Jupiter6

Send Message

Block

Add Friend

For those who wanna know only-- I plan some crazy weekends, and this one was sheer stupidity at it's finest...

Thursday Night--
Mother's in New Hope-- Sig Ot and I split a baked brie with almonds and berries appetizer, split a chicken, craisin, apple and bleu cheese salad, split a big piece of chocolate cake. Then we each had a ginger cookie dipped in chocolate and caramel-- and a couple SF creamsicle candies.

Friday on the road--

A couple SF cookies, a 100 cal pack of peanut crisps
A chocolite protein bar
Some turkey jerky
Chinese Buffet in Salisbury-- had a little of everything including a crab rangoon and half an eggroll, and bites of 6 desserts

Dinner Friday-

Baker's Crust in VA Beach-
Had half a chicken and bleu cheese salad with mustard dressing, roll with butter
Cup of mushroom brie soup
Half a crepe with bananas and chocolate sauce and whipped cream
Some caramel/peanut popcorn
Almond butter

Breakfast Saturday-  Citrus in VA Beach
half a cheese, mushroom, ham omelette 
slice of buttered raisin toast
2 slices of bacon

Snack Saturday-
Some chocolate peanuts
Samples at World market of chocolate pretzels
Big mess of chocolate / PB frozen Yogurt and The Skinny Cow with granola and a couple pieces of PB cups
Samples of 6 other kinds of fro yo
Diet Cherry Limeade from Sonic

Dinner Saturday
Jakes BBQ in VA Beach-- STUPEFYING amount of grub here---
Had 12 fried (you heard me!) corn nuggets and mustard sauce (!!!!)
BBQ brisket and smoked turkey
Bite of garlic bread
half a baked potato with sour cream
two bites of corn

Snack Saturday night-
More caramel/nut popcorn

Sunday AM-- Did a 2 mile walk, then
5 oz Fage with blueberries and protein granola
Toast with almond butter

Sunday PM
Back to Skinny Cow-- more yogurt (fat free this time) and fruit

Sunday Dinner
No Frill Grill in VA Beach-
Had half a chicken and cheese/bacon type salad with chipotle ranch dressing
Cornbread
cup of chili
1.5 oatmeal cookies
Big Grab bag of baked Cheetos
handful of chocolate peanuts

Monday AM- Going Home-- gettin' in all the faves!

Half a bag of Turtle Chex Mix
Half a Junior burrito at Sonic (and diet cherry limeade)
Half a Krispy Creme glazed donut (YUM!)
Lunch at Golden Corral-- big plate of meats, sampled of (literally) 10 desserts
Bag of Smartfood popcorn
4 fudge/peanut butter cookies
2 small rice cakes with almond butter
yogurt protein smoothie with blueberries

Okay, that's over! I'm up about two pounds as usual-- all water for the ol' glycogen party-- should be outta here by Sunday if I do what needs doin'.

\
This is what I ate today-- 1203 calories-- 31g fat-  110g carbs- 124 g protein-- a typical day, except that on a truly typical day I am too busy eating to take pictures! :) About 41% protein.

I also drank a bunch of delicious Matte Chocolatte tea, and raspberry lemonade sugar free slushies-- my favorite!

Post Op RNY eating doesn't have to be about deprivation or starvation if you put your mind to it!

Some general rules of thumb:

Iron is best on an empty stomach, taken with vitamin C (200mgs vite C to 30mgs elemental iron).  The vitamin C won't do you any good if taken seperatly -- they play well together.

Iron should not be taken within 2 hours of a large calcium source (300mgs or larger).  Creamer in your coffee will not kill your iron absorption.  Taking your calcium with your iron will.  Also, iron should not be taken within 2 hours of zinc and copper, nor whole grains and tannins (from coffee and tea).

All other vitamins do best when taken with food.

As a general rule, all vitamins should be taken with 8oz of fluid.  I know it's hard for us with the whole "best to eat with your vitamins" and "don't drink around mealtimes" but that's the recomendation.  Solve it how you wish.

Zinc and copper should not be taken within 2 hours of calcium (although some calcium supplements include zinc -- I plan on emailing Citracal and asking them about this, actually).

Zinc and copper have a symbiotic relationship -- if you take one, you should take the other.  Both help with iron absorption; zinc assists with calcium absorption and protein absorption.

B-complex containing riboflavin should not be taken with iron.  Iron and riboflavin don't like each other.  It's not a "it will kill you" type thing -- but the riboflavin will get eaten up by the iron.

Vitamin D is probably an oily compound -- I'd recommend going to vitalady.com and getting the same strength in her water-miscible "dry D".  But hey, that's just because we malabsorb fat and the vitamins contained within that fat.

Nexium should not be taken close to iron.  Neither should any other tummy meds.

Talk about Community Service! I was up until 4 am (I get rammy on days I exercise) looking these up on the 'net for y'all--on blogs, everywhere--so this info may or may not be correct (places might have closed or not offer it anymore)-- but here's a starter list that will help some lucky people find the Only 8 soft serve frozen yogurt in their area... this is by no means an exhaustive list, but it can get a few of you started! Remember-- 32 calories and 7 carbs per half cup-- a pretty good deal if you're an ice cream fanatic!  Note: tastes best fresh but you can often buy some to take home as well.

***IF YOU KNOW OF OTHER PLACES, please tell me the name of the store plus city and state so I can add them here! Thanks!*****

ALABAMA
Birmingham- Edgewood Creamery
Mountain Brook- Mountain Brook Creamery

ARIZONA
Phoenix- Desert Swirl
Tucson- Penguin's Frozen Yogurt

CALIFORNIA
Bay Area- Yogurtland
Eureka- Old Town Coffee
Los Angeles-Yogurtland
Orange County-Yogurtland
Rocklin- Big Chill Ice Cream
San Bernadino-Yogurtland

FLORIDA
Palm Harbor- Strachan's Ice Cream
Tampa- Britain's
Tampa- Debbi's British Goods
West Palm Beach- Charley's Frozen Custard

HAWAII
Honolulu- Fro-Yo Bar
Honolulu- Yogurtland
Pearl CIty- Yogurtland (coming soon)

ILLINOIS
Benld- Weather Vane Ice Cream
Bethalto- Weather Vane Ice Cream
Evanston- Cafe Mozart
Granite City (2 locations)- Weather Vane Ice Cream

LONG ISLAND
Smithtown- Granny's

LOUISIANA
Mandeville- Yagels Yogurt
New Orleans- Cherry on Top
Shreveport- Counter Culture

MASSACHUSETTS
Swansea- Eskimo King
Wellesley- Truly Yogurt
West Dennis- Kristy K's

MICHIGAN
Birmingham- The Cupcake Station

NEVADA
Las Vegas- Yogurtland (One open, 2 coming soon)

NEW JERSEY
Closter-Yogurt Lovers
Howell- The Ice  Cream Shop
Manahawkin- Ocean Ice Cream
Morganville- Galaxy Ice Cream
Mt. Laurel/Mt. Holly- Moose Mountain Creamery
Oaklyn-Yummies
Pennsauken- Mr. Softee

NEW YORK
Commack- Granny's
Garden CIty- Upper Crust Cafe
Glens Falls- Coopers Cave Ice Cream
Mamoronek- Esy's Frozen Yogurt
NYC- Greenwich Village Yogurtland
NYC- Pump Energy Food (38th and 6th)
NYC -Times Square Deli (211 W.43rd)
Pleasantville- RocNRoe's Pop Shop 
Sag Harbor- Ice Cream Club

NORTH CAROLINA
Salso- Village Conery

TENNESEE
Murfreesboro- Yogurt Oasis

TEXAS
Carrolton- Yogurtland
Houston- BerriBlends
New Braunfels- Marco Polo's

PRE OP 3/07     10/08    5/09        8/09

Chest:   58"         37"       36.25"     37"
Waist:    55"         36"       33.75"     31"
Hips:     65"          43"       41"          41"
Calves:  23"         16"       15" (r)     16"
Arms:     17"          x           14"          9"

I had my BodyGem RMR testing done in Ardmore, through Angela Grassi-- an eating disorder specialist. I didn't eat or drink, but I did exercise the day before, and I did have to walk in from my car-- and worry that might have skewed the results-- but probably not THAT much.

General upshot is that I'm actually undereating-- just as we all suspected. I'm just surprised how MUCH !

Results:

My RMR is 1680

Factoring in lifestyle (but not exercise) I should be able to take in 2000-2300 calories a day and not gain weight.

To lose a pound a week: 1500-1800 cals
To lose a pound and a half: 1250-1550
To lose two pounds: 1000-1300

Given that I am now hitting the gym a couple times a week, and staying pretty active in general, I feel pretty confident in starting to raise my caloric intake a little more. I don't want to screw myself over by undereating what my metabolism needs to run! So I am bumping up to 1,100 this week, and seeing if that has any ill effect at all. While I haven't exactly been "hungry"-- I have had more positional hypo bouts and the brain's been a little more overwhelmed and foggy than I like.

My caloric history, then:

Pre op diet: Started at 1800, then down to 1200 over 4 months- lost 68 pounds. Liquid diet the last 12 days. (less than 1000 cals a day)

Post RNY- about 650 cals a day (70+ g protein)
3 months-       700 cals a day
4 months-       800 cals a day
5 months-       850 cals a day
7 months-       900 cals a day
13 months-    1000 cals a day
13.5 months- 1100 cals a day (100+ g protein)

I do NOT suggest this for other people. My initial intake was very low and I probably suffered worse for that than I know-- I was just very concerned that with so much to lose I needed to really keep it down as long as I could stand it. Also-- my protein intake is excessive for a reason-- I have a longer bypass (200 cm) and a history of not getting enough protein since high school (despite a high protein diet) so I prefer to keep things protein-heavy.

So far, so good. I'll adjust things as the lab rat data comes back.

I've been reading a lot of threads about a dear OHer who passed away from an intestinal blockage, and how we need to advocate for ourselves-- and I wanted to make something clear--

If you are suffering an intestinal blockage, all the noise in the world may not save your life. Or better said, if you think you're being loud enough, BE LOUDER-- and arm yourself with knowledge so you recognize it beforehand.

My story: 3 days after having my gallbladder out in June, I started feeling very nauseous and suddenly could not keep food down. (That'd be hard for some to note because they have trouble keeping food down anyway.) I hadn't had gas or a bowel movement in 7 days, but having just had surgery suspected it was just slow in coming.

After 6 hours of this nausea and pain not passing I paged my surgeon and his assistant. I was told that neither were answering their pages. I was able to get in some water eventually and went to bed.
 
The next day the nausea and pain intensified. By 6pm I could take no more. I was home alone, and so instead of driving to the metro hospital where I had my RNY, I could only drive as far as the local ER. This choice almost cost me my life.

I was sweating and crying when I went in. I explained to the triage nurse that I had an RNY and a gallbladder removal just days before and suspected I had an intestinal blockage, and that the pain was excrutiating. An emergency. I could die. 

But It was a holiday weekend, and people who cut their fingers on beer pull tabs were taken back, women who were upset over boyfriends, the general ER riffraff BS that takes place on a holiday-- and I was left standing (couldn't sit) in the waiting room for FIVE hours-- even though I returned several times to triage to say, "I can't take this much longer-- I am very afraid I have had a blockage and need a doctor NOW."

When I was finally seen, the CAT scan was "inconclusive"...the doc told me he saw a lot of fluid in my belly but thought it might be from the gallbladder surgery, and I should follow up with my surgeon in the morning. I was discharged at 6 am with nausea meds and pain pills.

When I called my surgeon, I read him all my tests-- enzyme levels, etc. He said he didn't hear anything alarming-- but he was listening for something gallbladder related-- a bile duct blockage etc. would skew the numbers. When it didn't, he more or less said, "You'll be fine." This was Monday.

By Wednesday the pain at night was unbearable. I cried and screamed into a towel. Wednesday morning I had a regular check up with my surgeon. Luckily, his assistant knows me very well and said, "Shari, you don't look right. Seriously." The surgeon said, "I don't know what to do-- want us to admit you and run some tests?" I think he expected me to say no, but I said, "PLEASE!"

So I was admitted around 4 pm. By 7 pm the pain was back, but they wouldn't allow me pain meds until after I had a CAT scan. I didn't hve the CAT scan until 3 am. They left me on a gurney in the hallway for an hour and a half  aftyerward, sobbing in pain, because they didn't have anyone in transportation to come get me. By the time I finally received pain meds at 5 am, I would have shot myself if I'd had access to a gun.

I finally fell asleep. At 7 am, my surgeon breezed in, threw open my curtains and said, "You're having surgery today. You have a bunch of fluid backed up in your belly, and we need to find out why." He explained he'd use the lap incisions he'd made for the gallbladder and go back in.

By noon I was in surgery.

At 4 pm, I awoke in the worst pain I had ever felt in my life. I focused on a spot on the ceiling. I could not talk. I had tears streaming . The dilaudid wasn't even touching it. 

They explained to me, "You're a lucky woman. Your bowel (intestines) had twisted and actually permeated the wall of your excluded stomach. Generally when this happens, and days pass, we find a bunch of dead bowel which we have to remove. But for whatever reason when we reconnected you, you pinked up right away. Now we just have to see if it works-- if you can move your bowels or pass any gas." I was told that the lap procedure went open-- suddenly-- when they couldn't locate the source right away-- I had a large open incision now from my sternum to my navel. I'd been gutted and beat up pretty badly in the process. But I was alive.

For five days, nothing passed. My urine was dark brown, I was losing kidney function. Then it started to lighten, and returned. And finally on the fifth day, while walking in the hall, I passed gas. Sounds stupid, but I was so happy I cried. I gained 25 pounds in fluid and unpassed stool in 3 days--but within two weeks lost 40. My recovery took many weeks, but I finally  feel better now. I am grateful for the opportunity to live, and feel obligated to warn anyone who will listen.

Blockages like mine are 100% fatal if not caught in time-- usually within 72 hours. Why mine didn't take me down in the FIVE days that had elapsed, I am not sure.
 
I wanted to make sure you know what we're really discussing-- how it feels, what it looks like, how you might be treated. Your local ER will NOT be able to help you. You need to educate loved ones so that they can speak FOR you-- a medical alert bracelet will not help you. The beloved poster who passed away may have done all of the above, and still they missed her blockage until it was too late. You need to do everything you can to make sure it doesn't happen to you-- and this sort of herniation-- sometimes called a Petersen's hernia-- happens in about 5% of post bypass patients. Five out of one hundred. One in twenty. Could be anyone.

Symptoms in an RNYer include nausea, vomiting, abdominal pain and distention, inability to pass stools or gas. (Apparently in DSers, gas will still pass.)

Know the signs and symptoms. Don't allow anyone to dismiss you. Do NOT ignore pain that will not pass. Insist on prompt and appropriate treatment, and train your family to know how to help you if it should happen. You may save your own life.

This message is for all of patients who have undergone gastric bypass (weight reduction) surgery.  It is to inform you that a small percentage of patients who have undergone this type of surgery will develop severe abdominal pain due to internal hernias.  This condition is called a Petersen’s hernia and must be treated surgically on an emergency basis. 

  
When patients lose a significant amount of weight, the fatty tissues in the abdomen decrease in size.  In some patients, the position of the intestine can shift within the abdomen and become twisted and obstructed. 

If you should develop abdominal pain you must seek medical attention immediately.  Petersen’s hernia can be successfully treated and full recovery is to be expected.  Time is of the essence however.  

***If there is a delay in diagnosis and treatment beyond a few hours, there is the potential for loss of a significant portion of the small intestine and even death. ***

It is important that you be aware of this condition. If you develop abdominal pain, you must immediately seek medical attention and inform your physician that you have undergone gastric bypass surgery.  You should also tell them that you have been informed about the potential for a Petersen’s hernia and wish to be examined by a surgeon on an emergency basis. 

While the incidence of this condition is relatively low (less than 5% of patients who have undergone gastric bypass surgery), it is a serious development that must be treated very quickly.

  

 

Sincerely, Elliot R Goodman MD  
Beth Israel Center 
for Obesity Surgery

Ray's 6 Month Diet Landmarks
July 27                334.6
July 29                333
July 31                332
Aug   5                330.4
Aug 13                329.8
Aug 27                327
Sep 30                330
Oct  11               325.8
Oct  14               325.2
Oct  21               323  (lowest pre-op weight)

Ray's Liquid Diet
Apr   9      331          
Apr 10      327.6    
Apr 11      325.6  
Apr 13      322.2   
Apr 14      320.4     
Apr 16      317.6 
Apr 17      317.4  
Apr 20      316.8
Apr 21      315.6

After RNY
Apr 23      323.6
Apr 26      313.8
Apr 28      308
Apr 29      303
May 1       303.6
May 2       300.8
May 3       299.8
May 5       298.8
May 9       297.2   *Big ol' stall here
May 22     296.6
May 25     295.2
May 26     294.8
May 30     291.0
Jun 15     285.8
Jul  03     283.0
Jul  06     279.8
July 26     273.6
Aug 17     265.0
Nov 1       247.0
Nov 7       244.8
Jan 17     229