Nutritionist

After my behavioral health consult, I met with the nutritionist. Since most of what she had to tell me I had already heard in my diabetes counseling, she gave me the fast version. One thing she said that I have heard since looking into bariatric surgery is "Bariatric surgery is a tool, not a cure for obesity."

Here are some keys to success:

• Keep a food journal. I need to not only write down what I eat, but when I ate it, how long it took me to eat it, and how I felt before and after I ate. Sounds like an Excel spreadsheet waiting to happen. (And I love a good spreadsheet.)
• I need to have a specific exercise plan. Walking is the best exercise after surgery. Start gradually and work up to 15-60 minutes of continuous exercise 3-4 times a week. Write down exercise in the food journal.
• Slow down when eating. It should take 20-30 minutes to eat a meal. Eat at regular times. Don't sample while cooking. Eat at the table, not in front of the t.v. or computer. Use a smaller plate. Chew 20-30 times before swallowing (this will be necessary after surgery). Put the fork down between bites. Don't graze. 

The following pitfalls can sabotage success after surgery:

• Frequent snacking
• Drinking calories
• Not being active
• Eating fried foods
• Not coming to follow-up appointments
• Eating too many refined carbs

With the exception of exercise, I am already pretty good about all of the above.

Two weeks before surgery, I will go on a high protein, low carbohydrate (20 grams per day) diet. This helps shrink the size of my liver, which helps during the surgery since my liver has to be moved out of the way.

After surgery, my diet will be as follows:

• Day 1 and 2 - Clear liquids
• Day 3 through 10 - Liquids, including protein drinks (which will become a standard part of my diet from that point on)
• Sometime between day 7 and 10 - Pureed, 1-2 tablespoons at a time (this sounds gross to me)
• Afterwards - soft diet (soups, soft veggies, potato, yogurt)

After I'm healed, I will never be able to eat the same again. This is a hard thing to realize. I will never be able to eat and drink at the same time and will need to wait 30 minutes in between the two. There are some foods that will always be difficult (my favorites: bread, rice and pasta). 

And worst of all, if I'm not careful, I can gain it all back. This is sobering to realize, but I am trying really hard to face everything and be honest with myself. No food is worth losing my life and I love my kids more than any food. I will try to focus on that.