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Surgeon Testimonial

Joseph Chebli
After reading through all 112 reviews of Dr. Chebli here on OH and finding very little in the way of negative comments, coupled with his being a multiple-year recipient of the Top Docs award, I decided to schedule an initial consult for the VSG (I almost got a LapBand from a different surgeon, but that's another story... check my blog if you're interested).

If I had to choose three words to describe Dr. Chebli, they would be direct, thorough and meticulous. I don't know about you, but those are qualities I would absolutely want in a surgeon!

There is no question whatsoever that Dr. Chebli is a Type A personality from the east coast. If you're a native west coaster, take that into consideration going in. It seems to me that people out here tend to be not as direct, so meeting someone who is when you're not used to it (I'm from Boston, so he made me feel right at home) can be surprising and may take you back a bit.

As another reviewer said, let him get through all the information he wants to make sure you have first and then ask your questions -- you'll probably find that by the time he's finished he's already answered 95% (or more) of what you were going to ask.

At your initial consult, he'll give you a binder that will walk you through everything you need to know and do in the weeks leading up to surgery... this will be your Bible both before and after surgery as it also lists all the post-op resources available in both the Seattle and Eastside areas (he works out of both Northwest and Evergreen hospitals). If you have any questions as you're following up on everything, don't hesitate to call his office... his staff is very knowledgeable and helpful.

During my pre-op appointment, not only did Dr. Chebli go through all the information I expected, he also described the operation in great detail, even explaining the most up-to-date techniques being used and why. While some of it went over my head (I could have stopped him and asked for clarification, but wanted to see what I could gather from context clues), I understood the majority and was impressed at his depth of knowledge and the attention he pays to what the leading VSG surgeons are doing to mitigate the risk of complications.

As I write this, I'm 10 days post-op and have had no problems whatsoever. Everything has been textbook without so much as a single run-in with nausea or vomiting. I even managed to make it through those first few days without worrying about getting my required amount of protein and fluids in -- a common concern to all post-ops -- thanks to his detailed discharge instructions. He truly leaves no stone unturned and while acknowledging that all surgeries carry risk, he makes you feel as though there will be no surprises that are within his grasp to control, that you'll know exactly what you need to do, when you need to do it.

It's also worth mentioning that I have heard from several nurses in the Seattle area here on the forums who've worked with Dr. Chebli and the one thing they all said about him was that he's an outstanding patient advocate. I definitely got that vibe while I was in the hospital... it became quite clear that the staff intended to make sure his instructions were followed to a T. It's hard to describe, but it's like when you go to a restaurant with someone who used to work there and still knows everyone... there's a certain degree of feeling like you're getting the white glove treatment. I don't know if it's that the hospital staff was so attentive out of respect, intimidation or a mixture of both, but it definitely translates into a great experience for Dr. Chebli's patients!

In summary, Dr. Chebli gets my highest recommendation... I can see why he wins the Top Docs award for bariatric surgery year after year. Don't hesitate to send me a private message if you want more information.
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  • Parenting - I try to follow positive discipline principles with our 5 yr old son.
  • Movies - Harold & Maude, Little Miss Sunshine... love the thought-provokers.
  • Music - Mostly rock, jambands, alternative, and folk/singer/songwriter
  • Politics - Kennedy-loving Massachusetts liberal and proud of it!
  • Counterculture - "Taking Woodstock" will be part of our son's cultural education.
  • Baseball - Only the Red Sox, especially during the play offs.
  • Road Trips - As soon as our son is old enough, we will take a summer vacation on Phish tour!
  • Computer and Internet Surfing - Blogs, forums, facebook, twitter... total social media geek.
  • Paranormal Research and Investigations - Always been enamored with ghost stories.
  • Atheism/Agnostic - Raised Catholic, developed critical thinking skills, now it's the DIY approach.

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Dr. Jekyll and Mrs. Hyde
on June 29, 2011 4:25 pm

I don't know about you, but I'm pretty fricking jazzed about the lack of hunger that's accompanied my sleeve.  Even though I knew there was a chance it was temporary, I was happy to finally experience what it must be like for "normal" people who only eat when their stomachs are empty.

Last night, however, I got a reminder that just because the physical hunger has gone from Godzilla to Kermit the Frog doesn't mean that the battle is over... not by a long shot.

Head Hunger Rears Its Ugly... uh... Head

Not long ago I had a conversation with a friend around wondering where my "trigger" point is for carbs; at what point does the mindlessness start to creep in?  I know that if I keep it under 20-30g per day, I'm fine... no cravings, no obsessing over what else I can eat.  What I don't know, is how many carbs I can tolerate before I start floating into that Dr. Jekyl/Mrs. Hyde danger zone?

Yesterday I was doing pretty well.  I had my usual protein shake breakfast, had 2 tbsps of pureed egg salad for lunch and noticed that the vending machine at work has a tuna & crackers snack pack in it.  I can have both of those, so I had that and found that I'm probably better off making sure the tuna is pureed first as I'm not so great with chewing to a paste yet.  Not a big deal, not painful, but I definitely felt it sitting there after I ate it... I probably won't do that again until after I'm on the soft foods phase at the end of July.

I got home, had my 2oz of sloppy joe puree with some sour cream (reminded me of a taco) and a sugar free popsicle and thought that was it for the night.  But I wanted another popsicle... and another... and another... and another.  Then I remembered that I had picked up some Ritz crackers, which I hadn't tried with the hummus yet... so I had some of that.

Then I was done... and I was scared.  It started to feel like my control was slipping; I had to get a handle on it.  I went over to log my foods and saw that I was now up to 54 carbs for the day.

Journaling... NOW I Get It!

I've been a big proponent of using a site like MyFitnessPal.com to log everything that passes your lips.  Not only did it help me avoid going over my 30g allotment when I was on the pre-op diet, now that I'm finding my way back to regular food, it's helping me identify where that tipping point is. 

I still don't know exactly where that threshold is because I caught myself early enough that I hadn't yet ventured into auto-pilot territory, but I have a feeling I'll get a better feel for where the line in the sand is in the months to come.






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The Obligatory Husband Vent
on June 27, 2011 7:02 pm

As wonderful as my husband is, there are some things he just doesn't understand and probably never will.

Take, for example, 3pm on the day before my scheduled (but not completed) lapband surgery when I got the call from the surgeon's office letting me know that the operation I was planning on having in 16 hours and had been preparing for over the past month may not happen.  It could have, if I wanted to go with a surgeon I'd never met, but if I wanted my surgeon, I'd need to wait another 3-4 weeks while the shoulder he just dislocated healed. 

In that moment when I saw the choice in front of me, I didn't know what to do and told the woman on the phone I'd call her back with a decision within the hour.  I put the phone down and started sobbing; the emotional dam of everything riding on this surgery broke loose and I wasn't going to stop it.

My husband, who was already annoyed with me for some trivial bullshit reason (as is typically the case given the quarter inch fuse on his temper), walks in to the kitchen on his way out to work, sees me a mess and rather than softening and asking what's wrong, he freaks the fuck out because he thinks I'm crying over his recent gruffness.  When I explain he has nothing to do with it and what that phone call was, he gets annoyed again because he sees this little bump in the road as not a big deal and nothing to cry over.

Yeah.

Then there was the time when, after jumping through all the hoops to get the VSG, I got a rejection letter from my insurance provider, despite having been told not once, but TWICE that it's a covered proceedure.  The tears that came while reading that letter made no sense to him either; I shouldn't be getting sad, I should be getting mad!  I should start writing my appeal letter now.  I should go apeshit on them.  I should... I should... I should...

Thanks, hon... you let me know what I should feel and how I should react and I'll just pull that emotion right out of the rolodex so that everything I do will be in line with your perception of the world and how people should behave in it. 

I get that boys are socialized differently and some guys grow up with very little understanding or know-how when it comes to dealing when women (or anyone, for that matter) are showing extreme emotions, but Jesus Christ!  We've been together 11 years, you'd think he'd learn something about it by now!  And yes, I have told him point blank that when I'm upset or crying that I don't need his criticism, I need his support.  I know he's just trying to be helpful, but telling me what I'm feeling and how I'm reacting is somehow wrong, misguided, inappropriate, etc. doesn't fix the problem... it only makes me feel like I'm inferior, abnormal, broken, etc. 

Again, not helpful.

What would be helpful is if he'd just STFU with the judgements and advice long enough to let me just vent.  Why is it so hard for men to understand, all you have to do is say, "Honey, what's wrong?" and then just nod and look concerned while she talks?  Just do that and you'll be fine, guys!  Don't try to tell her anything unless she asks for your opinion... just let her talk.!

*sigh*  Glad I got that off my chest.

This started to be a post about how my stall is refusing to give up, but it took another path... I guess I needed it to.  The connection there is that when I told him I was frustrated at having been stalled for the past 15 days, he didn't understand how I could be frustrated when I knew that just about everyone runs into a 3 week stall.  Apparently in his world, if you know something suck ass is on its way, you can't be miffed at the suck-assyness of the situation when it arrives.

Go figure.
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Eggs and the Laws of Physics
on June 25, 2011 9:14 pm
So I gave eggs a whirl tonight... those of you who bake will probably laugh at this, but just go into it knowing that I don't (bake).

Now, based on the knowledge that no matter how much I chew eggs, they only break down so much, I went into this experiment thinking that a pureed version of egg salad would have bits of the white part of the hardboiled egg suspended throughout it.  I wasn't necessarily opposed to that idea, but it's what I expected.  

So, I boiled 4 eggs, pulverized them with a whisk and then added mayo as though I were just making regular egg salad (I'm not allowed fibrous stuff like celery yet, so it's just eggs and mayo), then popped it in the food processor.  The first go-round was a bit dry, so I added some mayo and put it through again.  It still seemed a little un-babyfood like, but I tried it and the taste was perfect... I didn't want to overdo the mayo for the sake of proper consitency.

Good thing I made that call because I don't think it ever would have gone to babyfood consistency no matter how much mayo I added; I think the laws of physics would have prohibited it.  The texture was silky smooth when you eat it (which shocked me... no egg bits at all), but it behaved like a cross between frosting and merangue.  I really thought the texture wouldn't be anything I'd like, but it's actually great.

So as I'm spooning it into single serve tupperware containers, I'm marveling at this unexpected, fluffy consistency and I can hear my husband chuckling.

"Ya know," he says, "when you're making a merangue, it's the eggs that make it fluffy."

Did I mention that he's a domestic god and I, most decidedly, am not?
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One Month Out, My 3 Week Stall and a New Puree
on June 24, 2011 10:01 pm

Yesterday was my one month surgiversary and I can honestly say that I'm pretty much back to 100% now -- no physical complaints at all.  The only pain I'd had was on the two largest incision sites, but even those seem to have disappeared.  I can get up without holding my belly, I can walk and not notice them at all and I can even sleep on my side again.  I think the third week is when I turned the corner.  The first half of it still had some lingering echos of the incision issues, but they had resolved completely by the end of the week.

I had my second post-op appointment with Dr. Chebli this week and he's happy with my progress.  At 21lbs lost over the past month, he said I'm actually ahead of the curve for those who get the sleeve.  Considering I've been stalled at 309 since around the 12th, that made me feel good.  I knew the dreaded three week stall was on its way, I've read plenty about it on the forums, but it's still frustrating when you know you're doing everything right and you're not seeing any difference on the scale.  I'm hanging in there though, trying to do more in the exercise department to see if that'll help break it, so hopefully I'll see a drop soon.  I did go down to 308 yesterday and 307 today, but I've seen both of those pop up in this 309 stall before... it always bounces back to 309, so I'm not going to break out the champagne yet.  If I get down to 306 in the next day or two, THEN I'll be happy.

Anyway, the reason I wanted to put up a new blog post is because I've got a few more foods to add to my list of stuff I'm eating while in the pureeds stage, so I should probably get on with that. 

Puree Experiment #3

I've already detailed the roast chicken and gravy puree (there's still some in the freezer), and the franks and beans experiment.  Just yesterday I was struck by inspiration while picking up some groceries.  As I was looking for a can of corned beef hash--I like Mary Kitchen's version (though stay away from the Roast Beef Hash, it smells and tastes like dog food)--when I spotted a can of Manwich Sloppy Joe sauce. 

I picked it up to read the nutritional information and immediately spotted the little banner on the front letting me know that each serving was equal to a serving of vegetables... perfect since I haven't been eating any (no room after 2oz of protein).  I decided it couldn't hurt to give sloppy joes a whirl as a puree, especially since I hadn't had any beef at all in a month.

Much like the franks and beans puree, this one actually worked out pretty well.  I do miss the flavor of the bread being mixed in, but given how limited my diet has been lately, I was thankful for something different.  Also like the franks and beans puree, I can't remember the last time I had sloppy joes, so it was another welcome trip down memory lane. 

It occurred to me that it really does feel like I'm re-learning how to eat; I'm even gravitating towards things I haven't had since I was a kid.  I was initially a little concerned that I'm not making the right choices with the franks and beans puree and now this one, but after looking at the nutritional profiles of each and knowing what my overall daily intake looks like, I don't have a problem with either.  These are just temporary choices to get me through until I can eat normal meals... I don't imagine a salad would puree very well, ya know?  So yeah, it may sound like not the healthiest stuff, but in the grand scheme of things, I don't think it's all that bad. The franks and beans puree I use sparingly to keep from boosting my carb count, but I don't see the sloppy joe one being an issue.

Here's the profiles for 2oz of each:

Franks & Beans Puree - 112 calories / 12g of carbs / 0g of fat / 5g of protein
Sloppy Joe Puree - 105 calories / 9g of carbs / 3g of fat / 18g of protein

Snacky Foods

In addition to these "meals", I've also discovered a couple of "snacks" that work well if you just can't bring yourself to down another protein shake, but need to eat something. 

My surgeon's guidelines allow for baked crackers and chips during the pureed stage, so the other day I gave a trial run to Keebler Town House Crackers with some hummus (Tribe is my favorite, but Sabra works too... not a fan of Athenos).  No issue there at all, but you do need to be mindful that this cracker/chip option will up your carb intake, so be sure to only go there on days when you can spare them.

Another one that worked well is graham crackers with peanut butter.  Again, be careful with your carb intake in relation to whatever else you've had on any given day, but if you've got the carbs to spare, it's a nice change from always reaching for a protein shake when you're between meals. 

Added Benefits

I don't believe I've mentioned it before, but my son is a picky eater.  If it's not pizza, fish sticks, chicken nuggets or hot dogs, fuggedabout it... he won't touch it.  We have limited success in getting him to eat steak, hamburgers and regular chicken or fish, but it's always a struggle.  Since hamburgers have become a bit less of a struggle recently, I decided tonight was the night when he'd try sloppy joes.  I told him it was just hamburger with ketchup mixed in, but of course, he still fought me on it.

Unbelievably, with the help of a promise of some video game time before bed, I actually got him to eat a half of one sandwich; I think that's a record-breaker for any new food with him.  Even more amazing,  I got him to do it again today when I re-heated some of my puree cubes and put them on a hamburger bun for lunch. 

So, all in all, I'm feeling a lot better than I was during the full liquids phase and I'm figuring out the pureed phase as best I can.  This part of the diet is a bit of a challenge mainly because I have no interest in eating at all.  Right now it literally is just something I do to stop that gnawing empty feeling in my stomach, so I find one thing that works and tend to stick with it.  I have plans to try out pureed tuna and chicken w/ mayo, but just haven't gotten that motivated yet. 

Maybe this weekend...
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Puree #2: Since I'm Eating Babyfood...
on June 16, 2011 7:45 pm

...I might as well go all out with the pint-sized palate theme.

Earlier today I was debating about what to make for dinner tonight.  I had picked up a few canned things that I could puree -- chili, baked beans, corned beef hash (which is mushy enough on its own to not need pureeing) -- but none of them sounded all that appealing.  I put the thought of out my mind at the time, but now that it was getting close to dinner time, I was getting hungry.

Having still not decided on what I was going to have, I asked my son what he'd like for dinner tonight.... he wanted hot dogs.  Easy enough.  I went into the kitchen and as I was cutting one up for him, it dawned on me that I could try doing a pureed version of franks and beans for myself.  I used to love that combo when I was a kid, but it's been forever since I had it.

After I got my son his dinner, I opened up the can of B&M Baked Beans (I remember that brand from when I was a kid back in Boston where the baked beans bar is set pretty high), dumped it into the sauce pan, added 3 cut up hot dogs (Hebrew National Beef Franks, if you're interested) and set it to medium heat.  I wasn't sure if that would be enough hot dog to balance out with the beans, but I figured it was a good number to start with.

Once it was warm enough, I dumped the whole thing into my food processor and whizzed it into babyfood.  When I first opened it, I thought it might be too liquidy... perhaps I should have strained some of the bean juice out first?  Once I stuck a spoon in it though, I was pleasantly surprised to find the texture was perfect.  Now was the moment of truth... how did it taste?

I'm not gonna lie; it looks like something my dog would leave in the yard after getting into something he shouldn't have, though thankfully the smell is enough to keep your brain from latching on to that nasty thought.  Despite how it looks, the taste was better than I thought it would be.  If you liked franks and beans as a kid, I highly recommend giving this a try. 

Let's Do the Math

For those of you keeping tabs on your protein intake (you should be!), there are 7 grams of protein per serving of the beans and there were 3.5 servings in a full can, so that's 24.5g in the beans alone.  The hot dogs each have 6 grams of protein and I used 3 of them, so 18g, which gives us a combined total for the entire thing of 42.5g. 

I had 2oz for dinner and put the leftovers into ice cube trays (each cube = 1oz), so I know the entire batch was 18oz.  42.5g of protein divided by 18oz = 2.36g of protein per 1oz serving.  4.72g of protein isn't a ton, but it's not like I can eat a lot of anything, so it'll have to do!

For any of you using MyFitnessPal.com, I worked out the calories as well (56 per oz) and added it to the database... just search for "Franks & Beans Puree" and it should come up with "Generic" in front of it.
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Post-Op Week 3: Lessons Learned from Pureeds
on June 11, 2011 11:02 am

If I haven't mentioned it before, I'm the breadwinner in our family.  My husband bartends a few nights a week, but is essentially a stay-at-home dad with our 5 year old son.  Being the domestic god that he is, he cooks, he cleans, he mows the lawn... it's great.  

When I told him that this Friday (last night) is when I could start pureeds, he asked what I wanted him to make for dinner.  It didn't take me long to ask for Chicken Brent, a.k.a  seasoned roast chicken with gravy and mashed potatos (if you've ever seen Cloudy with a Chance of Meatballs, you know where the name came from).  The chicken is always fantastic, but his gravy is to die for--picking up tips from chefs is one of the benefits of working in the restaurant industry--I swear he'd make a fortune if he bottled and sold it.  So, knowing that meats puree better with liquid, Chicken Brent seemed like the perfect first meal for my re-introduction to real food.

The past 20 days on clear, then full liquids hadn't been as difficult as I thought.  Even when my husband would make dinner for he and our son, it didn't really bother me that I couldn't eat it... I just knew I couldn't, so I wasn't really tempted.  There just simply was no choice if I wanted to heal properly and not risk a leak.  Last night, however, was a different story... last night, I had to exert more self-control than I thought I was capable of.

Lesson # 1: Who's in Charge?

Usually when my husband makes Chicken Brent, I typically hover around the bird picking at the wings while he works on the gravy.  Knowing I couldn't do that last night, I stayed in the living room to avoid the temptation, though resisting the smell was maddening.  Once he was done and had sectioned off the bird, I sent him to go eat with our son while I pureed up the dark meat (thankfully I'm the only one who eats it, so I had all the legs, thighs and wings to myself).  Little did I realize that resisting the urge to pick based on the smell was nothing compared to what I was about to do.

Peeling off the crispy, seasoned skin and setting it aside, I went to work with knife and fork to break the chicken up into small enough pieces to puree.  The action of cutting up chicken like this not to put in my mouth, but into a container to be whizzed away into babyfood was sheer torture.  The more I cut, the more uncomfortable resisting the temptation to eat some of it became.  

I started getting irritable, if someone had spoken to me at that point I might have taken their head off... and then I caught myself: learning how to gain control over food's power over me is exactly what I signed up for when I had this surgery, and now I was angry that I was faced with my first real challenge?  Hell no... time to get my head back on straight.

As soon as I made this realization, that this exact thing is part of the process of forging my new relationship with food with ME in the driver's seat, continuing on with my task suddenly got easier.  I still wanted to eat the chicken, the urge didn't go away, but it was suddenly more like I was back in the full liquids mindset.  There simply was no choice in the matter... I couldn't eat it in its current state if I wanted to heal properly and avoid the risk of a leak, I had to puree it first, so no sense wasting my energy on being pissy about it.

I got a good chunk of it it into the blender and added some gravy, which my husband was kind enough to keep totally flourless (it was more like an au jus than a gravy) so I could experiment with increasing thickness from square one to see what works best.  The first go 'round seemed a bit too thick, so I added more gravy and that did the trick to get it to baby food consistency.

I carefully measured out 1 tablespoon of chicken puree and 1 tablespoon of mashed potato (per my surgeon's tips for starting pureeds) and sat down to dinner with my husband and son for the first time in weeks... and it was heaven!  I've heard some say that the consistency just kills it for them, but not me... the flavor was the same and that's all I really cared about; it was delicious.

Lesson #2: Slow and Steady Wins the Race 

My next challenge quickly presented itself; I needed to eat slowly to a.) make sure my new tiny tummy was ready to take this next step and b.) to avoid overdoing it.  As this was my first foray into pureeds, I had no idea if I'd tolerate it or not, how much was too much, how long to wait to gauge if I was full, etc.  I took small bites, savoring each and waiting a few mintues between each to see if I'd have any adverse reactions.  Of course, this meant that my food got cold pretty quickly, but I didn't really care... I ate it anyway.

I'm happy to report that I actually got through both tablespoons without a problem at all (I was going to be devastated if it didn't agree with me after looking forward to it for so long).  I thought about heating up a bit more--my surgeon's guidelines recommend starting with 1-2 tablespoons, but say no more than four--but no sooner did I have the thought when I started to feel a bit full.  Not overfull, mind you, but satiated.

I went back to the rest of the chicken that I hadn't cut up yet and quickly went about pureeing the rest of it so I could store it into single servings via ice cube trays that I could freeze and use throughout the week (another tip from my diet guidelines).  I had a lot more chicken than I did potato, but that's fine... I'll just do all chicken lunches and will bust out the potato at dinner.  No doubt my husband will make more mashed potatos before I'm out of my ice cubed versions.

So, all in all, that's my first adventure with real food post-op.  I'm super excited to try out some of the recipes and new foods I have added to my pureeds shopping list, which I think will be yet another flagstone in the path of rebuilding my relationship with food from square one.  No doubt each new experience will bring with it new lessons and challenges, but now that I've reminded myself they're coming and facing down each will be crucial to my success, I'm ready for them!
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Post-Op Week 2: Variety, How I've Missed You!
on June 8, 2011 3:29 pm

The full liquids phase isn't as bad as I thought it would be, mainly because I have little to no interest in eating (or, rather, drinking) anything.  I have felt hunger here and there and have satisfied it with either a protein shake or else some strained soup, but it's not the ravenous beast it was, so that's a plus.  While this phase hasn't been terribly difficult, there is the problem of a lack in variety.

Unjury Chocolate Splendor protein shakes have been my stand-by, though I did pick up some of the Strawberry Sorbet to try it out (ok, but not great).  I decided to order some samples from Vitalady... I got 5 different flavors.  At this point, I haven't tried only one of them and of the four I have tried, I only liked one (Champion Pure Whey Stack - Banana Scream).  I also ordered a case of the Peanut Butter Cup Pure Protein cans, but they haven't shown up yet.  Knowing that what I have on hand and that there's only 12 cans on the way, there's no way I have enough shakes to last much longer.  So it's back to Unjury... I ordered a whole bunch of packets and a couple of tubs the other night.

My stand-bys for soups have been Better than Boullion's organic chicken flavor and Campbell's Cream of Mushroom soup with the bits strained out.  I made an attempt to do the same for their Chunky New England Clam Chowder, but it seems that one just doesn't work without the bits... I couldn't get past the first spoonful.

I tried Cream of Wheat last week, but my tummy didn't like it and I haven't gotten around to trying it since.  Sugar free pudding, jello and popsicles have been fine for treats, but I'm not all that interested in them most days.

On the upside, however, I get to start pureed foods on Friday.  I never thought I'd be so excited for babyfood consistency foods.  My husband makes a mean roast chicken and gravy, so I've already requested that for dinner... I may even attempt a little mashed potato and broccoli (pureed, of course).

I've started a folder in my bookmarks to collect pureed suggestions, so post links if you have 'em!



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