So an old friend of mine from high school gained a lot of weight and decided that gastric bypass surgery was the best answer to her weight-related concerns. She's been facebooking about it for months now and this week she finally had her surgery. I've been watching her progress with an uneasy curiosity since she announced she would have the surgery, wanting to tell her just how effed up I think the whole thing is but also recognizing that she is an adult and has to make her own decisions. Anyway, she has a blog where she has been documenting the process and I was just struck by this entry about how restrictive the pre-surgery and post-surgery eating requirements are. If you've ever spent one second of your fat life thinking "maybe I should consider that gastric bypass surgery", this will make you glad you passed it up. Check it out.

While blogging, I'm also having my "dinner". Tonight that is one cup of strained low fat cream of chicken soup. (Strained to get the chunks of chicken out!) My diet is extremely limited right now, which of course is to be expected. People are shocked when I tell them, but my tiny little stomach pocket just isn't up for too much yet! And since my understanding is that if I over do it the results will be quite uncomfortable for me, I'm not pushing it! (-:

The great news is that I am not feeling terribly hungry, and when I do feel slightly hungry, it is typically because it's time to eat something.

Here's the overall eating schedule that Dr. XXXXX requires:

2 weeks prior to surgery -- extreme low carbs -- max 20 carbs a day

day before surgery -- clear fluids only, plus Powerade with Miralax (bariatric colon cleanse)

day of surgery -- absolutely no fluids by mouth, later in the day got ice chips (was on IVs)

1st 2 days after surgery -- clear liquids only (broth, crystal light, sugar free popsicles, SF jello) -- in the hospital, they'd give me crystal light in medicine cups .... Here's one ounce of liquid, take 15 entire minutes to drink it.

Days 3-6 (where I am right now)-- Full Liquids (1% milk, low carb protein shakes, SF low fat yogurt, cream of chicken soup, plus all the things in clear liquids -- including SF jello, and SF popsicles) **now, the surprising thing here is the quantities... I should take a full hour to sip 8 ounces of whatever I eat/drink, yet I am to strive to consume at least 48-64 ounces of liquids over the the course of the day. Half should be clear liquids and half should be the full liquids, being sure to get protein in there.

Days 7-10 (begins Wednesday - woo, hoo!) -- Pureed/Soft Diet --- this is where my new magic bullet will be quite handy. See, my tiny new pouch isn't grown up enough to work as your stomach does.... using its muscles to break up and grind up the food we eat. So, for now, I gotta do that work before I eat something. Now, at this stage, I shall only eat 4-6 Tablespoons of food each "meal" and I should have 5-6 meals a day. I can add mashed potatoes, custard, and pudding, but I must be VERY careful to keep it really low sugar and really low fat. Otherwise, my tiny pouch will rebel and make me regret it. Other things, provided they are well cooked and blenderized, will be vegetables, scrambled eggs, LF cottage cheese, poultry, soups, applesauce, and stage 1 & 2 baby foods (but watch the sugar in those!). I must also be sure to remove all skins, visible fat, connective tissues, rinds, shells, seeds, etc.

Then, Days 11-30 (almost 3 weeks) -- Soft Diet -- Pretty much as above, but adding a few starches like cereal, crackers, and adding soft fruits (have to remove citrus membranes) and low fat cheeses. The instructions say "small distinct pieces of food that is tender and easily chewed. Begin with ground or flaked meats and chopped or mashed foods".

Then, Days 31-45 (two weeks) -- we continue as above, but get to graduate to 6-8 tablespoons per meal, 5 meals per day. Also can add some things like brown rice and whole grain pasta.

Then, Six weeks after surgery -- Healthy, Lifelong Meal Plan -- add a few tablespoons of food per meal, then after another month, a little more. Ultimately, the plan for post bariatric surgery patients, is to eat 3/4 - 1 cup per meal, and eat 4 small meals per day. Dr. XXXXX disagrees with the snacking throughout the day theory. Essentially, we'll need to add more fiber here, but be intentional about high protein, low fat, and lower carbs. We are told to stay away from everything High Sugar. My understanding is that high sugar will result in dumping syndrome, and that I will not like that one bit. (-; A few people have said, "yep, you'll only do that ONCE".

A few other things for post bariatric surgery patients, that are a little odd, are that we can no longer drink from straws or have carbonated beverages. Those put too much air in our pouches, and make us feel full when we aren't. Also don't want those bubbles to increase the size of the pouch, that would be dumb after having surgery, no!?

Another quirk is that we are NOT to drink while eating a meal. Yes, we must drink 48-64 ounces daily, but we must stop drinking 30 minutes before a meal, and not drink fluids again until 30 minutes after a meal. Our little pouches (can you tell I've grown attached to my little pouch already? (-: ) will tell us we've had enough to eat and we would not have. Or, the food will slide right through with the liquids, and we won't get the nutrition we need. Either way, that's bad. SOOOO, no drinking at meals!!!

Oh, and NO MORE NSAIDS. I know, what's that, right? No more aspirin or anti-inflammatory medicines like Aleve, Ibuprofen. EVER. They're bad for our little pouches. They can cause bleeding and ulcers, and bad stuff like that. Oh, except the chewable baby aspirin we take for the first month after surgery to prevent blood clots....

We must also take vitamins for ever and ever amen. Chewable Multivitamins with Iron and chewable Calcium with Vitamin D. And B-12. Can be shots or sublingual... I'll find out a bit more about that when I return to the doctor next Wednesday.

The part that shocked me the most was that it should take you an hour to drink 8 ounces of fluid. An HOUR. Also, four cups of food a day? How is it remotely possible to get the nutrients your body needs on four cups of food a day? And no straws?! That...ahem...sucks.

Anyone have any other thoughts on this? Is there anyone out there who has gone through this and can comment?