Dear Vicki,
I am so outraged by surgeons that are just in this for the money. They do
the surgery and leave you hanging with little or no information and that is
tragic.
Anyway, as far as food goes, Brian gave you excellent advice. You have to
tread lightly though if you don't know what will or won't work for you.
There are many rules to follow, but they are easy to do. These are my
surgeon's recommendations, and they work for me, so I'm offering them to you
and assuming you know nothing about any of this. If you do, I apologize for
my assumption.
First of all, vitamins are critical. You need to take a good multivitamin
(equivalent to centrum or whatever, but something that has many vitamins and
minerals in it); you need to get vitamin b-12 (I find the 2500 mcg.
sublingual one from puritanspride.com to be excellent. B-12 is ESSENTIAL to
your health and if you become deficient in it, you can cause irreversible
neurological problems for yourself (I'm not saying this to scare you, it's
true); if you are still mentruating, you will need iron. Feosol (over the
counter) is a good one because it's easily tolerated and absorbed. You can
take the iron with a little orange juice or a vitamin c because the orange
helps the iron absorb quicker. You also need to take 1000 to 1500 mg of
calcium citrate (make sure it's citrate and not carbonate. We don't absorbe
carbonate); I don't see many people posting this, but my surgeon also
recommends Vitamins E, D, A and K.
You should have blood tests run (by your pcp, since you can't trust your
surgeon) every three months the first year of surgery and every six months
thereafter. Be sure to ask your doctor for a copy of your lab results and
save them so that you can compare your trends. This way you will see how
you need to "tweak" your vitamins, etc. Once a year you can have (if you
wish) a dexasan to see how well you are absorbing the calcium and to keep
osteoporosis at bay. When you have your blood drawn, have your doctor write
a prescription which covers all the items listed here:
It is recommended that for the first year post-op that you have your blood
tested every three (3) months. After the first year then it is every six (6)
months. Just to let you know, this testing requires about 6 or 7 tubes of
blood so don't freak out when they line them all up !!! Also make sure the
lab knows the proper handling of the specimens, one test requires that the
blood be kept from light and several require special tubes....just politely
ask the lab to look up all the requirements for each test. You should
always get a copy of your blood tests and compare the results for trends.
For instance if your lab values are in the "normal" range but they are
consistantly getting lower each time you get them done, you want to do
something about it before they fall into the "abnormal" range.
Here is the list: Comprehensive Metabolic Profile Lipid Profile ALT
(SPGT)GGTLDH Phosphorous - inorganic Uric acid Hemogram with platlets B-12 &
Folate Iron, TIBC, % Sat Vitamin A & D (25-hydroxy) Thyroid panel (T3U, T4,
FTI, TSH)Zinc Magnesium Ferritin. These are the ICD-9 Diagnosis Codes
needed for insurance reimbursement 579.3 - post-surgical malabsorbption;
269.2 - hypovitaminosis; 244.9 hypothryoidism.
For drinking fluids, you should drink as much as you can daily, but the
minimum should be 64 fluid ounces. This can be from water, crystal light,
sugar free decaf beverages, sugar free popsicles, flavored waters like fruit
2-0 or propel, juices if you cut them at least 50/50 with water to reduce
the sugar content, protein shakes, etc. It is recommended that you stop
drinking 1/2 hour prior to meals, don't drink during your meal and don't
drink for 1/2 hour following the meal. At all other times, drink as much as
you can handle. I set myself up in the morning by making myself a 16 oz.
protein shake (I prefer the Champion Pure Stack Whey protein powder which I
buy from supplementcentral.com -- they have great flavors and are
reasonable. Each shake is 30 grams of protein -- 23 grams from 1 scoop of
the powder and another 7 grams from the lactaid I use to mix it in). The
most we can absorb every few hours is 30 grams, so there's no percentage in
eating or drinking more than that at one setting. After the shake, I set up
3
24 oz. water bottles of propel. I drink them from morning to night and, if
that's all I drink (I usually drink more), I've gotten in 88 oz. of fluids.
As for food, you are in the solid stage and should eat anything you want,
bearing in mind that, if you are like me, the amount you can hold is very
limited, so you want to make protein your priority and you want the biggest
bang for your buck. I eat protein first every meal (and most times I'm so
full I don't get to anything else) but if I have room following my protein,
I'll have a green veggie or salad and if I still have room (which is
laughable), I'll have some type of fruit. The only thing I can't tolerate
since surgery is pork (and you saw for Brian it's beef), but you may react
differently. Some of my main staples are cheese (approx. 7 grams per
slice); tuna (28 grams per 2 oz. portion); sardines (skinless and boneless
in oil are 23 grams per 3 oz.); eggs (2 extra large are 14 grams); turkey
pepperoni (17 tiny slices are 15 grams); pintos and cheese from taco bell
(about 20 grams); chili with cheese from wendy's (about 20 grams); shrimp
(about 14 grams to 4 small shrimp) and the list goes on. If I have carbs,
it's usually from my veggies or fruit. If I MUST have bread (which is rare
for me) it has to be toasted. Otherwise it comes back at me for some
reason. You have to read labels so you can find your comfort level with
food and what's going to be the best thing for you. I try very hard not to
snack on my old favorites (I was a chocoholic) but every now and then the
craving gets to be too great so I have a TINY (and I do mean tiny) amount of
something. I used to "snack" on a 1/2 lb. bag of M&Ms. Now, (in the 11
months since my surgery) if I have M&Ms it's only been twice in 11 months,
and each time it was 3 of them, not the whole bag. I'm not perfect and I
don't know anyone who is.
You need to pace yourself. Try to spread your meal out over 1/2 hour if you
can. Eat very slowly so your mind can catch up to your stomach and signal
you when you're full. If you eat too fast or don't chew well enough,
guaranteed you'll be puking.
Another thing (which I rarely do, but was hoping I would do more of) is
dump. This is the reaction you get if you ingest too much sugar. You will
feel like you're having a heart attack. You will feel as if you're going to
pass out. You can sweat and get the shakes. It can last for minutes or it
can last for hours and you never know what will throw you into it, except
it's pretty much a given that if you're eating too many sweet things or (for
me) pasta which breaks down to sugar in your system. When it hits you,
you're gonna regret having eaten what you've eaten.
I can't think of anything else at the moment, but if you've got any other
questions, feel free to post them to the board. You'll get an extraordinary
amount of support here. Best of luck to you.
live each day like it's your last... love like you've never been hurt...
Deb in Hazlet, NJ
"Debbie Dancer"
distal rny
September 3, 2002
386/235/160
BMI 60/34.7/24
-151
-69.5"
Angel to Bill (8/14/03), Debbie (waiting for a date) Ilene, Roy, and Ro