Starting Weight: 267 lbs.
Current Weight: 252.6 lbs.
Total Weight Loss: 14.4 lbs.
Goal Weight: 140 lbs.
Pounds to go: 112.6 lbs.
This time, there were only 3 weeks between my nutrition appointments rather than the usual 4-5. Kaitlyn seemed to think that since we didn’t have much left to go over, it was better to give us more time to wait for insurance approval.
Going into this appointment, I know I had gained weight. I felt bloated, I know I wasn’t eating particularly well, I had been craving salty and sweet, and my exercise had just been OK. And I was right, I gained 3 lbs. When I brought that up to Kaitlyn about how I was disappointed that I had gained that much weight, she told me that she wouldn’t be worried unless it was more than 5 lbs. That made me feel better.
The first thing that I did in this appointment was another quiz. Again, no copy, so this is not an exact copy. * denotes correct answer (or in some cases, any one of the options starred would be considered correct)
- 22 days after surgery, what kind of diet can you start
- Liquid
- Puree*
- Soft
- Solid
- Which of these must you ALWAYS use to ensure you are eating enough.
- Measuring cup*
- Food Scale*
- Smaller Plates
- Eating until you are full
- How many ounces of protein should you be ideally getting per day
- 20
- 40
- 60*
- 80
- Which of the following kitchen tools do you need for the puree stage.
- Scissors
- Blender*
- Immersion Blender*
- Food Processer*
- Which of the following can you eat in the puree stage?
- White Rice
- Blended bean and lentil soup*
- Raw carrots
- Egg Salad*
- You have not hit your protein goal for the day but are not hungry for more. You should…
- Finish your protein anyways
- Supplement with a protein shake or Protein water*
- Start with protein next time you get hungry*
- I don’t remember the 4th option
This was a tough one. I definitely got #1 wrong because my brain did not read the question correctly and I thought it was the when can you start solids (week 5). For the rest of the questions, #2 I had initially put smaller plates as another option, but then after reading, realized that that was not “ALWAYS” a requirement, but measuring your food is. 3 is pretty straightforward. 4 was a choice of one of the 3 options. Kaitlyn said to not go out and buy anything new. I did not select immersion blender even though I have one, because you can do what you do with an immersion blender with a regular blender. 5 is again pretty straightforward. 6 is a bit tougher. You don’t want to stretch out your stomach when you are full, but we NEED to get enough protein. Supplementing with a Protein Shake or protein water is a great way to get your protein in-and always always always eat your protein first.
So after the quiz, Kaitlyn went over the liquid diet phase. The clear liquids only diet (plus protein shakes) starts the day before surgery, and lasts for 3 weeks after surgery. Now, what is considered a clear liquid? A clear liquid is any liquid that light can pass through. This includes water, herbal teas, gatorade/powerade zero, bone broth, etc. Non-clear liquids include things like milk, hot chocolate, etc. (things light can not pass through). This is to help protect our new stomachs.
There are also a few other restrictions that I have to follow regarding liquids:
- No fizzy beverages-ever again
- No alcohol-6 months
- No sugary beverages-ever again
- No caffeinated beverages-3 months
The next thing we discussed was the method by which I actually have to drink. The whole thing after surgery is not introducing air until our stomach has had a chance to recover. This means no straws at the beginning, because the slurping motion I guess brings in too much air. I’m not sure if I agree with this, especially if we take a sip and then hold the water in our mouths before swallowing. I do get that they want to track how much liquid we are getting though, so I’ll play along, at least at the beginning. Instead of slurping, we should pour the water into our mouths and then hold it in our mouth until it reaches body temperature. This seems awkward, but is really not that bad. My bigger concern is that I think I will struggle to judge how much water is in my mouth at any given time.
Now that I knew how to drink, we talked about amounts. I’m going to be starting with sipping on 1 oz at a time. 1 oz is like the little medicine cup size. The expectation is one of those over an hour, then 2, etc. up to 6. Eventually the goal is to have 60 oz of water a day. Remember, no liquids a half hour before, during, or half hour after eating, so there is 4.5 h a day that I can’t have any liquids.
This means that if I get up at 6 and go to bed at 10, that’s:
16 hours awake-4.5 hours I can’t drink = 11.5 h I can drink.
Therefore:
60oz a day / 11.5 awake hours I am able to drink = 5.2 oz an hour.
This seems really doable, but I need to remember that currently I rarely drink this much. That’s probably one of the reasons I’m perpetually dehydrated, but I digress.
She also mentioned no chewing gum. Gum has the ability to start our digestive system, and we don’t want to push food out of our stomach faster than we have to.
Once Kaitlyn went over everything she had to go over, since Albert was with me, he had the opportunity to ask questions. Here’s some of what we asked and her answers.
- Jenn’s having surgery in the summer. What is her risk of fainting?
- It can happen, just keep cool and stay hydrated. If hydration gets bad you can get booked into an infusion clinic to get IV fluids
- What is the recovery time period look like
- 5-7 days for low impact jobs is technically how long, but I always recommend you take off as much time as you possibly can.
- Will she be able to put the baby in and out of the carseat?
- No. No lifting more than 10 lbs for 2 weeks
- *note that sometimes my purse weighs more than this, so I need to be careful of what I bring in to work.
- How long is the hospital stay?
- usually 1 night.
- Will she be able to take all her pills?
- Will stop the Jardiance ahead of time
- Will need to be on regular release metformin rather than extended
- Open ADHD capsule over small bite of unsweetened applesauce
- How long does it take for a protein drink to degrade? Like if I made a big jug of protein water in the morning, can I just sip on it all day?
- Yes, but don’t go more than 24 hours.
- What does pain management look like post surgery.
- No NSAIDs ever again. Tylenol is OK.
After his questions were answered, Kaitlyn told me that she thought I was ready, and that she did not think I needed the last session. I asked what the next steps were and she said, you take one last quiz.
Here were what I remember of the questions:
*Note that this was oral, not written, so there are not multiple choice.
- How many oz of water should you aim for a day?
- 60 oz
- How many oz of protein should you aim for a day?
- 60oz
- What are the drinking no-nos?
- sugary
- carbonated
- caffeinated
- alcoholic
- How many weeks after surgery can you start a regular diet?
- 5 weeks
- What should you always eat first?
- Protein
- How much will your new stomach be able to hold?
- 4 oz
- How much time should be on either side of a meal where you don’t drink?
- 30 minutes
- How long should a meal take to eat?
- 30 minutes
- What is one tool to help make sure you aren’t eating too much
- Food Scale, Measuring cups, smaller plates
- What is one protein of choice after surgery
- Chicken, Tuna, Beans, etc.
I struggled with the drinking no-nos question, just because I don’t drink alcohol really to begin with, so it’s not something I committed to memory.
So yeah, I passed. I’ve graduated nutrition counseling for bariatric surgery. Next steps are upper endoscopy, which is scheduled for 3/26, time TBD. After that I have to get a clearance letter from my GP and they will submit everything to the insurance. From there, it could take anywhere from 3 days to 3 weeks to get approval. Once I get my insurance approval, I will be contacted to schedule my surgery, and I’m hoping for June 24th. Then, I will have a pre-op visit with Kaitlyn, and then surgery!
It’s becoming a lot more real that this is really happening. I am having a sleeve gastrectomy in a matter of months. I’m trying really hard to not indulge in foods that I know I’ll never be able to have again, but that’s hard. I’m also trying to cut down on my calories now-hoping that that will make things a bit easier. I also need to get better at walking, since it’s really necessary after surgery.
I’m not really nervous, but to be honest, it doesn’t really feel real. I am starting to do more research on what to bring to the hospital with me, and what the day of surgery will look like.
I’ll talk to you next week after the endoscopy!
Vanishing Velez 
Leave a comment