And when something annoys me, I go fix it.

So, the food-plan! I've probably said it before and tried it before, but I'll just do it all again, because one of these days it'll stick.

In Perfect Diet Tracker¹ I can track my caloric intake, as well as protein, carbs, sugars, sodium, fat and fibers. I mostly care about the caloric intake, the protein and the fibers, and I make sure to keep an eye on the rest as well.
Because of the surgery I don't absorb protein (and some vitamins and minerals) as well as before. Some people do, however, I don't.
This means that I have to take in more protein than other people with my age, weight, lifestyle and gender. I aim for 60 grams per day, I have a fairly slow life.
I also like to eat enough fiber, because I noticed my tummy gets very happy with that, so I aim for 35 grams of fiber.
My total caloric intake currently doesn't do it. I want to get around 1600 kcal per day, which still doesn't qualify as 'good' in my book, but I have to start somewhere, and seeing how now on most days I float around 1000-1200 with an occasional 1600+ day in between, I'd say I better not overdo it. I might explode.

I eat about 6 times per day, sometimes a little more.
I've done some calculations and decided that I need to go for meals that contain roughly 150 - 250 kcal per meal. I'll come in too short, but I do also drink and can add (mostly) kcal with that, yay!
Chopping the Big Plan into smaller pieces makes it all less daunting. Also, I do really have to eat about 6 times per day, so it makes a lot of sense to approach each meal somewhat separately.

I say somewhat, because with tracking my meals the way I do now (logging everything right after I eat / drink it) I can adjust the following meals. If I notice after three meals that I come in short on the protein side, I can toss in an egg or some extra cheese. If I notice I need more fiber, I'll toss in some more vegetables. This does mean a near constant adjusting but it also allows for some more flexibility per meal.

Right now I mostly track my meals to see what things I eat, what I like, what goes easy and what stays in and / or causes no issues.
I had to eliminate all bread, pizza, cookies, pasta etc (wheat) and that does provide me with yet another challenge. However, since I did, I feel much better and have had a lot less tummy issues than before.

From tracking I've discovered that the following already obeys my 'rules':

• one portion of mashed potatoes (instant), with a little grated cheese and a hard boiled egg
  this qualifies as a pretty serious meal to me, and clocks in around 260 kcal, score!
• two rice-crackers with black-olive tapenade (or peanut-butter)
  pretty salty (not the pb), so can't have it too much (makes me thirsty), but tasty, and around 150 / 160 kcal. as an extra bonus, easy to make, woohoo!
• one portion of Quaker's oatmeal, prepared with water, no extra additions
  around 150 kcal, so if I add some dried fruit, it'll go even higher, yay!
• one portion of yoghurt and one high fiber OJ drink
  around 160 kcal, added bonus of extra protein and extra fiber, good breakfast :D
• one glass of Soya macchiato (drink)
  around 150 kcal, has protein and I can spread drinking it easily
• one hand of mixed nuts and dried fruits (about 1oz)
  around 120 kcal, so not entirely sufficient but it does really well on the fiber and protein part

I've only got a handful so far, so I want to spend more time trying out things and looking for easy snacks on the internet. When I find something that works, I'll experiment with it some more so I'll have variation and add a bit more oomph to it. For now I make the instant mashed potatoes with water, adding some cream to it will boost the kcal and the protein (and hopefully not the bad fats too much because I don't want to clog up my arteries...)

It feels like juggling most of the time, keeping everything tracked and in the right amounts and seeing what works and finding out it doesn't. Food high in calories usually also as either a lot of fat or a lot of sugar, and both make me ill in large enough amounts (not so very large, really).
I don't think this will ever really become routine, though I do hope that eventually I don't have to track as much and check as much and try as much. I'd like to do more on a day than 'dealing with food'. For now, I'll stick with it though.

If all else fails I do have few recipes for that Christmas dinner...

¹ Last year I got a license for Perfect Diet Tracker which, apart from running on multiple OSs (woohoo!), helps track food-intake. I briefly flirted with HealthNut and though I still like that program too, it didn't offer me enough data / settings / feedback. At least, not now, I need all the info I can get basically.

1. Danoontje Snack (curd cheese?)
2. Breakfast cereal (cornflakes)
3. Burrito for lunch (pre-made)
4. Little tomatoes filled with mozzarella balls, sprinkled with herbs and pepper and salt.
5. Slice of ontbijtkoek
6. Poffertjes!
7. A mini babybel or two.
8. Boiled egg.

For Tuesday I'll eat oatmeal, with fruit and cinnamon sugar, instead of cornflakes (oh, how I love the timer on my ricecooker). Not sure about lunch or dinner yet, will think about it some more tomorrow.

The women also looked pretty good post-surgery. Just one tiny tube. Maybe I just got the wrong straw with those two tubes in my nose, one in my back, my arm and a catheter (woopie!). They could have shown more of course, but the show isn't about CDH1 and HDGC, so I guess this type of exposure is OK.

Most people don't even know you can (fairly easily) live without a stomach, maybe this will help. Just too bad they didn't explain dumping syndrome a bit more, as this usually becomes the most debilitating part of a TG. If you look it up it'll say 'nausea, vomiting, cramps, abdominal pain, diarrhea' for early dumping and 'sweating, fast heart-rate, weakness, feeling tired, or mental confusion' for late dumping. It sounds so very simply, but trust me, it's not your regular discomfort. Though these days I know how to handle it better, the late dumping wears me out. The past few days have not treated me well on that area, though the symptoms stay mild (I can still function, but I have pain, nausea, fast heart-rate, foggy head etc, which complicate things).
Because most people don't know anything about this, they'll do the wrong things like offer food or water (when I have dumping the smell, sight and even thought of food makes it much worse, plus I can't drink water and drinking will make it worse, as dumping comes from food passing through to fast). They'll think that because you can eat a larger portion one time, you're okay, or you can eat that much all the time. (No, I can't, larger portions that seem normal mean I have a rare good moment.)
They don't understand I cannot skip meals, I really have to eat 6-8 times per day (I go for 8, the manual says 6). Or that if things go wrong, they really go wrong and it takes the rest of the day to recover. If you know me personally, and you think it's all going well, remember that you only see me on my good days and even if I look bad or ill at the time, it is still a good day cause on the bad days I don't go out. And I still have more bad days (or mediocre days) than good days.

Having said that, things don't go too bad (I'm at home, not in the hospital on a feeding tube), I'm just still very much in my recovery phase. I struggle daily to get enough food inside to maintain my weight, never mention gaining some of those 60 pounds back (no, weight-loss is most definitely not a good thing). Most of the time I hate food and eating, due to the problems it brings. The meal/menu-planning may help, but not liking food does not make it easier to pick foods to eat for the rest of the week. I live alone, so I have to do all the cooking myself, and cooking itself sometimes brings on nausea. Getting ready to go somewhere (without known food) takes about 2 hours, cause it includes things like walking the dog, cooking food, preparing lunchbox with multiple options, fill thermos with tea & milk, pack meds and food and such into backpack. It takes longer because I can't rush. Can't eat when I rush. Can't easily grab a snack on the go, or rely on any random restaurant for food. I have to bring my own and that takes preparation and preparation takes energy, of which I don't have much to begin with. It's all about the spoons...

I received my new Laptop Lunchbox which will let me more easily transport my tasty burritos. It turned out smaller than I thought, not a bad thing at all. It looks slightly bigger than a regular lunchbox and has convenient separate containers. From the website I learned most people found too many lids annoying, so they only put one lid on one of the larger containers. I would have liked more lids (but I knew this when I bought it), but I guess worst case, I can order an extra set of inside containers. So far, I like the size, I like that it comes with a spoon and fork and it closes easily.

Hopefully in a couple of days I'll receive my other bento-box, for more food fun.

I went out to the market today and bought veggies, and then purchased panko, chick-pea flower, rice sheets, mirin and sake at the chinese store so I'll have a good base of basic ingredients. I want to make spicy lentil snacks, japanese dry curry and vegetarian cake provençale. Tasty!

I spent most of the day continuing to not move much on the sofa. I did take a lot of time finding the perfect backpack for me. My other backpacks still work fine, so technically I probably shouldn't buy yet another one (but I still have less backpacks than most women purses or shoes! so ha). My daypack can hold up to 20 liters, which suffices for either groceries or going anywhere and bringing my own food and drinks (some of it at least), but not both at the same time, which means I can't decide to pop buy the store after work (I'll start work again soon, so I will want to buy food on my way home to save time and travel)

My other, slightly larger backpack, could probably do both, but borderline, with its (I think) 23 litres. It would get tight but would fit with not too many groceries. It feels a bit uncomfortable though, when it gets heavy. It's more or less very handy for clothes and laptop, but not so much for groceries. The hip-band doesn't do much for distributing the weight.

So I found the Vaude Gallery Air. It holds about 30 litres (a bit much, yes) but has straps to tighten it, so it becomes more flat. It has a raincoat (yay) and can expand with an extra 5 litres (yay). It has a great back (I have the same thing on my really large backpack) so you can have ventilation between your back and the pack, or wear it tightly to your back.


I needed a thermos (yes, needed, I don't drink as fast as normal people and with a thermos I can take my time and still enjoy a hot beverage), I looked around at Siggs and found the Metro Mug.
It holds 380ml or 13oz which means I can take a pretty large amount of hot beverage or soup (maybe even stew) to work with me. Or, I bring soup, have that, and fill it up with hot tea and milk at work. Win-win! Mmmm tea with milk.


I also ordered a normal water bottle, even though I won't drink water from it. It comes with its own cup. I could use it for beverages that don't need to stay that hot or cold. It has an optional neoprene jacket to keep it cooler / warmer for a longer time, so I may purchase that if needed. Or, I could just fill it up with booze ;)

I have plenty of containers to bring food in, and after searching found a handy small ovendish that I'll bring along to work as well, in case I need to heat something up (I don't like heating stuff up in plastic, eek). I have several and should it break I won't cry over it.

So, my backpack survival kit will contain:
- nifty backpack
- Metro Mug, with soup or tea with milk (mmm)
- waterbottle+cup with some other beverage
- about 3 portions of food / snacks, either in mr Bento or in my separate containers
- cuttelery (possibly getting a new set for this)
- cloth/towel, for drying used stuff and wipe hands with (might just cut up an old t-shirt for this)
- ziploc bag with medication (1 dose MTX, 1 dose folic acid, several naproxen / paracetamol, 2 dose of plaquenil, spare set of contacts, small bottle of disinfectant for hands, 2 sachets of ORS salts, 1 (lip)balm and I probably forgot something)
- with the weather probably safe to add extra set of gloves, hat, scarf, jumper of some sort, extra pair of socks

Just the basics. At least I can say, I've come prepared...

At first I thought I wanted to bring too much, but the more I think about it, the more I know I've only listed the bare minimum.....