Diet? for old timers

I am now four years out and I still struggle with a good carb protein balance. The surgeon recommends I get 120g protein a day for my age and exercise level. I find that I need to keep below 1400 calories a day. My problem is frequently I am in ketone acidosis after my work outs. I know that means I need more carbs but how do I get it in? I am still drinking a protein shake a day to keep up.

I'm guessing you mean ketosis. If you want to avoid ketosis up your daily carbs. According to webMD ketosis occurs in people who eat fewer than 50 grams of carbohydrate per day. Ketosis is a normal part of prolonged strenuous exercise.

Ketoacidosis is a life threatening condition that affects people with Type I Diabetes (rarely type II). It happens when glucose levels are off and the body must burn fat for energy. This throws off ketones. A build up of ketones produces the life threatening condition.

A lot of folks work really hard to get into ketosis. It's usually not an issue. Is ketosis causing medical problems that you want, or need, to avoid?

It isn't causing issues but I worry about long term affects. I notice it mostly this time of year because I wear layers and after my walk (I go 2 1/2 hours a day 5 days a week with hills) I am soaked through and smelling like I tangled with Mr. Clean.

One of the ways to address this issue is to eat a healthy pre-workout snack prior to strenuous exercise.  Approximately 90 minutes before you exercise, have a snack with a little protein but is higher in carb.  I like Luna Protein bars.  There's all kinds of suggestions for this out on the web too.  

Also, after strenuous exercise make sure you are getting in some protein and carbs within 45 minutes of ending your workout.  A protein shake works perfectly as a great post-recovery drink as long as it isn't zero or super-low carb.  

If you go to a GNC or Max Muscle they will have all kinds of suggestions for you too.  

Thanks. Typically I drink my shake and head out a couple of hours later with maybe a slice or two of cheese. I don't usually eat carbs until dinner. I think I may need to start tracking them more.  I typically have something with protein when I get home. I am probably too focused on the protein.

Protein is necessary but if you are exercising HARD you can't quickly turn protein into energy.  You've got to have some carbs pre- and post-workout to feed the muscles.