More Phase 3 Food Prep

I've spent most of the morning preparing food for eating in Phase 3. 

I cooked and prepped these.
- tofu with garlic, ginger, and soy sauce
- chicken breast with Laughing Cow Lite cheese
- white beans with reduced-fat ricotta cheese
- canned salmon with greek yogurt, dijon mustard, and red-wine vinegar
- sweet potato, baked
- white potato, boiled, then pureed with a bit of butter and salt
- and last week, I made lentil soup made with a ham hock

I pureed each one, and transferred portions to either the muffin tin or tiny Pyrex bowls. 

I decided not to add protein powder, in case the cooking and storing breaks down the protein. I'll mix in a teaspoon or two of protein powder as I eat each portion. 

I also have applesauce, canned fruit (which can be pureed or mashed), and baby-food fruit.

We also bought some sugar-free pudding. I normally don't eat such artificial food, but it seemed like a good snack idea. It has almost no flavour, but it's sweet and the texture is nice. I don't think I'll make a habit of this.

I really understand why in Canada, anyone who qualifies for bariatric surgery must first transition to a healthy diet and demonstrate that you can maintain it. I've always said that the first requirement of healthy eating is preparation. If you're not accustomed to planning meals, shopping for what's needed, and cooking in advance, it's not going to work. If you want to eat healthy snacks, they have to be in your fridge or cupboard! 

I've been on board with this for most of my adult life. But for so many people, this means crossing many hurdles and adopting many new habits. If you started that for the first time after your surgery, your chances of success would not be good.

Quarantine is Over! Plus Some Fun Facts About Phase 3

Hurrah! Yesterday was my last day of self-isolating! I've had no symptoms, so my calculated risk of traveling through US airports during covid-19 was a good one. I promptly cashed in my rain checks for hugs and kisses, and moved back into our bedroom.

I also used the occasion to dismantle my alternative workspace downstairs and move back to my home office. We set up the kitchen workspace to encourage better habits during the liquid diets, before and after surgery. I'll have to be more vigilant about drinking water than I've been in the past, but I think I can do it.

The pureed food diet is going really well. I sometimes feel a bit burdened or discouraged when I'm starting the food prep -- then I do it and it's no big deal. I'm aiming for making three or four pureed foods at a time, and putting the pre-measured portions in a muffin tin. So far I've done:
- canned tuna, made with greek yogurt, dijon mustard, and pickle relish
- canned salmon, made with greek yogurt, red-wine vinegar, and dijon mustard
- tofu, garlic, ginger, and a touch of sodium-reduced soy sauce

Each one is pureed in the food processor with some protein powder, one teaspoon per serving.

For the tofu, I cooked the garlic and ginger in a little olive oil, added the tofu and soy sauce, cooked that for a while, then transferred it to the food processor. It had the thick texture of hummus, and was very tasty.

I'm also going to try:
- chicken and low-fat ricotta puree
- lentil soup puree
- white bean and ricotta puree

Here's an example of what I'm eating in the course of a day:
- smoothie made with 16 ounces of dairy milk, 1 cup of frozen fruit, and 1 scoop of protein powder (in 3 or 4 portions throughout the morning)
- can of tuna, pureed, protein powder added (broken up into 3-4 portions)
- jar of baby food fruit or vegetable
- very small portion of soft cheese, such as Laughing Cow Lite
- water, herbal tea, V8

I had a weird feeling that I was eating too much. WRD asked me to scan a few pages of my food diary, so she could calculate approximate daily calories. It turns out I'm eating too little, or at least the very low end of the suggested intake for this phase. Very strange!

Eating slowly is a big challenge, especially pureed food! I'm working on it, one muffin cup at a time. 

Hopefully this is not TMI: for years my ankles and feet have been (seemingly) permanently swollen. I take a diuretic for blood pressure, and I eat a lower-sodium diet, but puffy ankles and feet have been the reality. This is suddenly gone. I was putting on my socks and lo and behold, thin ankles with an actual shape, and smaller feet! 

I will ask WRD about this, but I'm guessing it's from not eating in restaurants (or take-out). I use very little salt when I cook, and we don't even keep salt on the table, but I was eating take-out two or three times each week. Perhaps that, plus a big increase in water intake, has given me back my thin ankles.

I'm still talking myself out of getting on the scale. As we get closer to our planned December 1 weigh-in, this will become more difficult to do!

More About Phase 3 Eating

I had an excellent session with WRD yesterday, which really helped me understand the Phase 3 pureed food diet.

Two pieces about this phase seemed particularly challenging: the protein requirement and drinking enough water. And one instruction was confusing.

Protein

The hospital guidelines call for 60 grams of protein per day. That seemed like a high bar, but I was able to do it with a milk-based protein shake (protein from both milk and powder) plus small amounts of protein throughout the day, such as tuna or salmon salad. 

But... WRD told me that Health Canada says when you're recovering from this surgery, your requirements are much higher -- 70-120 grams per day. How on earth am I going to make that happen, at serving sizes of 3-5 tablespoons?

The answer -- as vegans and body-builders know -- is protein powder. I have unflavoured whey protein, and I can add it to almost anything. Depending on the food, it may change the texture slightly, acting like a thickener, but it doesn't change the flavour. This morning I pureed some low-sodium chicken-vegetable soup with a tablespoon of protein powder: 12 grams of protein. 

WRD recommends doing this for everything I eat. This can really increase the range of eating, too -- oatmeal, baby food fruit or vegetables, and soups can all be on my menu. Not at all once, of course, but over the course of the next couple of weeks. 

Water

The hospital instructions say I'm supposed to drink 2 litres (64 ounces) of water per day. I literally cannot do this. There aren't enough hours in the day to get both the protein requirements and drink that much water!

WRD thought 2 litres was excessive, especially considering I am also drinking a protein shake, V8, and soup. She feels that 1 litre (32 ounces) is adequate. I'll be able to do that without any trouble.

Pureed but higher-fat food

The hospital guidelines suggest hummus and smooth peanut butter as good go-to food for Phase 3. I enjoy both of those and would be happy to eat them (although I can't put them on a vegetable or cracker at this point). However, everything I read says to avoid high-fat food... so there's a contradiction there.

WRD recommended staying away from hummus and pb for another week, then trying in small quantities, and adding protein powder to the hummus. I've ordered some PB2 and look forward to trying it.

Vitamins!

Now is also the time to begin taking vitamins, which I will have to take for the rest of my life. Some people find this difficult or oppressive, but fortunately I have no problems with it. I already take several vitamins and supplements, adding a few more into the mix is no big deal.

The requirements are:

- A prenatal multi-vitamin that contains folic acid, zinc, magnesium, and iron

- Calcium citrate

- Vitamin B12

- A higher dose of Vitamin D (Everyone in Canada is supposed to take Vitamin D, and these guidelines double the recommended dose.)

 

Food Tastes Good!

I just had to pop back in to tell you that FOOD TASTES GOOD.

I whipped up some canned tuna in the food processor, with yogurt instead of mayo (I've seen it in recipes and thought I would try it), plus some Dijon mustard and pickle relish, which I always put in tuna.

I measured out 4 tablespoons into a one-cup Pyrex bowl and savoured it very slowly. I had no problem eating, and... I'm no longer hungry! Now I'm waiting the requisite 30 minutes before drinking water.

Eating one of these tiny portions and seeing how it is actually filling has given me a lot more confidence about this phase.

I Can't Stand This Anymore: Moving On to Phase 3

I'm moving on to pureed foods, two days early.

According to the hospital, I'm due to advance to pureed food on Wednesday of this week. From everything I see online, these are approximate guidelines. I cannot stand the liquid diet one more day! It's not the liquid that's getting to me, it's the total lack of variety. I need to taste something other than protein shakes, V8, and plain yogurt. 

The pureed food phase is a bit complicated. In looking for more information, I've discovered an overwhelming number of bariatric recipe sites. Most are like all recipe sites -- loaded with ads, floating video ads, stealth marketing, and the same recipes over and over again.

There are also myriad people advertising their services to be your "bariatric coach". I'm hoping I already have that in the WRD (I've added Wonderful in front of Registered Dietitian), but if I need more support I'm not adverse to finding it online.

Regarding the pureed food phase, there's a lot of conflicting information on what you can and cannot eat. These recipes look yummy, but they contain small amounts of some high-fat ingredients like tahini and blue cheese. I thought those were off-limits.

Do not worry: I'll stick to foods that the hospital says are safe until I can speak with WRD for more clarification. So far this means:

* Pureed tuna, chicken, ground turkey, eggs, tofu, and whole grain hot cereal are all OK. That's plenty to get me started! 

* Serving sizes are 4-6 tablespoons -- and this is supposed to take 20-30 minutes to eat! This will be my single greatest challenge. I eat too fast, and I will have to teach myself how to slow down. Waaay down.

* Food is put in the food processor rather than the blender.

* I'll use a muffin tin to separate and store portions.

* There are some restrictions. At this phase, your stomach is not ready for red meat or for any bread products. And you're not supposed to waste calories on high-sugar food. 

* You're supposed to drink a lot of water between meals, but not with meals. I'm finding the water guidelines challenging.

Here goes! I'll report back soon.