Worries after recent surgery...is it really OK to eat so little? Calories, protein, brain...

Pokemom
on 1/2/15 11:09 pm
RNY on 12/29/14

Hi! I am 5 days after RNY surgery.  Today is my second day on the full liquid diet.  I am following my doctor's plan. As I track my eating, I realize just how few calories I am eating.  And how little protein.  I wonder...can a person really survive on this? Am I doing something wrong?  

I realize I am still in the most early healing stages, and I am not at all surprised or troubled by eating very small portions.  I expected and accepted that.  It is just that when I see the numbers in my tracker, I am worried.

Yesterday, I ate three meals, each 2 oz.  So, 2 oz cottage cheese, 2 oz cottage cheese, 2 oz puréed soup.  With my liquid vitamins added in, my total calorie intake was 178, and my protein intake was just 15 grams.  I can up my protein today by doing 3 servings of cottage cheese, but that will be only 21 G protein for the day.  

My doctor's office emphasizes eating protein first.  But they also emphasize, no protein drinks.

As my diet advances in the weeks to come, my portions are still supposed to be 2 oz, 3 times/day.  How will I get enough protein?  How will those few calories sustain me as I start intense exercising again?  

i do feel light headed and hungry sometimes...the kind of hunger that feels like low blood sugar.  Today I am trying to increase my water intake.  I am up to about 48 oz/day so far.

Grim_Traveller
on 1/3/15 12:02 am
RNY on 08/21/12

Your body needs things it can't make itself. It can't make water, so that's priority one. Get at least 64 ounces per day. Now. No excuses.

You body needs energy, but you have stored plenty of that in fat. That's a good thing.

It needs micronutrients, like vitamins and minerals. That's why we take vitamins, calcium, etc. You should be taking those. It can get calcium from what you have stored -- your bones -- if you don't take any. You don't want that to happen.

Your body needs fats, so you should have some of that in your diet. And it needs protein. If it doesn't get protein (amino acids) in food, it can get them from what it already has, like muscle. If you don't get enough protein, your body will eat it's own muscle. Not a good thing, especially since your heart is a muscle. You should probably need to get 60 or 70 grams of protein per day to get enough.

Carbohydrates are not necessary at all. The minimum requirement is very low, but your body can manufacture what your brain needs, so you can live with eating zero carbs. But it is really hard to have a zero carb diet. Those little buggers sneak into a lot of things.

You can't get enough with 3 2-ounce meals. You need to ask your dietician for sample meals to show how this can be done. I would drink a protein shake, or have 5 or 6 2-ounce meals, but that's just me.

Food is energy, and calories are a measure of energy. Your body has a gazillion calories stored, so you can eat very low calories for a long time. It must get the minimum essentials I mentioned above, or you will eventually have serious troubles. It takes a while for deficiencies to show up, but they will sooner or later.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

Pokemom
on 1/3/15 12:33 am
RNY on 12/29/14

Thanks, Grim, for such a thorough and informative response.  It does echo and increase my concerns, especially about protein intake.  I had assumed that by making careful choices within the surgical practice's guidelines, I would be able to get adequate nutrition.

Maybe I have misunderstood their guidelines.  There is a dietician who works closely with the surgeon's practice, and I can make an appointment with her even before my first follow-up with my surgeon. That was very helpful advice from you, that I should do that.  Thank you.

poet_kelly
on 1/3/15 12:19 am - OH

Why don't they want you to use protein drinks when you're not able to eat enough protein?

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

Pokemom
on 1/3/15 2:00 am
RNY on 12/29/14

As I understand it, they want us to focus on "real food."  They have emphasized this in every class.  They have not given us a certain number of grams of protein to eat each day--just the expectation that we should eat protein first, and aim for a balance of 70% protein/30% vegetable. 

So I don't know:  maybe in their practice's point of view, the number of grams of protein are not as important as the balance and the habit.  Maybe they assume I will get up there before long (like the approach Kim mentions below).  I have just been concerned because with three 2-oz meals, I don't see how I will get up much beyond 20-30 gm/day. And as best as I understand it, I am to keep at 2-oz meals for 6 months.  It is by tracking things in My Fitness Pal that I realized how little I am getting currently. But I need to clarify this with the nutrition/dietician group that works with my surgeon.

poet_kelly
on 1/3/15 4:54 am - OH

Your doc's program seems... odd to me.  I've never heard any other doc say patients should only eat two oz meals for six months.  By six months, my surgeon's program said I could eat four to eight ounces.  I was also supposed to eat four to six times a day.  I don't see how you could possibly get enough protein eating only six ounces in a whole day.  Most meats only have seven grams protein per ounce so you'd only be getting 42 oz protein if you ate nothing but meat - but if their program says to eat 70% protein and 30% veggies, you wouldn't even get that much.

I would consult with a registered dietician that is experienced with WLS patients.  But in the end, I would also make the choice that I believed was best for me.  I do not believe I would be healthy eating only six ounces of food a day for six months and getting less than 40 grams of protein a day for six months.   So that is not a plan I would personally follow.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

Citizen Kim
on 1/3/15 12:39 am, edited 1/3/15 12:41 am - Castle Rock, CO

Many of us manage this journey without protein shakes - it's entirely possible without ill health or a heart attack (never come across anyone who did damage to their heart from not getting enough protein early on) - I did it!   People tend not to post about it because they get incredulous replies from people who don't understand why a surgeon would have such guidelines and not everyone wants to get into such discussions

There is a 30/60/90 plan - 30gms of protein at 30 days, 60gms at 60 days and 90gms at 90 days.   Those of us on these plans tend to have fewer problems eating protein first further down the line - so many people on here are still drinking protein shakes YEARS down the line.  

Water/fluid is your priority at this time - people go to the ER with dehydration but not protein deficiency!!!

 

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

Pokemom
on 1/3/15 1:42 am
RNY on 12/29/14

Thank you, Kim, for that helpful perspective.  The 30/60/90 idea makes me feel a little better!  Here I am 5 days out, at 15-20 grams, so I am ahead of the game!  :-)

Chilipepper
on 1/3/15 1:00 am

I keep RTD shakes in the fridge in case I'm on the run and take it with me but I am not a shake drinker. I may have one a month. I eat my protein and I always have. I know Nectar makes a good protien and I recommend it when someone is looking for one but I need food.  It really isn't hard to eat your requirements rather thank drink them. 

 

"The first thing I do in the morning is brush my teeth and sharpen my tongue." --- Dorothy Parker  

"You may not like what I say or how I say it, but it may be just exactly what you need to hear." ---Kathryn White

 

 

janols
on 1/3/15 2:18 am

Hello! You are also only 5 days out. You will be able to eat more than 2 oz later on.

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