6 weeks out- 1st fresh tomato caveat

Today's lunch: 4 small slices fresh mozzarella, chopped fresh basil, one peeled farmer's market tomato.

I was able to finish half of this, and the tomato, though delicious, isn't sitting well. Now I know why people wait 3 months before trying salad. Next time I do this, it'll be with canned tomato.

6 weeks out - general report

I'm averaging a loss of 3 lbs a week since surgery--which is what my surgeon said would happen. My biggest cheat (wine and dark chocolate) gave me 1,200 calories for one day, but on average it's about 800 a day. This morning I weigh 292. I started on my surgery day at 313. Slow but steady. 6 weeks, 21 lbs gone. It's the long term that counts--I don't pay attention to the day to day 1-2 pound fluctuations (probably water weight) on the scale, I go by my Monday weekly weigh-in.

Things I find helpful: Always having a shaker bottle in my hand. I use the kind with the metal ball inside for mixing protein easier ("Blender Bottle"); drinking no cal beverages constantly (helps with hunger feelings, which I still get sometimes. The Grehlin leaves our system slowly).

Things I keep in my desk at work: Protein powder, tons of the Wal-Mart version of Crystal Lite (half the price, and the apple one is really good)

Progresso Light Soups (160 calories a can, no opener needed, good when I forget to bring my lunch)

Areas where I seem to be different from other people on the VST board: my tastes didn't change after surgery; I have no problems getting liquids in (I drink like before, unless the liquid is thick) and meats are no problem to eat. I still haven't tried fresh fruits, salads, and veggies (because of the indigestible fiber) but I can have frozen, canned and cooked fruits and veggies so that's fine. I didn't become lactose intolerant. I had a very smooth surgery recovery. I think protein shakes taste fine (lots of people hate them but I think it may be because they buy the cheap ones, but I could be wrong).

Eating in restaurants isn't a problem, I just pick grilled or broiled meat, chicken, or fish and tell them to hold the carbs (no potato, bread, rice etc). I take whatever's left home for the next day's lunch. I stay away from fast food completely.

Areas where I was the same: Constipation as soon as I hit mushies/soft solids (it cleared up); the dreaded 3-week stall (it cleared up). It's just our bodies adjusting.

Things I'm working on: exercising more. For people who have reached goal, exercise seems to be key, and they do it every day. Doing it in the morning is best because you burn calories faster all day long. I use Leslie Sansone's 3 Mile Walk DVD for now.

In total, I've lost 37 lbs since I started the pre-op diet and I feel a lot better, I can walk more easily, and don't regret having the surgery. I'm off all my pre-op meds. (Diabetes, cholesterol, triglycerides, anti-depressants)

I am very conscious of having a protein RTD Isopure Plus drink in my purse and in the office for peace of mind. You never know when you'll need it (long meetings etc). I also carry a MedicAlert bracelet that says "Vertical Sleeve Gastrectomy-No blind NG tube" when I travel.

That's all I can think of, any questions just ask!

Spanish tortilla breakfast recipe

Ok, no pic this time, but it would just look like an egg, lol. A Spanish tortilla (from Spain, not Mexico) is an egg fritatta served in slices like a pie. I love the flavor, but I'm not going to make a whole pan of it, so here's my single serving substitute:

One SMALL (like new red 1 inch diameter tiny tiny) potato. Peel and then microwave 3 mins. Chop.
2 cloves chopped garlic
2 eggs
Salt to taste

Put a small amount of olive oil in pan. Add potato and garlic and cook until the smell is amazing. Then add the egg, crush the yolk and cook until egg is done.

Enjoy!

About 300 calories
15 gr protein
27 grams carbs (I don't eat other carbs when I have this breakfast--my limit is 35 carbs/day but my nutritionist says I can have 100 carbs/day but I don't believe her lol)
15 grams fat (but it's "good" fat)

I finished out this day with cheese sticks and protein shakes. I just wasn't that hungry after having that breakfast. Total calories today, about 700. Some days are less than others, but I run 700-1,000.

I will take pictures of the stuffed peppers when I make them this week. They deserve a pic.

5 weeks out - here's what I'm eating

With 64 oz of liquid and a protein shake and lowfat string cheese here and there, here is a one week menu for me 5 weeks out. I'll post recipes as soon as possible for the stuff that needs it. Tip: I got a George Foreman grill and it rocks! You don't use any oil for cooking and chicken, fish, beef, and quesadillas come out great. It's fast, too, because both the top and the bottom are heated.

Ok, here's the lowdown on the 5 weeks out menu, about 1,000 calories a day, mostly under 35 carbs a day, low fat and sugar--most meals average 200-300 calories each---recipes to follow in a later post:

Egg & Cheese omelet: Sunday breakfast

Roast Beef Quesadilla: Sunday lunch

Corn tortilla

Lowfat Swiss cheese

Lean Roast beef

Italian salad: Sunday dinner

Mozzarella (in a ball, lowfat if you can find it)

Fresh tomato

Fresh basil

Olive Oil & vinegar

Purple onion

Squash and zucchini fritatta: Monday breakfast, save leftovers for Tues breakfast

Garlic

Leek (you can substitute shallot or onion)

Prosciutto

Egg

Salmon and green beans: Monday lunch (cook in morning, wrap for lunch)

Stuffed green peppers: Monday dinner, take other half as lunch Tues

Onion

Garlic

97% fat free Hamburger

Mexican tomatoes from can

Fat free Ricotta

Lowfat Shredded cheese to melt on top

Fritatta: leftovers for Tues breakfast

Crock Pot Soup:  prepare Tuesday morning/Tues dinner

Beef

Leeks

Potatoes (small red)

Green Beans

Garlic

Canned tomato

Stock

Wed: Fritatta breakfast leftovers

Wed lunch: Soup leftovers packed for work

Wed Dinner: Roast beef quesadilla

Thurs breakfast: Steak and eggs

Thurs lunch: Leftover steak and frozen broccoli/carrots

Thurs dinner:  Cod and frozen green beans (save leftovers for Fri lunch)

Fri breakfast: Protein shake with iced coffee

Fri lunch: Corn tortilla, refried beans, cheese quesadilla

Fri dinner: Salmon and eggplant

Spanish tortilla: Sat breakfast, leftovers to follow

Potato

Garlic

Onion

Egg

Soft Solids Easy Recipe: 5 minute Portabello

This is for when you have absolutely no desire to cook--but you gotta get that protein in! And it's preferable that it taste good.

5 minute Portabello Mushroom Melt

1 medium portabello mushroom cap, stem removed, upended
1/4 cup fresh basil leaves (remove stems)
2-3 slices buffalo mozzarella (the kind that looks like a round ball; the best kind is packed in liquid. If you can't find that, get the one that's in the round ball)

Turn the mushroom cap upside down
Microwave for 4 minutes if you have the lowest-power/wattage microwave like me; 2 minutes if you've got a powerful microwave. The mushroom should be moist and tender.

Chop a reasonable amount of fresh basil (fresh is crucial for flavor) and completely fill in the mushroom cap.

Top with thick slices of buffalo mozzarella; be generous. Even if it's not lowfat, it's only 70 calories per slice.  If you can find lowfat, be even more generous. When I made this, I used 3 thin/medium slices of full fat cheese. (I was low on calories). The mushroom only has 20 calories.

Mircowave until the cheese starts to melt down the side. About 1 minute.

[For more protein, and if you have the extra time, sautee a bit of shallot, garlic, and ground meat to add to the basil filling.]


Eat!

Approximate stats:
150-170 calories, depending on amount of cheese
6 carbs
9 protein
3 fat

For pre-ops with a surgery date

After surgery, you are put on clear liquids. The big challenge is getting in your liquids, and your protein, that can help healing. I made sure I had a few bottles of Isopure Plus RTD, and when I got sick of sweet stuff, Unjury protein Chicken Broth. I had a very easy time after surgery, and I think having these was part of the reason.

I have a few packets of the Unjury protein chicken broth powder left--enough to get someone through the clear liquids stage. It's a shame to just have it sitting around, so if you have a surgery date, and there's time enough for me to mail it to you, send me an email and let me know you want it. I'll just need your mailing address. The first mailing address received gets it. My email is

I hope this is of help to someone!

Donna

UPDATE: Broth has already been sent to someone.

Soft Foods Recipe: Chinese Beef

Well, the scale has stopped moving so I've eliminated all possible extra calories from this recipe.

Chinese Beef & Vegetables








1/2 lb (1 cup/8 oz) lowfat ground beef 
1 minced shallot
1 minced garlic clove
1/2 cup any veggie combo, chopped. I used carrots and broccoli.
1 tbsp ground ginger
1 tbsp Chinese 5 spice (if you can't find this, throw in a little allspice)
Kosher or sea salt
Freshly ground pepper

Season ground beef with salt and pepper. Cook until halfway done. Then add shallots, garlic, and other spices to hamburger, and continue cooking
Microwave chopped veggies until tender (no peas/corn/potatoes allowed)
Add veggies to hamburger mixture and mix. If you want more calories and protein, add 1/4 cup nonfat ricotta to mixture and combine.
Portion into 1 cup servings and top with a bit of shredded cheese.

Enjoy!

Stats:
If you used at least 90% lean ground beef: about 350

The Dreaded Week 3 Post-op Stall

With the move to more solid foods, I'm constipated (even using Benefiber) and the scale isn't moving. Time to buy a laxative! I posted this to verticalseevetalk.com and it seems like others are in the same boat. It seems to be the body's temporary reaction to a major change, after being on liquids so long. It just got used to liquids, and now I'm making a change. I'm doing all the right things food-wise (600-800 calories a day, high protein, low carbs/fat) , so I'm going to step up my walking (I'm not cleared for regular exercise yet) and see if that helps.

If this happens to you, don't get discouraged, it happens to a lot of people week 3 post-op. Just keep following the good habits and it should sort itself out. Ill keep you posted.

My first soft foods recipe

I stop mushies and start soft foods as of tomorrow. According to my surgeon's plan this means:
Meats must be ground or finely chopped. No steak yet.
Veggies must be peeled and cooked until very soft
No fibrous veggies like corn and peas
No raw veggies/fruit
Eggs are ok now

I'll be posting recipes as I go. Here's the first one.

Italian Beef & Zucchini


This will make five 1 cup servings, so you will have leftovers.

2 medium zucchini, peeled and  chopped
1/2 lb (which is 8 oz, or 1 cup) lean hamburger
1/4 small onion
1 clove minced garlic (optional)
1 cup canned chopped tomatoes, with liquid
1/2 cup (4 oz) fresh minced basil (set aside)
1/2 cup (4 oz no or low fat ricotta (set aside)
4 tbsp grated Parmeggiano Reggiano (if you can get it, if not use the shredded Parmesan from the supermarket. Do NOT use Parmesan from a green (or any other) can. This is crucial to the flavor. (set aside)
Kosher or sea salt (very important to flavor--don't use regular Morton's) and freshly ground pepper to taste
1 tbsp dried oregano
Optional: 1 tbsp dried red pepper flakes

Chop the peeled zucchini and put into a microwaveable container with a tbsp of water. Since microwave times vary, I'm hesitant to give an exact time. Start with one minute and then check it. Keep going until the zucchini is soft and tender, but not mushy. Drain and dry with paper towels if needed and set aside. It should be moist but not wet.

Finely chop the onion and garlic, and then mix with the zucchini that you have set aside.

Heat a skillet and brown lightly salted and peppered hamburger with oregano, (and red pepper flakes if you are using them), breaking the hamburger into small pieces.

When hamburger is halfway done, add the reserved zucchini mixture and cook until the onion is clear and hamburger is done through. Add tomatoes and simmer for 10 minutes or until liquid simmers off. Add a bit of chicken stock to moisten if pan becomes too dry. When done, drain any excess fat/liquid and transfer mixture to a large bowl. The mixture should be moist but not wet.

Add ricotta and basil to bowl and toss with cooked mixture. Season to taste. Divide mixture into five one cup servings in small bowls, or small plates. Divide Parmesan evenly, to top each serving. Garnish with a small amount of minced basil over the top.

Approximate stats per serving:
220 calories
18 protein
5 fat
8 carbs
2 fiber (subtract from carbs to get 6 net carbs)

Enjoy! If you have to cook for other people, mix left over mixture with rigatoni, fusilli, rotelli, or penne pasta for them and top with fresh tomato.

A little fat philosophy on a Saturday morning

I was working my university's booth at the State Fair this Saturday. The booth faced the entrance so it was great for people watching. As I casually watched people/families come in, I noticed a couple of interesting things. First, most people were overweight/obese. Maybe 20% weren't. And of those who were overweight, about half looked like they had BMIs of over 40.

I had the Fair brochure that listed all the food booths available, and out of about 50 choices, only two were reasonably healthy (kebabs and fajitas). The rest were full of sugar/fat and/or fried. I thought--"look how ingrained unhealthy food choices are in our culture--people couldn't make a healthy choice here even if they wanted to". I then thought about all the fast food and restaurants in town, and even our own university cafeteria--and the situation is just about the same. The State Fair was a mirror of larger life.

The reason that the unhealthy food is so successful is that cheap ingredients are high sugar/fat/carb so it's a great profit-maker for food businesses. Therefore they promote these items heavily; people respond to the advertising, eat the food, and get addicted to the fat/carbs/sugar, and eat more or at least regularly, driving the profit machine. Because they are addicted to this unhealthy food, economically they create a demand in business and a habit in themselves. Most of what is available for us to eat is no longer nutritious food. We get fat; business owners get rich.

Our children learn to like the first foods they are exposed to that hit the magic nerve centers of sugar/carb/fat. They create a larger demand, and they pressure their parents into buying them unhealthy food. Our schools serve pizza, hamburgers, and hot dogs to our children for lunch. It's cheaper for the school that way, and once it is available to the students, they get addicted and demand is created.

I think we as a culture could learn something very valuable from French food culture. American culture emphasizes portions. When talking about restaurants, Americans say things like "It's really good, they have huge portions" as if the amount of food is more important than the quality or taste of the food. In France the opposite is true. They grow their vegetables for taste rather than size. We breed huge tasteless commercial tomatoes, beans, everything with size, color, and shippability in mind. We are concerned with everything BUT taste. No wonder the kids don't want to eat their vegetables. Their vegetables are tasteless!

French schools don't serve junk food. They serve real food, a great variety, with plenty of vegetables cooked in interesting ways (not canned, not boiled, not tasteless). Kids are the opposite of picky because the culture encourages them to try a little of everything. And a "little" is key. The French are satisfied with far smaller portions, and emphasize taste over amount of food. This difference in the food culture is the reason that they, as a nation, eat extremely well, don't deprive themselves, but have lower obesity rates and a longer life span than we do. They revere food. We scarcely care about food as long as it's warm, comforting, and there's a lot of it. This is fundamentally unhealthy and leads to obesity.

We have to fix our food culture. It can only be done though the media and through education. We are treating the symptoms of our food culture with Photoshop, Jenny Craig and other useless diets that don't work, WLS, and eating disorders. We need to treat the cause, and that is junk food in our schools, fast food culture, and the commercial food producing practices that value color, size, and shippability over taste and nutrition. It requires a shift in culture and a shift in the way the food business operates. "Super-size it", cries the billboard and we say yes to double the fat and calories.

Having McDonald's offer a salad does not change the fact that that most of what they are selling is high-fat psuedo-food. Why are they selling it? Because people think they like it, creating demand. Why do consumers think they like Big Macs? Because they don't have better tasting healthful alternatives in reasonable portion sizes. Because they've been raised on high fat/carb/sugar food in large portions. Portions=comfort. If taste were comfort, we wouldn't have this problem.

So back to the State Fair: what I saw there was a slice of American food culture in microcosm. And I pictured what could be done about it. 50 stands of food that was healthy and delicious. Rich food in MODERATION. Smaller portions. But that would be expensive! To businesses and to consumers! Why yes, it would, but can we put a price on good health, a longer life span, and less disease? As a society, would this cost outweigh diabetes, cholesterol, triglyceride, and blood pressure medication and doctor visits? Would it outweigh lost workplace productivity due to premature heart attacks, strokes, and other obesity-related illness?

Maybe good health is expensive. Maybe if the demand was large enough for healthy items, the price would go down as food producers and retailers started to realize economies of scale--that's basic laws of economics.

WLS is a sad reminder that our culture is sick, and as a society we have chosen to stigmatize those affected by our sick food culture, and American culture is so sick that the only option for many is WLS. Instead of fixing individual victims of the food culture, we should fix the food culture itself.

So that's what my day at the State Fair made me think of. Comments/discussion encouraged!

Travelling early post-op: packing protein

I have to take a trip to the east coast at 4 weeks out. I never check luggage because of the hassle, so I needed protein that was under the 3 oz. TSA liquid limit to take with me. I found it on a bodybuilding website. Profect. It comes in several fruit flavors. Stats:2.9 oz, 100 calories, 0 carbs, 25 gr protein, plus vitamins. The official website is www.protica.com--you can order samples.

After I ordered those samples, I found Gotein and ordered a sample pack of that too. It's a powder that you add to water. It comes in individual serving sizes. I got the samples at http://www.gotein.com/sample_pack.html for $3.00.

This won't weigh down my carry-on bag, and I won't have to worry about getting my protein in. I'll be on the soft solids part of my diet, so I figured I'll be able to eat in restaurants as long as I'm careful what I choose. I thought I would share this tidbit in case anyone has to travel early out.

Stuff I bought pre-op: sources

I Googled to find the best prices. I live in a rural area so I have to do most of my shopping by mail. You will probably be able to find a lot of this at local stores.

1. Kitchenaid food chopper













2. 4 oz. ramekins














3. Isopure zero carb protein powder and DaVinci sugar free syrups (less than $5):
www.supplementwarehouse.com
4. Richard Simmons Sweatin' to the Oldies DVD Box Set. I know it's cheesy but it was the only exercise I could handle because I was so out of shape. I got a Zumba box set for later.










I googled for the best prices on the rest of the stuff in the pre-op pantry post--I just thought I would provide this info as reference if you're trying to gauge costs.

I can also tell you what to avoid--weight loss cookbooks by RNYers, who don't absorb calories. I got three of them before I realized I would have to modify every recipe. Weight Watchers cookbooks are more apropriate for sleevers than RNY recipes! Atkins recipes allow too much fat. We need high protein, low carb, low fat.

Week 2 post op- Quick Puree/Mushies

Now is the time to whip out the 4 oz. ramekins and start filling them with yummy stuff to eat. Here are some fast simple ideas, especially for when you don't feel like cooking, to get you started:

Fiesta bowl:
Fill ramekin with refried beans and top with shredded low fat cheese. Microwave for 2 minutes. Don't forget no liquids 1/2 before and after meal! Yummy! 90 calories, 15 carbs/9 net carbs, 9 protein. If you use non-fat beans there are only 6 carbs--read the labels.

Southwest treat:
Put 4 oz. canned all-meat chili in a food processor or blender. Add a bit of finely chopped onion if you like onions, and/or finely chopped tomato if you want a fresher flavor.

Add a little beef/chicken broth if it's too thick, and puree until it is as smooth as applesauce. Pour into a 4 oz. ramekin and top with low fat cheese. Microwave for 2 minutes. Great to satisfy those beef cravings.

Fast and easy beef stew:
Put canned beef stew (look at the label stats for the most appropriate one, remembering that 4 oz is 1/2 cup for serving size purposes) in a blender/food processor until smooth. Thin with beef/chicken broth if needed. Pour into 4 oz. ramekin and microwave 2 minutes. You can also make your own beef stew from scratch and then puree, but right now I'm focusing on those "I just got home from work, I don't feel like cooking" solutions. You can do the same thing with split pea with ham soup for a change.

Quick chicken salad:
One can of chicken breast chunks, or pieces of a roasted (not boiled) chicken breast, or chicken from whatever source you've got. Never boil chicken btw, it destroys the flavor. Chop it up and then add an appropriate amount of fat free mayonnaise (Hellman's has an olive-oil based mayo that is supposed to be good).

Celery is a no-no this early out, but you can add some crunch with a small amount of finely chopped jicama. Use celery salt for flavor. Put it in the food processor and blend until smooth. Use a small amount of chicken broth to thin if needed. Put into a 4 oz ramekin and garnish with finely chopped Italian flat leaf parsley. Salt and pepper to taste. Do the same thing with canned tuna for a change.

Deviled egg salad:
Everyone has their own recipe for deviled eggs. Mine is kind of simple; feel free to add what you want. Some people like to add pickle relish or mustard to the mix, for example. I prefer to simply boil eggs, cool, peel, halve, remove yolks. Beat yolks with appropriate amount of lowfat mayo, and sprinkle with paprika. Add some salt and pepper as desired.

Add chopped egg whites to deviled egg mixture in food processor. Mix until smooth. Thin with a little chicken broth if needed. Freeze leftovers for later. Use your ice cube trays--actually this is true for all of these recipes.

Serve in a 4 oz ramekin, garnished with a sprinkle of paprika on the top.

Summary:

The basic rule of mushies is: everything you can get into a food processor is dinner! Don't be bored stiff buying bland baby food like some people do. Just stick to the 4 oz ramekin, freeze the leftovers in an ice cube tray, and mushies will be a breeze! It's only for 2 weeks. The idea is to "pre-digest" things so your stomach doesn't have to work very hard to digest them.

It's at this stage you can add frozen berries to your protein shakes in a blender/food processor to thicken them, too. You can also thaw and puree fruit for a dessert treat. Top with a spoonful of nonfat Cool Whip. Be warned, fruit has a lot of carbs, so you don't want to do this all the time.

Don't forget that during the mushies stage you can still have sugar free pudding, protein shakes, and chicken broth like you did before. You can also have applesauce, and in moments of extreme weakness, mashed potatoes (only as 1/3 of your total meal volume--not 4 oz. by themselves.) Remember, protein first!

Stocking the Pantry

Once you get your surgery date, you want to prepare your kitchen. If you live alone, give away all your white carbs--rice, pasta, bread--you won't be needing them for about a year! Next, here's my surgery kitchen prep list, along with the rationale for the item:

Hardware:
4 oz ceramic ramekins (Amazon.com): So you can make portion controlled casseroles or other foods. 4 oz is what your stomach will be able to hold.

2 oz plastic measuring cups (Tupperware): Early out, you will only be able to get in 2 to 3 oz of heavy liquid or puree--use these so that you don't overload yourself, which hurts and causes vomiting.

2 oz ice cube tray: for freezing purees to use during the mushy stage. You can't eat enough of anything to not end up with leftovers. Then when you come home, microwave a couple of cubes for 2 minutes and you have dinner.

Toddler flatware: to get you used to how radically different your portion size is and to get you used to eating less. It works.

8 oz plastic bowls with lids: for leftovers and salads

Salad plates: use instead of regular plates for portion control

FOOD

Pre-op:
Atkins Advantage Vanilla Protein Shakes

IsoPure Zero Carb Protein Powder, Vanilla (you will use this forever)

Sugar free flavored syrups (for your Isopure powdered shakes)

Clear liquid phase (right after surgery)

IsoPure Plus RTD protein: to get your liquids and your protein in at the same time for your first 2 weeks post op.

Unjury Chicken Broth Protein Powder: see above (you just need a few sample packets of this--don't buy a big tub of it. It's rather salty (about 700mg).

Gerber 4 oz apple juice containers ( pack of 4 should do it)


Full liquid phase: (3 days to 2 weeks post-surgery)

Keep using the Atkins Advantage Shakes and the Isopure Protein Powder Shakes

Creamed soups (strain them)

Sugar Free Pudding (just a few, to break the monotony)

Greek Yogurt, look at label for low carb, low fat, low sugar

Low fat yogurt with no fruit in it. You can flavor with your syrups. The Greek Yogurt is better because it has 15 grams protein/serving.


Puree/"Mushies" (Week 2-4 post-op)

Canned chili

Cottage cheese

Applesauce

Refried beans

Lowfat cheese for melting

Frozen berries (for blending with your protein shakes or mixing with Greek Yogurt)

Regular soups (you have to blend them till the chunks are gone--avoid noodle soups, think split pea with ham, beef stew)

I'll be posting some mushies recipes, but if you have these things in your kitchen, you'll always have something to eat. After the 4th week you'll be transitioning to "real food" and I'll be posting recipes for that. Feel free to hit me up with recipe requests.

Avoiding Protein Shake Boredom

First off, buy a good whey isolate protein powder. I recommend IsoPure Zero vanilla-25 grams protein per scoop, mixes in water with a spoon.

Then decide what flavors you want your shakes to be, and choose the appropriate DaVinci or Torino sugar free syrups. That way you just doctor the vanilla powder with the flavored syrup, and voila!--any flavor you want without having to buy a bunch of different powders. You can get both cheap at supplementwarehouse.com

Some people say not to buy a big tub of anything before surgery because your tastes change, but my tastes didn't change, and I don't complain that my protein shake doesn't taste like ice cream, like some people do. I mix my protein with water. Later, in your post-op liquids stage, this makes it easier to drink so you can get your 60 grams of protein in at the same time you work on your 64 oz of fluid. Some people mix their protein powder with soy milk, rice milk, or nonfat milk for extra body, but I'd rather not have the extra carbs and sugar. If you look around you can find low carb soy milk, but you have to read the labels. I look for 5 grams or less of carbs per meal. BUT my nutritionist says 15 grams carbs/serving from milk is ok--but I am so carb conscious that I don't follow that advice. I low-carb it for faster weight loss, and to prevent carb craving.

Once you get to the puree stage post-op, you can add frozen berries to your protein drink to thicken it. You'll lose more weight pre-op by eliminating those carbs, but it's ok post-op as long as you don't overdo it.

I see people on other sites adding bananas and other high carb fruit to their shakes, but then I remember--they are RNY Gastric Bypass patients--they don't absorb all the calories they eat, and as a Gastric Sleeve patient, I do. So be careful of RNY nutritional advice--they can eat more fat and carbs than us because they aren't absorbing it. We are.

Pre-op diet vinaigrette/marinade recipes

Double the proportions for a marinade. Otherwise these recipes assume you're dressing 1 cup salad for yourself only.

Balsamic Vinaigrette
1 or 2 tbsp good balsamic vinegar
1/4 cup extra virgin olive oil
sea salt or kosher salt, freshly ground pepper to taste
Optional: Herbs, fresh or dried, 1 tsp (pick one: basil, tarragon, oregano)
Optional: Small diced shallot
Optional: 1/2 clove garlic, diced

Combine vinegar with other ingredients; slowly whisk in olive oil

Variations: Balsamic vinegar is very strong, has a distinctive flavor, and goes particularly well with tomatoes and basil. For a lighter, more subtle dressing, substitute white wine vinegar, red wine vinegar, or apple cider vinegar. Experiment with the different vinegars and see what you like.

Creamy dressing
1 individual small container low fat low carb Greek Yogurt
Between 1/8 and 1/4 cup extra virgin olive oil (add oil until you reach the desired consistency)
Juice of one lemon
Sea salt or kosher salt to taste
1/2 clove minced garlic
2 tbsp fresh chopped mint

Mix ingredients except for oil. Stir in oil until desired consistency is achieved.

Variations: for marinade, add 1 tbsp paprika or whatever other spice you'd like to highlight: cumin for a curry flavor, curry powder, powdered ginger. You can also use this as a sauce for blending pureed meats and vegetables in your food processor during the puree (mushies) stage of your post-op diet.

Pesto
You won't be putting this on pasta, but it's good on chicken and as a salad dressing if you thin it out a bit. This recipe makes a good size batch, so halve it if you want less. It freezes well--use the ice cube tray!

2 cups lightly packed basil leaves
Optional: 2 cloves finely chopped garlic
2 tablespoons pine nuts (look in the baking aisle)
1 tsp sea salt
1/2 tsp freshly ground black pepper
Up to one cup of extra virgin olive oil

Put everything except oil in food processor. Pulse until basil is pureed. Add olive oil slowly, while pulsing, until you get the consistency you want. Great on a low fat buffalo mozarella and tomato salad.

In general, I suggest you stay away from iceberg lettuce for your salads; it is bland in taste and has practically no nutritional value. Try some bagged baby greens, or a mixed bagged salad. Add mushrooms (calorie free!), tomatoes, or other veggies to your salads as you see fit. Enjoy your salads pre-op--you won't be able to have them again for 6 months post-op.

Pre-op diet

Two week pre-op diet: Ground rules
Breakfast: Atkins Advantage Protein Shake
Snack: 1 oz string cheese
Lunch: Atkins Advantage Protein Shake
Snack: 1 cup salad with homemade viniagrette
Dinner: 4-6 oz lean meat and 1/2 to 1 cup non-starchy veggie
64 oz non-carbonated, calorie-free liquid
Centrum multivitamin, calcium citrate supplement


The worst thing about this was the hunger on the first four days. After that it got better. Here are some of the menu highlights:

Salad viniagrette: Homemade olive oil and vinegar (red wine vinegar, white wine vinegar, basalmic vinegar, apple cider vinegar) dressing has much less fat/carbs/sugar than "low fat" and "diet" prepared dressings and they taste better. Change up your salad by changing your dressing every day. I made more dressing than I needed and used the leftovers as a meat marinade for dinner. Google for basic recipes--add shallots, garlic, different spices for variety. You can also use Greek Yogurt-based dressings--but be careful and read the label. It should not have more than 5 carbs and no fat or sugar. It should give you about 15 grams of protein per serving.

Dinner: My favorite dinners were pretty simple: butterflied marinated pork chops pan fried in a little olive oil. Seasoned with whatever that day's salad dressing was. For the veggie: microwaved asparagus with shaved Parmeggiano Reggiano and olive oil drizzled on top. Pan seared swordfish and sauteed summer squash.

Basic rules: stay away from potatoes, bread, wine, butter, and prepared sauces and frozen foods. Use olive oil and non-starchy veggies (no peas and corn).

After the first week, I found that I was actually enjoying the diet, and if I drank my 64 oz fluid, I wasn't hungry. When I didn't feel like cooking dinner, I substituted 2 protein shakes.

I lost 18 lbs over two weeks on this pre-op diet without feeling deprived. You can modify most of your existing recipes to use in this phase.

During this phase it's time to stock the pantry for post-op. more on that next post.