meds, slider foods and drinking after meals? long

Carrie W.
on 5/3/11 1:44 pm - KY
I've got some questions:

1.  As I've said several times, my surgeon says to always crush pills and I do.  In order to get the foul tasting stuff down, I put it in a bit of sf pudding.  The pudding has more carbs than what my plan allows so I try to eat the barest minimum in order to mask the taste of the pills.  Should I worry about the pudding pushing the meds through my pouch and intestines too fast?  I do NOT drink after I've taken my meds (I take them all at bedtime).  

2.  I've been following the no drinking 30 before and after rule.  I do usually start drinking at 30 minutes after especially if I've had something sort of salty.  Should I wait longer?  At this point I've pretty much given up my veggies in favor of getting in more protein.   Do things like baked chicken or turkey deli meat stick around in the pouch longer than 30 minutes?  I don't have any trouble getting my fluids in, I usually get around 100oz per day.

3.  Do you wait 30 minutes to drink after a meal of slider foods?  The past week I've been experimenting with some recipes which has led me to getting more calories than what my plan allows (40-50 cals over).  Between that and actually having to get up and out of the house at a certain time, I've quit fixing breakfast.  I put a scoop of unflavored protein powder in my carbmasters yogurt.  It's 100 calories and 18g of protein.  But it's a slider.  Should I wait to drink then? 

4.  Do you count the calcium from food towards your daily 1500mg goal? 

5.  Do you take your mulivitamin with a meal?  I take my iron seperate but I've been taking my b12, multi and vitamin d in the morning with my yogurt.  Then my first drink of the day is my crystal light oj with calcium crystals. 

6.  Do you think shrimp is a slider food?  I've been playing with different proteins and the past couple days I've eaten shrimp for supper.  I just heat it in a skillet with some garlic salt and eat it.  I've been able to eat 4oz of shrimp at a time without the weird backing up in my throat feeling that I've gotten with more dense things like chicken or salmon.  If shrimp is a slider food, should I quit eating it?  I'm sure I'll get tired of it before long but for now, it's totally yummy! 

I have taken a pain pill for the cramps so if this seems a bit disjointed I'm blaming the narcotics. 

Thanks in advance!!


  HW 347/SW 328/CW 176/GW 160                   
 
  
sherri7794
on 5/3/11 2:24 pm
Are you supposed to crush your pills forever?  I am not sure what advice to offer there because my surgeon had me swallowing pills while still in the hospital.  Some pills that are larger I do cut in half. 
On the drinking I think it's a good idea to go by your surgeon's plan (they vary).  My surgeon's rule is 30 minutes before and after. 
I, personally, don't count calcium from my food.  I take my multi without a meal.  I have to take it with a drink....so of course, no meal. 
I am just short of 3 months out and still don't feel a fullness or hunger sensation so I can't speak to you about slider foods because no food makes me feel full but I also never feel hungry, but I am not complaining about that little benefit.
    
Tracy M.
on 5/3/11 2:34 pm - KY
My nut told me not to crush the vitamins. I was breaking mine in half in the beginning and she siad it could hinder the absorption. I dont see how it could but I don't do it anymore. My plan says no drinking for an hour after meals and do not eat for at least 20 minutes after drinking. I do drink water with my shakes. I figure it is all liquid so it slides right through anyway but I do try to wait a little bit in between. I am getting so sick of shakes and I need to start getting my protein from food too. I hope I can figure something out soon. I am at least going to drop down to 1 shake a day. I'm not sure about slider foods either. I don't eat too much of them. Maybe you could use nsa applesauce to put your meds in. That's what I used in the beginning.

Tracy

Highest known weight- 512
Surgery weight-425
Current Weight- 260
   
       
Ladytazz
on 5/3/11 2:32 pm
I'll give my opinion on the things I can.

1. I wouldn't worry about the pudding pushing the meds through too fast.

2. I usually wait about an hour just to be careful but that isn't required.  I too have wondered about whether or not I would get too hungry after drinking because it pushes the food through the pouch but at least in my case that hasn't happened.  I haven't been hungry since my surgery thank God.  Even after I drink I still feel full.  I don't know if it's the fluid that makes me feel full or what but it hasn't been a problem.  I just wait extra time to be ultra careful.

3. Generally unless all I am having is a shake I do wait the extra time after eating anything, even something soft like pudding or yogurt.  I have heard some people say you should wait after a protein shake, too, in order to absorb it better but I don't know if that is the case.

4. I only count calcium citrate towards my calcium for the day.  I have heard that calcium from food isn't as well absorbed as the calcium citrate.

5. From what I understand, it doesn't matter when you take a multivitamin since it doesn't need food to absorb or keep from upsetting the stomach.  I take my morning vits with my breakfast shakes and my other batches after I start drinking again after meals only because I don't drink with my meals so I can't take my pills then.

6. I don't think shrimp is a slider food.  It fills me up pretty good.  It may not be as dense as other meats but I wouldn't call it a slider.  It was one of the foods I could tolerate early on, too.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

unewillow
on 5/3/11 2:46 pm - CT
1. I was only supposed to crush my pills for the first 3 months, I stopped after 3 weeks because I couldn't get them down that way no matter what I mixed them in. But, I know all surgeons are different. I wouldn't worry about the pudding being a slider, after all most pills don't get absorbed in the stomach anyway.

2. I personally drink right up until I start to eat and then wait 30 to 60 minutes after to drink again depending on how full I feel.

3. I wait to drink after pretty much everything, especially sliders. They already move through much quicker than other foods so why would I push them through even faster by drinking right away?

4. No.

5. I do, but only because I get horrible tasting and smelling burps from the multi if I take it on an empty stomach.

6. Shrimp isn't a slider food. Would it go through a funnel quickly? No..then not a slider. If you like it, enjoy it. I can eat more of some things than of others, it's totally normal. Some things just sit better.
            
Carrie W.
on 5/4/11 2:24 am - KY
Thank you for the funnel visual!  The shrimp just concerned me because it "felt" different than the other proteins. 
  HW 347/SW 328/CW 176/GW 160                   
 
  
Lady Lithia
on 5/3/11 2:48 pm
1.  As I've said several times, my surgeon says to always crush pills and I do.  In order to get the foul tasting stuff down, I put it in a bit of sf pudding.  The pudding has more carbs than what my plan allows so I try to eat the barest minimum in order to mask the taste of the pills.  Should I worry about the pudding pushing the meds through my pouch and intestines too fast?  I do NOT drink after I've taken my meds (I take them all at bedtime).  

Always crush pills? Forever? I wouldn't worry about the pudding pushing things through.


2.  I've been following the no drinking 30 before and after rule.  I do usually start drinking at 30 minutes after especially if I've had something sort of salty.  Should I wait longer?  At this point I've pretty much given up my veggies in favor of getting in more protein.   Do things like baked chicken or turkey deli meat stick around in the pouch longer than 30 minutes?  I don't have any trouble getting my fluids in, I usually get around 100oz per day.

I drink all the way up to my meal since I didn't have any issues with liquids, they didn't make me full or anything. But I always wait 30 minutes after. I don't always glance at the clock because by now I am "aware" of my pouch and it's full/empty situations. If it's a slider food I try to note the time so I won't drink too soon but any solid proteins usually feel like they are in my pouch much longer. If I'm behind on liquids I might drink before my pouch is empty, but otherwise I wait until I no longer feel full. My favorite meal of the summer is a turkey salad, and I feel fulll for three hours following. I've heard it said that waiting longer the further out you are is a good idea. 
 
I

3.  Do you wait 30 minutes to drink after a meal of slider foods?  The past week I've been experimenting with some recipes which has led me to getting more calories than what my plan allows (40-50 cals over).  Between that and actually having to get up and out of the house at a certain time, I've quit fixing breakfast.  I put a scoop of unflavored protein powder in my carbmasters yogurt.  It's 100 calories and 18g of protein.  But it's a slider.  Should I wait to drink then? 

Mostly I wait after sliders..... unless I'm short on liquids.

4.  Do you count the calcium from food towards your daily 1500mg goal? 

I do NOT count the calcium in food, because usually we don't have the stuff in our guts necessary to use it.

5.  Do you take your mulivitamin with a meal?  I take my iron seperate but I've been taking my b12, multi and vitamin d in the morning with my yogurt.  Then my first drink of the day is my crystal light oj with calcium crystals. 

I always try to have some food or at least a protein shake with my pills. I think that it helps my body metabolize it.

6.  Do you think shrimp is a slider food?  I've been playing with different proteins and the past couple days I've eaten shrimp for supper.  I just heat it in a skillet with some garlic salt and eat it.  I've been able to eat 4oz of shrimp at a time without the weird backing up in my throat feeling that I've gotten with more dense things like chicken or salmon.  If shrimp is a slider food, should I quit eating it?  I'm sure I'll get tired of it before long but for now, it's totally yummy! 

Shrimp is a FOOD OF THE GODS..... LOTS of protein, and it makes my tummy excessively happy. Shrimp is divine. That and raw fish and exquisite steak..... oh my goodness gracious me!

I have taken a pain pill for the cramps so if this seems a bit disjointed I'm blaming the narcotics. 

Thanks in advance!!

~Lady Lithia~ 200 lbs lost! 
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!
giraffesmiley.gif picture by hardyharhar_bucket

Carrie W.
on 5/4/11 2:26 am - KY

Thanks, LL. 

  HW 347/SW 328/CW 176/GW 160                   
 
  
wendy_fou
on 5/3/11 8:04 pm - AR
1. I was taking whole pills in the hospital, so not sure why your surgeon would have you still crushing your pills.  It seems unnecessary - especially considering that you are going off-plan with the pudding to get them down that way.  I'd take them hole or maybe broken in half with fluid.  (The pudding pushing your meds through too fast would not worry me.  The going off plan with the diet part is what would worry me.)

2.  If you are easily getting in around 100 oz of fluid per day, I would suggest you wait longer after eating to start drinking.  In the beginning, I did 30 minutes before and 1.5 hours afterwards.  Then I bumped it down to 1 hour afterwards with my surgeon's approval because I wasn't getting in enough fluid.  The break after meals is to keep food in your pouch longer.  In short: IT KEEPS YOU FULL LONGER.  So the longer you CAN wait after a meal to start drinking (and still get in enough fluid each day), the better.  That is a LONGTERM habbit you can form NOW that will help you as you get farmer out.  Since you no longer have a pyloric valve after RNY, most food simply sits in your pouch until you wa**** out.  Some "slider foods" will slowly leak out of your pouch after you eat it - which is why some people don't stay full as long after eating "slider foods" as opposed to regular foods.  To determine which foods are "slider foods" simply look at the drain in your kitchen sink.  Think about chewing up something and spitting it directly into the drain.  Things you mentioned like baked chicken and turkey deli meat would sit there until you turned on the faucet to wash them down.  If you chewed up pudding or cottage cheese or refried beans, some of that would go down the drain without help from turning on the faucet.  So yes, the baked chicken & turkey deli meat are still in your pouch after 30 minutes or even an hour if you don't wash them out with fluid. 

3.  Again, I would wait as long as possible after eating - especially slider foods that will leak out of your pouch before you start drinking again.  I would also LIMIT slider foods as much as possible (though that is next to impossible for many in the beginning - me included - if you move through your stages properly and stay with soft foods, etc).  Dense foods stay in your pouch longer.  I would not eat protein yogurt for breakfast just because it's easy.  Eating what was "easiest" or required the least effort on our parts is what got many of us to the point of NEEDING weight loss surgery.  It only takes literally 5 minutes to make a healthy meal - including breakfast.  Why are you "experimenting with some recipes" that have led you to get in "more calories than" what your plan allows?  This is the scond time in your post you have mentioned going off-plan because it is easier.  (Eating pudding off plan right before you sleep to get your meds down because they taste bad, so it's easier.  Now experimenting with recipes that are putting you off plan.  That would concern me if I were you.) 

4.  No.  Also, the nutrition guidelines approved by the ASMBS recommends 1500 - 2000 mg/d in ADDITIONAL SUPPLEMENTATION.  That specifically means IN ADDITION TO FOOD.  Be sure to take those calcium away from your multivitamin if it contains iron & away from any iron-rich meals since iron hinders calcium absorption.  Also remember to only do calcium citrate as opposed to carbonate. 

5.  No.  I eat 4 times a day, so I obviously start drinking 4 times a day (once after eat meal).  That is a convenient time for me to remember my vitamins, so I take them then as soon as I start drinking.  This helps me remember them, but it also helps me space my calcium doses evenly throughout the day to ensure it all gets absorbed.  But many people do this differently depending on what works for them.  As long as you are spacing out your calcium doses and taking the ones seperately that are supposed to be taken seperately (no iron at the same time as calcium, etc), do whatever works for you.

6.  No I don't think shrimp is a slider food. 

Good luck.

Wen

Carrie W.
on 5/4/11 2:18 am - KY
Thank you for your reply.

1.  I'm just following my surgeon's instructions.  In the handbook that outlines what we can and can't do, it is very plain that I will NEVER be able to take pills whole or even halved.  All pills have to be crushed. 

Pudding on it's own is not on my plan because it's empty calories and the carbs are too high for empty calories.  I use a tbsp to take my meds.  I'm going back to see the surgeon and dietician tomorrow so I'll ask if I'm messing that up.  I wouldn't be doing it if I thought I was really not following my plan by doing it. 

2.  That's what I was wondering.  Okay so the longer I wait, the better.  I can do that.  I don't feel full really or hunger yet but like you said, I want to make this type of thing a habit before the hunger comes back. 

3.  I was experimenting with recipes because I was getting really tired of tuna, salmon and baked chicken.  I contacted my dietician and she directed me to recipes that she and the other dieticians at the clinic recommend.  My plan allows 400-600 calories per day.  I've been over by less than 50 calories 3 days in the last week.  Yesterday was a low cal day at 430 cals.  I also gave myself the foamies from eating too much breakfast which is part of the reason for backing off to something easy for breakfast.  The pouch is a bit grumpy in the morning and yogurt goes down easy. 

Is that something that will go away?  Will it be more comfortable to eat more dense food in the morning?  I can eat eggs but not enough to get the protein I need without some meat.  My pouch did NOT like the turkey sausage I tried. 

Thank you for your advice.  You've given me alot to think about and discuss with the dietician tomorrow. 
  HW 347/SW 328/CW 176/GW 160                   
 
  
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