Due to the nature of this subject, it is quite a long read so buckle up and free yourself of chores or work for 5 minutes. You may learn some things that helps your own health too.
So eventually I am going to have had the surgery and I will need to change my eating lifestyle completely. I will now need to consider carefully every morsel that I put in my mouth. I will need to consider its size, its fat content, its sugar content and it’s carbohydrate content. I will need to work out in what order I shall eat my food and when and if I can get enough fluids into my body so that I do not begin to dehydrate. When the changes required are stacked up like this, you start to see just how much change there will actually be. There will no longer be any hunger pangs that can be resolved by a quick trip to the chip shop, I will not be able to pop into the garage when on a journey and pick up a sandwich, a bag of crisps and a can of drink to keep me going. If I am on a road trip with someone and we stop for fuel, I will probably now be telling the truth when they ask “Is there anything I can get you” and I reply in the negative telling them I’m fine when no doubt I could really eat a doughnut, a chocolate bar and a jumbo coffee. How strange will it be to go to a friend’s house, be offered a cup of tea and not really be able to drink it. This will change over time I know, the same as being able to return to chip shop for ones meal but it is these changes that my portion planning will prevent.
No, if I am to do this correctly then each meal has to be thought out, measured out and totalled up so I can make sure I am actually getting the nutrition that my body needs to heal. I shall work closely with the dietician and design a plan specifically for me to lose weight sensibly and to retrain my brain. A main consideration when retraining is learning to take smaller bites should I ever accidentally get my hands on any kind of hand-held convenience food a few months in to the diet. I am put in mind of a story told by a gastric sleeve patient when she allowed her diet to be compromised by poor time and food considerations. Finding herself several hours away from her home and desperately hungry after a series of mishaps had prevented her from eating the right food, she fell back into an easy habit. She went to the McDonald’s Drive Thru’. Being sensible (as sensible as you get in McDonald’s) she ordered a Spicy Chicken Wrap then without thinking, she took an altogether far too big mouthful, chewed it a couple of times and swallowed. BANG! Here comes the pain…
You see the brain isn’t thinking about your tiny new stomach. All it is thinking about is getting that food into the stomach to stop the hunger pangs; and for years a huge bite, a couple of chew’s and then a swallow would have been the norm but that way disaster leads. The person in question was super lucky not to end up in hospital having an endoscope put down her gullet in order to retrieve the all too big piece of food she had swallowed. No, instead she learnt a lesson because if you do something and the consequence is pain, you will normally find that registers with the brain as an association with something you don’t want to do again, unless that’s your bag of course. The famished diner remained in pain for 20 minutes whilst the swallowed pieces went down. Suffice to say this put her off of the rest of the wrap and it was quickly donated to the roadside wildlife.
Reading stories like this make you realise just how much things will change and how much planning is required. Another thing I learnt of was that post procedure, the ability to drink down water is vastly reduced. I love being able to glug down ice-cold squash or fizzy water, okay it makes me belch but its a side effect I am willing to deal with so much do I like my large mouthfuls of thirst quenching cold sparkling water. But it will be a thing of the past. There is no longer capacity to slurp long drafts of cooling drinks. I will have to learn the mantra little and often so I never get to the point when I am absolutely gasping for refreshment.
Little and often, little and often, little and often…
So the post surgery diet is designed to get me eating smaller amounts which will obviously help with losing weight. It is also designed to help with the fact that my stomach is now held closed on one side with rows of staples and not stretching any of these staples causing them to burst. Obviously the softer and less traumatic the consistency entering my new stomach, the better it is and the more full of nutrients the quicker it will heal. This means my diet will start to consist of nothing but water for the first two days but by all accounts there is absolutely no desire to eat and they need to make sure there are no issues with the stomach. As far as I am aware I do not get to leave the hospital until I have successfully taken on board some calories although for these first few weeks they will be in the shape of broths (thick soups) sugar-free gelatin (cannot wait for this one) and high protein drinks and yogurts such as Upbeat and Danone Rumbler. These are easy to take in, have low sugars, high proteins and low carbs. Fats aren’t really an issue at this stage but do have to be considered.
A guideline states when drinking in the first few weeks:
Sip fluids slowly and drink only 2 to 3 ounces (59 to 89 millilitres, or mL) at a time. Don’t drink carbonated or caffeinated beverages. And don’t eat and drink at the same time. Wait about 30 minutes after a meal to drink anything.
I think I can manage that.
The after these initial few weeks I get to move onto the puree foods. I must be honest, this is one I am not really looking forward to. I think there will be a good amount of juicing vegetables going into this stage for me to get my nutrients as the thought of puree just makes me think of slobber. As I said before, life through a straw…
During this two to four-week-long period I can have foods that have the consistency of a smooth paste or a thick liquid, without any solid pieces of food in the mixture. They talk about lean ground meats? Not a cat in hell’s chance that I will be puree’ing meat or fish. I reckon at this stage I shall possibly build up to eating cottage cheese, thicker yogurts, soft fruit like a banana or a peach. Maybe some liquidised strawberry or similar but I am sure to be keeping up my soup eating. The thing I will have to learn is that there needs to be a memory for eating these thicker foods slowly so as they don’t get caught in my gullet.
The portion control really starts to kick in after that puree stage as I will be allowed to actually”eat” food by this time as opposed to having it slip down into my new smaller sized stomach.. I will be allowed small pieces of fish and chicken to eat. Maybe some mince in the form of a simple cottage pie but only the smallest amounts will be both allowed and required. At no point do I want to over eat as by all accounts the discomfort is on a par with overeating when you have a normal size stomach.. Eventually this third stage graduates to what can be described as an almost return to normal when eating is similar to before but extra care is taken with the portion size. There are many handy tools that help to determine how much you should have of each food.
There is a plate that is smaller than usual that has amounts marked off in sections on the plate (as shown in the illustration above). There is a kind of “circle” system that gives you a template that you put on your plate and you fill each circle of the template with the relevant food thus ensuring you do not over eat. There are also small pots that can be used to both keep your food and measure it.
There are a good deal of lessons to learn with regard to the eating habits. Going to a restaurant is a difficult experience as you need to be on top of not eating the wrong things, having too much sugar, eating too quickly and the main one, eating too much. I will also need to avoid certain foods such as:
Nuts and seeds
Sodas and carbonated beverages
Stringy or fibrous vegetables, such as celery, broccoli, corn or cabbage
Tough meats or meats with gristle
To be honest, I’m good with avoiding the above stringy veggies but I reckon I will miss the others like a crazy boy. I mean, no popcorn? What shall I eat when I go to the cinema!
I will have a new mantra that has these three points at its heart:
I will drink liquids between meals. because drinking liquids with meals can cause pain, nausea and vomiting as well as dumping syndrome and you all know now how awful dumping sounds. I need to drink at least 6 to 8 cups of fluids a day to prevent dehydration. This is currently less than I drink but I can already see it being an issue because there is only so much room!
I shall eat and drink slowly because too quickly may cause dumping syndrome, choose foods low in fat and sugar and wait 30 to 45 minutes before or after each meal to have a drink. I will definitely need to slow down my eating as it reckons I need to take at least 30 minutes to eat a meal. As for drinking, I think it is pretty much sensible to have a water bottle on the go all day long apart from at meal times.
Finally I shall start once again to chew my food thoroughly. I remember when I was young I had an uncle tell me to chew my food 30 times before swallowing. I sometimes remember this when I am eating and try, but it only lasts a short while so lets hope I relearn it because I really need small, well chewed food pieces due to the size of the new opening that leads from my stomach into my intestine.
So all very technical if a little long-winded, however I really appreciate you reading all of this if you have done so and maybe now you will understand, should we ever eat together, why it takes me all evening to do what I used to do all evening.
Stay out of the fridge.