I had my second monthly appointment at GMC for Bariatric surgery and nutrition class #1 on May 15th. I lost 8 lbs since I started on April 3rd. I am now at 299 lbs according to their scales and I was 307 on April 3rd there. We discussed the RNY surgery and my diet and I am doing well. My surgeon's assistant said I may be able to have surgery by Month 5 or 6 since Medicare does not require a 6 month supervised diet and if I continue to do well with losing weight each month until then. I am now hoping to have RNY sometime in Sept. or Oct instead of over the winter months.

The class gave us more ideas of portion size and varieties we should be eating, cut out caffeine and sugars and eat more veggies and fruits and cut down on fruit juices. It is ok to use aspertame and splenda. Practice eating slowly, chewing small bites of food at least 30-40 times or more, taking time between each bite and chewing foods to a puree stage before swallowing and eat smaller bites. Start to Drink fluids between meals and not with meals to get used to that change after surgery. All Non caffeine and sugar free liquids count toward the water/fluid goal of at least 64 oz. per day. These include milk, broth, crystal lite, decaf tea and decaf coffee, jello. etc. We discussed protein sources and Animal Proteins such as meat and dairy are the best as far as good absorbable protein. Veggy protein such as beans, peanut butter, etc. we only absorb half of the protein from veggies and nuts, etc. according to my Nut, so Fish, Poultry and other Meats, Eggs, Milk, Cheese, Yogurt, Cottage Cheese , Whey are all very good protein sources, but eat the lower fat, fat free varieties and lean meats. Animal Proteins we absorb all  or 100 % of the protein they contain verses Plant Proteins where we only absorb 50 % of the protein they contain. This info. is from my Nut at our recent Nutrition class. Keep fats to max. of 5 gm and max. of 10-15 gm of sugar per serving, this will help prevent dumping syndrom after surgery. It is not nec. to count carbs or sodium in my case now or after surgery, that is individual according to other health problems.

No skipping meals, eat 3 meals per day with 1 or 2 planned healthy snacks per day. It should take 30 minutes to eat a couple oz. of lean protein after surgery. Drink in very small sips throughout the day but not withint 30 minutes before or after meals. We need a min. of 60 gm of protein per day and we cannot get too much protein in after surgery. Protein first, then low starch veggies and then starches if there is still room. The new stomach will be about the size of an egg. Do Not eat too much or eat too fast. Chew to applesauce conistency after surgery before swallowing and practive this now before surgery. After surgery a meal should consist of 2-3 oz. of protein and then a couple tablespoons of veggie and/or starch. Use smaller plates and baby utensils to help keep your portions and bites smaller. Measure your foods and read food labels well to make healthier better choices.

My next appointment is for June 2nd at GMC in the afternoon. I go to a Behavior class at 10am and then see Dr. Still at 11:30am and then I am staying at the hospital for a healthy lunch and will go to a Support Group meeting from 3-4pm that day. I have attended 1 support group meeting at Evan. Hospital which is closer to my home and will go to more there in Aug. and Sept. I only have to attend 1 at GMC and 1 at Evan. but I will try to go to more at Evan. this fall, they do not have meetings there in June or July. I try to take a short walk each day for 10-15 minutes when the weather permits and do some chair excercises, etc. indoors for another 10-15 minutes per day. I will update again after my next appointment and class.