Nutritionist appointment, 5 months in

This picture is from my girls' night out last weekend, not the nutritionist...these were Derby Punches, in honor of the Kentucky Derby--bourbon and lemonade from someone's grandma's recipe. The cool glasses had all the Derby stuff on them and you could buy them for a buck and keep 'em, so I bought mine. I have always wanted to go to the Kentucky Derby just so I could wear the big picture hat, but in reality, I think I just want the hat.

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I saw my nutritionist Monday. She was very encouraging and told me what a great job I was doing, which felt really good...I just feel like I'm treading water so much of the time. I had lost a couple of pounds, which surprised me because I haven't been exercising (my ankle is still popping and sore--my regular doc is sending me a written referral to have it looked at; one of my tasks for today is to find an orthopedist my insurance covers and to make the appointment). I've stayed within five pounds of what I was when I first went in to see her, but I still weigh less than I did at the beginning.

She praised me for using my time well by joining this group and really trying to get to the bottom of everything within me so I can succeed in the long run, and also complimented me on my food journal--its detail and follow-through. All of this just felt really good; too often, I am caught up in feeling guilty for being unemployed/not productive enough, not to mention overwhelmed by all the emotional stuff I'm working through. She kept saying things like how I was "on it" and "ahead of the game". This was my five-month appointment with her, meaning the six-month one is next month (June 12!) and the pre-op stuff can really begin then, if not before. (Another task for today is to contact the surgical center and see if I need to anything to start the ball rolling, as I know there are some pre-op procedures that need to happen--an abdominal ultrasound, bloodwork, etc.)

We talked about what I would be eating as surgery gets closer. I do not have to do a liquid diet prior to surgery as I had previously thought, but I do have to go to a very low-carb diet two to three weeks prior in order to shrink the liver. Low-carb in this case means a total of 40 total grams of carbohydrates per day. Fiber content can be subtracted against the carbohydrate amount. She gave me a couple of sample menus. The daily fiber goal is 25g, and the daily protein goal is 50g prior to surgery, but 60-80g after.

Thirty days prior to surgery, I will need bloodwork done. I also need to make sure my medications can either be crushed or will be available in a liquid form, and that I have vitamin supplements on tap for after--she recommends Bariatric Advantage.

I thought about getting a book on making baby food for afterward, but she referred me to a pureed diet on the Web through University of Pittsburgh Medical Center under "info for patients". She also said netwellness.org was a good resource for pureed foods information, and lent me Susan Maria Leach's book, "Before and After: Living and Eating Well After Weight Loss Surgery". Apparently this book is like the Bible of weight loss surgery, and the author also has a very comprehensive-looking website--I believe it is bariatriceating.com.

We talked a bit about sugar. I have been fairly successful in giving it up and just using artificial sweeteners. While a lot of programs suggest giving those up as well, I don't think it's realistic for me for any number of reasons. My diet is restrictive enough (and going to be even more so)--I don't want to set myself up to fail. I am not keeping it in the house, which seems to be a key point. Times like this weekend, I am always aware that this could be my last piece of pie or my last whole martini, and I have been enjoying those things in moderation and feeling fairly serene about it.

(Apparently the magic amount of sugar that usually causes dumping syndrome is just over 5g, though she cautioned me that this is not an absolute--some people take one bite of cake and that's it.)

I am going to have to discover all the natural stores in the area, which is previously uncharted territory (except for Trader Joe's). I need to start stocking up on healthy protein drinks, for one. Muscle Milk is one she likes, and Pure Protein drinks is another.

I have been using nutritiondata.com for a lot of my nutritional information for the food journal, but my nutritionist also recommends calorieking.com.