You Don’t Have to be Hungry to Need to Eat

Okay, bottom line post-DS rule:

YOU DON’T HAVE TO BE HUNGRY TO NEED TO EAT

That is – by far – the hardest thing to learn.  Here I am more than 7 years post-op and I still struggle with it!  I could easily NEVER eat because, well, there’s no real driving hunger for me 90% of the time, so why should I eat?

Wanna know why?

Cause my body needs fuel.  Food = fuel.  Novel idea, not one we really think too hard about, but it’s true.

Repeat after me:

FOOD = FUEL

It’s easy to forget that because we have so many warm fuzzy, and wonderful memories – all centered around food.  But the truth of the matter is that if your body doesn’t get the fuel it needs, it ain’t gonna work the way it’s supposed to.

Another important early post-op rule:

Nausea (about 99% of the time) is really a signal for hunger.  I.e., nausea is the new hungry.  [And just for interest’s sake, you should know the other leading cause of post-op nausea is dehydration!]

Let me tell you why.  Before you had big stomach that could hold up to (at least) 1 gallon (aka 128 ounces) (some people can actually get more in).  Now, you are a teeny weeny baby post-op tummy – Dr. Baltasar gives patients a 50 cc (which is 1.69 ounce) stomach.

This is why eating is so hard when you’re a baby post-op.  You’re adjusting to a HUGE change in your stomach’s volume capacity – and you have to completely relearn HOW to eat.

Other truly novel fact:  when you had the 128 ounce sized stomach your body produced enough stomach acid to digest and churn 128 ounces worth of stuff.  Now that you have a 1.69 ounce sized stomach you have almost the exact same amount of stomach acid pumping out!  Amazing, huh?!  It does get better – most post-ops are on an acid reducer at least the first few months post-op – sometimes they are able to be done with them earlier.  For me it was 6 weeks, and then they were no longer needed.

The reason you feel nausea or blickey tummy is because your tummy has all this acid churning around in there – and probably nothing for it to work on.  So you feel gaggy!

The trick to end the nausea?

You GOTTA eat a little bit of something AT LEAST every 2 hours.  It doesn’t have to be a huge meal.  In fact, if you eat a whole bunch, it’ll kinda irritate your tummy and will take a super long time before you even feel like you can fathom the thought of taking another bite.

For the rest of the world, grazing is a BAD thing.  For a DS post-op – grazing is the way to go – in fact, it’s a very GOOD thing.

Sometimes you just need a little help on trying to figure out how a day would look like or work if you were doing things the way you ought to as a post-op.  So, here’s an idea:

First thing in the morning upon rising (6am?):

  • Take your iron with 2 or 3 oz of fruit juice and/or Vitamin C.

30 minutes to 1 hour later (7am):

  • 1 egg (scrambled or fried or poached or hard boiled or whatever)
  • Maybe a bite or two of sausage or bacon (if you can tolerate it – I couldn’t when I early post-op) or maybe a slice of sandwich meat of some sort.
  • ½ a piece of toast with butter, cream cheese, or melted cheese on it
  • 1 cup of hot tea or coffee

1 hour later (8am):

  • 1 multivitamin
  • 1 Super B Complex
  • 1 B-12 Methylcocalbamin 5000 mcg
  • 4 ounces water, fruit juice, Gatorade, or something like that

1 hour later (9am):

  • 1/4th cup tuna salad
  • Handful of potato chips

1 hour later (10am):

  • 500 mg calcium citrate
  • 250 mg magnesium
  • 50,000 IU’s Dry D3-50
  • 25,000 IU’s Dry A (Palmitate)
  • 4 ounces water, fruit juice, Gatorade, or something like that

1 hour later (11am):

  • 1 container of yogurt of some sort or cottage cheese with fruit OR 1/4th of a deli sandwich (meat, cheese, mayo, etc.)
  • 500 mg calcium citrate
  • 250 mg magnesium

1 hour later (noon):

  • 1 multivitamin
  • 1 Super B Complex
  • 4 ounces water, fruit juice, Gatorade, or something like that

1 hour later (1pm):

  • 2 or 3 pork potstickers with hot & sour sauce
  • Some Egg flower soup
  • A few slices of Chinese BBQ pork

1 hour later (2pm):

  • 500 mg calcium citrate
  • 250 mg magnesium
  • 400 IU Dry E
  • 100 mcg Dry K-1
  • 4 ounces water, fruit juice, Gatorade, or something like that

1 hour later (3pm):

  • 1 slice of deli meat with a thin slice of cheese rolled up around a pickle spear or with some cream cheese inside it
  • A few crackers

1 hour later (4pm):

  • 2 ounces of honey roasted peanuts
  • 500 mg calcium citrate

2 hours later (6pm):

  • 2 or 3 ounces of pot roast
  • 1/4th cup of mashed potatoes with gravy
  • 1/4th cup of green beans
  • ½ cup of green salad with salad dressing
  • 1 zinc sulfate capsule

2 hours later (8pm):

  • 1/4th cup of pork and beans with a handful frito’s scoops

2 hours later (10pm):

  • 1 string cheese stick (mozzarella)
  • A handful of BBQ potato chips

IF by some miracle you were able to eat all of that listed above in one day (I’d be amazed if you could in the first few months after surgery) – it would equal:

2179 calories
99 grams of protein
16 grams of dietary fiber
And 51% of the calories coming from fat (that’s good!)

I would ASSUME that the liquids listed are simply in addition to the sipping you’d be doing all day long – you should get in about 64 oz of water MINIMUM each day.  If water is gross, try:

  • Changing temperature – either try it hot or try it nearly freezing cold (for some people nothing short of ice crystals is acceptable)
  • Adding a slice of lemon, orange, green apple, or the like to the water.
  • Iced green tea – a lot of people report that it helps with settling the stomach!  (I drink this almost exclusively in lieu of water.)
  • Gatorade or some other sort of sport drink.
  • Sprite mixed with fruit juice (like cran-raspberry or cran-grape – my personal favorites!)

Of course, non-sweetened fluids are BEST – i.e., avoid artificial sweeteners and regular sugars in your beverages.  But if the only way you can get your fluids in initially is with some sweetening, do it – just knowing that’s gonna have to change later on down the road.

And just an aside – breakfast and/or morning can be the hardest time.  Why?  Because you’ve slept all night long without any calories going in, and you wake up with a build-up of acid on your poor little tummy.  I often had to get up during the night and get a snack when I was an early post-op.  Now that I’m further out, if I’m feeling particularly acidy in the morning, I try starting with just a little bite or two of something, wait a few minutes, and then move on and eat something more substantial.  It’s kind of like the idea of priming the pump – you gotta get a little bit something bland down there to soak up that stomach acid and get it moving through your system.  Then, 15 or 20 minutes later try eating breakfast.

So – to recap:

  • You need to eat whether you feel like it or not.  Sorry – not fun, but necessary.
  • If you’re feeling nauseous – you are probably really just needing to eat something.
  • Don’t eat a ton.  Nibble a little bit of something at first, then wait.
  • Try starting with 1 or 2 soda crackers.  Then, 15 or so minutes later, try having a spoonful of tuna salad on a potato chip.
    • Ah…  burping.  Yes, totally normal.  Before, you had big huge mongo sized cantaloupe sized tummy.  Kinda like a big black hole.  You swallow stuff – it goes down the esophagus, and drops into the tummy.  Now you have tiny little baby banana sized tummy.  You swallow something and now it goes down your esophagus and then goes into your new tummy – and it displaces air – and the air – rather than having big black hole tummy to swirl about in, has to go somewhere – and up is where it goes.  Burping is normal.  It gets better.
    • One post-op wrote:  “It’s so weird, I went to a wedding and was able to sit and eat slowly for an hour without hurting or nausea.  Then there are times when one bite sets me off.  Don’t get me wrong, I’m not complaining or upset.  I figure it’s all normal and just go with the flow.”
    • The wedding example is the PERFECT example of how a DS’er should eat.  Slowly, with enough time.  My real success with eating finally happened when I realized that I needed a LONG time to get food down.  The key is:  1 small bite every 2 to 3 minutes.  If you go slow, take small bites, stay relaxed, and focus on something other than the food, you’re going to find that eating is SO much easier!
    • For most people the “one bite that sets me off” is the one where the person has not had anything to eat in a long time (more than 2 hours), is stressed out, or is feeling pressured to eat quickly.
    • BUT hurling – it’s NOT normal – so don’t accept it as okay, okay?  This is the hard work part of being an early post-op.  It stinks, but it’s so worthwhile to learn the habits necessary right now to have the kind of freedoms that will be coming soon.

So let’s repeat together one more time:

YOU DON’T HAVE TO BE HUNGRY TO NEED TO EAT

It’s actually kind of a hard concept to get your head around – especially if you’re a Weight Watchers lifer, like I was.  But it’s important to learn and implement.

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5 Comments Add yours

  1. Nicole says:

    I love this post! I was having a lot of trouble with puking and nausea. I got the memo today to ‘graze’ all day, and it seems to be working. Now, if I can stop flinching on every smell…

    THANK YOU!

    1. Dina says:

      I’m so glad it proved to be helpful!

      Just so you know – mint and ginger both help with the gag reflex. Try the Tazo Zen iced tea – it has mint and a lot of people who are having that overactive gag reflex find that it helps alleviate that a bit. There’s also a recipe on the Recipes page for a ginger drink that many swear by!

      Blessings!

  2. Maria says:

    What a wonderful post Dina! Thank you for sharing this with everyone!… I truly see a whole new side of eating post DS. I have been limiting myself a lot!.. to maybe 1 or 2 small meals a day (I am very very worried about weight gain) … reading this really opened up my eyes!..

  3. Great information on hunger and equation of food equaling fuel. Thoroughly understood every point,.

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