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FistFullaRoux

Gastric Bypass Surgery and Recovery

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Best of luck to your wife - I'm nearing 5 years' post op, and I can honestly say that the surgery was the best thing I ever did for myself.

From experience, I'd suggest the following:

1) If she likes Japanese food, make sure you have some miso on hand. It's ridiculously high in protein, it's easy to add to savory dishes, and a cup of miso soup gets past the "I don't want to eat but I need to consume something" problem.

2) Instant grits or instant oatmeal are good protein vectors. Cheese grits, oatmeal and yogurt, either of these are tolerable.

2) Most baby food is vile, except for the ones with fruit. And you can't live on those. I had some on hand, but I think we ended up giving it to someone with a baby because I couldn't stomach it.

3) Food processors are a wonderful thing. It's amazing how many things you can puree and have them turn out decently - beef stew was a favorite of mine, and has plenty of protein and veggies.

Unfortunately, I did end up eating a lot of scrambled eggs and peanut butter, since I couldn't tolerate the protein powders. I must have gone through 6 or 7 different types, and the texture's just all wrong for me. And, to be quite honest, I couldn't take eating mush for an entire month, so I ended up cheating with nice squishy easily chewable food. My first meal out was sauteed scallops and mashed potatoes. :laugh:

Oh, and this may sound weird, but I have 4 friends and 2 aunts who have had the surgery, and every single one of us developed a significant craving for sharp flavors like tomatoes and vinegar after surgery. I have no idea why, but it's something to keep in mind.


"Tea and cake or death! Tea and cake or death! Little Red Cookbook! Little Red Cookbook!" --Eddie Izzard

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I wish your wife and you the best. I have no advice on her post operative diet, but wanted to say that last night on a PBS show about dieting, the news on gastric bypass seems to be that it is very effective (in the 80% range after 5 years), as opposed to most other sorts of weight control programs that have nowhere near that track record. One woman who had the operation said her biggest difficulty was to get sufficient protein each day given the limited amount of food.

Cuisina's suggestion of a blog regarding your progress sounds like a good idea. I'm sure many would be interested and supportive. This will be a major change for both of you. There should be support groups for people who are going through this. Both the person getting the surgery and the family. You're wise to get the information you need now.


"Half of cooking is thinking about cooking." ---Michael Roberts

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Miso sounds great, but how do I get it? I'm in Birmingham, Alabama. Options are limited. The grits, however, I can get. And hell, how do I make it? We both like Chinese and Thai, but I can't get her near a Japanese place. Maybe I can tell her it's a different kind of Chinese...

Secondly, I can see the "logic" behind craving sharper flavors. If you are eating smaller portions, you want the same sort of flavor punch that you would get from a bigger portion. Highly flavored foods satisfy you more. It's not so much the "richness" that people talk about when they say they only need a small serving of something. It's the intense flavors. My opinion, at least. It's how the haute cuisine places get by with serving a small dollop of food and having people satisfied with it.

Finally, would this site and this forum be the place to do this blog, or should I put it up somewhere else and point folks to it?


Screw it. It's a Butterball.

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Hummis ahould be good. It is chickpeas, tahine (sesame paste), olive oil, and garlic. All pureed. I describe it as garlic peanut butter but with out the trans fats.

If you are interested I can post my recipe. There are a zillion but people seem to like mine.

Cakes

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Miso sounds great, but how do I get it? I'm in Birmingham, Alabama. Options are limited. The grits, however, I can get. And hell, how do I make it? We both like Chinese and Thai, but I can't get her near a Japanese place. Maybe I can tell her it's a different kind of Chinese...

Well, there's an Asian Super Market listed at 1407 Montgomery Highway - it's probably worth giving them a call. There are also places you can order online - I googled "miso paste order" and it came up with a bunch of vendors. Basically you can stir the paste into veggie broth or chicken broth to make the soup, or marinate things in it. There are plenty of recipes out there, and it's really easy to work with. (Note on soup: you can get an instant version of the traditional broth, called dashi, but it's really easy to make from scratch. Unfortunately, it involves seaweed, which may be a little overadventurous for her.)

My mom isn't big on Japanese either, but she really seems to like the Japanese steakhouse places - they're basically stir-fry, nothing raw unless you go out of your way to order it. They'll generally do miso soup too, if you want to try some before you invest in a tub of miso.


"Tea and cake or death! Tea and cake or death! Little Red Cookbook! Little Red Cookbook!" --Eddie Izzard

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Tryska - Yeah it came with my box a couple years ago, I don't know if they still have it as I now just buy the shakes and toss the literature.

All you do is prepare the myoplex as you normally would with I believe 16 oz of milk or water and then add two tablespoons of your favorite nonfat, sugarfree pudding. Mix it thoroughly and throw it in the fridge for an hour and you will be all set.

There is another great one where you add 3/4 cup of lite cool whip and make chocolate mousse - it is really good and packed with protein.

Bill Phillips the founder of EAS just came out with a new book Eating for Life, it features over 150 recipes that are well balanced (nice portions of protein) and smaller portion sizes, for those of us who eat 5 - 6 smaller meals a day. They are all incredible and include a section on nutrition shake flavors and desserts, often made with myoplex lite.

Fistfullaroux - this is another good book to check out as the recipes have a ton of flavor but are smaller portion sizes. The website, with some sample recipes is Eating for Life

Chad


Quickly, bring me a beaker of wine, so that I may wet my mind and say something clever.

-- Aristophanes (450 BC - 388 BC)

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Not sure what the goal is here. If she needs lots 'o protein with low carbs, then the grits and oatmeal suggested earlier are not really a good idea. Way too starchy. Soy may be your best friend for a while -- I'd look into something like TVP (texture vegetable protein), which is basically bits of processed soy. Insanely high in protein, virtually zero carbs, and works quite well as a sub for rice -- in rice pudding, say, or fried rice. Soy grits can also be delicious, though not exactly grits-like, and any good healthfood store should be able to provide them (along with TVP) or order them, if necessary. Do check with her doc before going heavy into soy, though

I second the miso idea, though as others have suggested, liquids may not be ideal, since they take up so much space for relatively little protein-punch. Another idea would be something like chicken-breast-and-tofu pate, otherwise known as mush. Super low in fat and carbs, v. high in protein, and only semi-solid.

You might also want to look at some of the low-carb cookbooks out there, as they'll feature recipes that are low in carbs but comparatively high in protein.

Be careful about legumes other than soy -- including chickpeas -- as they're relatively high in carbs, despite their high protein counts.

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I live in Appleton, Wisconsin, not exactly an urban metropolis, and I was surprised to find miso in our natural foods refrigeration case. Ask in your most upscale grocery, they might actually have it.

I would be curious to know what other options were presented to your wife and why she chose the bypass surgery. Sorry if I'm being too nosy.


What's wrong with peanut butter and mustard? What else is a guy supposed to do when we are out of jelly?

-Dad

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The carbs are kind of secondary. It's not Adkins. It is a high protein to bulk ratio, and a low fat/cholesterol per serving idea.

For example, an 8 oz prime rib steak (BTW, she can't have steak until about week 4) has:

690 calories - 37 grams of protein - 160 mg of cholesterol - 60 grams of fat

8 oz of grilled plain chicken breast has:

240 calories - 40 grams protein - 120 mg cholesterol - 2 grams of fat

An 8 oz protein shake has: (rough estimates, depending on what it is mixed with and the concentration used) this is for the EAS Myoplex as referenced above

200 calories - 35 grams of protein - 12 mg cholesterol - 1 gram of fat

The stomach will be able to hold about 2 ounces after the surgery. It will take 4 servings to get 8 ounces of anything in. A steak, while providing similar amounts of protein, is far less healthy than a shake. The chicken is better, but still not as good.

Not only that, but waiting 45 minutes to 1 hour before you can take the next serving means that the steak and chicken will frankly be... icky. The shake can rest in the fridge, and be just fine.

The point being, that in a few months, as the weight is falling off, she is going to be eating the same way I do, just in far smaller portions. The protein will have to be eaten first, since she will fill up far quicker. Casseroles are out, beacuse you can't bulk up on carbs, you get no value from the food. The protein levels have to stay high, because of the way the plumbing is rearranged. Fewer nutrients are going to be absorbed, so the above average (or "normal") protein requirements. Also add a multivitamin or two per day.

Without the higher levels of protein, the body will start eating the good stuff that you want to keep, like bones and muscle. It can have all the fat it wants. It takes more calories to burn fat than sugar (which carbs turn into). But that, like I said is secondary. you want to preserve the muscle tissue, and not have the body trying to burn that instead of fat.

:wacko: Visions of my old organic chemistry textbook running through my head.

I'm looking for protein sources that can be prepared in small batches. If it has carbs or fat in it, it's OK. At this point, I'm just trying to find options other than the 6 or 7 flavors of chicken breast that she will eat.


Screw it. It's a Butterball.

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Will she be able to eat only 2 oz at a time permanently or only at the beginning?


"Half of cooking is thinking about cooking." ---Michael Roberts

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I would be curious to know what other options were presented to your wife and why she chose the bypass surgery. Sorry if I'm being too nosy.

Not too nosy. A legitimate question.

I know that she has tried a number of different "diet plans" over the years. Weight Watchers, Jenny Craig, working out, Sugar Busters, etc... She weighs 320 pounds. She does not always make the best nutritional decisions. Since we've been together, she uses far less butter in the mashed potatoes, for example. So that part is getting better. We're more active now, but she has still put on 30 pounds since we got married (that's 10 pounds per year). She's been big all of her life, and at 35, thinking about starting a family, something has to be done.

As far as options presented, there really wasn't another one. Her blood pressure is getting iffy, she has sleep apnea and other respiratory issues, she's having musculo-skeletal problems, and she falls down a lot. It's time. She's tried to do it on her own, I've tried to help her, but it's not working.

It is not the easy way out. We both realize that. A lot can go wrong. It's not reversible. It is a major lifestyle change. That's why I'm trying to turn to the folks around here who know and care about food so I can try to provide her with the most options within the requirements of her new digestive system. I know that if she is faced with eating a limited number of things for the rest of her life, she will lose her mind. I'm just trying to be prepared. And I'm not far from needing the surgery myself. I'm hoping that the evening meals we share together are going to become healthier, and I'll drop a few as well.

Will she be able to eat only 2 oz at a time permanently or only at the beginning?

The stomach can and does stretch post op. It is possible to defeat the surgery. It's 1.5 to 2 oz at the time of surgery, but at about the 1 year mark, it has expanded to around 3, where it tends to stay, unless you try to stretch it more. I know my stomach handles something along the lines of 10-16 oz, depending on the day. You are talking about 1/8th of that size. Even if she were to eat 8 meals a day of the same food I do, it would only be equal to one of mine.


Screw it. It's a Butterball.

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hey fist - i just spoke to my coworker about her surgery. a couple of things she told me - first off there is a book that her doctor told her to get, she will pass on the title to me, on Monday - said it's been an invaluable resource, and her doctor told her to read through that before asking any questions, because that's hte resource he would get the answers from anyway.

second as far as food goes she said, for those first ocuple weeks coming back from surgery some must haves for the fridge include:

1. botteld water - it's real important to keep adequately hydrated since part of our digestive tract is not being used, and tap water can get real old real fast.

2. sugar-free popsicles - she says they were a lifesaver

3. sugar-free jello

4. broth

she says you wife is most likely not gonna want to eat, but this is the time to baby your stomach, since it's healing. so i guess for my coworker the first few days were strictly clear fluids.

she used protein shakes too - but her preferred brand is the atkins canned shake. she also said that it was 6 months before she could eat steak, but really she went by this mystery book, which i'll get you the name of.

lastly the thing she stressed most to me was that your wife has to ge tup and move aorund after hte surgery. don't treat it as a sickbed scenario when she's recovering. she said that the first 6 months are the most important where fatloss is concerned, and do it little by little, but don't jsut lie there first few days. get moving because it will help you feel better, and will get the body functions back to normal - meaning the catheter can come out sooner.

she said when she was came out of the hospital, she made it a point to get dressed everyday, and just make a few trips out to the mailbox, maybe 3 or 4 during the day. then when she started feeling better, she would go down the street a little and come back...and then further. but she couldn't stress enough how important this part was.

i will let you know the name of the book when she gives it to me. hope this helps.

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oh also on the 2 oz limit - she said that's why she uses the shakes - they go in and go out, so if you nurse one over say 45 minutes, you can drink it one at a time. she said after the first 2 weeks, you can start pureeing foods - like eggs. even meats, but be careful as they are harder to digest. and most importantly is definitely watch the sugars, because they are not gonna help with weight-loss.

what you might be able to do even, is take whatever the family meal is and puree the whole thing together, for your wife to eat. (that was my mom's babyfood trick when we were young)

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What a terrific friend and husband you're being!

BTW, Eden Organic makes very tasty canned black soy beans, which work great in hummus. A cup of the beans (roughly 8 oz.) has 22 grams of protein, 6 grams of fat and 8 grams of carbohydrate (of which 7 are fibre, which doesn't get digested). Of course, if you puree them into hummus, they'll represent a lot less than a cup in volume. They can be a bit difficult to find -- and make sure you don't get Eden's regular canned NON-soy black beans by mistake -- but I can give you a mail-order source, if you like. However, I would definitely check with your doctor, as there is a fair amount of controversy regarding soy.

Also, re the shakes: I have loathed all the ones I've tried, though your wife may well find some of them tasty enough. There has been a rush in the low-carb-products industry to sweeten things -- including shakes -- with "sugar alcohols," rather than with Splenda or older sugar substitutes, because the sugar alcohols taste better. Unfortunately, the SAs also tend to cause significant gastic distress for a lot of people, so even though SA-sweetened shakes might be yummier, I'd suggest being VERY wary. Look on labels for ingredients like malitol, maltitol, lactitol, xylitol....pretty much all the "ols." The last thing your wife needs right now is a miserable case of gas and the runs.

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the sugar alcohols typically wind up in bars and food-like products tho - not in shakes and whatnot - i think because they don't dissolve as easily as other sweeteners in water? (don't quote me on that)

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Hi,

I know you said your wife does not like eggs. I don't care for eggs either, but I do like egg salad, quiche and souffle's, you could even cut out the crust on the quiche so it would be lower carb.

Good Luck with everything.

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tryska:

The info my doc gave my wife stated that she would not be released from the hospital until she could tolerate pureed food. Theyare starting to introduce food much more quickly now, and she will be up and walking immediately after the anesthesia wears off. She should be up to 1 mile of walking by week 2.

This doctor has performed something like 1500 of these surgeries, and every one of his patients that we have spoken to were "back to normal" in less than a month, with only 2 exceptions. One was in a car wreck 3 weeks post op, and the other had already had 5 or 6 abdominal surgeries. The rest were just eating less, and really chewing food well. The 4 week limit is when you can introduce beef (other than ground) like steak or roasts.

And we've already been stocking up on bottled water. We've done babyfood tastings, since she will pretty much be using those for snacks when she wants something more solid than the shakes. We've found a couple that fit the bill, and we bought 3 enormous bottles of Centrum from Sam's that she tolerates well.

And the only eggs I can get her to eat are in egg drop soup. She says they don't taste like eggs, so I'll be perfecting my recipe, or buying it by the quart from the Chinese restaraunt she likes.


Screw it. It's a Butterball.

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that's a good idea - (the egg drop soup).

it's good that they are keeping her in the hospital til she can tolerate pureed food. my coworker was home 2 days after her surgery, and pretty much did all the healing on her own.

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FFRoux - I think your attitude about this is just wonderful. You and your wife should be applauded for your willingness to work through this together. I also really appreciate your willingness to share this with all of us. Even with all the changes I have gone through with my aunt's surgery, this has helped me refocus and re-think some food choices we have been making. Thank you!

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i have to second the sentiments of ellenc and mags - you rock! i'm touched by your level of support and dedication - your wife is very lucky!

with respect to foodstuff - amazon has a gourmet store with lots of high protein options. if you do decide to get miso - there are several varieties from white to brown. the lighter the miso is, the sweeter it is. the darker (or redder) the saltier it is. when i make miso soup (which i'd be happy to give you the recipe for) i use half white and half yellow miso.

do keep in mind that when using miso - the more you cook it, the more of it's value is lost - i think heat destroys it nutritionally. it's very tasty though - makes great dressings (chicken salad, anyone?) and is still nutritionally valuable gently heated but not broiled or baked (as in black cod with miso)

one caveat on amazon - you can easily get burned on shipping - if you buy lots of stuff from lots of different sellers - but there's a ton of selection - mags i think mentioned eden foods - amazon sells some of their stuff too.

GOOD LUCK and please do keep us posted!

amazon white miso


from overheard in new york:

Kid #1: Paper beats rock. BAM! Your rock is blowed up!

Kid #2: "Bam" doesn't blow up, "bam" makes it spicy. Now I got a SPICY ROCK! You can't defeat that!

--6 Train

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There are often support groups for gastric bypass patients and there may be one in your area. I am sure there are some on line although the quality of advice at some sites may not be up to the e gullet standards. Ask the surgeon or the clinic staff when she goes for follow up.

64 gms of protein is not a huge amount if you divide it up throughout the day. Every little "meal" should have some protein and some carb. Pureed food usually isn't necessary but initially soft, simple, non gassy, non fatty items are tolerated best. The goal is to make sure that the food choices are of high nutritional quality

because the she will do better, heal faster and have a better surgical outcome.

All my best to you both

Beth ( former registered dietitian/ GI surgery)

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I'll echo the former sentiments. You're a wonderful husband and a kind and caring partner. Your wife is one lucky lady :smile:

South Beach Diet has a website that you can peruse for recipes. Some of them are actually very tasty. There's a ricotta cheese faux tiramisu type dessert that's really good and definitely packs some protein. I'd just surf the web/bookstore for all the high protein/low carb recipes you can find. You obviously have handle on the logistics of packing a protein punch without "wasting" precious minimal stomach space on carbs, so just adapt from there and find things that you both like. You can eat regular portions and she can eat whatever she can tolerate in one sitting.

Having to analyze your food choices so carefully is a drag, but in the long run will be beneficial to you both.

I wish you both the best of luck, and a safe and speedy recovery to your wife. I have an infinite amount of respect for her courage in making the lifestyle changes required for you both to live out your dreams. You're blessed to have found each other.


Katie M. Loeb
Booze Muse, Spiritual Advisor

Author: Shake, Stir, Pour:Fresh Homegrown Cocktails

Cheers!
Bartendrix,Intoxicologist, Beverage Consultant, Philadelphia, PA
Captain Liberty of the Good Varietals, Aphrodite of Alcohol

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Well, just as an update, since a lot of folks seemed interested...

We found out today, for sure, without a doubt, it will happen this month. The insurance came through this morning. I've also (sort of after the fact) asked my wife if she would mind me blogging about her progress. I knew I should have asked first.

She wants to keep it private, for at least a while, and at least until the grosser parts of recovery are done. So I'll honor her wishes, and wait until she's at least back at work and closer to normal.

I'll keep you posted, and I'll let her know there are people thinking about her.


Screw it. It's a Butterball.

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hey fistfulla - my cworker just gave me the book that her doctor made her study (and tested her on) prior to her surgery, and which was an invaluable resource for after her surgery....thumbing thru, it's pretty cool - lots of good info on what to eat, when to eat, what supplements to use (both vitamins and protein), how to exercise, when to do those exercises and for how long. it also takes you step by step through the different forms of the surgery. all in all seems a pretty comprehensive resource.

The book is called A Complete Guide To Obesity Surgery by Bryan G. Woodward, MPH, LCEP.

the website for the book is http://www.obesitysurgery.com

shge says you can get it at any bookstore, and she bought her copy at Borders, but it's most likely at amazon too.

Also - i understand your wife would be reluctant to share her story or progress, however - there is a really great website, apparently with forums and places to put journals, with other people going through the same thing. My coworker likes it very much - the address for that is http://www.obesityhelp.com

good luck!


Edited by tryska (log)

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I have some experience researching high protein intake for my mother-in-law - but it's in the context of kidney failure and dialysis. People on dialysis need huge amounts of protein.

There are literally a ton of web sites devoted to how to get sufficient amounts of protein when you're on dialysis. So I'd start searching through those web sites (do a google search on dialysis and protein) - and throw out any suggestions that aren't appropriate for someone who's having the kind of surgery your wife is having. In my mother-in-law's case - she weighed about 90 pounds so losing weight wasn't at all important. But - due to other parts of her medical history - she did have difficulty consuming anything but the smallest amounts of food. So the supplement products were really important for her. Robyn

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