Food questions

[Mystrys]

I know there have been questions about this before. I've read the answers to those, but I really just need to ask. Dumb as it may be:

At 5 weeks out, Boyce's office wants me to eat 3x day and stay in the 700-900 calorie daily range with no more than 30 g fat. I'm a long time no/low carber and Keto girl so the carbs are not an issue for me ...well, except that they want ne to eat more.
I am actually able to eat about either 1/3 C of "whatever" or 3 oz meat pretty easily at a time. In fact, I've been having ground pork, ground chicken, grilled chicken, ham salad(w/mayo)chicken salad(w/mayo),shrimp,and the hubby smoked Boston butts this weekend and I've now had 2 meals of that with beans. I only eat till I'm full and then I'm just done. But in a couple hours I'm looking for protein again. I'm not having any real issue getting my protein in at all. I can do dairy well, so cheese, cottage cheese, Greek yogurt, ricotta, and eggs as well ,etc. I usually do a premier shake in the a.m. because it's easy. And a Lift protein drink during the day at work. That's 50 g of protein before I even eat anything.
So...to my real question. How much SHOULD I be eating at this point?? Should I stick to the damn shakes for a bit longer instead of food?
And I wonder if the fat at this juncture is an issue? I'm losing, but I'm really not doing what they told me to. Am I going to cause myself problems this way? Will I stall out early or stop losing if I don't eat the way they say??
I know this sounds completely stupid, but I'm just confused and don't want to sabotage myself right out of the gate.

 

[DSRIGGS]

Eat as much as you can and don't listen to diet advice from those nutritionist fools. They are clueless. Protein, protein, protein is what you need.

 

[Mystrys]

Thanks @DSRIGGS. Btw...I hope your recovery is moving along smoothly!!

I think I have been given a partial answer to my own question. As far as the fat goes, I actually think I will need to up... it like NOW! I'm still not sure about the actual amount of food I should be consuming. As in, what is normal for us at 5+weeks out. They still want me on pureed stuff, but again, not doing a lot of that. Yes, thinner or sauces added,etc. But not really pureed now. I'm wondering if this issue isn't because I'm not doing much pureed or if I'm getting in too much good for my new insides to process. I don't KNOW HOW that could be possible, but I'm beginning to realize I'm more than just a Zebra in a horse world.
I was up at 3:11 am and haven't been back to sleep. I KNEW I was having a poop issue last night before bed. It was in the chamber but I couldn't fire! I tried, somewhat gingerly,using my squatty potty until I realized...it just wasn't coming out. I've been having one BM first thing every morning,but since my oil explosion I just figures I was finding a balance. No Miralax for 4 days and still going in the a.m. so I thought I was ok. UGH!!
So dosed myself with Miralax before bed and by 3:11 it wants out. Only problem was the size and solidness wouldn't allow that. I was in labor!! Basically sweating, shaking, seeing spots, and it hurt worse than anything I've ever experienced. After fighting that for 20 minutes it was a blast and within 30 seconds the pain had me vomiting in the tub in front of me. I screamed and cried and my poor hubby didn't know what to do but hold my hand and a cool compress to my forhead. I went back to bed but my insides felt like a grenade had gone off in there. A bit of blood in the bowl (I expected THAT) but now it's a throbbing ache and I feel so sore all inside.

So,I just read the marquis mark thread about his issue and knew I needed to up my fat. I've been so worried about the oil leaks again that I have mis-judged my needs. I made it to the store to get some Colace and will split those 3 doses through the day and keep with the miralax in the evening. I'm exhausted and sore and I really dont want to do any damage down there.....but MOTHER OF ALL THAT IS HOLY....I have NEVER had an experience like that...and don't want to again. It makes me want to drink a nice warm cup of ghee right now.(not really, but ,ya know!)

 

[southernlady]

Boyce's office is NOTORIOUS for RNY advice for a DS'er.

I eat ALL the time. Seldom go longer than 2 hours without. And I do not count calories. Altho calories do count...you can stall and stop losing weight on THEIR diet. 700-900 calories is concentration camp level for a DS'er. Watch your macros instead. By the time you get to month 3-4, it needs to be about 100-120 grams of protein, 100-150 grams of fat and most stay under 50 grams of carbs. By the time you figure macros to calories: 100 grams of protein is 400 calories, 150 grams of fat is 1350 calories, and assuming 80% of carbs are absorbed (some at maybe 60% and sweets at 100%) the 50 grams of carbs would be another 160 calories...okay, add those up: 400 protein, 1350 fat, and 160 carbs for a total of 1910 calories which for a DS'er is barely enough. So the 700-900 would be ridiculous.

The general rule of thumb for how to eat, 30 grams of protein by 30 days, 60 grams by 60 days, 90 grams by 90 days...and watch your protein levels after that.

With all that said...don't try and bother explaining all this to the NUT at Boyce's office. They just do NOt want to hear it. I tried and got the RCA dog look. Once you are healed, just use your PCP for follow up.

 

[DSRIGGS]

sounds like you may have a fissure. Try to never force a poop or strain

 

[Clematis]

I am so sorry and know how scary it can be. This happened to me also at 3 am a month ago. I was TERRIFIED and thought I was tearing a fistula. I thought I'd have to go to the ER. I was doing lamaze breathing without pushing and wanted an episiotomy to deliver my poop baby. It wasn't hard, just the consistency of modeling clay, which I think was forming a shape internally like the end of a dumbbell. After 45 minutes of screaming pain and no progress, I pulled on rubber gloves and dug some out. (I'm sorry to be so crude but if anyone else has this happen, they need to have a solution.) Finally everything exited and my toilet looked like the scene of an axe murder. Blood everywhere. The pooper was coated in thick red blood. At the GYN a few days later, she said I had a small fissure but it was healing. No fistula, thank god. I have taken 2 Colace a day since surgery and upped it to 3 for a few weeks after. I have no idea why that happened, diet wise, but I may have been a bit dehydrated from exercise. I just pray it never happens again.

 

[DSRIGGS]

Yep do a softener and or mirralax as you don't want a chronic fissure that doesn't heal and requires a surgical fix. That happened to me

 

[CaraOC]

You can always try the constipated mathematician method. He worked it out with a pencil.

 

[CaraOC]

I suggest this though as its most very effective. Buy yourself a little enema bottle and a big old bottle of mineral oil. Stick the tip of the enema bottle way on up there and instill slowly the mineral oil. Keep it clenched. Let that stuff lube around walk about some and keep the squatty potty at the ready. Bombs away!!!

 

[southernlady]

Considering you are a Boyce patient, it's no wonder you are constipated. Most of his DS'ers end up with that issue. Esp if you have started your vitamins. Start upping your fat by eating full fat foods. Nothing low or no fat. I don't know how much you are getting right now but add about 10 extra grams today...and do that every few days til you reach the point of nice fluffy soft pooh.

IN the meantime, use the above methods to get it helped. Avoid straining if you can.

 

[KathrynK]

I remember reading that Dr. Hess, the innovator of DS, said that after having the surgery you are prone to dehydration and that as much focus you have on protein should also be directed to water. I aim for a 8 cups a day, and don't always achieve it, but I am always, always with water. I haven't had constipation, but I know my lips and skin get quickly dry if I fall short. It is very hard to achieve unless you sip all day. Confession: if I am having loose stools I cut back on water and it helps. I shouldn't do this and I quickly go back to my water. Then I have to focus on electrolytes to get back to balance. The water "dose" is not soda, juice or alcohol--all are weight loss killers. I can't drink sparkling water, it doesn't fit. But I flavor water with lemon or lime or a small amount of coffee, just to keep it interesting. And, if I miss my daily poop, the cure is Kentucky fried chicken. Don't know why it works but it always works.

 

[DSRIGGS]

Hydration is crucial. You will find a balance between fat intake and calcium and iron if you take. Fat will cause looser stool (btw I will take loose over bloated and harder to go solid stool) and calcium and iron bind. You will figure that balance out.

Also remember that loose stool isn't necessarily diahhrea but you obviously don't want diahhrea.

 

[CaraOC]

Hydration is crucial. You will find a balance between fat intake and calcium and iron if you take. Fat will cause looser stool (btw I will take loose over bloated and harder to go solid stool) and calcium and iron bind. You will figure that balance out.

Also remember that loose stool isn't necessarily diahhrea but you obviously don't want diahhrea.

* Diarrhea (sorry Scott. My nurse came out)

 

[Mystrys]

Thanks everyone!
I just want to clarify...I did NOT force this. I knew better. I was plugged and knew it, took miralax before bed and woke at 3 am to it needing to come out! The force had built up behind it and was what caused the issue. It wasn't budging at all...until it did! I had no control over it at that point but surely wished I did. And since it was so solid, a little slower exit might have caused less damage or pain. I would have liked time to get some mineral oil up there!! Great ideas for me and reason to prepare in case the is a 'next time'. I'm going to do everything I can to avoid that!!

I'm pretty sure I'm not dehydrated,but anything is possible. I dont know what is common for my new anatomy. I'm getting about 100-140 oz of fluids in every day. I've always been a big water drinker so this wasn't an issue for me. Just as much as my tummy will allow,I drink...all day. Not big on the add-ins either. Just plain water for me. But I do count in my coconut water, V8, Suja uber green juice and protein shakes.
My food has been full fat everything from the get go,because frankly I've always been healthier and able to function better with a Ketogenic/low glycemic diet. Never trust a food that is taking out fat and replacing it with sugar,salt and chemicals to "taste good."
That being said, I was taking it slow with everything but protein and fluids. I've alowly increased the fat as my protein increased. I am at about 100-120 g of protein and about 50-60g of fat. I will keep bumping it up now that im seeing more need for it. Under 40 for carbs for now.

I'm at the point where next week I advance to phase 3. I will be adding veggies and a few other things like my kimchi and sauerkraut that may help. Fermented foods ALWAYS helps me a lot. I've also been off caffeine for over 2 months and will be adding my bulletproof coffee back in starting today. I had considered not going back to the bean, but,it does help me in the bowel arena. Especially with the MTC and European butter. I love that I am finally part of a community that doesn't balk at this idea. I've been enjoying this tasty elixir for almost 5 years and no one ever understood me!! BTW...The NUT told me no nuts or seeds yet, but I could sure use my macadamia and pistachios in the fat area! Ok to eat at almost 6 weeks or no?

Like all of us at the beginning, I'm new to this. Its uncharted territory fo me. I have done my best to educate myself but I will make mistakes,learn from them and move forward doing better. I'm here because I don't necessarily believe I have to make ALL those mistakes myself. I am quite capable of taking direction and allowing those that blazed the trails before me, guide me. So again, thank you all for your input,advice and sage wisdom.

This has been the most difficult part of my process so far. And some may roll their eyes at that. But I feel very blessed and fortunate to have not had any other major issues as of yet. I've never had any constipation issues in my life...ever! I've always had the opposite in fact. I know how to traverse that road. This....this is completely new to me. Im with you @DSRIGGS ,I'd rather have it loose than a belly and ass load of bricks ANY DAY!

*sigh*
My poor parts took the entire day to recover and I'm still a bit sore this morning. I literally did nothing yesterday but rest and slept. But I THINK,other than feeling like someone kicked a log up my butt, I might be ok. No blood and I've had small BM's throughout the day/night. Nothing major but at least things,are moving. I added 3 colace, tsp of mag citrate powder, MiraLax and a lot of fluids yesterday. I will continue this until I'm sure things are in balance because I have NOT even begun to supplement with calcium yet. I have only started the dry D3 and new multivitamin. Also still using up the BariLife powder since I paid for it and I don't have a hard time with it.
IF I AM MISSING SOMETHING, you guys know I'm open to advice and suggestions.
This is, indeed, a balancing act that everyone needs to take seriously. I hope more DS'rs find their way here.

I am so greatful for this community and all of your genuine, caring advice.
Thank you,again.

 

[hilary1617]

Ouch! Hope your tailfeathers are healing and that you are getting some relief. I'd avoid vegetables this early out except the fermented variety that you know to help with the constipation.

I'd also recommend switching to Magnesium Hydroxide (Phillips makes a mint chewable - but there are other options) versus Miralax for long term use as there are a number of concerns with possible Miralax toxicity, plus magnesium is a dietary necessity anyway.

The issue is that the active ingredient in Miralax, Polyethylene Glycol 3350 (PEG), is a polymer made up of long strings of molecules of Ethylene Glycol (EG). EG is a neurotoxin, like mercury or lead, which damages the central nervous system, as well as heart and kidneys. EG is widely-studied industrial chemical used in toilet bowl cleaners, antifreeze, brake fluid etc. The concern is that PEG can break down into EG, both inside the human body, and also just on the shelf. The FDA placed Miralax and all other brands with PEG 3350 on its Adverse Event Reporting System (AERS) in Dec 2011 in connection to “neuropsychiatric events.” There have been, literally, thousands of adverse events reported since.