Nutrition One-Hour Wrap-Up

Friday morning was my one hour wrap up with Ashton.  I weighed in beforehand at 249.0.  Half a pound less than the day before.

Ashton went over in more detail each phase of my eating plan before and after surgery.  Here they are in a nutshell:

Phase 1
This comprises my pre-op diet which could be up to 14 days before surgery.  I can only have clear liquids plus protein shakes.  Clear liquids include sugar-free jell-o pudding, sugar-free popsicles, broth, crystal light, Powerade Zero.  The protein shakes are what's going to keep me full and the popsicles and pudding is what'll keep me sane LOL.

Day of Surgery
= NPO.  NPO means "nothing by mouth"...no ice chips, no gum, no NOTHING.

Post Op Day 1 is also NPO until I have my UGI which is a procedure that checks for leaks -- I believe it is the same procedure I had a little while ago when I drank some barium mixture so they can take pictures of my stomach.  As long as this is clear, then I can have clear liquid after.

Post Op Day 2 is when I begin Phase 2.  Phase 2 lasts up to 10 days until I follow up for the first time with my surgeon, Dr. G.  When I'm on Phase 2, I'm supposed to "eat" 3-5 times a day with at least two of those meals being "food" meals vs. protein shakes.  On this phase I can have watered down juices, broths, cream of wheat when cooked with lots of water or milk, milk, yogurt, and protein shakes.  I have to try to get in 80 grams of protein a day.

Phase 3 - Puree Diet
Well this should be interesting.  I'll be on the puree phase for days 10-30, approximately.  Ashton suggested mixing tuna with a bit of olive oil mayo in my Magic Bullet as a meal.  I'll only be eating 1-2 ounces at a time for each meal and my meals should last 20-30 minutes each with about 5 minutes in between each bite.  I can have all the stuff from Phases 1 and 2 plus pureed cooked eggs, high protein meats (pureed in the bullet!), smooth peanut butter (yay!!!!!), cereals like cream of wheat, melted cheese (double yay!), fat free cottage cheese, skim milk, mashed potatoes, pureed/mashed green beans, canned fruits (awesome), baby foods (NOT).  Things I can have but in moderation (once a day I think) are sf pudding, sf gelatin, low sugar or sugar free ice cream or yogurt, salt, mayo, butter, sour cream, herbs & spices.  This will be a fun phase I think!

Phase 4 - Soft Diet
I'll transition into Phase 4 at about the 30 day mark and be on it for approximately 4 weeks.  At week 6 post-op I'll meet with my surgeon again for follow up.  Again I'll be eating 3-5 times a day but only about 1-2 ounces per meal.  This phase basically includes any non-irritating low residue foods.  Everything I eat has to be thoroughly chewed to avoid obstructions or blockage.  I can only add in one new food to each meal so if I have an adverse reaction I will know what did it.  Protein will be the "star" of each meal and what I eat FIRST.  The foods I'll be allowed will include everything from Phases 1-3 plus low fiber cereals such as cheerios, rice krispies, or special K.  At this stage I won't have to puree anything but I just have to chew, chew, chew!  I have a feeling I will be eating a lot of eggs, cheese, yogurt, peanut butter, and chicken here.  I am going to change things up though and make some flakey fish here and there and have thin deli meats for lunches.

Phase 5 - Regular Diet
This will start at around Week 8 which will be mid- to late-August I think.  Initially, I can have all foods except those that cannot be thoroughly chewed or which cause discomfort or irritation.  I have to avoid bread, rice and pasta for SIX MONTHS after surgery and avoid solid red meat until I get my surgeon's OK.  I am supposed to have 2 cups of milk or yogurt daily and a protein supplement that provides at least 20 grams of protein.  A sample breakfast is 2 tbsp of eggs and 2 tbsp of oatmeal.  A snack would be 1 oz of cheese and 1-2 slices of apple or 1 ounce of chicken salad and a couple of whole grain crackers.  It's hard to believe that will fill me up, but I bet you it will!

Eventually on Phase 5 over time I'll be able to eat slightly more at each meal.  When this happens, my regular diet will consist of three small meals per day limited in volume to 3-4 ounces per meal.  I have to remember to listen to my body and stop at the first signs of fullness.  I have read on my Facebook groups that some people's first "signs" are hiccups, burping, or just an uncomfortable sensation.  That's why you have to space out your bites of food and take your time so that you don't eat too much and your body has time to TELL you it's full.  A typical breakfast for me on this second part of the Phase 5 diet would be 2 oz of high protein greek yogurt and 2 oz of Kashi Go Lean cereal. A snack might be a slice of cheese if I really felt I needed something between meals or there is a long time between meals, but I have to limit my snacks to 1-2 ounces.

So that's about it for my wrap up appointment.  Afterwards I went back to the front desk for Ashton and I to talk to Amber the insurance girl.  Ashton asked if they could submit to my insurance without cardiac clearance and Amber said they could, yes, since it isn't the insurance that requires the cardiac clearance, it's my doc, so we can get that later if need be.  While we were standing there, Nurse Jenn comes out and says she just got a call from the cardiac office and they said they didn't receive the results yet.

I decided to go up there to see what could be done to expedite things.  I was firm but nice and they told me that most likely my results were in "transcription" which is where they go to be written up for the doctor to interpret.  Ashton assured me when I went back down to report on my findings that she would keep on top of things.  When we asked Amber about submitting that day I told her there would be cupcakes in it for her...then Ashton mentioned to Amber that I was the "cookie lady" and Amber's whole face lit up!  She said she LOVED my cookies and she'd rather have those than cupcakes any day.  I told her you got it!  So I have some baking to do before my next appointment LOL.

This afternoon as I was reviewing the eating plan for this blog, I came across Amber's email address, so I sent an email to her and to Ashton asking if they were able to submit Friday.

Oh and I also got my lab work results -- I was deficient in Vitamins A and D, but being on the multi should take care of those levels.

This week is clear as far as appointments go, Thank God.  I am tired of driving around places after work, even though it is for this.

Ashton mentioned that once I get insurance approval, Jenn will call me to schedule the surgery AND my pre-op class which (again) goes over Phase 1 pre-op diet and other things.  I thought I remember her saying I'd have to have more labs before surgery too, but I honestly can't remember now.

What a whirlwind it has been and my poor leave balances at work have taken a beating.  I will be working the next few holidays to bank hours for my surgery so that I can be paid 100% of what I am used to getting.  And to ensure I have enough leave for our trip to Ireland in September.

One additional thought.  My husband and I often entertain ourselves by eating out or ordering in.  Once I have surgery, I have a feeling that eating out (in Phase 5 +) will be frustrating and a waste of money, which will totally take the fun out of it.  I hope that we can come up with new (more active) ways of spending time together like working out or taking more drives to the beach with our pups.

I am nervous about Ireland and what I'll be eating there.  I have a feeling I will be taking a bunch of protein powder with me to ensure I get 80 grams in.  At least I'll be thinner by then and feeling better.

So now that I don't have any more appointments scheduled (although I do have a PCP appt 6/4), it is now just a waiting game until insurance approval.

I have a guess as to my surgery date:  the 17th.  It's my lucky number.