Posted on the main board 8/4/07 thank you Elizabeth N.

Aug 04, 2007

The DS consists of two procedures: the subtotal sleeve gastrectomy, which is the removal of most of your stomach with preservation of normal stomach anatomy (no pouch, no stoma), and the bileopancreatic diversion with duodenal switch, which involves dividing the small intestine into two limbs. Digestive enzymes flow down one limb, food flows from the stomach (prepared for absorption by the stomach acids and stuff) down the other limb, and the two come together at the bottom of the small intestine in a "common channel." 

That common channel can be made just about any length the surgeon might consider appropriate. There are basically two schools of thought about how to do the common channel. One is the Hess method, which uses a percentage of the total length of the intestine to figure out the length of the common channel. The other is where the surgeon either gives everyone the same standardized common channel *or* has some variation of length that s/he uses depending on the person's starting BMI and any of several other variables.

The starting stomach size can also be varied depending on any of several variables. 

The common channel can, if necessary, be shortened or lengthened to increase or reduce malabsorption, if problems crop up. 

Malabsorption is not a bad thing. It MUST be accomodated in a lifelong commitment to eating lots of protein and taking a regimen of supplements as determined by periodic lab work. If you're unwilling to make that commitment, don't have the DS, because you could develop malnutrition (which is a very different thing from malabsorption) and it could kill you. But in the vast majority of people who have the DS, it's no biggie, as long as you comply. 

tips on what to eat post DS

Jul 06, 2007

  Amazing tips on what to eat post DS!!! Thank you Tammy!!!
on May 20, 2007 5:17 am

Since Alyson is having some difficulty with food I was going to post this on her thread but I thought instead I would make a whole new thread so everyone would see it.  This is info gathered over the past 20 months so it is a LOT.  But please, read through, copy and keep it if you like, gleen what you will use and most importantly, PLAN ahead and keep food at hand so you never end up without anything to sustain you.  All of you post-ops, whether new or old, jump on in and post what works for YOU so that we can share and compare!!  *hugshugs*

This is a lot of information so don’t get overwhelmed!  *hugs* 

My saving grace during the first few weeks after surgery was milk.  I absolutely never, ever used to drink milk before surgery, but afterwards, it was a godsend.  Basically it’s a protein and a fluid source that you can do anytime you want/need.  1g of protein per oz. So each little amount you drink is both fluids and a decent protein for you, if you can tolerate milk. 


Right after surgery I started drinking Carnation Instant Breakfast (CIB) in milk and that was very helpful. Not really high in protien but with the milk it was a decent amount.
         

One thing I wish I HAD found early out was a good unflavored protein powder. ANY unflavored powder you can tolerate would work here but my experience was with Unjury so I’m gonna go with that.  Some people HATE it but I think that’s probably because they tried it by itself.  ICK.  If you flavor it up enough, you wont know it’s there.   It is light, easy on the taste buds and quite tolerable. Here’s the secret recipe/mixing instructions:


For me the clumps/texture of protein powders is ICK so here’s a few tricks.  Stir one serving of Unjury into your milk, SLOWLY, slowly, slowly… adding just a little at a time and stirring constantly.  This allows it to really mix in with the least amount of texture.  Once you’ve gotten it all in, add your Carnation Instant breakfast, one serving or two depending on your taste.  More is more protein and I liked mine extra chocolaty so it worked for me.  After it is ALL mixed together, pour your drink though a very fine teas strainer to remove any last clumps/texture!  

The colder the drink is, the more palatable it is for many people.  Sometimes I’d stick mine in the freezer until it thickened up almost like a Frosty.  Sometimes I’d just drink it as is.  Using a straw helps because you get the liquid and not any of the froth that can accumulate on top of protein drinks.  I hate the froth so I use the straw hehe.  If you do 16oz of milk (16g) and 1 serving of Unjury (20g) and Carnation Instant breakfast (5g for one, 10g for two servings) then one shake is at least 41g and as much as 46g of protein.  You can drink it over time as you can and again, pop it in the freezer and eat with a spoon later if you want to.  This was a staple for me for about a year.  Any time I was low on protein from real food I’d do a shake.  If I KNEW I would be out and about and busy, I’d do one early on and then deal with my day.  (For ME, by 1 month out I was drinking 16oz of milk with carnation instant breakfast.  Slowly over a span of time and only as my tummy was comfy.  I added unflavored protein powder to that and it became a MAJOR staple of my protein world for a while.  16oz milk, 1 serving Carnation, 1 serving protein powder and you has 41g of protein.)   This was a LIFE-saver in my journey.  =D


Unflavored protien powder is easily mixed with things like Oatmeal, pudding, jello & eggs etc to boost your protein too by the way.  I found mixing it in my slightly cooled oatmeal was easy to eat, toss on some cinnamon, splenda or whatever you use and some milk and nibble at that for a while.  Good protein in the milk, the oatmeal and then the powder.  Start off light on the powder, like ¼ a serving until you find your tolerance level.  I don’t think I ever did more than ½ a serving at a time for my particular tastes.  
  

Now for some food suggestions ~

Here's a list of a few things I could eat in that first month.  It will differ for us all!


Very small protein shakes, careful if they are too airy they might cause burping.  I would do milk, protein powder and then use any of the following to flavor it up: Bananas, peanut butter, strawberries or other berries/frozen fruit or even yogurt.


EGGS!! Every way you can imagine! 
Very soft-boiled eggs, bout 8 min. so they were firm but soft

Deviled eggs
Egg & cheese quiches (homemade or storebought)

Scrambled eggs (add a touch of water or milk for lighter, fluffier eggs)

Scrambled eggs w/cheese or Omelettes, add meat/veggies/spices as you like
Fried/poached eggs

Tuna or chicken salad with lots of mayo

Cream of wheat w/unflavored protein powder

Oatmeal w/unflavored protein powder

Any soups you can tolerate.  If they are bulky simply blend them for consistency if you need to.

Tomato soup made with milk and w/cheese melted in it

Chicken noodle soup, easy on the noodles
Egg Drop Soup (10g of protein per serving, SO good)


Chicken if cooked right.  Dark meat preferred for moisture, small, small bits, like 1-2oz over the meal slowly.  Very moist recipes with butters/sauces/gravies are critical in the early stages. 

Cottage Cheese
Cottage Cheese Pancakes!!  Recipe to follow!

Yogurt (add protien powders if you like)

Pudding

Fruits with no pulp/skin/etc. are tolerable
Melons

Peeled/cored apple slices with peanut butter
Bananas mashed with peanut butter and a little honey

Cheeses, any kind you can tolerate, be inventive, try tons of new cheeses.  Remember fat is our friend and its great protien.

 

Real mashed potatoes with butter, sour cream or cheese.  No instant, they swell and tend to feel really, really heavy.

Carl Buddig lunch meats

Other thin sliced lunchmeats

Adding whole grain crackers like triscuits with the meat/cheese/tuna salad etc. is a decent way to get some fiber in and make the food happier in your mouth and tummy and so long as you don't go overboard, it's not a big deal on the carbs.  I was eating triscuits (like 1-2 of them) on my 4th day post-op.


After 2 weeks I began expanding my horizons.  Here are some additional ideas: 

Tilapia or other fishies
Seafood

Very moist meatballs & gravy/sauce

Stouffers meals (protein only) like turkey & gravy, Salisbury steak, Swedish meatballs, even their baked chicken breast w/gravy was moist enough.  *Again, small bites and slowly but very palatable.

Began eating nuts when I was on the go and needed protein.

Casseroles, very moist only

Meatloaf, again very moist

Soft vegetables; green beans, zucchini, squash, etc. with butter

Chili with cheese and any other toppings as you like:  Cheese, sour cream, onions and a few chips eventually. (Chili can be very heavy on the tummy early out so caution)


The best thing I ever tasted was at Arby's at 4 weeks out.  I ordered a beef and cheddar, no bun, no red sauce.  They put the hot sliced beef in a plastic container, poured hot cheese over it and I dipped away in Arby's sauce and horsey sauce.  I swear that was that the best thing I ever tasted in my life.  OH my goodness, so tasty.  Hehe.


I stock up at Costco once a month, here's some ideas for you.

Costco STAPLES: 

Flap meat is a cut of meat I've only found at Costco and it is AMAZING.  It's large sliced pieces of very tender, very marbled meat that cooks up so fast and SO juicy and tender you wont believe it.  I LIVE on this steak.  Medium rare is perfection.  Mmmm.

If you grill, season with garlic salt and pepper or other dry steak seasoning, cook 4 min., flip, another 4 min. = medium rare.  Or on the stove, olive oil in pan, slice across grain, sprinkle with garlic salt and pepper, high heat for 2 min. per side = medium rare.


Rotisserie chicken, tender, juicy beyond belief and a hundred uses for this!

Shredded Mozzarella

Kraft American cheese slices

Sliced turkey/ham/lunch meats

Crystal Light ice tea

Disposable 16oz cups

Disposable plates (Such a relief to use post op, just makes life easier)

Eggs

Milk

Butter (YAY BUTTER!)

Cream

Peanut butter
Chili

Olives!!!!  WOOHOO

Spices at Costco!

(My FAVORITE spice in the whole world is the “Canadian/Montreal Steak Seasoning.”  It is the same thing but called different names in different parts of the country.  It is amazing on steaks on the grill.  I eat sliced raw tomatoes with my steak and dip them in the seasoning too hehe.  I used to HATE tomatoes but the acids in the tomatoes break down the protein in the meat so I got used to eating them together and now I’m highly addicted!!   My favorite protein meal is still grilled steak w/sliced tomatoes.  Nothin’else.  The moisture from the tomatoes also makes this a wonderful combination for us post op!)

 

 

 

 

 Other Costco Favorites for later down the road:

El Monterey Chicken Quesadillas (20g of protein in each, only 21carbs)
Pre-made meatballs, love these things in so many ways.  I can give you ideas if you like.
Fishys and shrimps and seafood
Hot wings
Tyson breaded chicken filets.  MOIST and meaty and so many uses!  
One final note:  I created a file of recipes over the past year + and I basically plan 2 weeks worth of meals, buy for that menu and then I have all those meals available to me during howevery long I make them last for.  I usually choose my next days meals and get that meat out of the freezer and try to stay one step ahead of myself.  Leftovers ROCK and I almost always cook more than needed so I can have it the next day if I want.   Just take the time to prepare for YOU so that you are taking the BEST possible care of YOU, no matter what.

I hope no one has had a seizure reading all of this hehe.  As I said, gleen what you will use and try to make your life easier!  Much love to you all!

As promised ~

Ezpy's Cottage Cheese Pancakes:

Ingredients:

1 cup of cottage cheese (any kind -- I like Knudsen small curd)
4 eggs (3 if they're really jumbo)
1/4 cup of flour (this can be almond, but is best with wheat)
2 tbsps of butter melted (can be salted)
Cinnamon and salt to taste if you like (I like LOTS of cinnamon)
Milk to thin (optional)

Scoop the cottage cheese into a blender (You can use a hand blender instead) Add 2 eggs and blend for like 30 seconds.  Scrape the sides of the blender.  Add flour and 2 more eggs, blend for another 30 secs or so until pretty smooth.  Add cinnamon and salt to taste.  If batter is too thick and thinner is preferred, or to use as crepes, blend in milk to thin. 

They cook just like regular pancakes on a oiled skillet.  I use real maple syrup heated very hot so as not to add too much sugar but to get the taste.

Val's recipes:
Fabulous Trail Mix
Base mix
1 jar peanuts
1 jar sunflower kernels
1/2 bag raisins or "berries and cherries"
1/2 small bag chocolate chips.
1 small bag macadamia pieces
1 small bag pecan halves

To this, I might add other nuts depending on what's on sale (walnuts, cashews, more pecans).  I've also varied the fruit, too, so play around.  Try to keep the proportions the same.  It's so easy to load up the sweet stuff, but it's the nuts that are so valuable here.  The balance makes the perfect sweet and salty snack and my daily breakfast.  If proportions are kept, it's about 32g of protein for 8 oz.

Fabulous Custard -- full of protein, easy on new post-ops ~delicious!
3 cups milk
3/4 cup splenda
4-5 eggs (depending on size)
2 tsp vanilla
1/2 tsp nutmeg (optional)
handful of coconut (optional)

Preheat oven to 375'.  Beat eggs, nutmeg and vanilla together in baking dish.  On the stove, bring the milk and splenda just to a boil, then stir together to the eggs.  Bake for 25 min
NOTE:  when the milk is coming near to a boil, you'll get a little foam on the top.  Remove this foam before stirring into the eggs, or it will get a weird texture on top.

God Bless Paula Deen for flourless peanut butter cookies!

1 cup peanut butter
1 egg
1 tbsp vanilla
1 cup Splenda

Mix and roll into balls (about walnut sized) and flatten with fork dipped in Splenda.  Bake at 350 for 12 minutes.  

TIPS
-Do NOT overocok -- they will get crumbly since there's no gluten
-Peanut butter is naturally low sugar - the low sugar kind only reduces it by 1g per serving.
-If you're picky about artificial sweeteners, I've done a 3/1 with splenda and sugar to cut the after taste and it's good.  Presently, I do full-splenda in the cookies, and roll in regular sugar and that's good too.  I've also added semi-sweet chocolate chips to shake things up.

 

 Carolyn M's Post on hairloss Prevention:Post Date: 7/31/07 8:22 am
I didn't use the biotin supplements. My program for hair loss prevention involves (1)limiting the severity of ketoacidosis (which is toxic to fast-growing cells such as hair follicles) by forcing fluids; (2) getting in as much protein as possible as early as possible, and (3) supplementing zinc and selenium, which support the telogenic phase of hair growth.


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Posted on the main board 8/4/07 thank you Elizabeth N.
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