Okay - here's most of the info the nutritionist gave us. Her spiel probably took up more time than anyone else's, and with good reason. My stomach is going from (well I probably don't want to know how big) to down to the size of my thumb. The basic rule of bypass surgery is protein first, so your body won't "eat" all of its protein stores (muscle mass), and instead will use up its fat stores. Since the stomach is so small to begin with, and is recovering from major surgery, the way they recommend is by using protein shakes. Not like the ones you get in the grocery stores, those usually have loads of sugar and not enough protein. According to the handout she gave us, the supplement should have at least 30 grams of protein and less than 3 grams of carbohydrate per serving. They gave us a couple of websites that let you order samples, www.vitalady.com and www.wlssuccess.com . So far the ones I have liked the best have been the Champion brand chocolate (mix with a lot of ice and its like a milkshake), Nectar brand very berry cherry (use about an ounce more water than they call for and ice in a blender - its like crystal light, but has a bit of a "hot" aftertaste if you don't use enough water), and then I haven't tried this, but everyone raves about Isopure brand vanilla - because they say you can add all sorts of sugar free syrups and flavorings to it and its a great base.
Also, since you can't eat very much - vitamins and supplements are very important; but they can't be taken in pill form like normal because 1. you couldn't swallow them - you'd just throw them back up, and 2. you couldn't digest them properly even if they would go down. (That's part of the process of GBS - malabsorption to a certain extent) So all supplements have to be cheweble, liquid, crushable, or dissolvable. They recommend a multivitamin, iron (ferrous fumerate 325mg/day, or chelated iron 30mg/day - because they are more easily absorbed and don't irritate the stomach as much as ferrous sulfate), Calcium (calcium citrate 500mg/ 3x day - calcium and iron cannot be taken at the same time), and Vitamin B-12 (this is the one that dissolves under the tongue)
Also, we have to be very careful about chewing. If food is not chewed enough, it will not go down through the much smaller opening - and will just be thrown up. One thing that kind of freaked me out was chewing gum. She told us sugar free chewing gum was OK as long as we were't prone to swallowing it. Now I am terrible about swallowing gum, especially if I forget to spit it out before I go out on stage to sing, its a very bad habit that I never think about. When I asked her what happens if you swallow gum she informs me they have to do an open surgery to remove the gum from the stomach, because it will not go down, and it will completely block off the passageway from the stomach to the intestines! [+o(]
After surgery it is a slow progression to eating normally again (but you do get there, if in much smaller quantities, and you do tend to eat more along the lines of a diabetic or a low-carb dieter).
Day after surgery - clear liquids
2nd day - add full liquids (including protein shake)
one week after surgery, after clearance from doctor start soft proteins: soft eggs, cottage cheese, unsweetened yogurt, soft fish - chicken - turkey (MUST be moist and chopped very well), cooked beans (lentil type, not green) - and add vitamins
6 weeks after surgery, add soft vegetables and fruits - no leafy greens or fruit skins or citrus, also can add small amounts of complex carbohydrates. Protein always comes first though.
6 months after surgery, add red meat and raw, leafy vegetables
Major things to keep in mind:
Protein first, veggies 2nd, fruits 3rd, carbs last
No caffeine - causes dehydration and increases appetite, My Dr. also says no carbonated drinks because the carbonations can swell the stomach pouch
Water- VERY IMPORTANT - 64 oz per day - but, you can't drink it all at once, and you can't gulp. You have to sip on it constantly throughout the day. Also, you cannot eat and drink at the same time, because the liquid helps to push the food through the digestive tract more quickly, making you hungry again more quickly.
Eat less than 5 g of sugar - otherwise you risk "Dumping syndrome" - this is not vomiting (although oftentimes you wish you would). Diabetics may recognize the symptoms from when their body overloads them with insulin. Because that's exactly what happens after this surgery. You get light-headed, pulse starts racing, you feel flushed, start feeling sick to your stomach, bowels start cramping, and often feel like you are going to pass out. Usually you need to lie down until the dizziness passes - and then you often will be sick to your stomach with diarrhea. I am familiar with this because this is what my body does during panic attacks. I cannot imagine bringing one on intentionally! Vomiting usually occurs if you hae eaten too quickly, not chewed your food well enough, or eaten something that your stomach has not healed enough for. That's one reason many post-op patients give the advice "Try new foods at home- not at a party or restaurant!" But, just because a food makes you sick one time, does not mean that 2 or 3 weeks down the line your stomach won't be ready for it. So don't completely mark it off your list. The nutritionist mentioned keeping a food diary of what foods you can and cannot tolerate. You might list what dates you tried the foods that made you ill, then try them again a month later.
OK, I'll sign off on this one, I think I listed the most important stuff. You'll fet the whole spiel from your own Dr., and every Dr. may not have the exact same guidelines (every other person I know drinks diet sprite!) But since this is who I chose to go with, I'll follow their advice.