constant nausea

Hey everyone,

 

I am about a month out from having a laparoscopic gastric bypass surgery. A major problem I am having is nausea. Everything i try to eat (with the exception of mashed potatoes, jello, pudding, applesauce, and chilli) make me nauseous. I obviously can't eat crackers or drink ginger ale. I just don't know what to do. I do not want to keep eating mashed potatoes because they are packed with carbs. what options, if any, do I have ? I could really use some help with foods to eat and how to tame the beast otherwise known as nausea !!!!

Charlem:  By my calendar you are EXACTLY where you need to be on your food plan.   It is at least 2 or in some people's case 3 months before you should eat full foods. 

Phase I: Clear liquid diet (in hospital only surgery day and 1 day following)
Phase II: Next Full liquid diet (1-2 weeks)
Phase III: Following Phase II start the Puree diet (2 weeks)
Phase IV: Move on to a Soft diet (2 weeks)
Phase V: Getting closer - Regular diet (after 1-2 months)

You are not to worry about carbs or calories at this point...concentrate on the full Protein and Iron intake.  It will be several weeks until you Nutritionist will discuss Carbs etc;  Believe me it is a full-time job just trying to get the Protein and water in now.    I'm starting 3 months post surgery and no matter how hard I try I can't get 1200 calories a day in me.

REMEMBER ... YOUR POUCH IS ONLY THE SIZE OF A  "CHICKEN EGG" 

1. After 1-2 weeks on the Full Liquid diet, you will be able to SLOWLY add foods of a thicker consistency. All foods for the next 2 weeks will be blended to a baby-food consistency.

2. You can continue to include foods on the full liquid diet throughout this stage.

3. It is very important to chew foods thoroughly to avoid blockage or nausea. Try 1-2 Tbsp of food at a time to see if tolerated. Each meal should consist of only 2-4 Tbsp (1/8 – ¼ cup of food).

4. Remember include protein first at each meal. You need a minimum of 60 grams of protein each day.

5. Keep yourself hydrated! Drink 6-8 cups of water and low-calorie beverages between meals. Fat free or 1% milk can be included as part of your total fluid intake.

6. Continue to keep track of the kind and amount of protein you eat every day.

The following are examples of foods from each food group that should be included on the Puree (Blended) Diet. The meat and the milk group include food choices that are “complete” proteins. “Complete” proteins contain all the essential amino acids your body needs. Food choices from the starch, fruit, and vegetable groups are not “complete” proteins and should only be used with foods from the milk and meat group.

Meat Group (7 grams protein per serving) soft very finely chopped
2 Tbsp (1 ounce) cooked pureed lean meats (chicken, fish, turkey are best tolerated)
¼ cup (2 ounce) baby food meats

Milk Group (8 grams protein per serving)

¼ cup fat free or 1% pureed cottage cheese  (Love Breakstone cottege cheese and fruit)
¼ cup low-fat pureed ricotta cheese

Baby Bell cheese or string cheese

1 cup fat-free or 1% milk
¾ cup no-sugar-added/low-fat “light” yogurt (no fruit pieces)
1 cup sugar free pudding made with fat free or 1% milk
1 packet of no-sugar-added instant breakfast made with fat-free or 1% milk (12 grams of protein)
1 cup strained cream soup made with milk (no tomato, mushroom or corn pieces)

Starch Group (3 grams protein per serving)

½ cup cream of wheat/rice/baby oatmeal
½ cup mashed potatoes, sweet potatoes, winter squash or mashed yams
1 cup broth-based soup

Fruit Group (0 grams protein per serving)

½ cup pureed peaches, apricots, pears, melon, banana (eat no skins or seeds)
½ cup unsweetened applesauce (add a packet of sweetner)
½ cup baby food fruits
½ cup diluted unsweetened fruit juice (limit to 1 serving a day)

Vegetable Group (2 grams protein per serving) (nothing with  skins or seeds)
½ cup pureed carrots, green beans ½ cup baby food vegetables

Important Tips:
1. You may need to add fat-free milk, clear broths or fat-free gravies to the above foods and use a blender to make the foods a baby-food consistency.

2. Add non-fat powdered milk or acceptable protein powders to your foods to boost protein amount.

3. Try one new food at a time. If you feel nauseated or experience gas or bloating after eating, then you are not ready for this food. Wait a few days before trying this food again.

4. Portions may need to be adjusted depending on your individual tolerance. Listen to your body. Stop when you feel full.

Phase IV: Soft Diet______________________________________________

1. After 2 weeks on the Puree Diet, you will no longer have to blend your foods. You can slowly add foods that are soft in consistency. Soft foods can be cut easily with a fork.

2. You will remain on the Soft Diet for 2 weeks. Remember to try one new food at a time.

3. For better portion control, use smaller plates and baby spoons and forks. Stop eating when you feel full.

4. Keep yourself hydrated! Drink 6-8 cups of water and low-calorie beverages between your meals. Don’t drink with your meals. Don’t drink 30 minutes before and 30 minutes after meals.

5. Continue to take your supplements as prescribed.

6. Continue to keep track of the kind and amount of protein you eat every day. Remember, your goal is a minimum of 60 grams of protein each day.

The following are examples of foods from each food group that can be included on the Soft Diet.

Meat Group (7 grams protein per serving)

 

2 Tbsp (1 ounce) cooked lean meats: skinless chicken, fish, turkey, ground beef (moist meats are usually tolerated best, beef is usually least tolerated) 

Egg salad,  Tuna Salad,  Chicken salad  (4 saltines)
2 Tbsp (1 ounce) water-packed tuna or chicken
¼ cup egg substitute or 1 egg scrambled
1 tbsp CREAMY peanut butter

Milk Group (8 grams protein per serving)

1 cup fat-free or 1% milk
¾ cup no-sugar-added/low-fat “lite” yogurt (no fruit pieces)

¼ cup fat free or 1% cottage cheese
1 oz (1 slice) low-fat mild cheese
1 cup sugar-free pudding made with fat free or 1% milk
1 packet of no-sugar-added instant breakfast made with fat free or 1% milk (12 grams protein)
1 cup cream soup made with milk (no tomato, mushroom or corn pieces)

　

Starch Group (3 grams protein per serving)

1 slice of bread (toasted) Chew, Chew, Chew or toasting is better...don't clog up the plumbing
4-6 crackers
½ cup cooked cream of wheat/rice/oatmeal
½ cup mashed potatoes, sweet potatoes, winter squash
1 cup broth-based soup

Fruit Group (0 grams protein per serving)

½ cup canned peaches or pears (in own juices or water packed)
½ soft banana
½ cup unsweetened, diluted fruit juice (limit to ½ cup a day)

Vegetable Group (2 grams protein per serving)

½ cup soft, cooked carrots or green beans (no skins or seeds)

Important Tips:
1. All foods should be cooked without added fats. Bake, grill, broil or poach meats. You may season meats with herbs and spices instead of fats.

2. Moist meats are tolerated better at this phase. Add chicken or beef broths, fat free gravies and low-fat cream soups to moisten meats. Finely dice meats  the size of you small finger nail......and chew well.

3. Add 1-2 Tbsp of a new food at a time; if you feel nauseated or bloating after eating then you are not ready for this food. Wait a few days before trying this food again. Everyone progresses differently.

The nausea, I'm sorry to say from experience,  is pretty much because whatever you are trying to eat isn't making your POUCH happy.  My surgeon said I was rushing too much ahead and he made me stay on Soft foods and Liquid shakes until my pouch would accept new things.   Have you mastered eating slowly yet?  How about stopping your liquid intake 1/2 hour before and after eating?  And last eating slowly.  When my Surgeon told me I should take at least 1/2 hour to eat a 4 oz meal I thought he was crazy, but it turns out he was right.    If you would like a good Bariatric website with a full list of foods and receipts you might Google "Cleveland Clinic Bariatric Program"   Besides my own Bariatric handbook I've found Cleveland's handbook very informative.

Best of luck...and it does get better.

 

 

 

 

 

 

 

Phase I: Clear liquid diet (in hospital only surgery day and 1 day following)
Phase II: Next Full liquid diet (1-2 weeks)
Phase III: Following Phase II start the Puree diet (2 weeks)
Phase IV: Move on to a Soft diet (2 weeks)
Phase V: Getting closer - Regular diet (after 1-2 months)

I believe I did the two weeks pureed diet and attempted to go straight to regular foods which is proven to be a bad thing. I have tried fruit( peaches in juice) which makes me nauseous as well. My stomach always feels full and bloated even when i do not attempt to eat not to mention the constant constipation.(sorry if that was tmi) I guess now I realize that I should have done more research than I did. I am highly frustrated. I have not mastered eating slowly which has caused me to vomit. I do stop fluid intake before i eat however sometimes i sip a little bit after eating because i feel like something is clogging my throat. I want to make sure i am doing the right things because I do not want to jeopardize my life. I am going to stick to the soft foods for another 2 weeks and maybe that will help.

CHARLEM-you have already discussed this with your doc/nurse-right? Many peeps require a few weeks-even months-even longer-of tummy meds, such as Prevacid or Protonix type meds, to help the new tummy "adjust"..I stayed nauseated for what seemd liked FOREVER (I vividly recall it, even after all these years, and my heart goes out to you!-it was like pregnant morning sickness 24/7)...

Something that helped me..and still DOES..is drinking warm stuff..esp warm mint tea...Oscar (my grouchy pouch) still likes to do nausea flips some days, and warm tea really helps-plus it gets in decaf fluids.

At a month out, your MAIN concentration really HAS to be FLUIDS FLUIDS FLUIDS FLUIDS..Dehydration can KILL you..I don't know how to be more blunt than that...Yea, you need protein, but right now you need FLUIDS more..With your doc's blessing, you can add some protein powder to that pudding/applesuace/etc..I do it everyday..but I'm nearly 11 YEARS post-you are 1 MONTH-pls use your own common sense..

If the nausea gets to the point where you cannot swallow spit..seriously..or you do not urinate at least every 6-8 hours PLEASE seek medical advice, outside an internet message board (sorry..30+ yr nurse, 23+ yr mama coming out here..creature of habit)..

Mostly..be kind to your newborn baby pouch...this is a LIFETIME learning curve,,and we're all here, to learn WITH you..every day

I have not contacted the doctor because I have already bugged them so much. I wanted to first see if this was something common amongst those who have also had this procedure. It is extremely hard for me to get in all the fluids that I am supposed to because I constantly feel bloated and full. I have been able to incorporate protein powder in my pudding and applesauce the problem is eating all of the portion that is there. I haven't tried tea yet but I will have to pick up some mint tea. Thank you for all of your advice.

A huge contributing factor to nausea for new post ops is dehydration.  Be sure you're getting a minimum of 64oz of fluids - anything decaf that is wet.  If you're dehydrated - nothing's going to help the nausea except of rehydrating.

I also want to note that things like potatoes seem to get stuck, even with my sleeve stomach 7 years post op, if I eat them too fast.  Ground beef took a while to tolerate, too, so perhaps some new options may help.  Try some yogurt, cottage or ricotta cheese, scrambled eggs, etc.

That has proven to be the hardest thing for me to do. I now I am not getting in the correct amounts of fluids. I just always feel too full to function let alone add more into my angry nauseated pouch!!

Perhaps a trip to the doc or ER to get an IV will help - and you feel better pretty fast.  The key from there is to continue hydrating, and yes, it's a full-time all day job, sipping every other minute it seems.  If it's any motivation, another thing that dehydration can contribute to in new post ops is kidney stones, which you do NOT want to add to your list of woes.