What not to eat

Originally published Jan. 15, 2005.

I mentioned last week that I have to start living my life as if I have already had gastric-bypass surgery. This means, I must exercise regularly and eat differently.

Exercising regularly is a no-brainer. I’m expected to exercise at least 30 minutes a day, six days a week. This will help get my body in shape to recover faster from surgery. Exercising regularly now also means that I’ll be more able to increase my workouts after surgery. Most patients I’ve spoken to exercise one to two hours a day, six days a week.

Having spent much of my life trying to control my weight, I’m familiar with exercise.
I like doing yoga and lifting weights. Pilates is fun, but I have trouble completing an hour-long session. Cardio is my least favorite form of exercise, but I have grown to enjoy using an elliptical cross-trainer at the gym. The zero-impact motion is easy on my knees without being too easy on the rest of me.

I’ve been told cardiovascular exercise will help my body better handle the effects of anesthesia, though I have yet to confirm this with a surgeon; however, doctors have told me that strength training now will help me to preserve my muscle mass during recovery. Building my stomach muscles should also help my abdominal wall heal from the incision wounds faster.
Aside from needing to be better about scheduling my workout as if it were any other unbreakable appointment, I’ve gotten the exercise component down pat.

The more difficult aspect of preparing for surgery is eating differently. I’ve grown accustomed to my new eating habits and am comfortable with them now, but that wasn’t the case three months ago when I received my pre-operative eating requirements.

Except for the week of Christmas, I’ve diligently followed my prescribed 1,200- calorie-a-day eating plan for the past 12 weeks. As I touched on last week, though, there is a lot more to my new plan than just watching calories.

Limiting myself to 1,200 calories a day and making sure I consume 80 grams of protein, 133 grams of carbohydrate and no more than 40 grams of fat is easy. But there’s a whole list of rules accompanying that seemingly easy meal plan that is more difficult.

The rules are there to prepare me for life “on the other side.” As such, they don’t make a lot of sense for my body now, but I’m getting ready for when they really do matter.

Here’s a rundown:
• No snacking — I’m supposed to fully fill my pouch at mealtime three times a day. Doing so will enable me to go about five hours between meals with little feeling of hunger.

• No fast foods — Healthy food can be found at fast-food restaurants. But the sights and smells of McDonald’s and Jack In the Box are triggers. For many of us, it’s hard to walk in or go to the drive-through window and only order a salad.

• No caffeine — The stomach pouch has little to no stomach acid. With no acid to dilute it, caffeine could very quickly ulcerate the pouch.

• No carbonated beverages — Carbonation will add gas to the stomach pouch, which can stretch it and enable it to hold more food. Not so good if the idea is to restrict the amount of food consumed in one sitting. Stretching the pouch is also bad because if it’s done too soon after surgery, the staple line could rupture.

• No fluids with meals — This is another rule to help keep the pouch full as long as possible to maintain the feeling of satisfaction. If fluids are consumed with meals, the pouch may empty faster, which means I could eat more in one sitting.

• Avoid starches — Bread gets doughy in the pouch and can clog the outlet, which would be very uncomfortable and could require medical attention to clear.

Because the opening from the pouch to the intestine is only the size of a dime, food must be chewed to the consistency of baby food. Some foods, however, are too difficult to chew that well. These foods include coconut, popcorn, corn and skins and seeds of fruit.

When I first encountered all these rules, I remember thinking that there was no way I could go through with the surgery. There were too many foods I’d have to avoid that I swore I could never live without. But I’ve managed for the last three months, and I don’t miss many of the things I thought I would.

How did I accomplish this? That’s what next week’s column is about.