Puree stage help

[TiaLi]

I'm now two weeks post-op and due to move on to purees tomorrow. My recovery process has been rather slow and I'm still in a bit of pain - especially in the right hand side of my stomach, which is quite bruised. I'm therefore quite worried about trying anything new that might make me vomit, as I can imagine the retching would be very painful.

Can I ask: did anyone have any trouble with not tolerating things at the puree stage, or does that all come later when solid foods are introduced? For example, I've read that broccoli is difficult to digest and is one of the things you should wait with introducing when you move onto solids - but would the same be said for for example broccoli and stilton soup? That is, does the pureeing take away the risk of the pouch rebelling against what you put in your mouth?

What is your experience? Could you handle pureed chicken fine even though you had trouble with solid chicken? Etc etc

 

[Hannah2]

Hi @TiaLi how have you got on? I started with purée veg soups with added grated cheese for protein but was then fine with chicken or ham soups puréed too I didn't have a problem at that stage. I didn't try broccoli soup so can't answer that but it would be a case of trial and error - everyone is different and to be honest what is ok one day in your pouch might not be another day! Good luck and take it one step at a time!

 

[TiaLi]

Thanks @Hannah2 ! As it turns out the biggest problem isn't that my pouch could reject anything, it's that I start gagging just at the thought of food! Managed two tablespoons of blitzed lentil soup with added cottage cheese today, before I had to put it away. I am so grossed out by everything. The only things that work are cold, acidic items (juice with lots of ice, yogurt).

 

[SAM55]

Thanks @Hannah2 ! As it turns out the biggest problem isn't that my pouch could reject anything, it's that I start gagging just at the thought of food! Managed two tablespoons of blitzed lentil soup with added cottage cheese today, before I had to put it away. I am so grossed out by everything. The only things that work are cold, acidic items (juice with lots of ice, yogurt).

A few of us found our taste buds changed after surgery and we preferred acidic. How were you doing with liquids with protein? What about lemon yoghurt? Chicken and fish were big problems for me for some time and i had to puree chicken long after I could eat lumps, and temperature certainly made a difference - either really hot or really cold, but not lukewarm. What about making an iced soup? Can you drink coffee? I find an iced coffee is nice, made with all milk for the protein. Anything that had a tomato taste was good too. It was a long time before I fancied cheese

It is trial and error and your body will learn what it wants, which is probably nothing you ever fancied before the op!

 

[TiaLi]

@SAM55 Yeah yogurt works, it's pretty much what I live on at the moment (Skyr protein yogurt and Tesco cholesterol-lowering Blueberry drinking yogurt). I don't drink coffee unfortunately, and anything with milk in it makes me gag.

I did try blitzing up a tomato soup with some lentils today, and it was the first savoury hot thing I've managed to swallow without gagging. Guess tomato is the way to go, perhaps it works since it is more acidic than other soups. Only managed two tablespoons though, but better than nothing.

 

[SAM55]

@SAM55 Yeah yogurt works, it's pretty much what I live on at the moment (Skyr protein yogurt and Tesco cholesterol-lowering Blueberry drinking yogurt). I don't drink coffee unfortunately, and anything with milk in it makes me gag.

I did try blitzing up a tomato soup with some lentils today, and it was the first savoury hot thing I've managed to swallow without gagging. Guess tomato is the way to go, perhaps it works since it is more acidic than other soups. Only managed two tablespoons though, but better than nothing.

Wey hey! 2 Tablespoons sounds excellent at your stage.

 

[TiaLi]

Wey hey! 2 Tablespoons sounds excellent at your stage.

Is it? So confusing how much you should eat, I see people having loads more and also managing 2 litres of fluids so I assumed i wasn't getting enough in.

 

[SAM55]

Is it? So confusing how much you should eat, I see people having loads more and also managing 2 litres of fluids so I assumed i wasn't getting enough in.

As much as is comfortable and little and often. I was told not to expect to get 2 litre of fluids in in the first 4-6 weeks. I even struggle with that now, although I should be drinking more water.

 

[TiaLi]

As much as is comfortable and little and often. I was told not to expect to get 2 litre of fluids in in the first 4-6 weeks. I even struggle with that now, although I should be drinking more water.

Those 2 tablespoons was all I had yesterday (plus liquids). Bought some more Skyr yogurt now though, that goes down easier. It's so hard to know what's normal and not. I'm so, so weak - but I'm not sure whether thats ok and just to be expected, or if I need to keep an eye on it and possibly go get a drip or something.

Sorry about the whinging, just feeling really miserable and alone at the moment.

 

[Carby2barbie]

@TiaLi sorry to hear your down!!
Have you thought about soaking ready brek in your yoghurt over night?? Are you using protein powders?? Xxxx

 

[SAM55]

Those 2 tablespoons was all I had yesterday (plus liquids). Bought some more Skyr yogurt now though, that goes down easier. It's so hard to know what's normal and not. I'm so, so weak - but I'm not sure whether thats ok and just to be expected, or if I need to keep an eye on it and possibly go get a drip or something.

Sorry about the whinging, just feeling really miserable and alone at the moment.

Your feelings are understandable. Can you contact your team? I was told if I had any worries about my food intake then to contact my dietitian (NHS M-F). Were you not given a diet sheet/book to refer to? You will feel very tired as your body adjusts and also gets rid of the anaeasthetic. What colour is your wee and are you going ok? That should give you a sign as to whether you are dehydrating (orange). Is this your first experience of any surgery?

If you are really worried then call your GP or 111 for advice.

 

[TiaLi]

Thanks @SAM55 ! Yes, this is my first surgery and I (and my body) feel a bit shell-shocked. I used to think I was pretty tough, but this surgery has really knocked me over. We were given a diet book with suggestions on menus, but the things suggested are things that make me gag completely at the moment so I have had to try different things to see what I can manage. I don't look too dehydrated judging by the colour of my urine, it's more the complete lack of nutrients I'm a bit worried about since I feel very weak. I'm also supposed to take a high dose of iron and folates every day since my blood count was so low, but I can't get it down. So it sort of becomes a vicious circle. Feels like my body won't let me eat until I'm healed a bit more, but I won't heal unless I actually help it along with my meds and protein.

Maybe this is all normal and it's just post-op blues making me miserable! So hard to tell what's normal. I live alone and my family doesn't know anything about my surgery so it all just feels a bit overwhelming at the moment. Very glad I have this forum!

@Carby2barbie I'm one of those people whose taste buds have gone haywire after surgery, so I can't stomach protein powders anymore. Tastes like liquid sugar, it came up straight away. Might try the Ready Brek though!

 

[Hannah2]

Have you tried apple sauce - homemade? Just cook down some sliced cooking apple with a little bit of water (no sugar, so it is quite tart) - I had it with some NAS (no added sugar) custard - both on our diet sheet! I really liked it. Sainsbury's and aunt Bessie's do packets of nas instant custard.

Otherwise the smooth ready brek is good - I had it with some apple sauce.

I had a lot of lattes but you can't have milk? What about almond milk?

Have you put grated cheese or milk powder into your soup? One of my favourites was tomato, red pepper and wendsleydale soup that I blitzed and then added grated cheddar for extra protein. Think I was having 150 to 200 ml soup with 1 oz cheese in.

I did have to force myself to eat some things and get over the mental hurdle of trying new things but if I hadn't done that I was worried that I would end up very limited or with an unhealthy eating problem.

You are still early on so don't panic but do keep trying different things.

What about yogurt smoothies? They don't need to be overly sweet. You could put spinach or kale in which would help with your iron levels.

 

[SAM55]

Thanks @SAM55 ! Yes, this is my first surgery and I (and my body) feel a bit shell-shocked. I used to think I was pretty tough, but this surgery has really knocked me over. We were given a diet book with suggestions on menus, but the things suggested are things that make me gag completely at the moment so I have had to try different things to see what I can manage. I don't look too dehydrated judging by the colour of my urine, it's more the complete lack of nutrients I'm a bit worried about since I feel very weak. I'm also supposed to take a high dose of iron and folates every day since my blood count was so low, but I can't get it down. So it sort of becomes a vicious circle. Feels like my body won't let me eat until I'm healed a bit more, but I won't heal unless I actually help it along with my meds and protein.

Maybe this is all normal and it's just post-op blues making me miserable! So hard to tell what's normal. I live alone and my family doesn't know anything about my surgery so it all just feels a bit overwhelming at the moment. Very glad I have this forum!

@Carby2barbie I'm one of those people whose taste buds have gone haywire after surgery, so I can't stomach protein powders anymore. Tastes like liquid sugar, it came up straight away. Might try the Ready Brek though!

It is understandable if you live alone that you will feel overwhelmed. Do you have anyone who can support you? Is there are Home from Hospital scheme in your area? I live alone too, and whilst daughter knew, she was hundreds of miles away, so not a lot of help.

Any surgery will make you feel weak for a while, as it takes time for the anaesthetic to wear off. What vits and minerals have you been given and in what format? I was told iron would be difficult to tolerate at first. Have you tried chewable vits? They have a sharp fruity taste and whilst they don't have all the nutrients you need, they are better than nothing to start with. Its the protein that is key to the healing. If you can get Arla yoghurts in, the ones with 20% protein, then that is fine. Have you tried any protein shakes? There are some quite sharp tasting ones around. I was advised to add Marvel milk powder to food to up the protein, much more digestible than protein powders. You could add it to tomato soup.

Other things I lived on was Strawberry Slimfast, Horlicks light (which has lots of vits and minerals in), tinned minced beef, pureed - make sure it is a good make so high in protein and not lots of fat, (red meat will have iron and protein) and Ready Brek, again it has lots of nutrients, and if you really cannot face the milk with it, you could mix it with water. I started with the chocolate one as I couldn't face the thought of the non-sweetness of plain, but now prefer the plain.

As your blood count is so low, I would suggest you contact your doctor to see what they suggest. It may be that all you need is reassurance...

 

[TiaLi]

Thanks @SAM55 and @Hannah2 ! So yesterday I managed to have:

Breakfast: 100ml blueberry cholesterol reducing drinking yogurt, with half a teaspoon of protein powder (surprisingly that stayed down!)
Lunch: 2 tablespoons of pureed tomato/lentil soup mixed with Arla high protein cottage cheese
Dinner: 2 tablespons of Skyr yogurt

Liquids: about 0.5 litres of pomegranate juice mixed with loads of ice.

That's the most I've eaten so far, so was happy with that - or does that sound like far too little?

In terms of vitamins and minerals, I've been given Forceval (don't have that at home though, they didn't have any at the pharmacy so I need to go get it when it comes in), Desunin, Liquid ferrous fumarates, Adcal, Folic Acid and Lanzoprazole (well, not a vitamin obviously but...). All liquids or dispersable tablets. Having a really, really hard time getting any of those down though. The only thing that isn't a problem is the folic acid. Can't wait for the day when I can have tablets instead! The liquid iron in particular tastes like pure evil. And it makes your teeth black. They want me to have 20ml of liquid iron daily, which is just impossible. I'm lucky if can manage 5ml. I'm a bit annoyed with my team, because apparently my blood count was far too low already in the blood tests back in June last year - but nobody told me. So now, with the surgery as well, it's dropped down to the level where they'd normally give a blood transfusion. My surgeon wanted me to get it up slowly with meds instead though, since that's a bit less shocking for the body. Had they told me about my blood count results back in June I could have brought it back up to a normal level prior to surgery. Don't understand what the point is in taking my blood every time if no one is going to bother to tell me the results.

I was looking for chewable vits at Tesco but couldn't find any. I've bought Ready Brek now though, so will try that. Almond milk is a no go - that's what I used in my home made smoothies prior to surgery, and since it's the unsweetened kind I thought I'd be able to tolerate it post surgery as well. But now it tastes horrendous.

In terms of support, I guess I've painted myself into a corner a bit since I've kept this surgery so quiet. There are only two people who knows, and none of them live here in London.

Hopefully this will all work out fine and this is all within the "normal" range. It's just frustrating when you don't notice much progress from day to day, while others seem to go from strength to strength. I really suck at being sick haha - I'm so used to being independent, that now when I'm stuck here like an upside-down bug in my bed I'm a bit shocked and miserable.

Thanks for letting me whinge guys, and thanks so much for all the advice x

 

[SAM55]

Thanks @SAM55 and @Hannah2 ! So yesterday I managed to have:

Breakfast: 100ml blueberry cholesterol reducing drinking yogurt, with half a teaspoon of protein powder (surprisingly that stayed down!)
Lunch: 2 tablespoons of pureed tomato/lentil soup mixed with Arla high protein cottage cheese
Dinner: 2 tablespons of Skyr yogurt

Liquids: about 0.5 litres of pomegranate juice mixed with loads of ice.

That's the most I've eaten so far, so was happy with that - or does that sound like far too little?

In terms of vitamins and minerals, I've been given Forceval (don't have that at home though, they didn't have any at the pharmacy so I need to go get it when it comes in), Desunin, Liquid ferrous fumarates, Adcal, Folic Acid and Lanzoprazole (well, not a vitamin obviously but...). All liquids or dispersable tablets. Having a really, really hard time getting any of those down though. The only thing that isn't a problem is the folic acid. Can't wait for the day when I can have tablets instead! The liquid iron in particular tastes like pure evil. And it makes your teeth black. They want me to have 20ml of liquid iron daily, which is just impossible. I'm lucky if can manage 5ml. I'm a bit annoyed with my team, because apparently my blood count was far too low already in the blood tests back in June last year - but nobody told me. So now, with the surgery as well, it's dropped down to the level where they'd normally give a blood transfusion. My surgeon wanted me to get it up slowly with meds instead though, since that's a bit less shocking for the body. Had they told me about my blood count results back in June I could have brought it back up to a normal level prior to surgery. Don't understand what the point is in taking my blood every time if no one is going to bother to tell me the results.

I was looking for chewable vits at Tesco but couldn't find any. I've bought Ready Brek now though, so will try that. Almond milk is a no go - that's what I used in my home made smoothies prior to surgery, and since it's the unsweetened kind I thought I'd be able to tolerate it post surgery as well. But now it tastes horrendous.

In terms of support, I guess I've painted myself into a corner a bit since I've kept this surgery so quiet. There are only two people who knows, and none of them live here in London.

Hopefully this will all work out fine and this is all within the "normal" range. It's just frustrating when you don't notice much progress from day to day, while others seem to go from strength to strength. I really suck at being sick haha - I'm so used to being independent, that now when I'm stuck here like an upside-down bug in my bed I'm a bit shocked and miserable.

Thanks for letting me whinge guys, and thanks so much for all the advice x

That's a fantastic achievement with the food. Certainly doesn't sound too little. Make sure you mix the Ready Brek with lots of liquid so it is really runny, almost like a liquid to start with. I had forgotten about the Arla cottage cheese as my Tesco stopped stocking it when I got to about 4 weeks. It was yummy. I also used to puree it with low sugar baked beans, which were a help with the constipation.

I didn't like the prescription liquid ferrous fumerates, and i had been taking a liquid iron supplement for years - Vitabiotics Feroglobin liquid, Gentle iron, with folic acid and vit B12, plus lots of other vits. I went back to that. The best thing about it is it doesn't constipate you. Their tablets which are supposedly the same do. Obtainable in Asda (where it is the cheapest), some Tesco's and also on Amazon. Are you trying to get 20ml in at once or splitting it into four doses? I found the secret of getting everything in was to really space them out. It is easy to forget that they are a significant part of our overall consumption. It is so annoying when surgeries don't pick up on test results, and dangerous too in some cases! My surgery set a policy a year ago that they would only contact you if there was a problem to save time. My Vit C results in January got lost, but i wouldn't have known that if i hadn't asked what they were. Even more annoying as they have to be taken at a path lab and be tested immediately, which involves a 43 mile car journey, so have had to go back.

When i was a kid and my grandmother made me drink disgusting cough mixture, I found it helped if I held my nose when I swallowed. Didn't taste quite as disgusting then...

Be prepared when you get the Forceval that you may experience problems with that too, as lots of us have. I couldn't face them until 4 weeks. I found it helpful to dissolve them in the smallest amount of water that you can, about a teaspoon' worth. My chewable vits are Bassets.

Are you using a very tiny spoon to eat your food? I used baby weaning spoons as I found it very hard to get tiny amounts in on a teaspoon and took too much at once.

You don't mention your wounds, are they giving you any problems?

It does all seem slow to begin with and there is little else to distract you

I think you are doing well. People's stories differ, and they seem to come in waves. The January surgeries went through a particularly hard time.

 

[TiaLi]

That's a fantastic achievement with the food. Certainly doesn't sound too little.

Oh that's good to hear! I thought everyone else were eating around 200ml per meal by now and managing 60g of protein. That sounds like a physical impossibility to me! Today so far I've had 100ml drinking yogurt, and about 1/3 of a 150g Skyr yogurt. It's hard work and certainly not enjoyable eating, but I've managed to keep it down at least. Just feel ridiculously weak, but I guess that's normal (and perhaps a bit exacerbated for me due to my blood count). Just having a shower feels like running a marathon.

Thanks for the tip on that iron supplement, I might switch to that until I can manage tablets again. Better than nothing, right? I do try to space out the iron, but it's just...impossible. I'm really scared of vomiting since I'm still so sore (don't want to pop an internal stitch either), so when I feel I really, really can't swallow it I put it away.

I think perhaps part of the reason I feel so frustrated and worried is that I am absolutely petrified of having complications and them having to open me up again. I couldn't handle another surgery, this has been kind of traumatic. I always thought I'd be one of the people who healed fairly quickly, but instead I was stuck in hospital for a week, and haven't really made much progress since coming home either. While in hospital I had people having surgery two days after me, who ended up being discharged several days before me.

Can't wait for soft foods. Maybe there'll be stuff I can eat there. Scrambled eggs would be nice. I think. Well, probably wouldn't if you put it in front of me but...

In terms of the wounds, I think they're fine, but I'm not sure. Still have my dressings on, dont dare to take them off - I don't want to see what's underneath, that'll probably make me gag too. They looked fine when they changed the dressings at the hospital though, and I have no other signs of infection.

 

[Oopseydaisy]

. . .

 

[TiaLi]

Thanks @Oopseydaisy !

 

[SAM55]

Oh that's good to hear! I thought everyone else were eating around 200ml per meal by now and managing 60g of protein. That sounds like a physical impossibility to me! Today so far I've had 100ml drinking yogurt, and about 1/3 of a 150g Skyr yogurt. It's hard work and certainly not enjoyable eating, but I've managed to keep it down at least. Just feel ridiculously weak, but I guess that's normal (and perhaps a bit exacerbated for me due to my blood count). Just having a shower feels like running a marathon.

Thanks for the tip on that iron supplement, I might switch to that until I can manage tablets again. Better than nothing, right? I do try to space out the iron, but it's just...impossible. I'm really scared of vomiting since I'm still so sore (don't want to pop an internal stitch either), so when I feel I really, really can't swallow it I put it away.

I think perhaps part of the reason I feel so frustrated and worried is that I am absolutely petrified of having complications and them having to open me up again. I couldn't handle another surgery, this has been kind of traumatic. I always thought I'd be one of the people who healed fairly quickly, but instead I was stuck in hospital for a week, and haven't really made much progress since coming home either. While in hospital I had people having surgery two days after me, who ended up being discharged several days before me.

Can't wait for soft foods. Maybe there'll be stuff I can eat there. Scrambled eggs would be nice. I think. Well, probably wouldn't if you put it in front of me but...

In terms of the wounds, I think they're fine, but I'm not sure. Still have my dressings on, dont dare to take them off - I don't want to see what's underneath, that'll probably make me gag too. They looked fine when they changed the dressings at the hospital though, and I have no other signs of infection.

Did they keep you in because of your low blood count or were there other complications? Don't forget that some of those who seem to be doing a lot, probably have someone looking after them. Are you going out to Tesco or are you having it delivered? I didn't leave the flat for two weeks, and didn't carry anything heavy for a while after that. It is important you take it easy, and ask your doctor if you can have some caring support if you really don't have a friend or neighbour to help out. I know when we are independent normally it is difficult to ask for help, but some times we need to. It will get better with time - at 4 weeks you should be feeling a lot better, it is still very early days, particularly as you were in hospital for some time... x