Vitamins, Calcium, Protein, Vitamin D, & Biotin

I have found a chewable multi-vitamin at GNC. It's called Solotron Chewable. It's Natural Berry flavor. There are other types out, shop around and see what you find and what your doctor recommends.

Calcium - CitraCal. It comes in chocolate and caramel. The chocolate is yummy. I have haven't tried the caramel. This is also chewable. I have found this at Walmart, Kroger, and Giant Eagle. You want to make sure you do NOT get the calcium that is carbonate. Your body does not absorb the calcium the way it should. This is especially important if you've had the gastric bypass.

Vitamin D - Also found at GNC. It's small and it's easy to swallow.

Biotin - Also found at GNC. I take this because my hair has started to shed more than normal. From what has been explained to me by other people who have had WLS and my doctor, this is normal. That's one reason it is so important to get your protein in.

Protein - The best one I have found for me is Whey Protein. I have gotten it from GNC and Walmart. You'll have to find one that you like and can tolerate. There are many sites and stores you can visit to find different proteins.

There are a few things to remember:

1. Your stomach opening is only the size of a dime. My nutritionist said if the pill is the size of an eraser, you can swallow it. If it's bigger, you'll need to crush it up or cut in half. That's why I have the chewable.
2. The items listed above is what I use. This does not mean it's OK for you. You will need to talk to your doctor and see what they want you to do!

DISCLAIMER

Please note that all information I have posted is what my doctor and nutritionist had ME do. This is not what all doctors do. I am just sharing what I have to do per my MD's instructions. Please do as your doctor instructs.

TEN IMPORTANT RULES FOR PATIENTS TO BE AWARE OF:

1. Eat only 3-4 meals a day (2-4oz of food per meal)
2. Chew thoroughly (25-30 times per bite), and eat slowly (wait 1-2 minutes between each bite)
3. Stop eating as soon as you feel full.
4. Do not drink while you are eating or 1-2 hours after eating.
5. Do not snack between meals.
6. Eat only good quality food.
7. Avoid fibrous food (asparagus, pineapple, rhubarb, broccoli, artichokes, celery), as they may not digest well. Dried fruits are likely to swell and get stuck ih the new opening to the stomach. Doughy or sticky foods like white bread, popcorn, and coconut can also obstruct the lap band.
8. Drink 48-64oz of water per day. Consume 60-80 grams of protein per day.
9. Avoid carbonated beverages; avoid caffeine until 6 months after surgery, and avoid alcohol until 2 years after surgery.
10. Exercise daily or as instructed by MD.

Soft Foods

5th Week Post Op

***Follow for 2 weeks with gradual transition to regular consistency as tolerated***

All foods used for clear, full liquid, and pureed diets, plus:

• Tender cooked foods: chicken, turkey, fish, tuna, salmon
• Soft foods: string cheese, beans, cottage cheese
• Thoroughly cooked vegetables

Goals:

• 2-4oz of food per meal over a 30 minute period (3-4 meals per day)
• Introduce one new food at a time
• 60-80 grams of protein per day
• Consume 48-64oz of water daily
• Do not drink while you are eating or 1-2 hours after eating
• Remember to take small bites/sips
• Chew your food very well 25-30 times per bite
• Wait 1-2 minutes between each bite
• Daily chewable multi vitamin and calcium supplement
• Remember to get your protein foods in first
• Keep a daily food record and take w/you to your appointments

Pureed Diet

3rd and 4th Weeks Post Op

All foods used for clear and full liquid diets, plus:

• Pureed skinless chicken, turkey, tuna, eggs, beans, tofu, hummus, refried beans
• Pureed green beans, carrots, peas, beets
• Pureed soups such as turkey, bean, chicken
• Pureed canned fruits packed in water, pear juice, or own juice
• Ripe mashed banana
• Baby Food

Full Liquid Diet

1st and 2nd week post-op

Full liquid diet as tolerated:

• Sugar-free pudding
• Low-fat (1%) or Skim Milk
• No Sugar Added Carnation Instant Breakfast
• Cream of Wheat (Made thin or soupy with milk)
• Oatmeal (cooked well, made smooth, and thinned with milk)
• Mashed Potatoes (made smooth, and thinned with milk)
• Light yogurt (plain or flavored, no fruit pieces at this time)
• Low-fat small curd cottage cheese (mashed to smooth consistency).

Lap Band Post-Op Diet Instructions

• Stay away from carbonated or citrus drinks to decrease nausea.
• Avoid foods that are "doughy" or "sticky" such as soft white bread, coconut, chips, popcorn, or dried fruits - they could obstruct the band.
• Very fibrous foods such as broccoli, asparagus, celery, artichokes, pineapple, and rhubarb could obstruct the band if not overcooked and cut into small pieces.
• Food that is difficult to digest include: nuts, almonds, and peanuts.
• Avoid caffeine until 6 months after surgery.
• Consume 48-64 oz of water per day. Avoid gulping waterp; sip small amounts slowly. You may find that cold water tastes better.
• Do not drink while you are eating or 1-2 hours after eating.
• Chew your food very well 25-30 times per bite.
• Wait 1-2 minutes between each bite.
• Stop eating when you feel full.

Adjustable Gastric Lap Banding Diet Information

This is what my nutritionist gave to me before and after surgery.

GOALS

• Consume 2-4 ounces of food per meal (3-4 meals per day)
• 60-80 grams of protein daily.
• Drink 48-64 ounces of fluids daily (water, crystal-light, or other low sugar/low calorie beverages.).
• Do not drink while you are eating OR 1-2 hours after eating.
• Remember to chew your food 25-30 times per bite.
• Wait 1-2 minutes between each bite.
• Daily chewable multi-vitamin and calcium supplement.
• Follow a low fat and low sugar diet

FOODS TO AVOID:

• Do not try red meat until 6 months after surgery.
• Bread, pasta, crackers, should be avoided until 8 weeks after surgery.
• Do not try raw fruits and vegetables until 12 weeks after surgery.
• Avoid carbonated beverages.
• Avoid caffeine until 6 months after surgery.
• Avoid alcohol until 2 years after surgery.

You should always keep a food journal/diary and take it with you to your appointments. If you are not losing weight like you should, your doctor and nutritionist can look at this and see if there are improvements that can be made.

Day of Surgery

My surgery date was July 11, 2007. My mom and I decided to go down the night before and spend the night. Good thing we did beause the clinic called us at 7:45am asking us to come in an hour earlier. That's fine. The sooner the better. Instead of being at the clinic at 12:30, I had to check in at 11:30. I was there and got all my paperwork processed and then at 1:30 they took me back to surgery. I was in my room a little before 5pm.

I settled in pretty well. I was instructed that I would have to get up and walk once every four hours. I ended up having to use the restroom once a hour so whenever I got up to go to the bathroom, I walked.

The pain level was fine. I didn't ask for any pain meds at all. About 9:00pm my mom and the nurse talked me into getting my morphine. They both knew I was getting tired and the muscles were aching really bad in my stomach area. At 10pm I got up to use the bathroom and to do my walk. I seemed to be belching quite a bit and we figured it was from the gas that is used when doing a laparoscopy. I no sooner got back to my room and I had the dry heaves. That is not good because that can cause the band to slip. Mom went and got the nurse and the nurse came running to make sure I was ok. She gave me some meds to help with the nausea.

It didn't take long for me to settle down after that and start to sleep but then the IV bags started to kick in. I was up every 15 minutes going to the bathroom. Just remember that if you decide to have WLS.

The doctor came to see me the next morning at 7:30am and he said I was good to go home after I had my xrays. It wasn't a half hour later and I had my x-rays and then I was discharged from the hospital. I was home by 11:30/12:00pm.

Preparing for Surgery

I had my pre-op tests done two weeks (to the day) of my surgery. (June 27, 2007). At that time I weighed in at 308. I was at the doctors office for five hours. WOW!!! You are probably wondering why I was there so long..................................When I had my consultation in January, my doctor was against the LapBand and did not want to do that surgery. He hadn't heard good things about the surgery at all. He went to a conference and training in March and heard wonderful things about the LapBand and found it was much better than the gastric bypass and it's also less invasive.

Before I could be considered for surgery, I had to have the following. (Keep in mind I was supposed to have the Gastric Bypass originally. Whether or not all of these things are needed for the LapBand, I don't know. Each insurance company is different.

• Sleep Study Test
• Psych Eval
• Three months behavioral modification w/a dietician or Six months with a MD.

Here I am two weeks before surgery and he gives me the LapBand speech. He told me why he changed his views and why he wants his patients to have this surgery. The pro's out weighed the con's. With the help of my mother and a lot of praying to God, I knew this was the right decision. We did the LapBand. I'm glad I did.

I had a two week pre-op diet I had to do to prepare for surgery. Here is what my diet consisted of two weeks prior to surgery:

• 4 cans of Slimfast Optima
• 4 servings of fruit
• 1 1/2 cups 1% milk fat free cottage cheese
• 2-8 oz servings of 1% milk
• 48-64oz Water
• Daily multivitamins and calcium supplement

This is what I had every day for two weeks until my surgery. I was given another option but I don't remember what that was.

The Beginning

I have been over weight for many years. Probably the last 10 years I have been. I had considered having gastric bypass but thought I'd never qualify. I was during the year 2006 I decided to really look into it. I called OSU and Mt. Carmel but they wouldn't return my calls or send me the material they promised to send me. I then called Holzer Clinic located in Gallipolis, OH; a recommendation from a friend of mine at work. This place is awesome! They are wonderful people and they take the time to talk to you and treat you like a human being.

I had my initial consultation on January 26, 2007. I weighed in at 321 pounds. For those of you who don't know me you wouldn't think I weighed that much because of my height. Almost 6' tall. Dr. Canady met with us and explained the gastric bypass and what would be involved during the surgery and after surgery. I had to meet with the dietician, the office counselor, and the nurse. I was given several hand outs of things I had to have done before I could even be put on the surgery schedule.

1) I had to have a pysch evaluation. This is mandatory with insurance companies and for this surgery. (This was done by pysch at OSU towards the end of February).

2) Had to have a sleep study. (This was done at Holzer Clinic in Jackson, Ohio in the middle of February.)

3) I then had to have three months of behavioral modification with a dietician. Once a month for three months I drove two hours to Holzer Clinic for these sessions. The sessions went over foods I should and shouldn't be eating, how to eat slowly, increase on exercise and water intake, etc.

4) Information submitted to the insurance company.