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Day 7 intake

Originally published at Misangela.com. Please leave any comments there.

Mon 5/23/16
no fever at all, back to my normal 97.5
1 oz Internat’l Delight SF vanilla, 1oz half n half, 3 oz Silk, 4 oz coffee 9oz
2 oz vit water
fruit smoothie
3 oz frozen fruit blend (blue, straw, cherries and kale), 3 oz greek yogurt, 4 oz silk (lt vanilla), 1 tsp agave, 2 sc vanilla protein TL: 25gm 16 oz fluid after blending
8 oz vit water
9 oz tomato soup w/ 1 oz half n half 10 oz (forgot to add protein)
10 oz vit water
broccoli cheese soup
1 cup broccoli puree, 1/2 cup shred cheese, 1/2 cup half n half, 1 cup chix yield about 2.5 cups; had half w/ 1 sc protein left a little in bowl 8oz + 16 gm protein
10oz water
10oz water
fluid: 83oz
protein: 41gm

Not very hungry today. A bit tired.

Miscellaneous Gastric FAQ

Originally published at Misangela.com. Please leave any comments there.

I’ve had a lot of disparate questions come up, so here is a collection!

Q: What was your health before surgery?
A: Other than being fat, I’m in excellent health. All my lab work pre surgery proved that. I take no medications other than my daily supplements. I am also at the bottom end of qualifying for the sleeve. My weight is relatively low for a sleeve patient (250) and my BMI was just one tick above the minimum 40. I think this contributes greatly to my speedy recovery and success so far. As they say, your mileage may vary (YMMV).

Q: Why did you go to Mexico?
A: Coupla reasons. The first is cost. Sleeve is $4k in Mexico rather than $10-20k that you’ll pay here. Second is my complete lack of confidence in the medical industry here. If you want exemplary care, the US is not the place to look for it. I also feel that RNY is still pushed in the US as the “superior” gastric surgery, and I disagree wholeheartedly with that. I think the US healthcare system is mired in status quo rather than looking at what is BEST for the patient.

I went to Tijuana, Mexico and Dr Mario Camelo did the surgery at Florence Hospital. If you’d like a recommendation, I’m happy to hook you up with the coordinator, Veronica, who works with Americans who need bariatric, dental and other medical stuff done. Please email me for contact info: misangela at gmail.

Q: What is the timeline from surgery to real food?
A: The standard answer for gastric sleeve is 2 months. For poor RNY people, it’s like 3-4. MY timeline is this:
Liquids until May 30
Purées until June 13
Soft foods until July 11 (aiming to be off these sooner than a month)

Furthermore, once I hit the soft food mark, I’ll be incorporating soft whole proteins, mainly fish. Fish is the softest protein and a great place to transition. For more on this, pick up the book Ultimate Gastric Sleeve Success.

Q: How did you get that surgical tape residue off?
A: I tried Goo Gone, alcohol, acetone and oil. Nothing. Then I read about liquid eye makeup remover. THAT worked better that the others. I saturated the goo with EMR, rubbed with rough gauze to loosen, then got into a hot shower and literally rolled up the goo into balls and picked it off. Time consuming, but it worked.

Q: When can you take pills, capsules, etc.?
A: Official answer from my Dr: 2 months. Which makes sense. Currently I’m opening up the prilosec and cephalexin (smells and tastes like FEET). I do think it’s wise to put off pills for a bit. I have begun my Vit B12 sublingual tabs and I’ll probably try out a gummy vitamin by the end of the week. Since I take a vitamin regimen anyway, I just found chewy/melty substitutes for everything except turmeric and selenium. I’ve started opening the selenium (very tiny cap) in my smoothie in the morning. It’s for hot flashes, I need it!

Q: OMG! You drank coffee and tea! Won’t your stomach explode?!!??
A: Obviously NO. The party line is to avoid all coffee, tea and caffeine for the full 2 months. But if you think about this logically, that’s just a one size fits all answer, like most things from Drs. I drink coffee and tea, yes, BUT it is 50% or less of the beverage! I’m really drinking cafe au lait, which has little coffee in it. I don’t think I’d dump in plain coffee, it’s too acidic. I did drink some plain tea and it was fine – tea has less acid than coffee. My logic is that with so much Silk (or whatever your mixer), the acidity is near zero. I’ve had no issues. I would say to use caution if your pouchie has been bitchy with you. Mine doesn’t seem to care what I drink so far. YMMV

Q: Why are you documenting all this stuff?
A: I think the more info out there about living with sleeve (or Pouchie as I call mine. YES I named it. What?) the better. I found lots of “official” info that was just copied over from RNY (bypass) and that is not really applicable, IMO. I think sleeve offers a faster recovery, faster transition to whole foods and is overall less harsh on the body than RNY. If you’ve not found it already, I also post video updates on my youtube channel.

Q: Did you get pix or video from your surgery?
A: Why YES! Yes, I did. I’m weird that way. I got a pic of my excised stomach from the doc. Stomachs are HUGE, dude! And grossly RED. They also promised me some video of my actual surgery (it’s laparoscopic, so there’s always video), but I’ve not received it yet. Another great thing about Mexico is that you get ALL your files. X-Rays, EKG, blood work, barium leak test, EVERYTHING. Unlike the US, where your medical files belong to everyone else BUT you. I love having all my medical files at hand so I can compare my follow up blood work and have records of my overall health.

Q: Is your Dr doing follow up?
A: Well, if I had a great Dr, my answer would be a strong yes, but my crazy Indian Dr is CRAZY, so the best I can say is maybe. From the get-go I’ve handled all my own arrangements and planning, so my follow up is the same. I’ll have blood work done in six months to see what’s changed and if I am doing OK with my supplements. As for physical healing, my incisions (FIVE!!) are healing up nicely and starting to itch – which is a good sign. Speaking of incisions, there are no sutures on the outside, they are sealed with Dermabond! The drain hole heals itself from the inside out. I’ve had no issues, so no Dr intervention has been needed. YMMV

Q: Can you help me with my planning and recovery?
A: Yes. I am available for consulting, menu planning, travel arrangements, etc. I’m a professional organizer and I’m ALWAYS for hire. Hit me up if you’d like some help.

Intake Day Six

Originally published at Misangela.com. Please leave any comments there.

Sun 5/22/16
10oz tea+silk
anti/prilosec 9:20am
smoothie 2 cups (16oz)
1.5 Tbl yogurt, 1 Tbl pnut butter, 6 oz silk, 2oz water, 1 sc vanilla protein 11gm (about 20 TL)
vit b12 sublingual tab 1000mcg
1 cup chix, 1.5 tbl broccoli puree, 1 sc plain protein – DO NOT MICROWAVE PROTEIN POWDER! It poofs up and coagulates! 18gm
10 oz vit water
1 cup broth
thai smoothie 10 oz
1 tbl greek yogurt, 2 tbl natural creamy pnut butter, 1 tbl shroom puree, 1oz coconut milk, 1 tsp miso, 1/2 cup chix, 1 sc plain protein, 1 squirt sriracha. heat on stove. 30gm –>> Only ate half, too rich! 15gm

first bowel movement 6:45pm!! Yay!!
20 oz water
5 oz vit water
Protein: about 60 gm
fluids: 82 oz

ANSWER to surgical tape goo removal: liquid eye makeup remover. Saturate the goo, then rub on it with rough gauze or a washcloth. Get into a hot shower and just roll up the goo into balls and pull off. I got about 80% of it today.

I highly recommend Quick Dots sublingual Vit B 12 1000mcg from Vitacost.com! Yummy cherry flavour!

Day Five intake log

Originally published at Misangela.com. Please leave any comments there.

Sat 5/21 intake
low grade fever remains 99f
2 oz vitamin water
1.5 oz coffee + 2.5 oz silk (shhh don’t tell the Dr I drank coffee!)
1 oz more silk
2 oz vitamin water
tylenol/anti/prilosec 9:30am
8 oz miso+broth+shroom
6oz vit water
10 oz broth+soy
temp 97.4
10 vit
10 broth+carrot
53 oz
2 oz water
10 broth+shroom
one hershey dark chocolate square (licked it ALL!)
anti/prilosec 8:30pm
10 vit
TL 75oz

Today (Sunday) I’ll begin adding protein powder to my liquids. I think the fever has worked itself out. My biggest issue? Dang sticky stuff from all the tape! ARGH! I’ll also be doing a video today.

Day Four intake log

Originally published at Misangela.com. Please leave any comments there.

The goal is 64 oz of fluids a day. Since you’re limited to a 5oz pouch, I divide all mine into 4 oz servings, about one per hour, finishing in about 15 mins. If it’s more than 4 oz, I sip it for a longer period. I am happy to report that my veg purees are serving their purpose well. Using them for flavour in your liquids is helpful to stave off going crazy from ONLY LIQUIDS. Blech. Here is everything I took in on Day Four, give or take an ounce.

Friday 5/20 intake
omeprazole and cephalexin, first round
4 oz gatorade
4 oz silk
2 oz tea + 2 oz silk
2 oz tea + 2 oz silk
2 oz tea
6 oz miso over 45 mins
6 oz miso over 45 mins
2 oz water
4 oz silk+tea
4 oz silk+tea
6 oz miso+chix broth
4 oz silk+tea
low grade fever 99f
1.25 cup 2 Tbl carrot puree, 2 Tbl miso, 1 oz pedialyte, top with chix broth
5 oz vitamin water
TL: 65 oz

NOTE: Any time you see something that’s more than 4 oz, assume that it took a half hour or more to consume. I’m very careful not to overload my little pouchie. :)

Sleeve Gastrectomy timeline

Originally published at Misangela.com. Please leave any comments there.

Well, it’s done. I do, occasionally, think that I must be crazy, but it’s a done deal now, so, ONWARD!

Ok, flew into San Diego on Sunday. Got picked up and taken to the Grand Hotel in Tijuana. Had soup for dinner, got to bed early. Being on Eastern time is very handy since they like to get started early.

Monday, head to Hospital Florence. It looks a little skeevy on the outside, but it’s fine on the inside. Meet the patient coordinator ladies, get settled in the room. They bring you compression hosiery to put on. Then here come the vampires for your blood. Y’all know how wound up I get about needles. The girl that did it was AMAZING. It didn’t even BLEED. I didn’t even bruise! That is a first!

So then they do the EKG. Interesting experience! They put these clamps on your wrists and ankles along with the electrodes. It takes 5 minutes. Fun!

Then there’s the chest x-ray done by a little old man named Miguel Angel. Very sweet.

Then they come to get your IV going. UGH. Of course they are bound and determined to use my left hand rather than my arm. Fine. It took two nurses and a vein finder (very much like a stud finder for the wall!) to finally get a vein. Not too painful, either. Too bad it didn’t work and my hand swelled up. So now this poor kid Luis comes and tries to find a vein. He as looking literally everywhere: wrist, forearm top & bottom… I finally said, honey, please go get someone to help you! So here comes two more nurses with the vein finder. They stick me in the middle of my left forearm. Nothing – except a huge bruise. I’d been telling them all along that they’ll end up using this one vein that I know is a good one and guess what? That is the one they used, which is in the bend of my left arm. What I told them TO BEGIN WITH. Why do people not listen?

Then the parade of Drs comes in: the internist, Camelo the surgeon (cute!) and Reyna the floor Dr (VERY cute!). I could look at Dr Reyna allll day. ;)

Then they haul me off to surgery. It took about 45 mins then about 45 mins recovery. I felt amazingly well right after surgery. I figured I’d pay for that, and I have. :P

Day two, Tuesday, I’m sore, of course, and don’t do much other than sleep and be prodded by nurses. I did have the leak test where you drink barium. Again, administered by the sweet old man Miguel Angel. I never had too much gas pain. I burped some, but not too much gas. Mainly it’s just SORENESS, which makes sense. Expect to feel like you’ve been beaten with a baseball bat.

Day three, Wednesday, we go back to Grand Central hotel rather than the Hilton SD because I don’t feel well enough to be that far from the hospital. I threw up a lot on Wednesday. Throwing up is actually much less of a production w/out much of a stomach. It’s like BLECH, VOILA! No pain, at least. Hilton refused to cancel my reservation and charged me for the room. Letters will be written to those fuckheads. That would have never happened with Hampton Inn, but sadly, I’m foregoing all Hilton properties because of this treatment, so I guess I’m a Marriott girl now.

Thursday we come back to SD for the flight home. I am very sore and moving slowly, so Nick gets me a wheelchair. This apparently pisses off the TSA to no end. I didn’t do the nudie scan because a) it violates my rights and b) I couldn’t raise my hands anyway. Therefore I had to get a pat down, which is fine, as long as the agent is not a midget with an attitude. I told her exactly where all the incisions were, even SHOWED her and she manhandled me like I was meat. She SLAPPED my incisions in the pat down! When she hurt me, I grabbed her hand by reflex and she freaked out because I touched her. Fucking cunt. There were FIVE TSA agents called over, so I yanked up my shirt and said WHAT PART OF FIVE INCISIONS DO YOU NOT UNDERSTAND? I was also dizzy from dramamine and percocet, but they make me stand anyway. So they bring another bitch over who also manhandles me then they all walk away. ?? Letters will be written, but since they conveniently separated me from my husband and my phone, I have no pix. FUCK THE TSA.

So, that’s it. It goes by extremely quick! The coordinators Veronica and Azalia are amazing! The hospital liaison Rosa is very sweet, too. Really, everyone there is awesome and the care is top notch. Just a coupla caveats: the hospital had no hot water in the rooms one day and the wifi is fairly useless. The Hotel is NOT quiet, so don’t expect it. It’s loud with slamming doors and our last night there was a party at the pool right below us. At least the music was good!

They send you home with a bad of meds: prilosec, pain meds, antibiotics, mylanta type stuff, dramamine, dressings and antibiotics for your incisions and whatever else you need. At this point you have to open up the capsules and take the powder or bbs, which sucks ass. Cephalexin smells like feet. Prilosec is little bbs that have a weird taste. Learn how to hold liquid in your mouth and toss in the meds. You don’t want to taste that. Ick.

I’m now on day 4, Friday, and I’m up early. Didn’t sleep much. I am having Nick pick up a bed wedge for me today, I think that will help. Since there is a drain hole on the left, I have to sleep only on my right, so my neck is jacked up from that. ALSO: make sure to practice your deep breathing! Anaesthesia is very hard on the lungs. The bed wedge will make it easier to sleep on your back and help clear out your lungs.

Today I woke up extremely dehydrated, so my main task today is to follow the 4 oz every half hour rule. So far, so good. I’ve had gatorade, Silk Vanilla and some weak tea + Silk.

Just checked my weight. Pre-surgery it was 239.8; today it’s 242.2. ? Anyhoo, it won’t be that for long. :)

My Bariatric Vlog is UP!

Originally published at Misangela.com. Please leave any comments there.

I got my Canon camera rigged up and I’m now officially a vlogger! I put up two intro videos with my stats before surgery.

My YouTube Channel is http://www.youtube.com/c/AngelaPrattvlog.

Aside from a little weirdness with the sound, the camera takes great video. The next few will be iPhone ones while I’m in Mexico and San Diego – assuming I’ll feel like doing anything.

I’ll be doing weekly updates with weight and inches lost as well as what I’m eating and how I feel.

Follow my channel if you’re so inclined. :)

Universal Pushback

Originally published at Misangela.com. Please leave any comments there.

Steve King was right when he talked about the past “pushing back” when the characters in 11.23.63 tried to change history. I think the universe pushes back when you try to make big life changes, too.

Since I’ve made the decision to get gastric sleeve surgery – despite the cost (~$6000) and the bad timing (re: Nick’s job ending), SO much shit has started to happen. First, my body starts losing weight – 10# so far – for no reason. I’ve not changed a thing. Then we start getting busy with the arcade games. Then I get offered two jobs that I can’t take because of the surgery. Then my Honda’s clutch goes out and will cost me $1000-1400 to fix. Then the panic and anxiety start to kick in.

OK, universe, I get it. You don’t like change. Well, guess what? I DGAF. I’m doing the surgery. I’m getting my fucking body back. I’ve got xanax, motherfucker, so don’t fuck with me.

I WILL NOT BE SWAYED. I’ve already wasted 4 years of waffling and letting my fear of medical procedures take over. NO MORE. The flights are booked (trouble with those, too, fuck you Orbitz) and I’m waiting for the invoice to pay for the fucking surgery. DONE. No changing it now.

So, universe? EAT A BAG OF DICKS. I am not going to let you foil me. Not this time. You got more shit? BRING IT. I’m doing this and you can’t stop me. ::shakes fist at sky::

Bariatric Vitamin Regimen

Originally published at Misangela.com. Please leave any comments there.

Along with protein, the next most important thing for a gastric sleeve patient is vitamins. This also applies to RNY patients – even more than sleeve because bypass pretty much eliminates absorption of all nutrients for the rest of the patient’s life. My posts are guides for sleeve in particular, but I’m sure RNY patients will find them helpful as well.

Bariatric Vitamins

Bariatric Vitamins

The only vitamin that requires lifetime supplementation for a gastric sleeve patient is vitamin B12. Why? Because this vitamin requires a protein made in the stomach called Intrinsic Factor. The vitamin binds to this protein in order to be absorbed in the small intestine. Less stomach = less intrinsic factor to bind with B12.

I take a handful of supplements every day – as listed in this post. I’m a firm believer in taking vitamins and herbal supplements because I can tell a difference when I don’t. I’ve found suitable replacements for all the capsules except turmeric and selenium. I take turmeric for inflammation and selenium for hot flashes. I don’t expect to take any of these for the first couple of weeks, but I’m going to try to take one as soon as I feel that I can. There is much discussion about when you can take pills or capsules after surgery, so I’m going to play it by ear. You have to take omeprazole immediately, so that would indicate that you can take pills/caps. I’ll just have to see.

But for ease, I have gotten everything else in a chewable form. Here is the list:

Multivitamin Gummy Kirkland (Costco had a better price than vitacost) 2 gummies has 833% of daily B12
Vitacost Quickdots B12 sublingual melts 1000mcg per one tab (Vit B12 is water soluble, you cannot OD, so take a LOT)
Nature’s Plus Chewable Cal/Mag/D3 600/300/500iu per 2 tabs; about 85% of daily. (I like this one because it has the correct ratio of calcium and magnesium. These two supplements work together so the ratio is important. You will usually see Calcium with D3 because they work together for absorption – hence the Vit D added to milk.)
VegLife Vegan chewable Iron 18gm iron per tab. This is a child’s supplement and is extra gentle. I do not take iron because I’m never anemic and it hurts my stomach, however, I thought it would be prudent to add this to my regimen while I can’t eat much meat. I’ve tried it out and it seems to be OK on my whole stomach. We’ll see how it is in a partial stomach.

I also picked up some Kirkland sugar free calcium chews for variety. These are not balanced with magnesium, but they do have D3 and K for absorption. These are 50% DV (500mg) calcium per one chew.

As for my insomnia supplements, I think I’ll get some Deep Sleep tincture and valerian tincture. Since I’ve no idea when I’ll be able to take multiple pills or caps, I want to have *something* available if I need it.

Bariatric High Protein Smoothies

Originally published at Misangela.com. Please leave any comments there.

Since so much of the bariatric diet depends on blended things for the first couple of months, I’m exploring various kinds of smoothies. I’m in my last two weeks pre surgery, so I’m trying to do a smoothie for breakfast every day. Not a fan of smoothies, but it’s doable. Here’s what I’ve discovered.

I’ve said this before, I’ll say it again: GET A NUTRIBULLET. Unless you have a Vitamix or Ninja already, which I did not. These things make the best purees you’ll ever see and they are MUCH more affordable than a Vitamix.

Protein powder is your best friend. I got vanilla and unflavoured. I buy from vitacost.com and I recommend them for good prices and good quality products. They also have a 100% satisfaction guarantee, which I used with the first thing I ever bought from them, an old lady supplement that had bad side effects for me. They gave me credit and I didn’t even have to return the unused product.

Anyway, protein powder is a necessity when you only eat 1/4 cup at a time. The vanilla powder has 11gm protein per scoop and the plain has 18gm. I’ve found that the plain is fine in anything: soup, smoothies, purees, whatever. It has no effect on the end product other than just a little thickening, which is why I recommend not adding it until you are serving. I’ve been using the vanilla in breakfast smoothies and 2 scoops work fine when making about 3/4 to 1 cup. I’m trying to get the recipes down to about 1/2 cup – it’s harder than you think!

What I’ve been using in various combinations are these ingredients:
Silk Vanilla (it is fortified with more protein and calcium than dairy milk; 6gm protein/cup)
Greek yogurt (LOTS of protein: 23gm per cup! I like Fage.)
Natural peanut butter, smooth (8gm protein per 2 Tbl)
Vanilla protein powder (Vitacost brand, 11gm per scoop)
Unflavoured protein powder (Vitacost brand, 18gm per scoop)
frozen fruit; strawberry, blueberry and mango blend
Agave syrup if I want something sweet (rarely)

Fruit Smoothie (About a cup)
1/3 cup Silk Vanilla
1/4 cup greek yogurt
1/3 cup frozen fruit
2 scoops vanilla protein powder

This will blend up and gain volume to about a cup. About 35gm of protein. I’m working on smaller portions.

Peanut butter banana smoothie (about a cup)
1/3 cup Silk
1 med banana
2 Tbl smooth natural peanut butter (or ANY nut butter)
1/4 cup greek yogurt
2 scoops vanilla protein powder
2 cubes of ice if you want this cold

About 37gm protein.

Peanut butter smoothie
Same as above but no banana. Add ice if you want this cold.

I’ve seen various recommendations for protein intake, from 50gm to 100gm per day. Judging by these smoothie recipes, I’d say that getting in 70gm is totally doable even if you just drink these two smoothies all day. I’m going to try to see if I can make one that’s half a cup finished AND has 2 scoops of protein powder. I’ll update this post when I do that.

The reason people lose hair is the decreased protein intake and not taking enough B12. You MUST load up on gummy vitamins! I’ll make a separate post about that. Protein and supplements are not negotiable. Same for omeprazole (Prilosec), which is necessary in the first few months while the stomach adjusts to its new size.

I also have lots of veg purees that I intend to use for high protein soups. I’ve tried this with the unflavoured protein and it is EASY to put in 2 scoops (36gm) per 1/2 cup serving. So one smoothie and one serving of soup will give you plenty of protein if you keep the flavour profile up. I don’t like fruit much, so I’ll probably eat a lot of soups. I need flavour, which is why all my purees have onions, garlic and S/P in them. I refuse to give up FLAVOUR just because I have to eat purees! Neither should YOU.


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