“How do you feel?” The nurse practitioner asked while studying the healing scars and bruising on my abdomen.
That was a pretty good question. It was two weeks after my surgery. How was I doing?
“I feel a LOT better than the last time we saw each other!” I said, waiting for the joke to impact, “Seriously, I feel better. I still don’t feel like myself. I don’t feel the same, but I feel like I’m getting better each day.”
He smiled. “It’ll take three months for you to finally get all of the bugs worked out, to be completely comfortable with your new digestive system and know your limits. Give it some time.”
I was relieved. Nobody told me how I was supposed to be feeling.
He also said I could start eating mushy foods, start driving, and do all the aerobics I wanted. No strength-training or travel yet, though. But plenty of exercise if I wanted it.
The nutritionist was next. She explained to me that, for the next six weeks, my life was going to be governed by a stopwatch and some new rules about eating.
As she explained it, my stomach has finished its initial healing, but there are crevices where the staples are still holding things together. Over the next six weeks I should build up scar tissue, which will finish out the healing process.
Until then, I have to deal with a stomach the size of a walnut, and one in which I don’t want to put anything in there that could get stuck in a crevice. In addition, since it’s all new to me, I’ll need to be very careful about how much I put down there at any one time, so everything is measured before going on the plate, and everything is mushy. Just to make things a little more difficult, if I eat anything with more than six grams of sugar, I’ll experience “dumping syndrome”, which is sweats, heart racing, and all kinds of other unpleasantness involving either throwing up or going to the bathroom.
These stomach guys are not fooling around! But I’m not hungry, and most patients view these things as great positive reinforcers. Plus there’s no limit to the amount of spice I can put on my food, as long as its mushy. She said everything had to be chewed to the consistency of applesauce before swallowing, which means a lot of chewing. “Put your fork down between bites!” She reminded us. Most normal people don’t hold their fork at ready with a load of food on it all of the time. Take a bite, sit, chew, and make sure you’ve chewed it well. Double-check. Don’t read, don’t watch TV, don’t be on the computer. Just sit there and eat. Slowly. Learning a little bit at a time how this is all going to work.
That means soups (drained of liquid) are fine, creamy peanut butter is fine, bananas are fine, beans are fine, unsweetened applesauce is fine. A lot of stuff is fine, really. Just not anything with seeds or anything hard. So no peanuts, tomatoes, strawberries, or cucumbers.
Rice and pasta is bad. Because of the carbs, I asked?
“We don’t do carbs anymore,” she replied, “with a stomach so small, the carbs are not going to amount to much anyway. Rice and pasta are bad because both of them expand in your stomach. They might cause digestion problems.
So every day now I’m on the stopwatch. I get up and have breakfast. All of my meals are 4TBS in size. Today I had 4 TBS of Greek yogurt with 3 teaspoons of splenda and a splash of vanilla flavoring. Nice breakfast. Not a lot of chewing. I time each meal. Today’s breakfast was 3 minutes and 21 seconds. A new record.
Then the stopwatch starts again. There’s to be no drinking for 30 minutes before or 30 minutes after each meal. (This is the famous 30-30 rule that gastric bypass patients live by.) That means meals involve no liquids for me. Once the stopwatch gets to about 45 minutes, I get on the elliptical machine and go for 3 miles.
Getting off the machine, it’s vitamin time. I take 1.5 TBS of liquid Omega 3-6-9 oil, a TBS of B complex, a micro B-12 dissolving tablet, and 2 Centrum chewable multivitamins. To wash it all down, a Isopure protein shake (40 grams protein, 160 calories), sipping a little at a time. Then a large sports cup of water (34 ounces). That takes a couple of hours.
Lunch is coming up, but wait! No lunch until I’m sure I haven’t drank anything in 30 minutes, and no meals less than 3.5 hours apart. (4-5 hours is better). So after the water I start the stopwatch again.
Lunch will be a mix. Maybe 2 TBS of drained Campbell’s Chunky Soup, and another 2 TBS of either mixed veggies or a southwest bean salad. Supper will be either 4 TBS of chicken salad or 4 TBS of baked seasoned Tilapia.
And so it goes, the stopwatch keeping track of when I can eat what. It also helps with the meals themselves. For things I have to chew, I find that meals last between 10 and 15 minutes. The first night I had Tilapia I was in a hurry, wasn’t paying much attention, and ended up eating it all within 7 minutes or so. Bad idea. For about 20 minutes, it felt like that Tilapia was ready to come back up. When they reduce your stomach size, it can only take so much so quickly. If you go too fast or don’t chew enough you either barf or have that feeling of “something stuck in your throat” for a half hour. Either way, not pleasant.
But like I said, these are actually GOOD things. It teaches me to thoroughly chew my food, to pay attention to my body signals to know how full I am, to eat in a self-conscious way instead of just shoveling food in there, to have very small portions. These are all things that various diets have told me to do in the past but I haven’t been able to get with the program. This time I have no choice.
As far as losing weight, now that I’m eating and exercising, it’s beginning to stabilize. I lost 6 pounds last week. I’m hoping that it runs at 4-5 pounds a week for the next few months. My physical energy levels are good. My mental energy levels are still a bit low, but improving with exercise. I do have various stomach aches much more than I like, but I’m slowly learning how to avoid them.
All in all, it’s been a pretty good week. It this trajectory continues, by the time I get to the three-month period the doc was talking about, I should be a completely new person.If you've read this far and you're interested in Agile, you should take my No-frills Agile Tune-up Email Course, and follow me on Twitter.