Monday, March 7, 2016

a visit to the dietitian

A few weeks ago I mentioned that I made an appointment with the dietitian at my surgeon's office, because I got an ass chewing at my two-year post-op checkup (which I totally needed to hear!).  I was supposed to go on February 23, but it snowed and they closed the office early.  I was incredibly disappointed, since I planned to take that Friday off work so I could have a "me" weekend:  stocking the cabinets, fridge and freezer with the foods I should be eating, cooking in bulk, and basically just getting my focus back so I can lose the last of the weight.  Since they rescheduled for March 1, I decided to take this past Friday off instead, which actually worked out better for me.

I was happy to hear they have a new dietitian, as I really wasn't thrilled with the last one they had, so I was excited about the appointment.  The one I had before my surgery just really never had anything to say.  She handed me a pre- and post-op binder and then asked if I had any questions.  Um, yeah. What should I be eating to prepare for surgery?  Do I need to lose weight?  Maintain? Do I need to start supplements yet? And after surgery, she was on maternity leave and then just never came back, so the physician's assistant took over (she's no longer there, since the doc cleaned house).  She was better, but I was never told eat this kind of protein, take this kind of supplement, don't take my calcium within three to four hours of taking anything containing iron, etc.  Really, most of what I learned I learned by reading other blogs and chat forums.  I felt that I really needed some guidance, even though I'm more than two years post-op.

Unfortunately, they double-booked the appointment and were also running behind, so I was about 45 minutes late in getting in to see the dietitian, Nancy.  She was very nice and had lots of questions for me.  I told her about my daily food intake, what I normally eat--good and bad--, what I'm having trouble with (snacking!  crunchy carbs!), the fact that I track input off and on (more off than on...), etc.  She made some suggestions, like cutting a protein bar into pieces and snacking on it throughout the day.  This was new to me, since the physician's assistant always said that we shouldn't eat protein bars, as they're not "real food."  Nancy disagreed and said that many are high in fiber, low in sugar and are made with high quality protein.

This is the good part, and what made it worth the long drive and the wait.  Nancy then asked me how many calories I eat. I told her I try for 900, but feel that's too high.  She gave me a weird look.  She asked, "why 900?" I told her that that's what I had read all over the internet and seemed to be the popular consensus, plus that's what the physician's assistant told me about six months ago.  She said that I should be eating more than that, because I'm tall and have a bigger frame.  She then suggested a new way of tracking my intake that might be a lot easier and fast track the weight loss:  track protein intake, not calories. She said that I should up my protein to 85g-100g a day and get about 30% of my calories from protein.  So, after doing some math, that means I can eat about 1300 calories a day, of which 400 of those will come from protein.  She said that most of the time, concentrating on the (lean) protein intake will cause the calories to take care of themselves. Assuming I don't load up with butter or other fats, of course.

So, even though I had to drive an hour each way and wait 45 minutes to get in, it was totally worth it just to hear that I've been doing it wrong by aiming for too few calories. I never thought I'd hear that!  And that really helped get my head back in the game.  When I was aiming for 900 calories, most days I felt defeated before I even started.  There's just something about seeing that number in writing and then seeing it dwindle to almost nothing after inputting my breakfast, lunch and snacks, and then realizing at 3 pm I have about 300 calories for the rest of the day. That might sound like a lot to some people, but it's really not when you factor in any fats or condiments and the fact that you still have about seven to eight hours before bedtime.  But now I have a new focus:  protein.  I think that will help me lost the rest of the weight, because I have to get "at least X number," rather than "no more than X number."  I'd much rather track protein than calories!

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