Feeding the Hunger

I hate to borrow from Weight Watchers, but I think their hungry monster is the cutest thing ever LOL.

So I have been struggling with major hunger since day one of my surgery and it has been incredibly frustrating. I kept wondering if something was wrong with my surgery and it wasn't going to work, or if something was wrong with me and everyone else was tougher than I am... something like that. As you know I was on one ounce of select soft foods every two hours. I was still hungry ALL the time.

Well yesterday as we were getting ready to leave the hospital, I had a stroke of good luck. Kim came in to talk to Ian. She is the head of the entire bariatric program at the hospital. She was asking us questions about our experiences and how everything went since doing the VSG (Sleeve) is still such a new thing there. Funny she made a comment about always going to see each patient, cuz I never saw her! But that's okay, she redeemed herself! I mentioned to her that I had been hungry this whole time, that I was on the restricted soft foods, one ounce every two hours, etc. She told me that was way too restrictive and that if I was experiencing hunger, I should advance to the full soft foods diet... and ALSO I could have anywhere from 1 to 4 ounces every 2-3 hours!

I asked, how can I advance to the next food stage when the class isn't until Wednesday? I don't really know what I can have. She took the time to write down some notes for me!

So as of now I can have:
- Any meat that I can mash up to a mushy consistency. The easiest things are tuna salad and chicken salad but I can do other things too.
- Some fruits and vegetables that are soft and chewed well
- Any kind of fish
- Peanut butter
- Soft cheeses, white cheeses are preferred because they have less fat
- Protein bars, the more dense the better, no hard crunchy ones
- Soups and Chilis

Each meal should be at least 90% protein, only 10% complex carbohydrates from fruits and vegetables.

She also said that even though they usually do not crack down on the 'no drinking during or after meals' until you're on completely solid food, that I should start now and see if it helps with my hunger. So I am not drinking after my meals for an entire hour.

I started that yesterday, and also had some tuna salad that I made up, which I was able to eat 2 ounces of. It helped, but I still felt hungry sooner than I should. The next meal was more tuna and I had 2 1/2 ounces, and this time I felt full the whole rest of the night.

Today has been great - no hunger bothering me today!! This morning I had egg beaters with cheese, diced onions and red and green peppers, of which I ate 2 ounces. My next meal was more of the tuna salad - 2 ounces. My third meal was 1 ounce chicken salad with a 1 oz mozzarella string cheese. My fourth meal was 1 ounce chicken salad and 1 ounce edamame (soy beans). The only time I've felt hunger today is right before I go to eat again, and most of these meals have lasted me 3 hours, not just two!!

I am feeling SO RELIEVED. Nothing is wrong with me, I just needed more substantial food in a larger amount. The thing is, the Sleeve is a 3-4oz stomach right off the bat, whereas gastric bypass patients have a 1oz stomach to start. Since the sleeve is new and not popular yet due to no insurance coverage, they group us with the bypass people. We have their nutrition classes, their instructions and guidelines... but a bigger stomach!!! I mean I can't even eat the 3-4 ounces yet which is great, but I can eat 2 - 2 1/2 so no wonder I was fricken hungry all the time... I was never filling my stomach more than half way with each meal! Kim said they have a lot of work to do developing the program for the sleeve, and this is obviously a major oversight right now. My surgeon was just telling me "the hunger will go away." Kim is a Dr. as well as the director of this whole program so I trusted her too and obviously she was right. I feel so much better and finally feel HAPPY that I did this instead of worried that something was wrong.

Cheers to no hunger pains!!!

Days 2 - 5 Post Op

All of my days post-op have been very progressional. What I mean is every day is definitely better than the day before. The first 3 days post-op, the only stuff I was drinking was water, isopure clear protein, and diluted apple juice (1 part juice to 3 parts water.) I was supposed to drink 1oz of fluid every 15 minutes and keep track, like I had been doing in the hospital. I would take usually 2 1-oz cups to the couch with me so that I would be getting back up to walk around every 30 mins (walking around frequently is really important in the healing process.)

Here's the stuff I pretty much had in front of me all day long.



At first I was pretty convinced the pain meds were not really helping... but at the last hour of every 4 hour cycle my pain would get worse so I realized they *were* helping :)

Days 2 & 3 were the weekend, so I had both my husband and my friend to keep me company. We watched a lot of tv all day long but honestly I was so occupied with getting in my fluids that I barely remember! Sarah enjoyed her relaxation time... and our 3 cats enjoyed Sarah:



By Day 4, which was Monday, I was feeling a bit better and getting my liquids in much easier. The hunger pains were lessening, so was the gurgling in my tummy. I decided to go off clear protein and start on protein shakes. I mix up 8oz of water with two scoops of protein powder into my max muscle shaker cup... shake it up well and keep it in the fridge.



With the protein shakes, at first they say only 1oz per hour, so on day 4 that's what I did. I still continued water and diluted juice every 15 minutes for the other 3/4 hour.

On Day 4 I was also able to go for a real walk. They want me to be getting 30 min walks even this early on. I was shocked that I managed to do the whole walk at once!

On Day 5 (yesterday) I woke up and noticed a major difference in the pain, I felt a lot better. I would call it more "discomfort" now than actual pain. I was able to go for another 30 min walk on Day 5, except my back hurt REALLY badly this time.. probably because I didn't take my pain meds which masked my back pain the day before. On Day 5 I was also able to take in more fluids so I upped my protein shake to 2 oz per hour. Both days though I noticed that by 5-6pm my tummy just didn't want any more, so in the last few hours of the night I only had 1oz per hour or even every other hour.


Sleeping - I have only been able to sleep on my back so far (way too uncomfortable to sleep on my side) and it hasn't felt good to lay flat. The first several nights it was a BIG ordeal to get into bed. I needed my husbands help to get situated and as comfortable as I could get. I would need his help to sit back up or get out of bed. By day 5 I was able to get in and out of bed on my own. It still hurts some but much much better. I still have a hard time sleeping comfortably, but it's getting better.

Hunger Pains - The first couple of days, EVERY sip I took of anything resulted in major gurgling from my stomach and sharp, severe hunger pangs. This has pretty much gone away by Day 5. I am still having hunger pains but they are less often and less severe, and no longer seem to happen as a result of drinking. The first few days they were seriously nonstop, and these hunger pains were the worst and most painful part of my recovery.

Drinking - The first couple days it was very difficult to get in all of my fluids - partially because of the hunger pains they would induce. Also it's been explained to me that the stomach is so swollen right after surgery that you can barely even fit that 1oz of liquid. I have been doing my best to progress to more and more liquids, but I listen to my body and take breaks when I need to. I get a gurgle/bubble feeling in my esophogus when I need to slow down. It's not painful... but a good reminder.
After the first couple of days I stopped putting water into the 1oz cups - just drank water from my sippy cup instead and would record it when I finished 10 ounces. I drank it in between all the other things I was drinking, and this had worked well. Now I'm able to drink the 10 ounce cup usually in about an hour and a half to two hours.

Walking - The first 2-3 days, it was really a challenge making myself get up every 15 to 30 minutes to walk to the kitchen, rinse out my little cups and get more liquids. Standing up was a struggle (it would strain my sore abdominal muscles) and walking was very stiff for me. I felt like I couldn't stand up completely straight because if I tried to straighten up, things would pull - both internally at the stomach and externally at the incisions. By day 4 I could stand up straight and go for the long walk. I think the more you walk around the faster this healing takes place. Now I am up all the time, not just every 30 minutes. I don't sit down for very long at one time. During this blog post I've gotten up about 3 times and gone to get something from downstairs, and come back up. My mobility is excellent.

Food - The only "food" items I've had are sugar free jello and sugar free popscicles... but I think I've only had one jello and 1 1/2 popscicles. As much as I am craving variety, it has felt good to be on liquids and it was harder for those things to go down. Even last night the popscicle I had made a lot of gurgles... I think it was too big.
An interesting side note - while it has been a little bit hard watching my husband and best friend cook dinners and eat things I wish I could have.... in a weird way I have enjoyed it! While I do wish I could take a bite of what they are eating, I have actually LOVED being able to smell everything. They seriously hand me their food and let me smell it really good. You would think this would make me feel awful but I have liked it. It's the closest thing I have to eating it so I have been enjoying the smells!!
My main problem has been that I am SICK of sweet. The protein drinks, jello, popsicles, etc...
everything is sweet. I have always been more of a savory/salty person. This has been the hardest part for me. SO looking forward to starting on soft foods so I can get some of that variety.


Semi-Soft Food Diet
I'll be able to start my soft food diet today after my appointment. This includes sugar free pudding, yogurt, cottage cheese, egg beaters and refried beans. Still not a ton of variety but certainly better than what I've been having and I can get some salty/seasoned things which will be heaven.
At first I am only supposed to consume 1oz of one of these foods every two hours (wow.) gradually working up to 2 oz every 2 hours. I'll be on this diet for two whole weeks and then at my 3 week appointment I will progress to a full soft food diet which has a lot more variety.

Once I am on this diet, I can start using this nifty product:



This is Any Whey unflavored protein, specially formulated to mix well with liquids and also into any food. I can mix this into my foods to up the protein content, which will be super helpful especially in the beginning when I can't eat hardly anything!



Challenges
The biggest challenges I have faced are:
- intense hunger pains
- painful gas/bloating
- intolerance to vitamins
- unable to sleep comfortably
- dealing with the drain

I've already explained a bit about the hunger pains.... vitamins... yuck. I had chewables at first. The taste is fine but it would take me so long to get it down... I'd have to divide it into 4 pieces and it would take me like an hour to eat it so by then I was HATING the taste. Also have to do this TWICE per day ugh. So I had Ian get me a liquid version:



Again the taste is ok but it's hard for me to get it down. The first couple of days I diluted it with water.... but it didn't really help so yesterday I didn't dilute it so I could get it down faster. It makes me feel SO SICK. I had this problem with multivitamins before surgery too. Taking it with food is the only thing that helped. So for now I am taking a break until I can get to the point where I can take it with some food.

The drain - double yuck. There's a tube coming out of my abdomen, into this see thru rubbery bottle. The bottle is attached to a clip that's on this patch attached to my tummy (so that it doesn't pull at the tube.) Every day I have to empty this bottle twice a day into a cup marked with mL and record on a sheet the date, time, and amount of fluid. I do not like having this thing coming out of me!!! In the past couple days there's been hardly any blood it's mostly a yellowy-clearish fluid. I get to have it removed today!!! Whoo hooo!! I will feel so much more normal after that.

The gas and bloating... ugh! They pump so much air into your abdomen for the surgery (so they have room to work in there) and it it really painful the first few days. They told me taking things for gas wouldn't help because it's in my abdomen, not in my intestines, but everyone in the forums said gas-x strips would help so I took them - and they DID help. A lot.



They also freshen my breath which is nice because the protein stuff leaves an aftertaste in my mouth and a sticky-ness in my teeth. As of today my gas is much much better and I only use like one strip a day (I used 4-5 a day at first.)

So that's pretty much it! Now this part is mostly for others who have had or will be having surgery, it will mean something to them. This is the counts of fluid and protein I have been able to get in each day.

Day 1 was mostly in the hospital and I don't have the sheet I recorded my liquid intake on.

Day 2 - 37 ounces of liquid, 30.3 grams of protein

Day 3 - 62 ounces of liquid, 30 grams of protein

Day 4 - 86 ounces of liquid, 51 grams of protein

Day 5 - 78 ounces of liquid, 56 grams of protein