Adjustable Gastric Band Podcast - 1 Week Follow-up
Hi, I’m Debbie Petitpain, one of the Bariatric Surgery Program Dietitians.
Well, you’ve made it to the other side of surgery – congratulations!
You may or may not feel a strong sense of restriction from your band. You do not have any fluid in your band but there may be some swelling around your band that is helping you feel full. Over time, this swelling will go down and your hunger will increase. Then, we will fill your band with saline during your monthly visits to chase that feeling of restriction.
What we need you to focus on now is staying hydrated. Sip, sip, sip on plenty of low calorie fluids such as water, crystal light, broth, and tea or coffee. You definitely want to get in at least 5 protein shakes per day as well. These protein shakes will help with the healing process and will keep you feeling full on the liquid diet. You can buy ready to drink protein shakes from most grocery stores and drug stores – products like Atkins Advantage, Muscle Milk Light, Glucerna, Slim Fast and carnation instant breakfast. Or you can buy a protein powder like whey or soy protein powder and mix it up into milk or water. Even with 5 protein shakes per day, you will be consuming only 1000-1200 calories per day and you will lose weight. It is important to stick to an all liquid diet in order to prevent vomiting which can lead to band slippage. After one to two weeks on this liquid diet, you will slowly transition to a pureed diet so that you include things like cottage cheese, yogurt, refried beans, blended meats and applesauce. You will make this transition slowly. For example, if you are getting very hungry at 2 PM, you would remove that shake and replace it with a yogurt or cottage cheese and then stick with this meal plan for a day or two. If you are still feeling hungry at 5 PM, you will then pull that shake out to replace that with a pureed food like blended beans or meat. You slowly phase out all your shakes or food over a series of days. The thicker textures of the foods should stay in your pouch longer, helping to promote that feeling of fullness.
You may be wondering: do I stay on all liquids for one week or for two? That depends on how you are feeling. Everyone’s sense of restriction is different and the swelling that is helping you feel restricted will go away at a different rate for each person. However, you will lose more weight more quickly, the longer you stay on the all liquid diet. Also, at your first post-op clinic visit, you will see the dietitian – either me or Nina – and we will discuss how you are feeling on the liquid diet and whether or not you should go ahead and start including some pureed foods in your diet. When you leave that first visit, you will schedule an appointment for your first potential fill. In the 3 days before that visit, you will slowly transition all the way to regular textures. For example, you will eliminate the pureed foods at dinner time and replace them with stewed or baked chicken and tender green beans, and you replace your puree lunch with baked chicken and steamed broccoli. When you come in for your first fill, we will ask you things like, ‘How are you feeling? Are any foods getting stuck? How quickly do you feel full?” If you are already on regular textures, it is easier to have this conversation.
Dr. Byrne is here to tell us more about what to expect during the first fill.
Remember, any time you get a fill, you need to go back to a soft, slushy diet like soups, protein shakes and yogurt for 1-2 days in case there is any swelling around your band. After that, avoid those slippery foods in favor of solid foods that will make you feel fuller, longer. We will see you monthly to assess how you are doing with your exercise and diet. Remember, the appropriate rate of weight loss is anywhere from ½ to 2 lbs per week but it might take you months of adjustments to feel like you can comfortably cut back and start losing weight!