First appointment with my nutritionist!

Today I had my first appointment with the nutritionist! She was friendly and didn’t make me feel stupid or pathetic. Awesome. She even had visual aids to show me what future portion sizes will look like. Teeny.

She gave me a list of nutrition goals that I’m supposed to work on between now and my next appointment.  (I get the feeling that these goals are similar to how I should eat once I reach maintenance, but I'm supposed to start now.)

1. Continue my exercise of 5x week - 30 minutes of elliptical 3x a week and weight lifting 2x a week. I just got back on my schedule on Monday (due to a plantar faciatiis flare up that required attention)… well the elliptical part of it. And I’ll be adding weights back in next week. It’s so nice to be exercising again.

2. Pre-exercise, I need to start eating a small carb. She suggested 1/2-1 banana, depending on size or wheat crackers such as triscuits. Of course I forgot to buy either of these at the grocery store on the way home.

3. “Breakfast” I can eat tuna salad with veggies or crackers or eggs with veggies and some extra protein like turkey bacon. I picked up smoked salmon, mushrooms, and broccoli for the eggs plus cukes and celery for the tuna. Yum.

4. “Lunch” She thinks the protein powder I have is perfect – I took a picture of the bottle/nutritional info since I knew I would forget. I need to have a shake with a scoop + 8 oz of skim milk. She doesn’t recommend almond milk due to the lack of protein. I bought some anyway to try out.

5. For dinner I need to start focusing on protein and veggies with no more than 1/2 cup of starch. Sadly, from now until surgery and maybe for a year after, this means separate things. So I really need to pay attention to make sure I’m getting enough proteins and can avoid the carbs in dishes. This will be a challenge for me.

6. Beverages – I need to avoid sugar and carbonation. I do already, so that’s an easy thing. I asked her about caffeine and she says the occasional Throwback won’t kill me, if it’s flat. Or the caffeine strips that I’ve used in the past could work. I already drink lots of half-strength crystal light, so I just need to keep that up.

7. “Practice page #6” – more on that later.

8. Try vitamins and take notes about the ones I like. She gave me sample packets of Bariatric Advantage.

9. “Work on checklist” – more on this later too!

Page 6 tells me to do the following things:
Eat 3 meals a day, but no snacks.
Always stop eating or drinking as soon as you feel full.
Eat slowly! You should take at least 20-30 minutes to finish each meal.
Do not drink with your meals. (30 minute rule)
Do not drink liquids that have calories (1/2 cup fruit juice a day is ok.)
Always eat protein first.
Take your multivitamin supplements each day.
Exercise regularly, 30 minutes a day. (I’ll need to walk only for the first 6 weeks after surgery.)

The checklist is as follows:
I eat three times a day (breakfast can be a protein shake)
I eat at about the same time each day
I have decreased my portion sizes
I eat at least 3 servings of vegetables a day (1 serving = 1/2c)
I eat at least 2 servings of fruit each day
I have cut in half the amount of fat that I add to foods
I am choosing low-fat products more often than I choose high-fat products
I only eat sweets, desserts, and/or candy one time per week
I only eat fried foods one time per month
I have increased my activity
I have cut in half the number of caffeine drinks I have each day
I have cut in half the number of carbonated drinks I have each day
I drink at least 64oz. of water each day
I sip all my drinks slowly
I take a multivitamin each day
I have practiced chewing my foods 30 times before swallowing
I have practiced not drinking during or 60 minutes after a meal
I have a set of measuring cups/spoons to use for measuring after surgery
I have tasted and purchased a supply of the supplements I will use to get most of my protein after the surgery.

Pretty straightforward, I think!

She also gave me the pre-op diet which I need to start 10 days out due to my BMI. It is as follows:
High protein liquid supplements for all meals. I should be aiming for around 1200 calories. Up to 6 protein drinks a day.
I can also have water, crystal light, sugar free jello, sugar free popsicles, and all varieties of broth soups.
No solid foods, drinks with sugar, or carbonation.
Limit coffee/caffeine to 1 cup a day
64oz fluids a day

We went over my post op diets as well. (SO MUCH INFORMATION)
Stage 1: Clear Liquids – this is only until I go home from the hospital
Stage 2: Full Liquids – this is for 2 weeks.
Stage 3: Pureed Diet – another 2 weeks.
Stage 4: Solid foods – for the rest of my life. Although I’ve got specific instructions for the first 4 weeks to ease me into hard foods.

And I think that’s everything. Worth noting – she says that “in a year” I should be eating 1200-1500 calories a day. I’ll interpret this as “once in maintenance.”

More appointments have been scheduled/rescheduled so here’s the current list:
9/13/2013 - PCP
12/2/2013 - Surgeon
12/11/2013 – Nut #1
12/13/2013 - PCP
1/2/2014 - Psych Eval
1/3/2013 – Nut #2
1/7/2014 - Endoscopy

Sounds like a very thorough plan and like your dietician is going to do a great job keeping you informed about what you need to go. Awesome!

I was really pleased!  I had a billion questions and she answered all of them :)