Just got my Swedish post-op diet and would love some input and opinions from vets!

So, a friend who had RNY in the same program I will just a few weeks ago sent me her post-op diet. Since there is a central healthcare system, I can only assume the diet will be the same.  They require a three week liquid diet pre-op, though my friend had to do four.  Bah!  I thought it might be interesting to some of you to see the diet in another country and also for me to get some feedback from seasoned vets.  Of course, I will follow what my doctor says, but it seems they are bigger on telling you exactly what to eat, rather than telling you which types of foods to incorporate when.  There’s also nothing past what says week 5 onwards.  I don’t know when you would move on to making healthy choices for yourself.

First, let me say that a dl/deciliter is 1/10 of a liter.  It’s also .42 cups.  Filmjölk is somewhere in between buttermilk and unsweetened yogurt. 

 

Days 1-7: 
Breakfast; 1 dl milk/light filmjölk/light yoghurt/gruel and 1 dl juice/proviva
"Snack"; 2 dl juice/fruit soup like nypon or blueberry soup
Lunch; 1 dl milk (½hr before "eating") - then 1-1½ dl soup
"Snack"; a glass of Modifast/nutrilett/Naturdiet  (This is meal replacement shake)
Dinner; 1 dl milk (½hr before "eating") and then 1-1½ dl soup
Later in the evening; 2dl milk/ light filmjölk/light yoghurt
2 liters of liquid a day (Water, coffee, tea)

Weeks 2-4:
Breakfast; 1 dl milk/light filmjölk/light yoghurt/gruel and ½-1 slice of crisp bread with liver pate/spread cheese or something "soft"  OR 1 dl of oatmeal and ½ dl milk
"Snack"; 1 dl milk/ light filmjölk/light yoghurt and ½ dl fruit or veggie puree
Lunch; 1 dl milk (½hr before "eating") - then ½-1 dl of both meat/fish/egg AND rice/pasta/potato AND vegetables - all mashed/minced and a bit of low fat sauce/dip
"Snack"; 1 dl milk/ light filmjölk/light yoghurt and ½ dl fruit or veggie puree
Dinner; 1 dl milk (½hr before "eating") - then ½-1 dl of both meat/fish/egg AND rice/pasta/potato AND vegetables - all mashed/minced and a bit of low fat sauce/dip
Later in the evening; ½-1 pt. of modifast/nutrilett/Naturdiet (meal replacement shake)
2 liters of liquid a day (Water, coffee, tea)

Week 5 onwards:
Breakfast; 1 dl milk/light filmjölk/light yoghurt/gruel and ½-1 slice of crisp bread with liver pate/spread cheese or something "soft"  OR 1 dl of oatmeal and ½ dl milk OR 1dl milk/ light filmjölk/light yoghurt with a few spoonfulls of cereal
"Snack"; ½-1 dl milk/ light filmjölk/light yoghurt AND ½-1 fruit OR ½-1 slice of crisp bread with turkey/ham/whatever low fat thing you want
Lunch; 1 dl milk (½hr before "eating") - then ½-1 dl of both meat/fish/egg AND vegetables AND 1 little potato OR ½ dl rice/pasta AND a bit of low fat sauce/dip
"Snack"; ½-1 dl milk/ light filmjölk/light yoghurt AND ½-1 fruit OR ½-1 slice of crisp bread with turkey/ham/whatever low fat thing you want
Dinner; 1 dl milk (½hr before "eating") - then ½-1 dl of both meat/fish/egg AND vegetables AND 1 little potato OR ½ dl rice/pasta AND a bit of low fat sauce/dip
Later in the evening; 2 of the following: 1 dl milk/ light filmjölk/light yoghurt, ½ slice of "soft" bread soft cheese or 1 slice of crisp bread with soft cheese / ½-1 fruit

2 liters of liquid a day (Water, coffee, tea)

 

They plan says to start out with small amounts and work your way up when you feel comfortable, starting with proteins.  I don’t want to go in all *****y and questioning my nutritionist, but I need to do what’s absolutely best for me and I am not sure some of these things are appropriate.

 

Here are my concerns:

Is it just me, or doesn’t it seem like I would need more protein the first week?  There is no mention of protein shakes at all on their plan.  I don’t think it sounds like I would ever get my protein in.

 

By week 2, I am supposed to be having potato, rice or pasta with two meals a day.  Why push carbs?

I don't eat meat, so twice a day, every day, I am going to be having an egg with a carb and veggies all mashed up (I am hoping there may be an alternative vegetarian option here)

 

Crisp bread on day 8?  That’s like a big crunchy cracker.  It seems like I should at LEAST still be in a soft food stage at this point.

 

So, what about the coffee thing?  Yes, coffee is a way of life in Sweden.  People drink it like crazy.  They like it strong and black and often and you can hardly find ANY decaf and it’s always instant.  It seems weird that it’s a no no to most everyone else, but not us.

Any input would be GREATLY appreciated. 

Here's my thoughts.

First, seems like they suggest a lot of juice the first week.  I did small amounts of juice in the hospital, when on clear liquids, diluted half and half with water.  I would not be drinking a cup of juice at a time unless you want to risk dumping.  Even if you don't dump, a protein drink would be a much better choice.

I would also stick to soft foods at least the first few weeks, so I would not eat crisp bread.

In week two - four, if I understand, they say dinner should be approximately 1/4 - 1/2 cup meat PLUS 1/4 - 1/2 cup veggies PLUS 1/4 - 1/2 cup pasta or rice.  Is that right?  For a total of 3/4 - 1 1/2 cups food?  Um, I don't know how you could eat all that two weeks out.  And no, I would not suggest eating two servings of starch each day (well, three servings if you eat the crisp bread for breakfast).

I was on 1/4 cup meals for the first three months or so....worked fine for me. I cant' comprehend of eating that much postop that soon.

 

Thanks for the response! I really think I am going to have to modify and go by the recommendations I have seen on here. This just doesn't seem to make a lot of sense. I mean, I love cottage cheese and Greek yogurt and there's just no room for those things on here. There are more carb suggestions than I get in my diet NOW. Much of it is because of the Swedish way of eating. They serve crisp bread and soft cheese at most meals.

Well, the American way of life is to eat lots of carbs too, especially lots of sweets.  If they were going to design a diet based on the American way of life it would include cold cereal for breakfast (and people would want a sugary one), half a sandwich and some fruit for lunch, pasta with meat sauce and a salad for dinner, and a 1/2 cup no sugar added ice cream for dinner.

Certainly consider their advice and then do what you feel is best for you.

some doctors don't believe in or consider protein shakes....are they readily available in your country? perhaps that is why they aren't on the list... personally I'd push the protein myself and skip on a bit of the carbs

I think they push carbs because they know their clients WANT carbs...they don't want you to feel deprived..... I'd go bonkers trying to follow such a specific schedule.

Toasted bread actually goes down EASIER than soft bread, believe it or not. Soft stuff just gumms up into a ball and blocks everything. But I'd still avoid it. I still can't eat an entire piece of bread.

I agree the coffee thing is a social thing rather than the best possible decision, particularly for a newly healing pouch. since I'm a non-drinker of coffee I wouldn't start then! 

If I had the resources you have, and was doing this over, and was given that plan, I'd adapt it to what I know works well for those who have been successful..... I don't think adapting "down" or being more conservative is wrong unlsss taken to extremes.... for example if the doc wants you on 600 calories and you "adapted" it to 60 calories, that would be wrong.... but if he wants you on a simple carb and you select a complex carb, or if he wants you on coffee and you select a protein shake, I don't think that is wrong.

There is a balance in all things... take what works, leave the rest.

Thank you! We do have protein shakes, but I think they are usually marketed to body builders. I ordered all the samples in the US and my mom is shipping them, then I will order in bulk. I tried several here, but mostly found duds. I have a chocolate one now that's doable, but may be too sweet post-op.

Crisp bread isn't toasted bread, really. It's like the Wasa crackers in American grocery stores. It's thick and very crunchy. http://www.amazon.com/Swedish-Crispbread-Wasa-ounce-igourmet-com/dp/B00471U9RM It seems a little too hard on the new tummy!

I will absolutely discuss these things with the nutritionist and if she doesn't agree, I guess I will make my own calls. My better half is a nurse and a health nut. She'll keep me in line. lol

Thank you again.

For the INTELLIGENT people whoe are able, I think that modifying the surgeon's plan is not a huge problem.

The big problem is when yhou see posts from some postops who are 'shopping around" for postop plans that allow them to indulge in behaviors prohibited by their surgeons..... to adapt a meal plan for your own personal needs is entirely different.

My wife's first comment was, "Yeah, we can replace those 'meal replacers' with protein shakes!" I think I have read enough and have enough contacts here that can help me make smart choices for me. I keep looking for the plan that allows Häagen-Dazs, though.

Tell you what - I'll look for the Haagen Dazs for you, if you look for one that allows Coldstone Creamery for me!