054 Gastric Sleeve Diet Stage 3

Today marks four weeks out from Jimmy's gastric sleeve weight loss surgery! We are so excited because he is doing really, really well AND he gets to start his Stage 3 Diet on Sunday! He won't have his month appointment for a couple more weeks (due to the holidays) but when he does we will let you know what Dr. Hornbostel and everyone else had to say. So I know that everyone really seems to love and be fascinated by what Jimmy is allowed to eat and what he is not. I am including his whole Stage 3 diet below. Be aware that some of the foods Jimmy was allowed to eat before are being phased out for healthier options now that he is allowed a wider variety of foods. Don't miss that because I guarantee Jimmy won't! I realize this diet may be different than the one prescribed by your surgeon. All bariatric surgical programs are different. Talk to your surgeon before changing your diet or exercise program. This diet was prescribed to Jimmy by his surgeon (Dr. H) and nutritionist (Krystal).

Jimmy's Post-Op Stage 3 Gastric Sleeve Surgery Diet
What is the Stage 3 bariatric diet?
It is a soft diet that consists of foods high in protein with no added sugar and minimal fat

Recommended Foods:
Meats/Eggs/Cheese/Dairy/Legumes - These foods are high in protein, consume them first at meals. Meat should be lean, moist, tender and must be chopped or ground. Make sure your body can tolerate fish and poultry before trying to eat beef and/or pork.

• Skinless chicken or turkey
• Baked or grilled fish and shellfish
• Lean ground beef or pork (if tolerating poultry and fish well)
• Thinly sliced deli meats such as chicken, turkey, roast beef, or ham (these should be purchased at the deli counter so they will be lower in salt and preservatives)
• Meat, tuna, or egg salad prepared with light mayonnaise
• Meatless burger (vegetable, bean or soy based)
• Well cooked beans: black, garbanzo, kidney, lima, navy, pinto (including low fat refried beans), etc.
• Cheese (reduced fat)
• Eggs
• Creamy peanut butter (less than 5g of Sugar per serving & may be used in small amounts to add protein to foods such as oatmeal, yogurt, and/or protein drinks)
• Skim, 1% Milk, or soy milk (containing no more than 20g Carbs per serving)
• Yogurt - Low fat or Fat free (must be no sugar added and have less than 20g Carbohydrates per serving)

Protein Supplements - It is still very important that you consume between 40g to 60g of protein a day. This requirement will never go away.

• High Protein nutritional drinks as allowed on Stage 1 and Stage 2 diets (must have a minimum of 15g Protein per serving and less than 20g Carbs per serving)
• Powdered protein drinks may still be used
• Protein bars (containing at least 15g protein per serving and no more than 20g of Carbs per serving)

Vegetables - Vegetables MUST BE COOKED until very soft and prepared with minimal fat. Do not eat skins.

• Asparagus
• Beets, Broccoli, Cauliflower
• Celery, Carrots
• Eggplant, okra
• Lentils, beans as listed above
• Mushrooms, onions, peppers
• Spinach, sugar snap peas
• Squash, any kind
• Turnips
• Green beans or wax beans
• Tomatoes, no skin
• Potatoes, white or sweet (no skins, no fried potatoes)

Fruits - All fruits must be canned or frozen (except ripe Bananas). Do not eat skins or peels. Canned fruits must be packed in its own juice. Frozen fruit should have no sugar added.

• Apricots, peaches, pears, crushed pineapple
• Applesauce (no sugar added), mandarin oranges, fruit cocktail
• Frozen honeydew melon, cantaloupe, seedless watermelon
• Canned or frozen mango, papaya, cherries

Starches/Oils/Misc. Foods

• Oatmeal or Cream of Wheat (no sugar added)
• Cold Cereals (containing no more than 5g. of Sugar per serving)
• Fat Free or Low Fat Soup
• Whole Wheat Crackers (Triscuits - updated 12/17/12 as of Jimmy's meeting with Krystal)
• Whole Wheat toast, melba toast
• Sugar Free Pudding
• Sugar free ice cream or frozen yogurt. Avoid sherbet.
• Oils - olive, canola, soybean
• Margarine (trans fat free), butter, sugar free jelly
• Herbs, Spices, Salt, & Pepper

Foods to Avoid

• Soft bread (it can make a dough ball that could plug up your stomach)
• Rice
• Spaghetti and other pastas
• Macaroni and Cheese
• Raisins, prunes, and other dried fruit (these are too sweet)
• Granola and other Cereals with nuts
• Raw fruits and vegetables, salad
• Nuts and Popcorn
• Chips and crackers (other than whole wheat crackers)
• Tough or chewy meat
• Whole pieces of corn or whole peas (puree before eating)
• High fat foods (butter, margarine, oil, regular mayonnaise, sour cream, cream cheese, salad dressing, whole milk, half and half, ice cream, cakes, cookies, pies, other desserts, bacon, and sausage)

Serving Size: 1/4c. - 1/2c. (2 - 4oz) of food, 3 - 4 times a day. NO MORE THAN 1/2c AT A TIME! Focus on eating foods containing protein first. Avoid drinking with meals and for at least 30 minutes after meals. Drinking with meal or directly after meals can cause Dumping Syndrome. Continue to drink a minimum of 6c. of fluid daily (see Stage 1). Avoid Fruit Juice or limit it to a maximum 4oz. per day (100% juice with no sugar added). 

Duration: Follow this diet for Weeks 5, 6, 7, & 8 following the surgery or until your doctor advises differently (this diet begins 1 month after your surgery)

018 Portion Size Matters

Another of the appointments we had during our doctor appointment blitz was with a Nutritionist named Krystal Staggs. Let me tell you right now that Krystal is A-MAZ-ING! I know that she has really helped Jimmy A LOT! So much so that we have even set up additional monthly meetings with her so that Jimmy can talk about ways he can prepare himself for healthier living and what he can be doing now to gradually ease into the new way of eating he will have after the surgery.

The biggest realization that we have come to is that PORTION SIZE MATTERS. I would guess that about 90% of people are regularly overeating and they don't even realize it. It's not because they are "pigging out" necessarily but it is because of an ignorance of portion size. I about cried laughing when Krystal pulled out the little rubber piece of beef that was an ounce portion. It was minuscule compared to what is normally on my plate. When she held it out to us she said, "This is how much Jimmy's stomach will be able to hold right after surgery." Let me tell you that my jaw about dropped to the floor. I mean--come on--I knew that he wouldn't be able to eat a lot but this easily fit into the palm of my hand!

It was in that moment that I truly realized just how much I was overeating without even giving it a second thought. I know that Jimmy must have been thinking the same thing from the look on his face. So in addition, to setting some other realistic goals for ourselves--like not keeping chips or sweets in the house--we also decided to make a conscious effort to actually pay attention to the amount of food and the number of portions we were putting into our mouths.

Because PORTIONS DO MATTER!

015 Dr. Appointment Blitz

After completing the six months of doctor supervised weight loss, Jimmy was scheduled to go in for what we have affectionately deemed the “doctor appointment blitz”! Our blitz was on July 10, 2012. What it entailed were back to back visits with the Surgeon, Dietician, Physical Therapist, and Psychologist. Basically it was everyone you needed and wanted to see to finish getting your insurance approval.

The blitz lasted for approximately five hours. During that time we collected a TON of information, answered a plethora of questions and were given various tests to determine Jimmy’s physical and emotional/mental preparedness for his WLS. The best thing about the whole experience is that this team of blitzers will be helping Jimmy prepare for his surgery, file his insurance paperwork, performing his surgery (ok just the surgeon) and helping him with adjusting to a new diet and exercise program. So it was really great to get a chance to finally meet these people.

During our Dr. Appt. Blitz we also learned that for Jimmy’s safety and a possible transitional weight loss method, Dr. Hornbostel (Jimmy’s surgeon) would like Jimmy to consider doing the gastric sleeve surgery. It will help him to lose weight quickly without the complications of replumbing of the small intestine (on a person Jimmy’s size) that the gastric bypass would include. He is confident that Jimmy will do well with the sleeve and should Jimmy need an additional weight loss push in a year or two the gastric bypass will still be open to him since Dr. Hornbostel will be pursuing the gastric sleeve as a treatment for Jimmy’s acid reflux. The only additional thing we have to do to qualify to have the gastric sleeve as an acid reflux treatment is to have an EGD (esophagogastroduodenoscopy) to prove that Jimmy has a hiatal hernia which is causing his reflux. We even scheduled his EGD for July 17th before we left the office.

All in all, we have nothing about great things to say about Dr. Hornbostel and his team. They really took their time with us and made sure that we understood what we were getting ourselves into. They were realistic with us about the positives and the negatives of the WLS and they are prepared to go through them with us. All in all it was one of the best Dr. Appointments we have ever had.

Over the next several posts I will be talking about some of the specific appointments that Jimmy went through and our experiences through it all.