Since so many of you have asked me for Dr. Aceves' post-op diet as well as what to bring to the hospital -- I decided I'd post all the information here for you to refer too as needed. If you have any questions, please feel free to ask. However, I think these lists do a pretty good job.

REMINDERS:


Do not eat on your arrival day. You may have a light breakfast before you leave home but remember that your pre-op testing will be done the same day that you arrive to San Diego . You need to be fasting 6 hours before your tests, water is OK to have. After the tests you may have something to eat.

For those of you who are flying be sure to travel light as you do not want to have to carry a heavy bag on the return trip, especially if coming alone, wheels on luggage are strongly advised. The storage space in our van is also limited so we would really appreciate it if you limited your luggage.

It is Very Important for you to bring the appropriate documentation for re-entering the US on your way back -BRING YOUR PASSPORT.
Finally per our patient information guide, our driver arrives at the airport around 10:30 am, if you flight arrives earlier please wait for him at the baggage claim area for you flight. He will be there with a sign with your name on it. Bring our 888 344 3916 number with you.

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SHOPPING LIST:

Just as a suggestion you might want to do a bit of grocery shopping before you have surgery so that when you come home you will not need to go to the store, you will be able to rest and relax. Some ideas are:

Broth, Chicken, Beef, Vegetable, or they have new products out (new to me) that are Chinese soup broths in a carton that you simply heat. It would give you a bit of variety.

Popsicles that are water based, sugar free, and a variety of flavors.

Ramen Noodles. While the noodles are not acceptable during the clear phase of the post op diet there is a packet of dry broth mix that many seem to like, it has a bit more kick than regular broth, I am told.

Propel water, you can purchase this as bottled water or you can purchase individual packets of this product and put it in water and mix. The reason this product is good is because many are used to a high carbohydrate diet and when your body is used to many carbs, especially white carbs such as flour, pasta, rice, potatoes, sugar; your pancreas tends to put out a bit too much insulin because of the carb load. When you remove carbs from your diet it can potentially be a drastic change and your pancreas is still putting out a bit too much insulin during the post op diet. This can cause low blood sugar, your stomach might feel nauseated, you might begin to perspire, feel like you are trembling. This does not happen to everyone but it does seem to happen more to older folks or those used to very high white carb diets. Propel water has a very small amount of sugar in it. Just enough to bring your blood sugar up but not enough to cause large blood sugar spikes.

Power Aid Zero, it is a new product that is low carb but it has some electrolytes that are beneficial during the post op stage.

Water, you need to get about 64oz of fluids in daily. Your broth and Popsicles count toward your 64oz of fluids daily. The key is to sip, sip, sip all day long. The first few days you may find that you cannot get your full 64oz of fluids in, try as hard as you can. You do not want to become dehydrated. If you enjoy tap water that is fine, if you don't then perhaps try bottled water and see if that goes down.

Crystal Lite, Sugar Free Hawaiian Punch, pretty much any sugar free water flavorings are fine during the post op diet.

Protein products, during days 1-5 you'll need a clear protein product such as Isopure clear bottled protein liquid or Unjury. You can find Isopure at General Nutrition Stores or a variety of Health Food stores. Unjury must be ordered on line in advance of your surgery, www.unjury.com. They have an unflavored product that is nice because when you are done with clears it is versatile and you can add it to Jello, cooking, smoothies, etc. Please note, this is a whey protein product. All whey protein products have one issue in common and that is that they don't heat easily. If you add any whey protein product to a hot liquid it will clump. The key is to add it to a cold liquid and heat slowly, then it will not turn into lumps.

A good source of protein products after the clear liquid phase (you can use these with water instead of milk starting day #5, and with milk starting day #11) can be purchased reasonably at:

www.netrition.com

Some excellent products are:

Matrix 5.0 by Syntrax http://www25.netrition.com/syntrax_matrix_page.html

The more popular flavors are Chocolate and Cookies & Cream.

You can spice up the Chocolate with Da Vinci Sugar Free Syrups:

http://www25.netrition.com/cgi/prices.cgi?manu_id=121

Another very popular protein product if you like Chocolate and Peanut butter is Whey Gourmet, Choco/Peanut butter:

http://www25.netrition.com/pvl_whey_gourmet.html

I suggest the above because you'll need to consume about 60-80gms of protein after surgery. During the post op diet this can be difficult to do. Adding protein supplements can make this much easier.

You'll want to track your protein intake in the beginning and a few free, on line sites you can do that are:

www.thedailyplate.com
www.sparkpeople.com
www.fitday.com

Just see which format you prefer of the above. The Daily Plate has a weight graph, daily you put your weight in and it is satisfying to see the numbers go down!

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ITEMS TO TAKE TO THE HOSPITAL:

Some items you may want to consider taking to the hospital with you:

Pajamas, the nurses and doctors will be checking your incisions so you might
be more comfortable in your own pajamas than the hospital gowns, however,
hospital gowns are provided if you prefer.

Non skid slippers, thongs, or slip on shoes of some sort. The hospital
floors are very clean and waxed, so you'll want non-skid. It will be sore
to bend over so you won't want to tie shoe laces so slip on shoes are
easier.

A favorite robe, many times it is comforting to have a favorite robe.

Computer - if you have a laptop you are welcome to bring it. The hospital
and hotel are set up with wireless internet connection. Any of Dr. Aceves'
staff can give you the password at the hospital. You do not need a password
in the hotel.

Cell phone - Most cell phones work well in the hospital, if your phone does
not work most of the staff will loan you their phone.

The electrical system is the same in Mexico as the US so you do not need a
converter for your hair dryer, computer, or cell phone charger.

Shampoo - this is provided by the hospital but many prefer their own brands
so they prefer to bring their own.

Book or other reading material. You will not likely feel like reading the
day of surgery but you might the day after surgery.

Loose fitting clothing to wear coming home. You will likely feel a bit
bloated after surgery so bring a sweat suit or something very loose fitting
and comfortable for your ride home from the hospital.

I do not suggest bringing much cash with you. Unless you want to do a
little shopping the day before your surgery there is no need for much cash.
You will want to purchase dinner the night before surgery and $25.00 per
person will cover that easily, less for most restaurants. If you want to
have access to cash then credit cards are a safer alternative. You will not
need to convert US dollars to pesos, you can use US dollars for your
companion in the hospital cafeteria and all businesses around Mexicali if
you choose to do a little shopping

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POST-OP DIET:

Here are a few ideas concerning the post op diet


Day 1 thru 5 ( clear liquids Only )
Fruit Juice ( apple, grape, cranberry )
Propel
Broth
Jello-O
Water
Tea
Protein Water by Kellogg’s
Water popsicles
Clear protein drinks only ( example Isopure, Unjury )

Day 6-10 ( thin liquids )
All of the above and:
Natural Vegetable Juices ( example Carrot, V-8 juice )
Protein drinks mixed with water ( example Matrix )
Whey Nectar Protein Mix


Day 11 thru 20 ( full liquids )
Cream soups
Yogurt
Jello-O
Boiled pureed fruit ( example apple, pear) applesauce
Watermelon, papaya or melon in small pieces
Low fat milk 1 or 2%
Water, Propel, tea
Soy beverages
Sugar free pudding
Protein shakes and protein powders mixed with milk

Day 21 thru 30 ( soft food )
Soft food should be the consistency of a thick liquid ( no chunks or solid material ) and it should be chewed very well before swallowing until it is a liquid consistency )
Tofu
Low fat cottage cheese
Cereal
Oatmeal
Precooked pureed rice
Low fat Yogurt
Yogurt mixed with fruit very well blended
Cream soups
Eggs
Boiled pureed fruit ( example pear, apple )
Watermelon, papaya or melon in small pieces
Boiled pureed vegetables
Beans

Day 31st and beyond ( solid food )
Fish,
Chiken
Meat
Turkey
Vegetables
Fruit

A diet consisting of 800 calories and 70 grams of protein should be your goal.

There is a book called " Weight loss Surgery for Dummies"
Authors: Kurian, Thompson and Davidson
You might find it helpful.
I contains several recipes and ideas on what to eat after surgery

Grilled Marinated Tuna with Lime
Herbed Beef Patties
Turkey Meatballs
Seafood Salad
Chicken Salad

Please do not forget to take your Nexium .
Patients who fail to take the Nexium may experience nausea, reflux and swelling which may lead to difficulty in eating. We recommend you avoid complications that are very easily preventable and plan on taking the Nexium for at least 3 months.

We recommend you have your first check up 3 months after surgery.It will consist of an upper GI and some blood work.
The upper GI is an x-ray examination of the pharynx, esophagus,
stomach and first part of the small intestine (also
known as the duodenum) that uses a special form
of x-ray called fluoroscopy and a contrast material
called barium.


Blood work could include checking the following...
CBC ( to check anemia and lack of vitamin B12 ) and
SMAC 24 (sugar, cholesterol, calcium and hepatic
functioning )

I will also copy paste some information that can help you during these first weeks after surgery.

A diet consisting of 600-800 calories and about 70 grams of protein should be the goal

Protein will not only help you heal and build muscle mass but acts as a
natural appetite suppressant.

Concerning protein supplements here are a few ideas:

Isopure protein drinks - 40 grams of protein per bottle.
Isopure you mix with water - 50 grams of protein.
You can find them at GNC.

"Protein Water" by Kellogg’s - 5 grams of protein per drink.
You can find it at WallMart

Unjuryclear protein drinks - UNJURY Medical Quality Whey Protein Isolate. Great Tasting Whey Protein Supplements for Everyday Health! High Protein and High Quality.
Not so good tasting.

New Whey Nectar Protein mixis very good but it is kind of expensive.
It is said to be one of the best tasting protein products in the market today.
You can get itat GNC or on line
www.google.com/products?client=safari&rls=en&q=whey+nectar+protei n&oe=UTF-8&um=1&ie=UTF-8&sa=X&oi=product_result_group&resnum=1&ct=title


Some patients enjoymaking popsicles and Jell-O Jigglers out ofproteinliquid.
Others enjoy Swanson Clearbroth that comes in a can .
But most enjoydelicious homemade broth using chayote squash for flavor
( they strain the broth to make it clear)

CHICKEN AND FRESH VEGETABLE BROTH

2-3 pieces of chicken for every 2 bowls of broth1 celery stalk
1chayote (hispanic grocery stores)1 carrot
2zucchini2 small tomatoes
2small onionscilantro (optional)
salt to taste

- BOIL chicken pieces for approx. 20 minutes
- ADD celery, chayote, and carrot
- SIMMER 30 minutes
- ADD zucchini,m tomatoes and onions
- SIMMER15 more minutes (cilantro is optional)
- STRAIN and serve.

You can also buy Powder chicken broth that contains 10 grams protein per serving.
You can find it on Amazon.com, it is called ProCel

When you start on full liquids try Matrix 5.0 protein drinks.

Protein shakes and mixes are very good tasking.You will need to wait until they are allowed in you food stage.
Advocare high protein drinks called “meal replacement shakes “have vitamins added to them andare a great optiontoo

FOLLOWING THE POST OP DIET IS VERY IMPORTANT
REMEMBERWE ARE TRYING TO PROTECT THE STAPLE LINE
THE SCAR TISSUE IS STILL FORMING AROUND IT
DO NOT OVERFILL YOUR STOMACH AND DO NOT JUMP ANY FOOD STAGES

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Thats a great reference for ALL sleeve patients. Thanks Vegas!

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September 15, 2009
Dr. Audencio Alanis
Houston, TX

Thanks Vegas! That was alot of work on your part! Your a darlin' . . .

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We are what we repeatedly do. Excellance, then, is not an act, but a habit - Aristotle





Sleeve Date: Dec 29, 2009
PreOp Weight: 332 lbs 6' tall (highest wt: 350 lbs)
Goal Weight : 170 lbs

Wow..thanks for the information Vegas. Did you go back to Dr. Aceves for your three month check up?

No, I went back at 1 month when Bearded had his surgery and that is when he found my spasms. I had my PCP do my 3 month bloodwork - we may be going back eventually though.

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Thanks so much for the details Vegas! What spasms did you have? As far as the Upper GI, do you mean Dr. Aceves wants that done?

I too was a little shocked by this:

We recommend you have your first check up 3 months after surgery.It will consist of an upper GI and some blood work.
The upper GI is an x-ray examination of the pharynx, esophagus,
stomach and first part of the small intestine (also
known as the duodenum) that uses a special form
of x-ray called fluoroscopy and a contrast material
called barium.

I didn't know that they wanted this done - not something I had considered at all?

This protocol is much more regulated than what I recieved from Dr.Almanza. I have to say yours makes more sense. I am only 7 days out and I am on cream soups already and yogourt, pudding. I may have mis understood the info. will go back to clears until 10 days out.

__________________
Carolyn on the journey
Sleeved 10/15/09
hi 252/ now 180/ goal 150

Courage in Women is often mistaken for insanity. In new speak--bitchy-ness

Quote:

Originally Posted by Itstime Thanks so much for the details Vegas! What spasms did you have? As far as the Upper GI, do you mean Dr. Aceves wants that done?

I had esophogeal spasms (still do; however, they're not as bad as they were early on) and so Dr. Aceves suggested a barium swallow and since I was going to be there with Bearded, I had it done there. It was pretty cool to see it - although it's not much fun to live with - I've learned to deal with it and they aren't as frequent as before. Dr. Aceves said they should dissipate by 6 months out.

Quote:

Originally Posted by newmom I too was a little shocked by this: We recommend you have your first check up 3 months after surgery.It will consist of an upper GI and some blood work. The upper GI is an x-ray examination of the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum) that uses a special form of x-ray called fluoroscopy and a contrast material called barium. I didn't know that they wanted this done - not something I had considered at all?

I didn't have the Upper GI; but did have all the labs done (9 different tests) and all my lab work came back totally within normal range. I probably do still need to have the Upper GI; however, Bearded and I may be making a trip to Mexicali in December for another matter and I may just "drop" in and see if Dr. Aceves will do it for me.

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Hey Vegas, you said you will be back to Dr. Aceves in December, what dates? Maybe I could meet you there around Dec. 4?

Quote:

Originally Posted by Itstime Hey Vegas, you said you will be back to Dr. Aceves in December, what dates? Maybe I could meet you there around Dec. 4?

We may be making a trip for another matter; however, I'm not positive - I'll let you know though if it's around 12/4 and definitely we'll meet!

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I am sure you're smarter than me to make sure you call them ahead of time to see if they are going to be there.I was not able to have my tests because I did not realize that the entire staff takes off one week every month. It was the only week I could get off work, but it did not work out with their schedule, so I was not able to go to Mexicali and have my tests.

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band to sleeve surgery 4-29-09
Dr. Alberto Aceves