I need to gain some weight HELP

Never ever thought I'd have this problem, but Im 10 days from a Lumbar fusion. I'm down to 146lbs, the pain is tremendous, about a 9 out of ten without medication, and a 6 or 7 with, and trust me, my pain scale is very accurate, this hurts worse than having the full open incision from my rny, and almost as bad as a bulging bowel obstruction. I've been like this since the beginning of the year, and yes, it's totally sapped my appetite. I've gone from 188lbs, and extremely muscular and toned, now I'm 146lbs at my pre-op yesterday (quite the change from 400lbs 10 years ago). Anyways, my back doctor says I need to stop loosing weight, and preferably put 10 lbs back on. He's not going to stop the fusion if I don't, but says if I hit 138 he's ordering emergency reversal of my rny, and this is work comp, if he orders it, and I say no, they drop all my medical care!

What I've been doing: I'm really trying to eat what I can, at this point hang plan or off plan, to an extent, still trying to get some protein in, but all I can stomach right now is yogurt or ground meat. He told me a month ago to try to put on a couple pounds, but since then, I've dropped two, now it's sink or swim. I've been down to costco every week and gotten the flats of Boost shakes, I'm drinking 4 per day now, plus, I've been including those butter crescents in my day, we all know those should put on some lbs. I've started forcing myself to eat pasta again, gotta be cooked extra soft or it gets stuck, almost anything I can think of, my dr told me to add some milk shakes in there from McDonald's, but I'm not able to have dairy since the rny, and the bloating from a little shoots my back pain through the roof and puts me on the floor in tears. Only since yesterday did I bump the shakes up to four per day, but beyond that, I'm really having such a hard time eating more than a few bites and I'm full, just like in the beginning. Any ideas, I'm really at a loss here, I've forgotten how to eat it seems like. I just dont know what else to do.

Gaining is very easy, but I think you want to gain in a healthy way, dont do it eating any fried or bad foods, you dont want fat cells to grow and NEVER LEAVR!

• Carbohydrates such as bread, pasta and potatoes should make up about one third of your diet. 
• You should eat plenty of fruits and vegetables (aim for at least 5 per day). 
• About one fifth of what you eat should be foods like meat, fish, eggs, beans or nuts
  
• Try to eat 3 portions of dairy foods each day. 
• And, fatty or sugary foods should make up the smallest part of your diet.

Examples

• Have an extra slice of toast for breakfast.
• Snack on nuts and seeds, sprinkle nuts or seeds into yogurt, cereal, oatmeal and stir fries.
• Have a bowl of vegetable soup with your sandwich at lunch.
• Drink 100% pure fruit juice at dinner rather tha water
• Serve an extra spoon of mashed potato, wholemeal rice or wholemeal pasta at dinner.
• Add peas, beans or lentils to meals such as curries, casseroles and soups.
• Finish your evening meal with some fresh fruit and natural yoghurt.
• Use fortified milk in hot drinks and soups.
• Limit low-calorie beverages, such as diet drinks, and replace with milk, smoothies or juice.

Good luck!

Looks like you are eating softer foods (yogurt and ground meat).  Can you drink your protein.  Put double scoops of protein in your drinks.  I like vanilla in coffee.  Iced or hot.  If you use hot you need to mix the  protein in cold or cool liquid first then add the hot coffee.  I use sf hazelnut or caramel and milk then add the hot coffee.  It's like a latte.  Or a RTD high protein drink. 

 I don't know much on the gaining weight after this surgery because I just had it and I am losing, but I totally know how you feel on the lumbar fusion. I have had TWO of them.  Not fun...  If you need any support or encouragement after your fusion, I am here.  Even though it hurt like you would not believe when I woke up after it had happened... Now 2 years later from my last fusion, I only have occasional flare-ups.  Most of the time my back feels like a million bucks!  Good Luck.

Hi, thanks for the replies, I'm really sorry to post this on this site, I'm sure it must be discouraging for people to look at when so many are struggling with the opposite problem. But I need some rny experts on this, and my old bariatric team refused to comment on this without seeing me, and I just don't have the physical capability to make that drive.

Yeah, fried foods are out, they have always made me sick, I'm almost 10a years post op on my rny and that hasn't changed. Think I'll try the protein shakes, I think if I can get two or three down, with two or three times the normal powder, that might really add some calories. I know part of my problem is my pain medication, my back surgeon said he believes its compounding the malabsorbtion, kind of like alcohol would, but my spinal cord is being crushed to a third its normal width, I can't bear the raw pain with out some help.

Hoping the "nutrition experts" will jump on here. They seem to really know at least 10Xs more than I do, problem is, I've been rny for so long now, I'm just not sure anymore what kinds of super high calorie foods are safe. One of my biggest down falls pre rny was jumbo-jacks, I couldn't stomach one bite from one of those now. Keep throwing the ideas out there, I need all the help I can get.

I think you want to focus you extra calories on proteins rather than fatty foods. How about extra protein shakes.

On another note, I've had 2 spinal operations - a lumbar fusion (L5-S1) and a cervical fusion(C4-5-6-7). I am now pain free so both were successful. Good luck with your surgery,

A few suggestions:  The protein shakes will probably go down easily and you might want to make them with whole milk rather than water (you can use lactaid milk or take lactaid pills since you are lactose intolerant).  The milk will also add some carbs, which you do need if you are trying to put on weight.  Stay away from the McDonald's shakes though, because they have too much sugar and will probably make you dump or at least feel unwell.  Cheese and nuts are calorie dense and you could snack on them throughout the day.  Since yogurt agrees with you, look for higher fat versions instead of fat-free, and add a scoop of protein powder to the yogurt.   Good luck with your surgery!

 Try to increase some carbs together with proteins and Fat.
I.e. make a protein shake with banana whey isolate and based on coconut milk. That will add fat And carbs. 
Best way to gain weigh is to eat carbs with fat.   I do get the full feeling. For best say is to drink my protein shakes. 
Increasing proteins and fat without increasing crabs - may make you lose weigh and feel full. Easy way will be also eating crackers with peanut butter. Chips with dipps. That goes so easy. Try that. Grazing all day on chips with some healthy dips will increase you appetite. Son of healthy dip may include guacamole style dip or cheese or even good salsa with some fat added.  Easy and fan way to do it. Pick easy crackers or good quality chips.  Or anything that fast good to o and will make you eat more. Even dorrito style chips - may be a good choice for now. I don't like or crab chips but there are some that I know I can't have in the house. 
Good luck.