So a few weeks ago I talked about how I have to meal plan because of my bariatric surgery. Today I’m going to talk about the stages of eating a patient goes through before he can have “regular” food again.
The first thing to understand is that bariatric surgery is major surgery. If you’re getting a RNY, or bypass, they take your small intestine and bypass most of your stomach, attaching it to a tiny portion of the stomach, then sealing the rest of the stomach. It stays inside you:
For my procedure, the sleeve gastrectomy, about 80% of the stomach is removed, leaving a pouch the size of a medium banana
As you can see, both require major cutting and sealing. This takes time to heal. And especially with the gastrectomy, that is a LONG incision that needs to heal. Once you’re out of hospital, your eating becomes very regimented by what you’re allowed to eat when. That is, if you don’t want to end up back in the hospital with internal bleeding or infection.
Surgeons and bariatric teams vary, but the order of what foods you can eat at each point is pretty consistent. My team was VERY strict. So here’s how my team broke it down:
Clear liquids ONLY: One week. Self explanatory. Things like sugar free gelatin, clear bone broth, and the like. Unfortunately, in order to get the protein, you also need things like clear protein drinks. Not tasty.
Full liquids: FIVE weeks. A “full liquid” is something that is not clear, but can still be translated into a liquid. Things like strained cream soups, Greek yogurt, pudding, and what not. During those five weeks I survived on what would be called powdered protein shakes—although my favorite was a cream of chicken soup. Add water and nuke—and Oikos Triple Zero yogurt. My team set this LONG frame because they wanted to be SURE my incision would heal properly and nothing bad would happen. What kind of bad? Something gets caught in the metal mesh holding the incision together.
Puree: One week. This is when blenders and stick blenders come in useful. Take something like a taco salad, or tuna or chicken salad. make it, then use the blender to puree. Today’s recipe is a standard for this stage.
Soft foods: One week. Things like omelets with just egg and cheese, Nova salmon, canned meat, and what not. I made lots of tuna and chicken salad after mashing the meat out of the can. Plus a 3-4oz package of lox or Nova salmon is a wonderful snack.
Regular foods. After 8 weeks of “rehab”, this is where you apply everything you’ve learned throughout the healing process.
So what should you learn going through these stages? First, as I’ve talked about, you learn your macros. Especially protein. If you don’t get your protein in, bad things happen. Like hair loss or tooth loss. Second, you learn what happens if you have more than 10g of processed sugar at a time. Or fat. With such a small pouch, your stomach cannot digest it properly before it passes into your intestinal tract. That means you can get dumping syndrome. Not pretty, and you feel sucky as well. Finally, if you simply go back to what you ate before only “just less”, you haven’t learned anything and you WILL have major regain.
I plan my meals for the week, as I mentioned in v. 17.37. Always taking into account my pouch is STILL, four years out, only able to hold a little more than 5oz total weight.
So that’s the process. Tonight, I want to focus on THE dish of the puree stage. It’s called the “Ricotta Bake”. Why is it so popular? It’s essentially lasagna without the noodles. And who doesn’t like that? There are DOZENS of recipes out there for this dish. The first one I made went as follows: 32oz of non fat ricotta. 1 or 2 eggs. Salt, pepper, herbs as you like. 1oz grated low fat parmesan or other similar cheese. 8oz canned tomato sauce. Mix the ricotta, eggs, cheese, and seasoning. Put into a pan sprayed with cooking spray. Add sauce and a bit of low fat shredded cheese on top. Bake at 400F until brown and bubbly. I’ve added things like canned tuna or canned chicken to it, changed up the herbs and spices from an Italian profile to something else, and so on.
This past time I made it a bit more, shall we say, “normal”. That is, what you may see in a regular lasagna.
My ingredients this time:
2.5 lbs ground beef
1 large onion
1 32oz and 1 16oz tubs of ricotta
8oz grated parmesan
8oz grated mozzarella
2 large eggs
2 8oz cans Hunt’s tomato sauce
Salt, pepper, Italian seasoning, cayenne, Aleppo pepper
First, I took some ground beef and onion and browned it
I took it off the heat, let it cool for a couple minutes, then added shredded mozzarella.
Meanwhile, I mixed ricotta, egg, seasoning, and shredded parmesan in another bowl.
Then I layered it. A little bit of sauce, half the ricotta mix, half the beef, some more sauce, then repeat.
Then I put the rest of the sauce then the rest of the cheese on top.
Bake it at 400F for like 40 minutes until it’s brown and bubbling. Let cool, then parcel out into meals for the week. It comes out kind of looking like a Hachis Parmentier, only with ricotta instead of mashed potato.
And that’s reflected in the breakdown of macros—from my original recipe which was a 200 calorie meal, to this current edition which is about 330 calories. Fat and meat adds up. BUT, 22 grams of protein per meal. If I have four of them, I make my protein goal, and only eat 1200 calories in a day. Not bad.
This is why I earlier mentioned once you get on the regular food, you cannot go back to what you were, even though you may be eating way less at a time. I’ve done pretty well, and while I could use less fat, things are holding steady. My only issue is liquid calories, but that’s another diary in another group.
Tonight, I’m attempting a recipe that my mom never quite duplicated. I figured I’d take a shot, since one of the recipes I did had a similar flavor profile. I’m going to slow roast some nice chuck, then the alchemy begins. I’ll remove the meat when done, and add some noodles to what’s left in the roaster. My aunt, who originally made it, called them “greasy noodles”. I’ll let you know how I did in the comments.
Anyway, Have you ever had to go on a special diet as ordered by a doctor, and what was it? Let us know in the comments.
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RESULTS: Sadly, I overcooked the beef and liquid, so there’s some bitterness. But all in all, not a bad attempt. It still tastes REALLY good. So I’ll take that as a W.