Friday, September 25, 2015

Diet and exercise, you say?

The past few weeks I have been eating...a lot...and it's all been pain free.  Since I have a loop ileostomy, the transit time is fairly short so food is not staying in my system for too terribly long.  And by that I mean, I eat some rice and maybe 45 minutes later I'm seeing pieces of rice in the bag.  This is common for people with loop ileos and can cause some weight loss, depending on your health and diet going into surgery.

I was at a healthy weight and five weeks into a mild/moderate flare-up just prior to my step 1 surgery.  The flare was caused by cessation of Remicade and 6MP usage in preparation for surgery, since it is my surgeon's strong preference that those drugs filter out of your system beforehand.  But the flare hadn't caused me to lose any weight, so I was a pretty healthy weight going into it.

Since surgery, I have lost about ten pounds.  I'm blaming this on the loop ileo, and I have made a concerted effort to have several high calorie snacks throughout the day since my goal is to stay at this weight, at least until my second surgery.  The standard post surgery diet is called the soft/low fiber diet.  It's actually not that bad!  Foods that thicken your output - bread, bananas, rice, applesauce, creamy peanut butter - are encouraged early on since your loop ileo will likely only produce liquid output initially.  

While I do miss raw veggies and fresh fruit, here are a few of my favorite foods for the first couple of weeks post-op:

  • Chicken soup:  I make my own broth from a roasted or rotisserie chicken, sautee celery and onions in some olive oil to soften them up prior to adding it (and cooking it into) the soup, and include rice or noodles to make this a well balanced meal in and of itself.  So comforting and delicious.
  • Egg salad sandwiches: Something I love, but never really think to make very often whatsoever.  Boil some eggs, chop them up and add mayo, and spoon it out over soft, white bread (NO seeds or wheat/grain bread!)
  • Bananas and avocados: Ok, I kind of lied about the fresh fruit thing.  I also don't eat bananas and avocados together, so I'm sorry if that created some confusion.  I love both, just separately, and they are 100% allowed.
  • Sweet potato biscuits:  I found these in the frozen food section of Fresh Market and I am totally hooked.  Made with real sweet potatoes so high in Vitamin A, it's rare that a day goes by without me eating at least one.  
  • Baked cod with lemon and butter:  I am a huge fan of fish and cod is an excellent source of lean protein.  Add a cup of salted rice and you have yourself a nice little meal.   
  • String cheese and crackers: I crave salt now - with good reason - and find this snack satisfies my salt tooth, provides a complex carb which helps thicken up output, and provides some delicious protein that's also fun to eat.  
  • Linguine Alfredo:  I found that the creamier the sauce, the better it got along with my GI tract (sorry ,tomatoes!  you're simply too acidic for me).  I like Classico brand since I was too exhausted to make my own.  
  • Chocolate milkshake with banana and peanut butter: This is one of the high calorie snacks I mentioned earlier.  A few generous scoops of Breyers chocolate ice cream, one ripe banana, and a couple tablespoons of creamy peanut butter.  Perfection.  
  • Yogurt:  I got in the habit of eating Blue Hill since they come in unique flavors, like beet and carrot.  Since they actually contain vegetable ingredients, its healthier than eating the sugar-packed run of the mill brands.  Delicious, as well as being a good source of protein and probiotics.

Also worth noting - I've been battling dehydration, so I drink a lot of water throughout the day, every day.  I'll add a nunn tablet to one or two of my glasses of water to help me get more electrolytes without any sugar.  I also have found that eating plenty of starchy, salty snacks like pretzels throughout the day helps thicken my output and stave off dehydration.

Exercise, like diet, is limited for several weeks after surgery.  The biggest challenge -- you can't lift anything heavier than 10 pounds for six weeks.  Also you are asked to wait at least four weeks before really starting to exercise like "normal people".  Luckily, walking is allowed from day one -- if you recall, I was determined to "walk" the evening after my surgery.  I doubt that walk in particular really paid off for me in any meaningful way, but I'd like to think that being determined to chase any opportunity to help the healing process will behoove you long term.  

I have made a daily habit of going for a walk first thing in the AM.  It's helped clear my head, keep me sane throughout this process, lets me stretch my legs and get some fresh air. There are of course more detailed scientific reasons as to how walking is good for you.  

I started off ridiculously slow.  In the hospital, I would walk 4 separate times a day along the perimeter of my floor.  One lap would take me about 10 minutes, which was the maximum amount of time I felt comfortable standing.

As soon as I got home, I was able to start steadily increasing my walks.  I am now at 3 miles a day -- broken up between one 2 mile walk and then either one 1 mile walk in the evening or two half mile walks.  It's been great to have this kind of structure built into the day and while I can't tell on a daily basis how much more my j-pouch is healing, I can measure progress by my walking mileage, and I've found that to be remarkably satisfying.