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ElizabethB
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The Last Supper

Tomorrow we have a 3 hour pre surgery session at the bariatric clinic.

Starting tomorrow George will be on a very strict diet designed to reduce liver size. Post surgery he will be on a clear liquid diet, then a full liquid diet then a soft food diet. 4 weeks before he can eat real food.

Tonight he will feast.

Appetizer - rib eye stuffed jalapenos with cream cheese wrapped in bacon
Braised pork shank
wild mushroom risotto
pan grilled asparagus with beur blanc sauce
mixed green salad with tomatoes, cucumbers, avocado and palm hearts.
Basil mayonnaise dressing

Baked apple with ice cream for desert.

Shame on me.

Not really. My Dear Man will be making life long changes in his eating habits. He deserves a final Hurrah.

He does not know it but I have an appointment with the nutritionist to discuss ways to incorporate my flavorful cooking with his dietary restrictions. My main focus is to follow the restrictions but provide him with full flavored, non boring meals. If he gets bored with food he will cheat in a big way.

So My Love will feast tonight.

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Eating sensibly yet not boring requires a re-tuning your taste buds. I mean that literally.

Fats, sweets and salts are addictive. Your brain craves it. View the four week liquids period as an opportunity for the both of you to take a break from sweets and fats. It can take months or longer for your brain to unwire it's addiction to fat.

But once your brain is restored to a more normal state you'll be able to enjoy foods that are not overloaded with fats.

The second challenge is to reduce portion size. All the food listed in your hubby's feast strikes me as an enormous amount of food. Training your stomach to be full with lower amounts of food is a second step to healthier living.

Good luck!
;)

imafan26
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The purpose of bariatric surgery is to reduce the stomach to the size of a thumb. He should feel full after a couple of bites. Usually, bariatric surgery buys you time to change your habits. He will have to take up some hobbies to get his mind off food. Portion control will be the easiest part, however, if he overeats he can stretch his stomach again over time.

Weight watchers principals still help
1. drink water between meals if you get hungry. The feeling of fullness should be able to turn the brain off. You can flavor the water with lemon, mint, and sugar free kool aid.
2.Get a smaller spoon. He should be full after a couple of bites, his stomach will tell him that, but he will be full in less than a minute so he need to have a smaller spoonful, chew 30 times (count it) then swallow, wait a few minutes. Need to have an alternative activity here, and take another mini bite. You want to spread your two big bites over 20 minutes so the brain has time to get the message from the stomach. Volume, chewing, and time determine feeling of satiety.

3. You will have to learn new eating habits. A lot less meat (1/4 of the plate) less carbs (1/4 of the plate) and more veggies (1/2 the plate). The plate should be a lot smaller too.

4. You can have dessert and favorites but they must be included in the calorie limits for the day and have to be a once a week or once a month deal, not every day.

5. Reduce the amount of salt, sugar, and fats you use. If you do it all at once, he'll notice but done gradually the taste buds will actually become more sensitive and "normal" salt and sugar will be too salty and sweet. Use good cheese and butter just use a fraction of it. A little smoked cheese will go a long way.

6. Exercise has to be a part of the plan. In the beginning it will be hard, but once you get a routine going it gets easier to do and you have to keep challenging yourself. You have to schedule it, because it is too easy to not do it.

7. For me, I had to have a diary to track my calories (I was never into points. It is easy to find calorie information for most recipes, not so much for points). The diary should also contain a daily exercise program and goal as well as how you feel.
Week 2 and week 6 are the hardest plateaus and usually when the cravings kick in.
These sites were helpful in finding alternatives and for support
https://www.eatthis.com/best-weight-loss-tips
https://www.hungry-girl.com/
https://www.acaloriecounter.com/

8. There are trigger foods you just can't have and
some times when food is your go to comfort place. You have to find substitute place to go to.

9. Most people gain the weight again after a year, especially when the wt loss is fast and your body thinks it is in starvation mode. It is important to be of the mindset that it is not a diet, that it is a lifestyle change. You may have to retool a lot of your favorite recipes to make them fit the plan and my downfall is that eventually, I stopped keeping the diary and stopped being aware of the amount of calories I was eating, so it is important to keep counting. It is easy to fall off, and hard to get back on again.

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rainbowgardener
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Imafan: lots of good info and tips. " It is easy to fall off, and hard to get back on again."

So true!! :shock:

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ElizabethB
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Thank you all,

Imafan - the thumb size stomach is gastric by pass. George is having gastric sleeve surgery. A portion of the stomach is removed. What remains is the size of a medium banana.

The session ended up being 4 hours instead of 3. LOTS of good information.

The most important part of the process is changing habits which = changing thought processes. That is a major hurdle for a stubborn, set in his ways, 70 year old man.

He is on a very restricted pre op diet designed to shrink the liver and shed as many pounds as possible in a 2 week period of time.

Breakfast:

4 oz. protein
- 2 eggs & 2 oz. turkey bacon
1/2 cup skim milk
2 oz. fruit

Mid Morning

1 oz. nuts
4 oz. fresh fruit or 1/2 oz. dried fruit

Noon

4 oz. protein
2 cups salad OR 2 cups non starch vegetables OR 1 cup salad AND 1 cup non starch vegetables
1 TBSP. Olive Oil

Afternoon

6 oz. plain, lite yogurt
2 oz. fresh fruit

PM Meal

Repeat Noon Meal

100 oz. of water sipped slowly through out the day. No gulping and no straw. Frequent small sips.

Stop drinking 30 minutes prior to a meal. Resume drinking 1 hour after a meal.

This is where George has to really pay attention. He only drank 64 oz. today. :(

Who would think that getting enough water would be such a job. :eek:

The first 6 to 8 weeks post op will be more challenging.

Exercise is a critical part of the process.

George ordered a stationary bike. We have a tread mill that is nothing but a dust collector. Our deal was that he gets the bike and sells the treadmill on Let Go.

I will keep a photo album of his progress starting tomorrow.

At the weigh-in Tuesday George Weighed 313 lbs.

His goal is to get down to 200 lbs. or less. At 200 lbs. he will be overweight but no longer obese.

The world we live in encourages obesity. All you can eat buffets, supper size everything. It is worse in Louisiana. Every holiday, celebration, get together revolves around food and drink. Lots of both.

Wish us luck and keep us in your thoughts and prayers.

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rainbowgardener
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Yes, indeed, we are the land of too much, of over-indulgence, of stuff. As a therapist (before I retired), I used to work with hoarders. I saw clearly how they were just an exaggeration of what our whole culture is about.

The diet plan sounds like plenty of food actually (but I'm a small person), but it would kill me to get 100 oz of water or even 64 oz of water in....

Best Wishes!

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ElizabethB
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BTW Imafan-

In keeping with your other comments.

Bariatric surgery is a tool not a solution. Success is centered on changing habits which = changing ways of thinking. The staff has suggested many ways to accomplish thought change. A dairy is one tool highly recommended. IDK if I can get George to keep a dairy. I am working on it.

I am very impressed with the Lafayette General Bariatric Clinic. There is no sugar coating. They are up front and in your face about the amount of personal commitment and effort needed to be successful.

We also have life time access to a master degreed health and fitness counselor and a master degreed dietitian/ nutrition specialist.

imafan26
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The program I am familiar with is the gastric bypass, the sleeve may be less risky but leaves a larger stomach so it is very important to stick to portions.

Before clients here could qualify for the surgery they had to have a condition that was life threatening because of their morbid obesity. Heart disease, organ failure, and complications from diabetes were at the top of the list. They had to be on a weight reduction program for at least a year, making a serious effort to try to lose weight by traditional means and failing. They did have to show commitment though and a willingness to follow strict rules. About a month before the surgery they had diet training. Learning to eat small portions of food 6 times a day rather than large meals three times a day. Water was scheduled. They drank 30 ml ( one ounce ) every 10 minutes from 8 a.m - 10 pm and they watched the clock for that next sip. I thought it was a strange strategy since it kept them thinking about food all day. Every thing was measured. The meals were planned out with the dietician. It was usually a 5 week rotation plan with precise amounts, like yours requiring the food to be measured and weighed. They suggested that some of the things could be prepared and measured ahead of time and frozen in vaccuum bags to make it easier to portion and because it allowed variety and what do else are you going to do with the rest of that chicken. Even meals were timed. The plate was smaller and so was the spoon so the food did not look like so much less. Since it takes about 20-30 minutes for the brain to catch on when you are full even when your stomach says you are, you have to eat slower. timing when to take the next bite and the number of times you have to chew.
I know a couple of people who went through the program who lost weight. One did not lose that much because she managed to eat larger portions and stretched out her stomach faster. The other two did lose wt and one did manage to keep it off and her diabetes improved. The other lost weight but ate what he did before. He kept the weight off about 18 months but still eating the same things but now stretched his stomach so he ate more. He is slowly gaining back the weight.

Moral of the story, it helps if you actually change what you eat if you can't maintain portion control

Eat more salads but go easy on the dressings. That is where the calories are. Low fat dressings have more sugar.
I like the hungry girl recipes. They are not the same as full fat but, after a while you get used to it. They do have flavor and almost guiltless calories.
https://www.hungry-girl.com/newsletters/ ... es-from-hg

Low calorie snacks 1 cup of air popped popcorn, no butter/oil but you can add spices and if you want to lower salt, use spices.
1 cup air popped popcorn, plain = 31 calories; eat it slow.

rice rusks- low calorie, low salt snack. Not much flavor, but the kids don't mind.
https://www.myfitnesspal.com/food/calori ... -194215615

have a lot of celery sticks, cucumber, and carrot sticks around for healthy snacks.

Substitute low fat for high fat. Mix low fat turkey in with your lean hamburger for a leaner burger. It can be challenging to keep it from drying out. Grilling it on charcoal adds a lot of flavor. Brush it with a healthier low calorie homemade BBQ sauce. It still has a lot of salt so I opt for low salt tomato sauce and I can cut the salt more. I have reduced my salt intake so that I actually leave out salt in most recipes and don't miss it, however, I do have a problem giving up ketchup. I have to substitute salsa instead. It takes a while to retrain your taste buds to less salt. Once you do, you will find what people consider normal salt is way too salty.
https://www.eatingbirdfood.com/healthy-bbq-sauce/

Avoid the white foods- white rice, potatoes, enriched pasta, white bread, mayonaise
Opt for whole wheat and cook it al dente (that took getting used to for me), mustard instead of mayo (I have to admit, I have tried this and I don't like it. I just use less mayo instead) I really miss not salting pasta water, but I am getting used to it.

green tea is good.

Luckily, I have been reducing sugar in recipes for years and I do use splenda in cooking and I drink diet colas so I find real sugar too sweet. I don't have that much of a sweet tooth so I don't miss most desserts Diet colas are not good for me either, but I have a tough time giving it up, I don't like water.

Ice cream! sub frozen yogurt or gnaw on some ice cubes. Most of the time, I just want something cold.

Real change is making lifetime changes like reducing sugar and salt. More vegetables, portion control, and increasing activity.

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applestar
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I applaud your dedication and his courage to take this step. It sounds like a difficult challenge -- physically, mentally, and emotionally -- for both of you. Good luck. :bouncey:

...what about fruit and veg infused water that tomf mentioned? he was making them in a filtered water pitcher. That seemed like an easy way to make them from tap water and good way to measure the amount of water, as well as making the water more palatable? It will be fun for you both to experiment with different combinations as well. :wink:

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Found it --

Subject: Infused water
tomf wrote:I had some at a hospital when waiting for my wife to get checked out. So I found some recipes on the net. This one is lemon, lime. cucumber and ginger cut up in slices. You just let what you add seep into the water, you can keep adding water to it when you drink some. It gives the water a nice flavor and adds vitamins and good things to the water with out much calories, some recipes say no calories. It is a way of getting us to drink more water and less juice. The cucumber in it is good, who would have thought.

Image

imafan26
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That looks good.
Flavored water is good, most fruit juices are not unless they are fresh squeezed. Most of the frozen concentrates have too much sugar. People do put lemon and mint in water to give it flavor.

Adding fresh herbs and grilling and poaching instead of frying, braising, soups or stews are better. Soups and gravies hold on to fat even when de fatted there is more fat and salt in them. Cook it with the fat so it won't dry out but remove the skin and cut out the fat and pat out any excess with a paper towel before serving. It retains more flavor and a few more calories but easier to eat than poached nude chicken breast.

It is a good thing you like to cook because simple cooking with fresh lean meat, colorful vegetables, whole grains, and herbs offers the most taste appeal and nutrition without the chemicals and salt added in processed foods.

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ElizabethB
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AppleStar - thanks for the infused water suggestion.

I will check with the dietitian. When I went on our Girl's Trip to Arkansas we had cucumber infused water at a dumpling shop. Devine! A wonderful summer drink.

Imafan - thank you for all of your thoughtful suggestions. My DIL had the surgery a year ago in March. I spent the weekend of the 4th with her and her family. She has put some weight on - at least 10 lbs. Watching her eating and drinking habits I understand why. She does not and never has exercised.

She was all about giving George advice about eating. Even without a discussion with the dietician he instinctively knew that her eating habits were all wrong. She was eating breads, rice, crackers - not allowed. Her vegetable and fruit consumption is minimal. Her water intake is supplemented with a large dose of vodka.

In addition to the bariatric surgery she spent another 10K out of pocket for body sculpting. Butt lift, tummy tuck, minor face work and boobs lifted and put where they are supposed to be.

I really think George has a greater commitment.

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rainbowgardener
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Wow! :shock: All that money for body sculpting is just going to go to waste if she doesn't take care of herself with diet and exercise!



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