop at 2/$6.00.

Beneprotein

This was recommended to me by the nutritionist.  It is a flavorless whet protein powder.  it is made by Nestle.  You can find it at Amazon, but I bought mine at a local chain pharmacy.  I believe it was 13.99, which I later found out is more expensive than Amazon.com.  It looks like this:

I've added this to a few recipes with great success.  I really can't tell it's in there.  It boosts my protein intake up a bit with being gross... so bonus!  It says to just stir it into hot or cold.  In cold drinks, I find that it doesn't stir in too well, you really have to use a blender of some sort to get out all the lumps.  For recipes that get microwaved, don't put it in until after you heat the food/drink.  It changes the texture and gets lumpy, not good.  I find if I add it to my Cream of Rice or oatmeal after the heating, it does just fine.  Remember, those items are supposed to thin anyways, so there is plenty of liquid to mix the protein powder into.

Day 3 - Day 9: Full Liquids

Starting on Day 3, I was allowed to include the following liquids:

• Sugar-free pudding
• Oatmeal - made with quick oats and milk or Quaker Oats Weight Control Oatmeal, made thin and liquidy
• Cream of Wheat - made with milk
• Cream of Rice - made with milk
• Grits - made with milk
• Malt-o-Meal - made with milk
• Low-fat creamed soups - made with milk and strained to get rid of chunks
• Protein Shakes

Meals: You must eat four small meals a day.  Eat slowly.  2-4 ounces over 15 minutes.  If you don't feel full, eat another 2-4 ounces over the next 15 minutes.  Stop eating when you feel full even if you have not finished 2 ounces.  Always measure your food and never eat more than a 1/2 cup per meal.

Fluids: You must drink 64 ounces of water or other sugar-free, non alcoholic, non-carbonated, caffeine-free beverages between meals.  This includes Crystal light, other drink flavorings, sugar free popsicles (but no more than 7 a day), sugar free gelatin, broth, and decaf herbal teas.

Not all of these are calorie free, but still allowed I guess.

You must not drink a half hour before or a half hour after each meal.  Do not use a straw as it contributes to swallowing air.  Count your protein shakes as part of your liquid total.

Protein: Protein is vital.  Your goal for this phase is 40 grams of protein a day.  Some tips to help get you there are:  make all hot cereals with milk, drink a protein shake as a meal once a day.  Use unflavored protein powder to boost the protein content of whatever you eat.

In order to hit that 40 gram goal, I had to have a protein everyday.  I was advised by the nutritionist to not use a protein as every meal though.  She said your system needs to have real food reintroduced as soon as possible.  It prevents eating issues and blockages down the road.

Medications: All pills should be taken a half hour apart.  Pills must be taken one hour before or after eating.  If the pill round and is larger than an M&M, than use a pill cutter to halve it.  Take each half a half hour apart.  Small capsules and standard size capsules should be fine.  Large capsules must be broken open.  You can add the powder to your meal.

Incredibly hard to get all your pills in when you have as many as I do.  I have to stay on top of it all day... the couple times I didn't I was up until Midnight or later to get them all in.

Exercise: By this time, you should be stretching and doing your band exercises.

I have been doing this, I also started walking on Day 4, and got up to a mile a day by Day 6.

The picture below is everything I bought for Full Liquids.  If you see something that isn't included in the list above, that is because the doctor's office provided some Full Liquids approved recipes that contained those ingredients.  I will share the recipes in a later post.

Full Liquids

As a caution, I will say that if you are reading this and you are going to have surgery, follow your surgeon's instructions.  I have been talking with people online for over two weeks now, and the programs people are told to follow can be vastly different.  Your doctor will know what he wants you to do.  This is what my doctor wants me to do.

Day 0 - Day 2

So, with my lack of changes, I thought I would put into the blog what my binder guidelines are telling me about gastric bypass.

Day 0 - Surgery Day - Take a shower, arrive at the hospital at the appointed time, have surgery.  Pretty easy in short words, but mentally, wow.  It was a lot.  I kept thinking, is this really happening.  I can stop this.  I can leave.  But I didn't let myself vocalize my anxiety.  I didn't let myself do anything I shouldn't, just listened to the hospital staff as they weighed me, IV'd me, injected me, moved me to the OR, put a mask on my face... left me in recovery, rolled me to my room, told me to transfer myself the 5 steps to the hospital bed.  Then I slept a lot.  No food on surgery day, just a glucose drip.

Day 1 - Grape Popsicle, so early in the morning!!  I have no idea what time it was.  If I could eat it and keep it down, time to move onto clear liquids.  Success.  Food for the day consisted of sugar free gelatin, broth, 50% diluted apple juice.  Two meals in the hospital, one at home.  I could barely drink anything all day, but since I had the IV in for over half the day, not a big deal.

Day 2 -  The day was supposed to consist of four 8 ounce protein shakes plus four cups of water or crystal light.  That didn't happen.  Day two was lousy.  For details, read Day 2 Post-Op - A really bad day.

At this point, the binder goes into detail on specific discharge and recovery instructions.

Recovery - I may be weak and tired, but try to be as active as possible.  Avoid sitting and standing without moving for long periods, i.e. we don't want you to get blood clots.  Perform 10 ankles pumps per hour to help prevent clots, and use spirometer every hour to help prevent pneumonia.  Avoid lift more than 20 pounds and do not vacuum or mow the lawn for two weeks.  You may travel in the car when you feel up to it, but no driving until you are completely off pain medication.

I did pretty good at this.  I was much more faithful with the spirometer than the ankle pumps.  But that darn lingering cough had me worried.  Thankfully, it is gone now.  I did not vacuum for two weeks, it drove me crazy!  Dog hair everywhere.  Yesterday, I swept the whole house and was happy to do so.

Pain Medications - Stay on top of the pain.  Pain medications work better at warding off pain than they do at stopping it once it has begun.  Cut the pills in half, wait 30 minutes and then take the other half.

No problems here.

Time Off Work - Plan on 2-4 weeks.  Less for sedentary jobs, more for active jobs.  Some extremely active jobs may need up to 6 weeks.  You are cautioned not to return to work too early.  You need time to recover, acclimate to your new digestive system, exercise, and get support.

No problems here either.

Personal Hygiene - You may need someone at home to assist you the first few days.  Flushable baby wipes are gentler as well as a peri-bottle.  You could also use a small sports-top water bottle.  A long handled sponge can be useful.

Thank God I had no problems here.  Able to do what I needed by myself without special equipment.

Incision Care - The incisions will need minimal care.  If you had sutures, they will dissolve.  If you had tape, leave it on until it falls off.  Wear loose clothing so the incisions are open to the air.  Keep them dry and clean.  You may shower with soap and water, but do not scrub them.  Pat the area dry.  No tub soaking for 3 weeks.

Signs of infection: incision is reddened, swollen, leaks pus, has red streaks, has yellow/green puss-like and/or odorous drainage, feels increasingly sore, or if you have a fever above 101.5 F.  Check your fever twice a day for ten days.
Signs of something wrong other than incision infection:  fever above 101.5 F, increased belly pain, persistent vomiting or diarrhea, shortness of breath, new leg swelling or new leg pain.  If any of these occur, call your surgeon right away, we have an after hours and weekend on-call doctor.  So call immediately!  Do not use any antibiotic ointment or other ointments on your incision.

I had a very successful surgery and outcomes with regards to recovery.  I did check my fever.  Especially with the green stuff I was coughing up.  But all was well.

Drainage Tube (if present) -   You will need to drain the small bulb at least three times a day, or when it gets half full.  Write down the amount of drainage.  Call the doctor if the drainage changes from pink to green or brown.  Do not soak in the tub as long as the drain tube is present.  normal drainage will change from bloody to pink to a clear yellow.

My doctor does not do the drainage tube unless circumstances warrant it.  His partner does for every surgery... phew close call!

Tomorrow will be Day 3 - 9, unless something more interesting happens to write about.

Also, my Mom came through surgery just fine.  :)

Keep On Keeping On

Things are going well.  I haven't had too much to say, simple because not too much has changed.  I have been consistently walking 1.5 miles a day since this past Sunday.  The last two mornings I even took our dog with me.  I have been better at doing my daily stretches and band exercises, but I did miss Monday.  My bathroom habits have remained regular without any over the counter assistance.  My food intake is the same although I have increased my protein as I am supposed to do.  I haven't noticed any changes in my body with regards to being small or losing hair.  I am losing at a steady pace of 0.5 - 1.0 lbs a day.

Mentally, I am in a better place than I was last week.  I am not being so hard on myself.  I still want foods I can't have.  But it is all in my mind.  I don't have any physical cravings as I have now been without any high carb/high fat/sugary food for four weeks now.  I am actually tired of all the sweet food.  Protein shakes, pudding, gelatin, popsicles, etc... almost everything I can eat at this point is sweet.  I look forward to the day that I can have meat again.

It is going to be busy here for the next week or so.  Tomorrow, my Mom is having surgery to have a hernia repaired.  I have an order to make a graduation cake for this Saturday.  First cake, since surgery, eek!  Monday, my husband is having his gastric bypass and gall bladder removal done.  So, I will have a lot on my mind and a lot to do.

One thing, that I have noticed, is I am having less back pain.  That is a major plus for me.  There is still some pain, maybe there always will be.  But a month ago, I wouldn't have been having a morning walk.  It would have been a late afternoon walk, maybe.  It took that much of the day for me to loosen up enough to walk more than 10-20 steps before having to sit down.  Look at me now!  A mile and a half at 7:30 in the morning!  Five days ago, I was doing my walking mid-day.  Ten days ago, it was in the afternoon.  Prior to surgery, as I said, late afternoon.  I am quite please with this.  I don't attribute it to the little weight I have lost so far though.  It is only 15 pounds difference since 05/10/15 and now.  I think it is mainly due to the stretching, band exercises, and walking.    So I've got to keep it up!

My knee and hip pain is almost gone.  I am still having ankle pain and Achilles tendon pain.  I ice for 20 minutes per ankle after I walk everyday.  It helps.  If I forget, I find myself hobbling around the house.  I am really looking forward to getting back in the water.  I'm just going to keep on keeping on at this point.

Attitude adjustment

Between this week's church service and something I read online, I've decided to adjust my attitude and stop being so negative however fast or slow my weight loss may be.

Yesterday's sermon was on using your compass to stay on the straight path, taking one step at a time, and fixing your eyes on the end goal.  Obviously they were not talking about weight loss, but rather on having a close relationship with God.  Still, I think it applies to me in weight loss too.  It was just what I needed to hear.

I have my compass, my binder, that will guide my exercise, food choices, vitamins, follow-up appts, etc for the whole next year.  It is up to me to stay faithful to the rules and stay on the path.  I am on the section labeled Day 10-Day 16.  One week, that is all I need to focus on.  What comes next week, well, when I get there I'll deal with it.  My end goal is to be healthier and more active with less pain.  Each day that I stick to the plan, that goal of being healthier and more active is realized bit by bit.

What I read online, was from someone else who had had a gastric bypass and was now a year down the road.  She said she didn't lose anything at all for the first three weeks.  Then it seemed like a struggled to lose every pound for four months.  Finally in month four, she was able to eat enough that her body no longer thought she was starving, and the weight began to fall off.  Maybe that is happening to me?  I don't know.  But I didn't go into this process with the sole purpose of losing weight.

I've already had accomplishments besides weight loss.  Everyday since day 4 post-op, I've been walking a mile just for exercise.  Today, I upped it to 1.5 miles.  In addition to that, I am using my Vivofit to track my total daily steps.  So including the exercising, I am making sure I get no less than 5,000 steps in a day.  Day 4, I put in 5,508 steps.  The Vivofit's step goal keeps creeping up, so I am aiming for 7,000 steps a day now.  That is amazing compared to what my activity level was even 2 months ago.

I've resisted a myriad of foods that I shouldn't or literally cannot eat.  Do they look great?  Of course!  Do I want them?  Yes!  Could I still eat some of them?  Sure I could, but I won't!  I didn't go through an expensive and painful procedure to sabotage myself now.

As of today, I've lost 5 pounds.  I want it to be more.  But it will come with time.  You cannot eat low amounts of healthy food and exercise daily, and still not lose weight.  So, I will get there.

So the Nutritionist said...

I am doing normal.  That is pretty much the results of my follow-up appointment yesterday.  Everyone is pleased with my results (except me).

We went over my food intake.  I had taken my tablet in with me so I could access myfitnesspal.com and show her exactly what I had been eating.  I log food into that website religiously.  She said it looked like I was doing great.  This is good news.

We discussed any issues that might occur such as dizziness, burping, heartburn, constipation, diarrhea, vomiting.  Which led me to telling her about my Day 2.  She said it sounds like my intestines had not woken back up after they were paralyzed for surgery.  There was enough room for my clear liquids to go down from Day 1, but once I moved onto thicker liquids, they just couldn't handle it.  So when I got over full, it came back up.  Then later in the day when they finally woke up, that is why I had so much cramping and pain in my abdomen as the intestines were moving what was in them down all at once.  She said if I had a build up of scar tissue, or any other surgery complication, I would still be having pain.  I am not.  More good news.

We discussed my weight loss.  She said they expect patients to lose between 3-7% of their excess weight by the one week appointment.  I am at 3%.  I went on to say I didn't understand how I would get to losing 44 lbs by one month when I was losing so slowly.  She did the calculation herself and saw that yes, a 25% loss for me would be 44 lbs.  Then she said that they expect patients to be a 25% loss by their 6 week follow-up appointment.  (Clearly in contradiction to what was given me by the doctor.)  So I just let it go, realizing that she had no answers for me.

After that I was taken to an examine room to see the doctor's Physician's Assistant.  The nurse took my vitals, reviewed what medications I was on.  I asked if if I took the leftover cough syrup with codeine in it to sleep at night if it would be okay.  She said she could not recommend it, but it would not interact badly with my surgery or any of the medications I was currently taking.  She said I could not take it if I was still on pain medication, but I am not.  She went on to recommend taking Claritin daily and Benedryl nightly until the Claritin took effect.  She said it was much more effective at clearing up post nasal drip than what I had been taking.  I asked her when I could expect to be healed enough to go back and see the chiropractor.  She told me to skip one visit and then continue on as before.  So that is good news.

They the PA came in.  He asked me some of the same things.  He told me that I could resume swimming after week three.  He examined my incision sites commenting on the huge bruise on my lower belly.  It is as big as a baseball.  I told him it was where I got one of the Lovenox injections, that's the blood thinner.  He said all the incisions looked great and to not pick at the tape covering them.  He said as I produce new skin the tape will come off naturally.  If edges start popping up, I could have someone I trust take a small, sharp pair of scissors and trim them.  He said the reason I should not pick at the tape is because if the tape comes away before it is ready, it may take the scab from the incision with it.  So all in all that was good news too.

I was given my lab work order to be completed a week before my six week appointment and sent on my way.

Weight Loss Expectations After Surgery

As I've posted before, I feel like I am losing weight very slowly.  I realize not everyone loses at the same rate.  But when I hear other people's success stories, both from Support Group and the Facebook support group I joined, it makes me feel like my progress so far is not the norm.  I know what you are thinking, it's only been eight days.  I should ease up on myself.  I know, right?

I have a chart from my doctor showing what my expected weight loss should be at certain times based on percentage of excess weight lost.  This is based on the averages of his past patients.  I also have a picture from the FB support group showing what you may expect to lose by a certain point based solely upon your beginning weight.  Let me share them.

From my doctor:

At one month, I can expect to have lost 25% of my excess weight.  For me this would be 44 lbs.

At three months, I can expect to have lost 43%.  For me this would be 75 lbs.

At six months, I can expect to have lost 69%.  For me this would be 121 lbs.

At nine months, I can expect to have lost 75%.  For me this would be 132 lbs.

At one year, I can expect to have lost 81%.  For me this would be 142 lbs.


From the FB support group:

As you can see, the FB expectations are much more moderate.  And I would be okay with them.  I fall in the 300-400 lbs category.  So in the first ten days, I could lose 10-30 lbs.  Well, seeing as I'm at day eight today, and I have not even lost 5 lbs, I just don't see that happening.

This is why I am not happy with my progress.  Chart showing my expectant loss, patient's telling of their success.  It makes me think, "Well, don't I just suck."

I can't eat any less at this point.  It would be difficult to eat more, although I could try.  So the only thing I can do is up my exercise.

My one week follow-up appt with the doctor is in an hour.  I will have to ask him about it.

Week One Post RNY in review

It's been a week!  I'm still moving along, not that I have a choice in it at this point.  But I am feeling a little better.  Here is my week in review.

1 - Made it through surgery with flying colors.

2 - Had my first food? blockage.

3 - Threw up for the first time.

4 - Cried for the first time.

5 - Had first BM and it was unaided by medications.

6 - Have begun doing my stretches and band exercises.

7 - Have started walking daily, though not far.

8 - Have taken all my pills each day.

9 - Am consistently drinking 5-6 cups a day, but need to get it up to 8 cups.

10 - Have gotten up to eating 40 grams of protein daily.

11 - Have not been tempted to eat anything off the plan.

12 - Still have a cold, spend most nights coughing.

13 - Getting very little sleep.

14 - Lost my first 2 lbs.

That about does it and there are more positives than negatives.  So yay!

Where is my ray of sunshine?

Well, it's Monday again, good ole weigh-in day.  I'm disappointed.  I weigh 333.1 lbs.  I haven't lost anything.  I expected something, a pound, maybe two, but nothing major and certainly more than zero.  Support Group is tonight.  At last month's Support Group meeting, there was a man who was five days out, just like me now, who had already lost ten pounds.  Granted, he is a man and they lose faster, but that was why I was going to be happy with a 1-2 lb loss.  Now, I fear I will fail at weight loss even with surgery.

Last night was my first night sleeping all the way through the night and actually in my bed.  It was great to get some good sleep.  I even woke up on my stomach at one point, which I didn't think I'd be able to do for a while yet.  Of course, now my lower back hurts like it always does when I spend more than 3-4 hours in the bed.  It was kind of nice going six days without back pain.

Most, but not all, of my six incisions have been stinging the past couple of days.  None look infected, so not sure what that is about.  I thought you were supposed to itch as you healed, not sting.  A couple of them have some pretty good bruising around them.  But there are the 3 bruises from where I had the blood thinner shots.  Those were to prevent blood clots while I was in the hospital.  Here is a picture.

Incisions and bruises

I feel like this was a very negative post.  I wish I had some good news or something nice to say besides that I slept all night.  I think I might be a little depressed, but I have to keep on a happy face for my husband who has surgery in two weeks.  I don't want to scare him off.  I know he'll do great, that's what guys do.