What to Eat

Everyone’s surgeon is going to give them their own take on what a baby post-op should or shouldn’t eat during the first weeks of life after surgery.  Some surgeons have their post-ops on a regular diet by the time they’re discharged from the hospial – horrors!  (Oh, the stories I could tell you!)  Some surgeons have their post-ops on clears for four weeks – EGAD!

I’m a Baltasar post-op.  I had my DS with Dr. Baltasar.  My husband has had his DS with Dr. Baltasar.  My son has had his VSG with Dr. Baltasar.  I’ve been back to Spain as a support person to 20 people, and have had the great privilege to coach hundreds of post-ops through their early post-op transition with food.  I can tell you what WE do and what WE recommend.  If you come away with something valuable from this, then wonderful!

When you have surgery with Dr. Baltasar, you will likely have surgery at 3:00 pm in the afternoon – his first surgery of the day.  Most people are in the operating room for a couple of hours, recovery for about 30 or 40 minutes, and then are back to their room shortly thereafter.  Of course, you’ve been NPO (nothing by mouth) since about 9am the morning of surgery, and will remain that way until the morning after surgery, at which time you’ll have the blue dye test.  Typically 24 to 48 hours after surgery you will then have the “big” leak test – down in radiology – to make sure that everything is as it should be.

Once the leak test is over, your x-rays have been reviewed, and Dr. Baltasar has given the go ahead, you get a small cup of water.  I mean small.  Like they hold about one ounce small.

1oz-cupsI have patients use a teaspoon to meter out sips from this cup.  You can get about five sips out of it – and they should be spaced out by 2 to 3 minutes.  (Sound familiar?)

These little cups can be really invaluable in helping you get perspective on what a sip should LOOK like.  We always leave the hospital with a few extra for help in keeping perspective on sipping.

At first water is the best thing you’ve ever consumed in your life.  It’s amazing!  It’s wonderful!  And then, before too long, it’s pretty boring and you want something else.

Next comes herbal teas.  In Spain they have something called Tila Tea – that’s the tea that the nurse will bring you when you graduate to tea.  Other options are Chammomile, Ginger, and Mint teas.  All are soothing and comforting to the healing tummy.

After teas, we add in fruit juices.  In Spain the possibilities are endless – I think every single one of us will gladly attest to the fact that the fresh squeezed orange juice from the freshly harvested Valencian oranges is absolutely the nectar of the gods and MUST be consumed daily!  Wow – that’s good stuff.  Spoiled me for life.  A lot of us also really like the green apple juice, the peach nectar, the pineapple juice.  If you go to a Spanish grocery store you’ll find nearly every conceivable type of fruit juice or nectar.  They’re wonderful.

Popsicles are offered fairly early on, as well.

And finally, consomme – soup broth.  Nothing in it, just the broth.

Those are the things you’ll likely get in the hospital.  Once you leave the hospital it gets a little trickier.  You have to find restaurants that work for you, figure out what to buy at the grocery store, etc.  But it doesn’t take long to figure out what works for you and it gets pretty comfortable really quickly.

For the first week from the day you have your first sip of water, you may have:

  • Water
  • Herbal teas
  • Fruit juices
  • Popsicles
  • Sorbet
  • Consomme or Soup Broth
  • Yogurt drinks

The key, really, is to mix it up a bit.  Don’t burn yourself out on one thing.  Try doing some fruit juice for a little while.  Then put it away and switch to water for a while.  Then switch to consomme for a while.  You get the idea.  You should be sipping water ALL day long.  A sip every 5 minutes during waking hours.  Getting hydrated is your number one priority.  In fact, by the 10th day post-op you need to be getting in 64 ounces of fluids daily.  That means you have to be conscientious and disciplined about getting those sips of water in!

But, you can’t live on water alone.  You need the other stuff, too!  You’re going to find after a couple of days that you are burning through calories at a pretty rapid rate.  You’ll need to make sure to get some protein calories in about once an hour that first week.  Soups are pretty easy to find.  It’s just that first week that you need to stay with clear soups – save creamy soups for the second week.  So – remember Chinese restaurants – they have lots of different soup options – and you can sip the broth around whatever contents might be in the bowl.  In Spain we get the great little cup-o-soup packages in the grocery stores and carry them with us when we’re out and about.  Any little cafe or restaurant will bring you a cup of hot water – and you’re set if you find yourself in desperate need of calories.

The second week of liquids are fuller liquids.  We define it as anything that would be liquid by the time it hit your stomach.  Here are things to add to the first week’s repetoir:

  • Creamy soups
  • Yogurt
  • Ice cream
  • You can lick cream cheese off of a spoon

Not hugely different, but a little more variety.  One word of caution.  Some post-ops are somewhat lactose intolerant as early post-ops.  Be careful with dairy – only add one item at a time and watch carefully to see if you have any response to it or not.  It’s a lot like when you have a baby that your graduating through new foods – you go slowly and carefully.

The third week is soft foods.  We define that as anything you can cut easily with a plastic fork.  Here are some ideas:

  • Eggs:  fried, over easy, or scrambled – just remember the cut easily with a plastic fork rule
  • Potatoes:  mashed, boiled, baked – keep them gushy tho, add butter or gravy
  • Soft cheeses
  • Very thinly sliced deli meat
  • Cottage cheese
  • Heartier soups – you can eat the chunky stuff in the soup now if it’s soft and cooked through.
  • Fresh fruit – but avoid super fibrous fruits initially.
  • Steamed veggies – nothing super gas producing, though
  • Tender fish filets – halibut, cod, tilapia
  • Shrimp

Once you make it through the third week of the graduated diet it’s sometimes difficult to think of ideas of what to eat.  Part of the challenge has to do with the fact that a lot of us simply don’t FEEL hungry – until we’re ravenous.  For that very reason I really advocate having things prepared and ready to grab for a quick snack.

Here are some ideas for the first couple of months post-op that can make eating a little easier:

The “salads”:

  • Tuna salad:  I get the albacore at Costco.  Mix it, diced dill pickles, diced celery, chopped up chives, a dash of garlic powder, mayonnaise.  Mix it very thoroughly – when I was an early post-op, I wanted it to be as smooth as possible – not chunky.  You can break it up easily with a fork, a hand blender, or toss it in the Cuisinart for a few seconds.
  • Egg salad:  grate up hard boiled eggs – I use more yolks than whites, throw in some dill pickle relish, some chopped up chives and or green onions, and some mayo.  Mix well.  Enjoy on crackers, chips, or bread.
  • Chicken salad:  Pretty much the same as the tuna salad, but I throw in a little Worchester sauce, and green onions.
  • Ham salad:  I get the ground ham from the Honey Baked Ham store.  It’s very good – but very salty – so a little goes a long way!  Same as the tuna salad recipe.
  • Macaroni salad:  for some reason, there was nothing better than a spoon full of macaroni salad on a potato chip for me about 3 weeks out.
  • Potato salad:  Mom’s Amazing Potato Salad never tasted better!

Meals that make for great snacks later on:

  • Meatloaf.  This is still one of my favorites – for dinner, and then for as many snacks out of it I can get.  I love it warmed up for breakfast – wierd, I know, but I love it!
  • Enchiladas
  • Home Made Chili.  We make ours heavy on the protein and fairly mild – so that everyone can garnish it to their hearts’ content.  It heats up great, and even freezes well, so that you can heat it up quickly for a snack later.
  • Hearty Soups.  One of my favorites is one that Jenn, a fellow Baltasar patient shared – it’s called Taco Soup and it’s amazing and addictive.  Finding a nice protein rich soup that you can make a nice sized pot of early in your week to put in the fridge to go back to for snacks is a great option.
  • Lasagna – really – focus on the fillings, it’s okay to have the pasta too, but remember, protein is your focus now!

We eat often as DS post-ops.  Most folks don’t do so well if they don’t get some calories in at least every couple of hours.  When you’re early post-op that’s often too long to wait between snacks and/or meals.  Before the DS grazing is bad.  After the DS – it’s a way of life.  I always tell my baby post-ops to never leave home without a bottle of water and a couple of snacks with them.  There is nothing worse than getting out and in the middle of an activity or event and realizing you’ve gone too long without calories and you feel like you’re going to keel over if you don’t get something to eat right away!

So here are some snack ideas – of course, there are tons of things you can think up, but here are a few that I particularly like:

  • A slice of deli meat with either a slice of cheese, or layer of cream cheese, rolled up to snack on.  I also love these with a pickle spear in the middle, too.
  • Cheese and crackers.  These are so easy to put together at home, and also for the road.  If we’re on a road trip or something I grab a box of Triscuits, get a quarter pound of a good quality cheese thinly sliced at the deli, and I’m set!
  • Summer sausage.  I only like it thinly sliced, but add it to some cheese and crackers – yummy!
  • String cheese – you know, cheese heads.  They’re great and have a really good protein count.
  • Hard boiled eggs.
  • Nuts.  Peanuts, almonds, cashews, sunflower seeds, pistacios – whatever!  They’re an awesome snack food.
  • Jerky.  We don’t really like the dry stuff at our house – but we LOVE the Tillamook Country Smoker jerky – the steak nuggets are amazing!
  • Pretzels, chex mix, sun chips, or the like.  The carb nazi’s aren’t going to like this suggestion, but these are a great snack food when used in moderation.

It would be lovely to say that no one ever finds themself in a situation where they must have calories and have nothing available to save the day with, but that’s not real life.  If you find yourself in that kind of situation and need calories now, remember you can find a few fairly decent options at fast food places.  Here are a few ideas:

  • Taco Bell’s refried beans and rice.
  • Wendy’s chili with cheese.
  • Wendy’s baked potatoes.
  • KFC’s mashed potatoes & gravy.
  • Popeye’s red beans and rice.

You get the idea – stuff that’s pretty much warm and gushy and will hold you until you can get a nice protein rich alternative.

A lot of post-ops have a hard time figuring out breakfast the first few months.  I’ll be honest I was NOT a breakfast girl as a pre-op.  It was a waster of valuable time, and I was able to pretty much ignore it.  Probably not the best thing for me, but I can admit it, that’s what I did.  As a post-op one of the things that I’ve learned over the last seven plus years is that if I get a really good protein rich breakfast in, getting my protein for the day as a whole goes SO MUCH better.  So, with that in mind, I’ll give you a few breakfast ideas – remember, you can mix and match these:

  • Scrambled eggs; fried eggs, over easy eggs, hard boiled eggs.
  • Omlettes.
  • Quiche
  • Fried ham..
  • Sausage.
  • Bacon.
  • Half of a toasted bagel or piece of toast with cream cheese and a slice of deli meat on it.
  • A deli sandwich.
  • Left over steak or pork chop.
  • You can buy Nancy’s little baby quiche at Costco – they take very little time to heat up, and are a yummy quick breakfast.
  • Biscuits & gravy!
  • Remember – you don’t have to eat breakfast food at breakfast time!

Yes, it takes a little more time to stop and actually do breakfast, but it’s SO MUCH better for you to start your day with a protein punch – and breakfast is the perfect way to do that.

Some post-ops tell me that eating out at a restaurant feels scary.  They don’t know what to choose – are afraid they’ll choose something “bad” or “wrong.”  Time to put that frame of mind aside and remember that the DS is all about real life and eating real food.  Having a strategy doesn’t hurt if you’re nervous, though, and I can give you a couple of ideas as to finding something that’s good, but gentle on the tummy:

  • Halibut or cod – try it as a steak – grilled, fried, broiled, whatever, or as fish and chips.
  • Rib eye steak.
  • Country fried steak with gravy and mashed potatoes.  Marie Callendar’s and Chili’s both have really good versions of this.
  • I really love the Cannelloni Al Forno at Olive Garden.  (Pasta rolls filled with beef, chicken and veal, topped with fontina cheese and meat sauces.)  I also like the Eggplant Parmigiana, but I substitute fettuccini alfredo for the spaghetti.
  • Lasagna is a pretty safe bet at most places.
  • Broccoli Beef at the local Chinese restaurant.
  • Fajitas when going out to Mexican.
  • Why not go for a big old juicy hamburger – just remember, if it’s huge, you’ll just get a couple of more meals out of it.
  • Yes, appetizers CAN be your meal.

I’ve got make sure and tell you, though, that the season of caution with eating as an early post-op lasts really only the first three or so months.  Remember you’re completely relearning how to eat.  Your guts have been completely rearranged.  This is a huge transition.  It’s just gonna take time to find your groove – but you will.

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5 Comments Add yours

  1. Joi says:

    Totally hooked on your blog now. Thank you for all of your help!

  2. Donna L says:

    Thank you so much. Your blog has really helped me through the first few weeks post op.

  3. Alana Roberts says:

    Thanks Dina! Terry is 8 months post-op and still having to take it really slow. Thanks for the information – checking out recipes next. I think we need to focus on making things “gushy”, as most of what he eats is dry. Alana

  4. Trilla says:

    Dina, I would be embarrassed as to say how much I’ve read, reread, and read this Blog again and again!!! Thanks so Much for making this and helping us New DS’ers Out!!! (((Hugs)))

    http://i0.poll.fm/js/rating/rating.js

    1. Dina says:

      I’m so glad it’s helpful!! 💓

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