Re: Richmond folks

[Guest guest]

Tami,

Can you eat cream of wheat or cottage cheese? Some people have told me that vanilla pro complex with 8 to 10 oz. of gatorade is really good. Maybe that would have a different smell and you could get that down.

CarolTQthinking@... wrote:

Hello all Richmond post-ops,I really need some help. I am two and half weeks out from San Diego. As most of us know PB requires a protien drink (preferably Pro Complex) I can not get them down or even sometimes even near my nose. I start gagging and that can last for hours. It hurts my tummy so I have stopped trying to drink it. I would like to know what kind of protien foods Richmond advises you to have. I know that I need protien seriously. After reading Elaine's post about protien and what will happen without it I am a bit worried. I am only eating once a day every other day right now because everything on the PB list makes me gag.All fruit juices are making me dump now too. I only bought the

no sugar added kind to begin with.Tami

[Guest guest]

Tami,

When I was as far out as you, I was depending mainly on yogurt and

cottage cheese. Sometimes I would mix the two. Make sure you get

the no sugar added yogurt. (For some reason the Albertson's store

brand seems to have the most amount of protein.) You can also try

Dannon Light n' Fit or the Yoplait with the blue top. I hope you

like yogurt. If you can't tolerate the cottage cheese plain, you

might try adding a little bit of splenda and some cinnamon.

pascha

11-4-03

Dr. Tanaka

> Hello all Richmond post-ops,

>

> I really need some help. I am two and half weeks out from San

Diego. As

> most of us know PB requires a protien drink (preferably Pro

Complex) I can not

> get them down or even sometimes even near my nose. I start gagging

and that can

> last for hours. It hurts my tummy so I have stopped trying to

drink it.

>

> I would like to know what kind of protien foods Richmond advises

you to have.

> I know that I need protien seriously. After reading Elaine's post

about

> protien and what will happen without it I am a bit worried. I am

only eating

> once a day every other day right now because everything on the PB

list makes me

> gag.

>

> All fruit juices are making me dump now too. I only bought the no

sugar

> added kind to begin with.

>

> Tami

[Guest guest]

Tami,

Sorry to hear you ae going threw this but rest asured you will get better. Here is a list of things you can have at your point.

Egg, Egg whites, Egg substitute, Poultry, Fish, Tuna, Shrimp, Lobster, Ham Turkey (lean}, Cottage cheese lowfat (i use lucern not fat it is realy good), Tofu Light, Non Fat Plain Yogurt ( I use Horizon Organic Non Fat Plain Yogurt), Popcycles (I Use Dryers Sugar Free 100% fruit), Beans and lenttils, Most Vegatables (easier to use gerber baby food for vegatables, and for juice but with juice you want to dalute it for every one cup juice with 3 cups water), Crystal Light they have many flavors, Sugar Free cool aid, Sugar free tea, water, decaf coffee, Non Fat lactaid, or soy milk(easier on the stomach), diet snapple, diet tang, bullion, diet jello (use to drink or so they say), cream of wheat or rice (use gerber), Sugar free jello, sugar free pudding, sugar free custatrd, "pam cooking sprays, vegtable butter, light mayo (use sparingly)", soft low fat cheese, thin sliced turkey or chicken lunch meatm, mashed potato without skin, or instant mashed potatoes, saltine

crackers, use the (unsalted one is better for you), clear broth, cream soups (you can find many of these at trader joes), salt substitute, herbs and mild spices

These are the things I know of and am practicing with now before my surgery I wont allow much els in my home. Another idea for poutry at safeway they slow roast on a rotisery machine chicken and it is realy good just take it home pop it in the microwave 6 minutes and it's ready, peal off the skin discard that eat it's yummy and it cost the same as a raw non cooked chicken (o^_^o)Now that you can't beat and since you have had surgery already take that chicken and a scale and mesure out 2 oz. and put them in lil gerber bowls with lids (you can find at safeway also) or a small tubpperware freezer, microwave safe container. and then for some extra flavoring or on the side have some 100% pure applesauce no sugar added. If you can't find any make some. hehehehe cut and peel apple decork it and put it in a blender it's yummy...(if you don't have a blender. Go get one you should have one by now for after surgery shame on you.) hehehehe jk you can use it for many things

including banannas, and strawberries (very high in vit. C) That's all I can think of for now.

Your Friend, Tina Marie from Healdsburg

> Hello all Richmond post-ops,> > I really need some help. I am two and half weeks out from San Diego. As > most of us know PB requires a protien drink (preferably Pro Complex) I can not > get them down or even sometimes even near my nose. I start gagging and that can > last for hours. It hurts my tummy so I have stopped trying to drink it. > > I would like to know what kind of protien foods Richmond advises you to have. > I know that I need protien seriously. After reading Elaine's post about > protien and what will happen without it I am a bit worried. I am only eating > once a day every other day right now because everything on the PB list makes me > gag.> > All fruit juices are making me dump now too.

I only bought the no sugar > added kind to begin with.> > TamiOregon Origin's Reunion Registry http://www.oregonorigins.com Oregon Origin's Search Support http://www.oregonorigins.net Oregon Origin's /

WWR http://oregonorigins.hypermart.net ~~~~~~~~~~~~~~~~~~~~~ help@...

[Guest guest]

Hi Tami,

I'd be curious to see what PB has on their list.

Now . . . as for what Richmond recommends . . . at two and a half

weeks out, you'd be on the Stage II (Modified Full Liquid) eating plan.

"Stage II foods are not typically rich in protein." (That's straight out

of the Info Binder.) Foods on the Stage II list include: Cream of

Wheat or Cream of Rice, strained soups, broths, puddings, applesauce, yogurt,

popsicles, gelatin, and custard (all sugar-free, of course). At this

stage, the primary focus is on hydration.

That's Richmond's plan . . . but I would strongly recommend staying

with your program's guidelines.

All the best,

Kay

open RNY 12/1/03

TQthinking@... wrote:

Hello

all Richmond post-ops,

I really

need some help. I am two and half weeks out from San Diego.

As most of us know PB requires a protien drink (preferably Pro Complex)

I can not get them down or even sometimes even near my nose. I start

gagging and that can last for hours. It hurts my tummy so I have

stopped trying to drink it.

I would

like to know what kind of protien foods Richmond advises you to have.

I know that I need protien seriously. After reading Elaine's post

about protien and what will happen without it I am a bit worried.

I am only eating once a day every other day right now because everything

on the PB list makes me gag.

All

fruit juices are making me dump now too. I only bought the no sugar

added kind to begin with.

Tami

[Guest guest]

Here are PB's guidelines post-op as of March 2003 - I've heard they are a

bit different these days, but no one has actually been able to produce documentation

from PB stating otherwise for me. So, if any of you recent PB post-ops out

there have your Patient Education Handbook and would like to update my info,

I'd greatly appreciate it! So, again, these are PB's guidelines from almost

a year ago. Please note also that PB's stages are different from Kaiser's

stages. Hugs, Jen

Stage I (in hospital):

Start: After surgery, you may begin ice chips and sips of water when approved

by your physician.

Duration: Usually the first day after surgery.

Fluid Goal: Aim for 1 ounce of ice or water per hour maximum.

Stage II

Start: Usually the first or second day after surgery.

Duration: Usually through hospital stay.

Diet: Clear liquids without added sugar.

Fluid Goal: Aim for 1 ounce of fluid per hour.

Foods Recommended:

Clear, no sugar added juices - apple, grape (NO CITRUS)

Cranberry juice cocktail

Clear broth (fat free) or bouillon (chicken, beef or vegetable)

Herbal decaffeinated tea

Sugar-free gelatin

Sugar-free, uncarbonated and caffeine-free beverage

Sugar-free popsicles (NOT MADE FROM JUICE)

Sports drink, diluted by half with water

Stage III:

Before discharge: (Usually the third or fourth day after surgery)

1. Diet - Clear liquids without added sugar (Stage II liquids)

2. Goal intake - 2 oz. per hour

After discharge: (Follow Stage III meal pattern until your surgeon advises

you to advance to Stage IV).

1. Clear liquids without added sugar (Stage II liquids).

Goal intake 2 oz. per hour.

Water or calorie-free, carbohydrate-free and sugar-free clear liquids

best to drink in order to minimize calories intake.

2. Pro Complex protein drink:

This is the approved drink for all gastric bypass patients of Pacific Bariatric

Surgical Medical Group. While we are aware there are hundreds of proteins

available on the market, we have found through extensive research and taste

testing that Pro Complex provides all the necessary nutrition requirements

with a tolerable taste. It is sugar-free and provides additional vitamin

supplementation.

After surgery, your quantities will be drastically reduced. Mixing directions

as follows:

Use a blender to mix when possible.

Mix two scoops of powder with 4 oz. of liquid and 4 oz. ice chips.

First, use water. If water is tolerated then,

Second, try 100% fruit juice with no sugar added.

After 2 - 3 days, try nonfat milk or lactose-free nonfat milk.

Additional choices include calorie-free uncarbonated beverages

such as Crystal Light or Diet Kool-Aid.

After mixing, allow beverage to set for 2 - 3 minutes in order to avoid

consumption of foam that may cause gas.

Recommended intake daily is 2 oz servings four times per day. Divide

into four equal portions, and refrigerate for use during the day.

You may change the quantity of ice and/or liquid used to alter the

beverage's consistency (i.e. thin versus thick) as needed to improve supplement

tolerance. For variety you may freeze portions.

Stage IV:

Start: As directed by surgeon. Add one new food at a time to assess tolerance.

FOODS RECOMMENDED: FIRST TWO WEEKS AFTER SURGERY. Always eat high protein

foods first from now on. All foods from previous stages plus those listed

below - Initially, limit portion size to approximately 1 tablespoon or less.

HIGH PROTEIN FOODS - EAT FIRST, primarily of animal origin.

Egg white or egg substitute - soft boiled or scrambled and cooked with

non-stick cooking spray. Do not use butter or margarine.

Cheese or cottage cheese - reduced fat or nonfat varieties.

Yogurt - nonfat plain or flavored, no sugar added, no fruit unless

blended

Tofu - soft, not fried

OTHER PROTEIN FOODS - typically carbohydrates

Dried beans or peas - navy beans, kidney beans, pinto beans, lima beans,

lentils and split peas cooked without added fat until very tender. (These

foods may cause abdominal discomfort and/or gas.)

Reduced fat, cream soup made with nonfat milk and blended.

Cream of Wheat, Cream of Rice or Malt-O-Meal, unflavored

Toast, dry refrined grain

Potato - mashes or boiled with skin removed. Do not eat potatoes that

have been fried.

Drink 2 oz. every 15 minutes - stop drinking 1/2 hour before meals and do

not resume drinking sooner than 45 minutes after meals.

ADDING NEW FOODS

Two weeks after surgery - Seafood - moist, white fish, baby shrimp

or other shellfish (do not start with clams or oysters as they are too chewy);

Do not fry!

Four weeks after surgery - Cold cereals, unsweetened - refer to guide

on reading food labels

Six weeks after surgery - Poultry - moist, white meat; do not eat

skin or fry (NOTE: If poultry tolerated, change to white meat only since

it is lower in fat.)

Eight weeks after surgery - Vegetables - over-cooked carrots,

green beans and peas. Fruits - ripe bananas, melon, canned fruit

in own juice. Pasta/Rice - overcooked consistency (NOTE: For pasta,

do not use white sauces as they are usually high in fat. Use red sauces

with no sugar added.) Bread - untoasted.

Twelve weeks after surgery - Vegetables - cooked greens, broccoli

and cabbage. Vegetables/fruit raw - peeled (chew well), no citrus.

Salad

Six to twelve months after surgery (with surgeon's approval) - Red

meat and pork - lean, trim visible fat, do not fry (chew well). Raisins,

grapes, corn.

Kay wrote:

Hi Tami, I'd be curious to see what PB has on their list.

Now . . . as for what Richmond recommends . . . at two and a half weeks

out, you'd be on the Stage II (Modified Full Liquid) eating plan. "Stage

II foods are not typically rich in protein." (That's straight out of the

Info Binder.) Foods on the Stage II list include: Cream of Wheat or Cream

of Rice, strained soups, broths, puddings, applesauce, yogurt, popsicles,

gelatin, and custard (all sugar-free, of course). At this stage, the primary

focus is on hydration.

That's Richmond's plan . . . but I would strongly recommend staying with

your program's guidelines.

All the best,

Kay

open RNY 12/1/03

TQthinking@... wrote:

Hello all Richmond post-ops, I

really need some help. I am two and half weeks out from San Diego. As most

of us know PB requires a protien drink (preferably Pro Complex) I can not

get them down or even sometimes even near my nose. I start gagging and that

can last for hours. It hurts my tummy so I have stopped trying to drink

it.

I

would like to know what kind of protien foods Richmond advises you to have. I know that I need protien seriously. After reading Elaine's post about

protien and what will happen without it I am a bit worried. I am only eating

once a day every other day right now because everything on the PB list makes

me gag.

All fruit juices are making me dump now too. I only bought the no sugar added

kind to begin with.

Tami

[Guest guest]

Jen,

I italized and wrote in purple the changes... Hope this helps.. (although the cover says revised March 2003)

Angie

Stage I (in hospital):

Start: After surgery, you may begin ice chips and sips of water when approved by your physician.

Duration: Usually the first day after surgery.

Fluid Goal: Aim for 1 ounce of ice or water per hour maximum.

Stage II

Start: Usually the first or second day after surgery.

Duration: Usually through hospital stay.

Diet: Clear liquids without added sugar.

Fluid Goal: Aim for 1 ounce of fluid per hour.

Foods Recommended:

Clear, no sugar added juices - apple, grape (NO CITRUS)

Cranberry juice cocktail

Clear broth (nothing in parentheses) or bouillon (nothing in parentheses)

Herbal decaffeinated tea

Sugar-free gelatin

Sugar-free, uncarbonated and caffeine-free beverage

Sugar-free popsicles (nothing in parentheses)

Sports drink, diluted by half with water

Stage III:

Before discharge: (Usually the third or fourth day after surgery)

1. Diet - Clear liquids without added sugar (Stage II liquids)

2. Goal intake - 2 oz. per hour

After discharge: (Follow Stage III until first appointment with your surgeon)

1. Clear liquids without added sugar (Stage II liquids).

Goal intake 2 oz. per hour.

Water or calorie-free, carbohydrate-free and sugar-free clear liquids best to drink in order to minimize calories intake.

2. Protein Drink, 2oz four times per day:

Mixing directions as follows:

Use a blender to mix when possible.

Mix two scoops of powder with 4 oz. of liquid and 4 oz. ice chips.

First, use water. If water is tolerated then,

Second, try 100% fruit juice with no sugar added.

After 2 - 3 days, try nonfat milk or lactose-free nonfat milk.

Additional choices include calorie-free uncarbonated beverages or diluted sports drinks

After mixing, allow beverage to set for 2 - 3 minutes in order to avoid consumption of foam that may cause gas.

** NOT INCLUDED: Recommended intake daily is 2 oz servings four times per day. Divide into four equal portions, and refrigerate for use during the day.

You may change the quantity of ice and/or liquid used to alter the beverage's consistency (i.e. thin versus thick) as needed to improve supplement tolerance. For variety you may freeze portions.

(This section is not included)This is the approved drink for all gastric bypass patients of Pacific Bariatric Surgical Medical Group. While we are aware there are hundreds of proteins available on the market, we have found through extensive research and taste testing that Pro Complex provides all the necessary nutrition requirements with a tolerable taste. It is sugar-free and provides additional vitamin supplementation.

Stage IV:

Start: As directed by surgeon. Add one new food at a time to assess tolerance.

FOODS RECOMMENDED: FIRST TWO WEEKS AFTER SURGERY. Always eat high protein foods first from now on. All foods from previous stages plus those listed below - Initially, limit portion size to approximately 1 tablespoon or less.

HIGH PROTEIN FOODS - EAT FIRST, primarily of animal origin.

Egg white or egg substitute - soft boiled or scrambled and cooked with non-stick cooking spray. Do not use butter or margarine.

Cheese or cottage cheese - reduced fat or nonfat varieties.

Yogurt - nonfat plain or flavored, no sugar added, no fruit unless blended

Tofu - soft, not fried POOR PROTEIN FOODS - typically carbohydrates

Dried beans or peas - navy beans, kidney beans, pinto beans, lima beans, lentils and split peas cooked without added fat until very tender. (These foods may cause abdominal discomfort and/or gas.)

Reduced fat, cream soup made with nonfat milk and blended.

Cream of Wheat, doesn't list Cream of Rice or Malt-O-Meal, unflavored

Toast, dry doesn't list refrined grain

Potato - mashes or boiled with skin removed. Do not eat potatoes that have been fried.

Sample Meal Plan

One to three small meals per day. High protein food with every meal.

Each meal should be at least 3/4 "High protein" and 1/4 or less carb. sources. refer to portion sizes below. Remember, stop at first feeling of fullness.

Two day sample menu (After all foods tested for tolerance)

Fluid Breakfast Fluid Lunch Fluid Dinner Fluid

8-12 oz 1/2 egg 16-20oz 1/4C refried beans 16-20ox 1/2C nonfat 8-12oz (fatfree, veg.) w/ split pea soup 1/2 oz red. fat cheese

8-12 oz 1/4 CCream of 16-20 1/4 C NF Cottage 16-20oz potato w/ 8-12oz

wheat w/ NF milk Cheese NF cottage Cheese

1/4 C TOTAL

Aim for 48-60 oz of h2o per day to preven dehydration

Carry a water bottle with you at all times

Drink 2 oz. every 15 minutes -

Do NOT drink liquid with meals. Stop drinking 1/2 hour before meals and do not resume drinking sooner than one hour after meals

Limit Juice and sports drinks to 4oz per day to minimize calorie intake

Protein drink should be used as a meal replacement for breakfast- 4 oz or quanity as directed by surgeon

ADDING NEW FOODS

Add only one new food to your diet at a time.

Keep portion size small. Follow this guide with each new food;

Day 1- one thimbleful for each meal

Day 2- If tolerated, increase to 2 thimblefuls

Day 3- if tolerated, increase to 4 thimblefuls or the size of a domino game

piece

If a food casues discomfort, wait 1 week before trying it again,

These guidelines may be adjusted by your physician

Two weeks after surgery - baby shrimp or other shellfish (do not start with clams or oysters as they are too chewy); Do not fry!

Three weeks after surgery- POULTRY-moist, dark meants (do not eat skin or fry), deli sliced, fat fee

Four weeks after surgery - Cold cereals, unsweetened - refer to guide on reading food labels

Six weeks after surgery - Poultry - moist, white meat; do not eat skin or fry (NOTE: If poultry tolerated, change to white meat only since it is lower in fat.)

Eight weeks after surgery - Vegetables - over-cooked carrots, green beans and peas. Fruits - ripe bananas, melon, canned fruit in own juice. Pasta/Rice - overcooked consistency (NOTE: For pasta, do not use white sauces as they are usually high in fat. Use red sauces with no sugar added.) Bread - untoasted.

Seafood- moist, white fish

Twelve weeks after surgery - Vegetables - cooked greens, broccoli and cabbage. Vegetables/fruit raw - peeled (chew well), no citrus. Salad

Six to twelve months after surgery (with surgeon's approval) - Red meat and pork - lean, trim visible fat, do not fry (chew well). Raisins, grapes, corn.

ALWAYS AVOID

Drinking with meals

Snacking

Carbonated beverages

Caffeine

alcohol

sugar

fats/ oils

Snack foods

Nuts

Popcorn

Pretzels

Chips

Citrus containing beverages

OJ

Grapefruit juice

Lemonade

Citrus Fruit

Nicotine

Non-sterodial anti-inflammatory drugs (NSAID)

Advil

Aleve

Motrin

Ibuprofen

Aspirin

[Guest guest]

Thanks Angie!

Some of that was included in mine and I just didn't type it all in (the sample

menu and list of things to avoid). My surgery was March 14, so they may

have revised it shortly after that. I had heard that these days they say

that anything is okay after 4 weeks except beef and pork. This is the change

that I have not been able to get anyone to confirm. Has anyone out there

had their surgery at PB in the past month? If so, when was your Patient

Education Handbook revised and does it differ much from what Angie's and

mine say?!

Hugs

Jen

teachercrowley@... wrote:

Jen,

I italized and wrote in purple the changes... Hope this helps.. (although

the cover says revised March 2003)

Angie

In a message dated 2/8/2004 3:04:03 PM Pacific Standard Time, nif@...

writes:

Stage I (in hospital):

Start: After surgery, you may begin ice chips and sips of water when approved

by your physician.

Duration: Usually the first day after surgery.

Fluid Goal: Aim for 1 ounce of ice or water per hour maximum.

Stage II

Start: Usually the first or second day after surgery.

Duration: Usually through hospital stay.

Diet: Clear liquids without added sugar.

Fluid Goal: Aim for 1 ounce of fluid per hour.

Foods Recommended:

Clear, no sugar added juices - apple, grape (NO CITRUS)

Cranberry juice cocktail

Clear broth (nothing in parentheses) or bouillon (nothing in parentheses)

Herbal decaffeinated tea

Sugar-free gelatin

Sugar-free, uncarbonated and caffeine-free beverage

Sugar-free popsicles (nothing in parentheses)

Sports drink, diluted by half with water

Stage III:

Before discharge: (Usually the third or fourth day after surgery)

1. Diet - Clear liquids without added sugar (Stage II liquids)

2. Goal intake - 2 oz. per hour

After discharge: (Follow Stage III until first appointment

with your surgeon)

1. Clear liquids without added sugar (Stage II liquids).

Goal intake 2 oz. per hour.

Water or calorie-free, carbohydrate-free and sugar-free clear liquids best

to drink in order to minimize calories intake.

2. Protein Drink, 2oz four times

per day:

Mixing directions as follows:

Use a blender to mix when possible.

Mix two scoops of powder with 4 oz. of liquid and 4 oz. ice chips.

First, use water. If water is tolerated then,

Second, try 100% fruit juice with no sugar added.

After 2 - 3 days, try nonfat milk or lactose-free nonfat milk.

Additional choices include calorie-free uncarbonated beverages or diluted sports drinks

After mixing, allow beverage to set for 2 - 3 minutes in order to avoid

consumption of foam that may cause gas.

** NOT INCLUDED: Recommended

intake daily is 2 oz servings four times per day. Divide into four equal

portions, and refrigerate for use during the day.

You may change the quantity of ice and/or liquid used to alter the beverage's

consistency (i.e. thin versus thick) as needed to improve supplement tolerance.

For variety you may freeze portions.

(This section is not included)This is the approved drink for

all gastric bypass patients of Pacific Bariatric Surgical Medical Group.

While we are aware there are hundreds of proteins available on the market,

we have found through extensive research and taste testing that Pro Complex

provides all the necessary nutrition requirements with a tolerable taste.

It is sugar-free and provides additional vitamin supplementation.

Stage IV:

Start: As directed by surgeon. Add one new food at a time to assess tolerance.

FOODS RECOMMENDED: FIRST TWO WEEKS AFTER SURGERY. Always eat high protein

foods first from now on. All foods from previous stages plus those listed

below - Initially, limit portion size to approximately 1 tablespoon or less.

HIGH PROTEIN FOODS - EAT FIRST, primarily of animal origin.

Egg white or egg substitute - soft boiled or scrambled and cooked with non-stick

cooking spray. Do not use butter or margarine.

Cheese or cottage cheese - reduced fat or nonfat varieties.

Yogurt - nonfat plain or flavored, no sugar added, no fruit unless blended

Tofu - soft, not fried POOR PROTEIN FOODS - typically carbohydrates

Dried beans or peas - navy beans, kidney beans, pinto beans, lima beans,

lentils and split peas cooked without added fat until very tender. (These

foods may cause abdominal discomfort and/or gas.)

Reduced fat, cream soup made with nonfat milk and blended.

Cream of Wheat, doesn't list Cream of Rice or Malt-O-Meal, unflavored

Toast, dry doesn't list refrined grain

Potato - mashes or boiled with skin removed. Do not eat potatoes that have

been fried.

Sample Meal Plan

One to three small meals per day. High protein food with every meal.

Each meal should be at least 3/4 "High protein" and 1/4 or less carb. sources.

refer to portion sizes below. Remember, stop at first feeling of fullness.

Two day sample menu (After all foods tested for tolerance)

Fluid Breakfast Fluid Lunch Fluid Dinner

Fluid

8-12 oz 1/2 egg 16-20oz 1/4C refried beans 16-20ox 1/2C

nonfat 8-12oz (fatfree, veg.) w/

split pea soup 1/2 oz red. fat cheese

8-12 oz 1/4 CCream of 16-20 1/4 C NF Cottage

16-20oz potato w/ 8-12oz

wheat w/ NF milk Cheese

NF cottage Cheese

1/4

C TOTAL

Aim for 48-60 oz of h2o per

day to preven dehydration

Carry a water bottle with you at all times

Drink 2 oz. every 15 minutes -

Do NOT drink liquid with

meals. Stop drinking 1/2 hour before meals and do not resume drinking sooner

than one hour after meals

Limit Juice and sports drinks to 4oz per day to minimize calorie intake

Protein drink should be used as a meal replacement for breakfast- 4 oz or

quanity as directed by surgeon

ADDING NEW FOODS

Add only one new food to

your diet at a time.

Keep portion size small. Follow this guide with each new food;

Day 1- one thimbleful for each meal

Day 2- If tolerated, increase to 2 thimblefuls

Day 3- if tolerated, increase to 4 thimblefuls or the size of a domino game

piece

If a food casues discomfort, wait 1 week before trying it again,

These guidelines may be adjusted by your physician

Two weeks after surgery

- baby shrimp or other shellfish

(do not start with clams or oysters as they are too chewy

); Do not fry!

Three weeks after surgery-

POULTRY-moist, dark meants (do not eat skin or fry), deli sliced, fat fee

Four

weeks after surgery - Cold cereals, unsweetened - refer to guide on reading

food labels

Six weeks after surgery - Poultry - moist, white meat; do not eat

skin or fry (NOTE: If poultry tolerated, change to white meat only since

it is lower in fat.)

Eight weeks after surgery - Vegetables - over-cooked carrots,

green beans and peas. Fruits - ripe bananas, melon, canned fruit

in own juice. Pasta/Rice - overcooked consistency (NOTE: For pasta,

do not use white sauces as they are usually high in fat. Use red sauces

with no sugar added.) Bread - untoasted.

Seafood- moist, white fish

Twelve weeks after surgery - Vegetables - cooked greens, broccoli

and cabbage. Vegetables/fruit raw - peeled (chew well), no citrus.

Salad

Six to twelve months after surgery (with surgeon's approval) - Red

meat and pork - lean, trim visible fat, do not fry (chew well). Raisins,

grapes, corn.

ALWAYS AVOID

Drinking with meals

Snacking

Carbonated beverages

Caffeine

alcohol

sugar

fats/ oils

Snack foods

Nuts

Popcorn

Pretzels

Chips

Citrus containing beverages

OJ

Grapefruit juice

Lemonade

Citrus Fruit

Nicotine

Non-sterodial anti-inflammatory drugs (NSAID)

Advil

Aleve

Motrin

Ibuprofen

Aspirin

[Guest guest]

Jen and Angie....I had my surgery on 12-30-03. My handbook is the revised March

2003.

Shirley

Dr.

281/247/150

[Guest guest]

Jen and Angie....I had my surgery on 12-30-03. My handbook is the revised March

2003.

Shirley

Dr.

281/247/150

[Guest guest]

You should put a copy of this in the files folder online for the group..... (o^_^o)Jen Hogsett wrote:

Thanks Angie!Some of that was included in mine and I just didn't type it all in (the sample menu and list of things to avoid). My surgery was March 14, so they may have revised it shortly after that. I had heard that these days they say that anything is okay after 4 weeks except beef and pork. This is the change that I have not been able to get anyone to confirm. Has anyone out there had their surgery at PB in the past month? If so, when was your Patient Education Handbook revised and does it differ much from what Angie's and mine say?!HugsJenteachercrowley@... wrote:> Jen,> I italized and wrote in purple the changes... Hope this helps.. > (although the cover says revised March 2003)> Angie> In a message dated 2/8/2004 3:04:03 PM Pacific Standard Time, > nif@...

writes:>>> Stage I (in hospital):>> Start: After surgery, you may begin ice chips and sips of water when >> approved by your physician.>> Duration: Usually the first day after surgery.>> Fluid Goal: Aim for 1 ounce of ice or water per hour maximum.>>>> Stage II>> Start: Usually the first or second day after surgery.>> Duration: Usually through hospital stay.>> Diet: Clear liquids without added sugar.>> Fluid Goal: Aim for 1 ounce of fluid per hour.>> Foods Recommended:>>>> Clear, no sugar added juices - apple, grape (NO CITRUS)>> Cranberry juice cocktail>> Clear broth (nothing in parentheses) or bouillon (nothing in parentheses)>> Herbal decaffeinated tea>> Sugar-free gelatin>> Sugar-free, uncarbonated and caffeine-free beverage>> Sugar-free popsicles (nothing in

parentheses)>> Sports drink, diluted by half with water >>>> Stage III:>>>>> Before discharge: (Usually the third or fourth day after surgery)>> 1. Diet - Clear liquids without added sugar (Stage II liquids)>> 2. Goal intake - 2 oz. per hour>>>> After discharge: (Follow Stage III until first appointment with >> your surgeon)>> 1. Clear liquids without added sugar (Stage II liquids).>>>> Goal intake 2 oz. per hour.>> Water or calorie-free, carbohydrate-free and sugar-free clear liquids >> best to drink in order to minimize calories intake. >>>> 2. Protein Drink, 2oz four times per day:> Mixing directions as follows:> Use a blender to mix when possible.> Mix two scoops of powder with 4 oz. of liquid and 4 oz. ice chips.> First, use water. If water is tolerated

then,> Second, try 100% fruit juice with no sugar added.> After 2 - 3 days, try nonfat milk or lactose-free nonfat milk.> Additional choices include calorie-free uncarbonated beverages or > diluted sports drinks> After mixing, allow beverage to set for 2 - 3 minutes in order to > avoid consumption of foam that may cause gas.> ** NOT INCLUDED: Recommended intake daily is 2 oz servings four times > per day. Divide into four equal portions, and refrigerate for use > during the day.> You may change the quantity of ice and/or liquid used to alter the > beverage's consistency (i.e. thin versus thick) as needed to improve > supplement tolerance. For variety you may freeze portions.>>>> (This section is not included)This is the approved drink for all >> gastric bypass patients of Pacific Bariatric Surgical Medical Group. >> While we are aware there are hundreds of

proteins available on the >> market, we have found through extensive research and taste testing >> that Pro Complex provides all the necessary nutrition requirements >> with a tolerable taste. It is sugar-free and provides additional >> vitamin supplementation.>>>> Stage IV:>> Start: As directed by surgeon. Add one new food at a time to assess >> tolerance.>> FOODS RECOMMENDED: FIRST TWO WEEKS AFTER SURGERY. Always eat high >> protein foods first from now on. All foods from previous stages plus >> those listed below - Initially, limit portion size to approximately 1 >> tablespoon or less.>> HIGH PROTEIN FOODS - EAT FIRST, primarily of animal origin.>>>> Egg white or egg substitute - soft boiled or scrambled and cooked >> with non-stick cooking spray. Do not use butter or margarine.>> Cheese or cottage cheese -

reduced fat or nonfat varieties.>> Yogurt - nonfat plain or flavored, no sugar added, no fruit unless >> blended>> Tofu - soft, not fried POOR PROTEIN FOODS - typically carbohydrates>>>> Dried beans or peas - navy beans, kidney beans, pinto beans, lima >> beans, lentils and split peas cooked without added fat until very >> tender. (These foods may cause abdominal discomfort and/or gas.)>> Reduced fat, cream soup made with nonfat milk and blended.>> Cream of Wheat, doesn't list Cream of Rice or Malt-O-Meal, unflavored>> Toast, dry doesn't list refrined grain>> Potato - mashes or boiled with skin removed. Do not eat potatoes >> that have been fried.>>> Sample Meal Plan> One to three small meals per day. High protein food with every meal.> Each meal should be at least 3/4 "High protein" and 1/4 or less carb. > sources. refer

to portion sizes below. Remember, stop at first > feeling of fullness.> Two day sample menu (After all foods tested for tolerance)> Fluid Breakfast Fluid Lunch Fluid > Dinner Fluid> 8-12 oz 1/2 egg 16-20oz 1/4C refried beans 16-20ox 1/2C > nonfat 8-12oz (fatfree, veg.) > w/ split pea soup 1/2 oz red. fat > cheese >> 8-12 oz 1/4 CCream of 16-20 1/4 C NF Cottage 16-20oz > potato w/ 8-12oz> wheat w/ NF milk Cheese NF cottage Cheese> 1/4 C TOTAL>> Aim for 48-60 oz of h2o per day to preven dehydration> Carry a water bottle with you at all times> Drink 2 oz. every 15 minutes -> Do NOT drink liquid with meals. Stop drinking 1/2 hour before meals > and do not resume drinking sooner than one hour after meals> Limit Juice and sports drinks to 4oz per day to minimize calorie intake> Protein drink should be used as a meal replacement for breakfast- 4

oz > or quanity as directed by surgeon>>>>>>> ADDING NEW FOODS>> Add only one new food to your diet at a time.> Keep portion size small. Follow this guide with each new food;> Day 1- one thimbleful for each meal> Day 2- If tolerated, increase to 2 thimblefuls> Day 3- if tolerated, increase to 4 thimblefuls or the size of a > domino game > piece> If a food casues discomfort, wait 1 week before trying it again,> These guidelines may be adjusted by your physician>> Two weeks after surgery - baby shrimp or other shellfish (do not start > with clams or oysters as they are too chewy>>> ); Do not fry!>>> Three weeks after surgery- POULTRY-moist, dark meants (do not eat skin > or fry), deli sliced, fat fee>>>> Four weeks after surgery - Cold cereals, unsweetened - refer to guide

>> on reading food labels>>>> Six weeks after surgery - Poultry - moist, white meat; do not eat >> skin or fry (NOTE: If poultry tolerated, change to white meat only >> since it is lower in fat.)>>>> Eight weeks after surgery - Vegetables - over-cooked carrots, green >> beans and peas. Fruits - ripe bananas, melon, canned fruit in own >> juice. Pasta/Rice - overcooked consistency (NOTE: For pasta, do not >> use white sauces as they are usually high in fat. Use red sauces >> with no sugar added.) Bread - untoasted.>>> Seafood- moist, white fish>>>>>> Twelve weeks after surgery - Vegetables - cooked greens, broccoli and >> cabbage. Vegetables/fruit raw - peeled (chew well), no citrus. Salad>>>> Six to twelve months after surgery (with surgeon's approval) - Red >> meat and pork -

lean, trim visible fat, do not fry (chew well). >> Raisins, grapes, corn.>>> ALWAYS AVOID> Drinking with meals> Snacking> Carbonated beverages> Caffeine> alcohol> sugar> fats/ oils> Snack foods> Nuts> Popcorn> Pretzels> Chips> Citrus containing beverages> OJ> Grapefruit juice> Lemonade> Citrus Fruit> Nicotine> Non-sterodial anti-inflammatory drugs (NSAID)> Advil> Aleve> Motrin> Ibuprofen> Aspirin>>