Would It Kill Me....

[losingjusme 12]

i strongly suggest you follow your DOCTOR's direction. you went through surgery to help you lose the weight, an extra few days on liquids will not kill you.

and to be blunt - to the people who said "i went on mushies/solids early and am fine"... how do you know? are you 4-5 years post op and no slip?

the post op 'diet' is not to lose weight. it is to anchor your band into place to reduce the chances of a slip. the more you eat, the more your stomach churns, the more difficult it is to heal/anchor.

good luck.

[hollyu2 0]

I am six days post op and supposed to be on liquids only for 10 days. Has anyone violated this policy? I would love to have some chili or potato soup...

I strongly recommend lasting a few more days. get some slim fast with protien or something else liquid but dont move to mushies just yet. you will thank yourself in the end.

[*susan* 1,709]

i strongly suggest you follow your DOCTOR's direction. you went through surgery to help you lose the weight, an extra few days on liquids will not kill you.

and to be blunt - to the people who said "i went on mushies/solids early and am fine"... how do you know? are you 4-5 years post op and no slip?

the post op 'diet' is not to lose weight. it is to anchor your band into place to reduce the chances of a slip. the more you eat, the more your stomach churns, the more difficult it is to heal/anchor.

good luck.

Worth repeating as this is an excellent post!!

[NJ Richie 0]

I am starting to get worried hearing about all these people on liquids for so long. I was only instructed to do liquids for the day after surgery. The day after that I started pureed foods. I am supposed to do that for 2 weeks and then introduce "soft foods" for the next two weeks. I was banded on March 25 and, thank God, have had no ill effects to date. I was eating yogurt, cottage cheese, tuna, and scrambled eggs the first week!

The post-op diet is clearly an individual thing with an approach that varies from doctor to doctor and from patient to patient. Like everyone else is saying, ask your doctor first, but in the end, you should have a program that you will be able to do comfortably. Good luck.

[StarbuxQueen 0]

I am starting to get worried hearing about all these people on liquids for so long. I was only instructed to do liquids for the day after surgery. The day after that I started pureed foods. I am supposed to do that for 2 weeks and then introduce "soft foods" for the next two weeks. I was banded on March 25 and, thank God, have had no ill effects to date. I was eating yogurt, cottage cheese, tuna, and scrambled eggs the first week!

The post-op diet is clearly an individual thing with an approach that varies from doctor to doctor and from patient to patient. Like everyone else is saying, ask your doctor first, but in the end, you should have a program that you will be able to do comfortably. Good luck.

Which is exactly why in my earlier post I stated that I made a pureed Soup. I felt comfortable doing that because so many start their pureed diet after one week. I realize that I am only 2weeks post op and don't know everything. I have been very careful and only had pureed. I felt the moderators response was a little rude. No one is wanting to give bad advice. I just stated what I did because I wanted the posting to have a response. It is so hard to have a question and no one has a response.

[sharona 2]

I agree.....I'm a nurse and I can tell you every physician appears to be different for the same surgery...my surgeon two weeks out I was on chicken salad, tuna salad etc. Moderators need to keep things in focus.....all physicians' have their own "thing" but remember we all had the same surgery.

sharon;)

[losingjusme 12]

I agree.....I'm a nurse and I can tell you every physician appears to be different for the same surgery...my surgeon two weeks out I was on chicken salad, tuna salad etc. Moderators need to keep things in focus.....all physicians' have their own "thing" but remember we all had the same surgery.

sharon;)

dont forget - not only am i a Moderator, i'm a lap band patient who has been here for quite some time and has witnessed slipped band posts.

99.9% of my posts are not as moderator but as a LBT member.

that being said, i STILL think that everyone should follow their doctor's instructions... cause you never know ...

for example - i just had plastic surgery (a Tummy Tuck) and my doctor said i could walk straight up on day 1 and i had no drains... other members who had the same procedure couldnt walk straight up for days/weeks and had drains...

why? different surgical techniques. so, you never know.

[Oregondaisy 2,021]

Do you know your doctor's complication rates? My doctor keeps us on liquids for 4 weeks before we can move to mushies and he has the lowest complication rates in the Pacific Northwest.

It would be interesting to find out the post op diet from doctors who have a high rate of slips a few years down the road.

[WASaBubbleButt 41]

Which is exactly why in my earlier post I stated that I made a pureed Soup. I felt comfortable doing that because so many start their pureed diet after one week. I realize that I am only 2weeks post op and don't know everything. I have been very careful and only had pureed. I felt the moderators response was a little rude. No one is wanting to give bad advice. I just stated what I did because I wanted the posting to have a response. It is so hard to have a question and no one has a response.

That response most certainly was NOT rude, it's just hard to hear. That's all. It's hard when someone confronts us on inappropriate behaviors.

Look, facts are facts. Your doctor knows more about this than you do. If he didn't you could have placed your own band.

Since US docs started doing banding slips have increased. They have DOUBLED. They know we are too big of weenies to do without our glorious food for a few days so they dumb it down for us. Well, people are paying for it.

I'm blown away that someone with NO medical training but they have had a band for a short time would give someone else the okay to go against their doctor's advice. That is just... I have no words.

If you do not value your band I suggest everyone run out and eat steak and taffy during the post op diet. If you want to keep your band follow your doctor's advice. There isn't an obese person in the world that starved to death when drinking liquids for a few days.

[WASaBubbleButt 41]

I agree.....I'm a nurse and I can tell you every physician appears to be different for the same surgery...my surgeon two weeks out I was on chicken salad, tuna salad etc. Moderators need to keep things in focus.....all physicians' have their own "thing" but remember we all had the same surgery.

sharon;)

Moderators are indeed keeping things in focus. They are suggesting people follow their doc's advice and they are right.

Some docs have better stats than others for a reason.

I'm not sure I'm understanding what you are saying. Are you suggesting that it's okay to suggest people tell others to go against their doc's advice? Care to place your RN license number behind that advice? ;o)

Honestly, I'm not trying to be nasty. But there are times when really bad advice is given and I do hope you aren't suggesting it's okay for message board members to suggest they know more than a patient's doctor. Perhaps I am misunderstanding your point about what mods need to keep in mind. I too, am a nurse and I fully agree with the mods posting here.

[steph_co 9]

I have seen this same post 100s of times and it's always the newbies that've been out for a couple months or less saying to go ahead and do it - they did and they are fine. Can you say misery loves company? What is the point? Trying to get people to do the same thing so you don't have to feel so bad that you did it?

I really don't see what the big deal is with her calling her doctor at the very least before taking the advice of some faceless people on some online chat board. Give me a break.

Longtimers....I'm really beginning to see the oversensitivity that seems to run rampant. I just thought it was a certain batch of people right when I started posting here. I guess there's a reason I don't spend much time in pre-op/post-op forums. Sheesh. This post can be hammered into the ground and it still will continue this way because new people will come and ask, and other new people will tell them to violate their doctor's orders because they, themselves did it.

[sharona 2]

wow!! I'm speechless...

[sharona 2]

I believe people are asking us our opinions of what we may have done. This isn't advice to anyone to do it. The reason for the board is to get that honesty. Should people follow their physicians' advice? Of course but obviously it is clear that all physicians' have different approaches to the same surgery. That is the point...

sharon:)

[faithmd 14]

LJM, Susan, Wasa, Denise and Steph-good posts, ladies. I agree, I think the fresh bandsters are getting less and less tolerant of our advice and wisdom. Not all of them, but I've been gone for a couple of months, at least, and I see the difference. The oversensitivity is exponentially worse than even in January or February as is the bad advice from one to another.

Newer bandsters:

There is sound reasoning behind the liquid diet, I'll explain below. I know it's AWFUL not to be able to chew, it stinks! If we weren't addicted to food, we wouldn't have needed surgery in the first place, but you just have to suck it up and do what your doctor says. Loads of us have had to do FOUR and SIX weeks of liquids. It is a few WEEKS out of your lives, how long have you been fat? I've been fat a crapload longer than four or six weeks. That's all it is, folks. And those of you being banded now are getting WAAAAAY more relaxed dietary guidelines than those of us who were banded even less than a year ago. Do I agree with that? No, but I'm not a band surgeon, so it is not for me to agree or disagree with. I can only explain my point and let you decide for yourselves.

I really, really wonder about the slip rate we'll soon see in the next year or two with these changes in the post-op diets. I think they'll shoot up. We have more and more providers banding people and they simply do not have the experience behind them to say to their patients "You need to be on liquids for four weeks." They are going by what they are learning from other docs and they are getting deluged with phone calls from us patients who are whining and crying and begging for food because we can't seem to handle a few weeks of our lives without chewing something. So they throw up their hands and tell us if it doesn't hurt when we eat it, go ahead. That is bad, we do not know what it will hurt in terms of internal healing and what that will mean for us LATER.

Those of you who advanced earlier (even if your doc said it was okay): If you slip down the line, I want you to think back to this thread and these posts and maybe, just maybe you'll understand why we "oldies" (and I'm not even a year post-op, so I'm not that experienced at all) were so emphatic about our beliefs in following your doctors advice and that IT IS NEVER BAD TO GO SLOWER AND STAY ON LIQUIDS LONGER. (Let the flaming of me begin for saying that.)

I am a person who wants data to back up most things a health care provider is doing to/for me. The Allergan website (the folks who MAKE the LapBand) says this about food stages:

Dietary Guidelines

After surgery, you'll need a new nutrition plan. You'll learn about the positive changes you can and need to make in your diet and lifestyle from your surgeon and/or dietitian. It's very important to follow your new eating and drinking instructions beginning immediately after the surgery.

In the first few weeks after your LAP-BAND® System surgery, you will be on a liquid diet since only thin liquids will be tolerated by your stomach at that time. As you heal, you will gradually progress to pureed foods (three to four weeks post-op) and then soft foods (five weeks post-op). Finally, after about six weeks, you will be able to eat solid foods.

Here's what J & J (Realize) has to say:

Recovery at One to Two Weeks

Progress from a clear liquid diet to a full liquid diet as the healing from surgery progresses. Your healthcare team will provide advice on the quantity and types of liquids that are right for you at this stage

They do not suggest starting soft foods until Three Weeks out.

Granted perhaps there is new research that says prolonged periods on liquid diets are not necessary and the Allergan site just hasn't been updated yet. However, I want the data to back up why it's okay to introduce foods with more substance earlier. Even J&J's site suggests soft foods at week Three and I've love to see their slip rates. Wait, they don't really have any data yet, they are too new in the US.

I would also ask your surgeon about what her/his complication rate is and more specifically what their SLIP rates are (and how many bands have they PERSONALLY done and how long have they BEEN BANDING-not doing lap surgeries).

Are they making post op diet guidlelines because of the increased width of the AP and Realize bands and the selling point that it's less likely to slip *because of* said width?

Is there a study they can show you to support the fairly quick move to pureed and soft foods?

Has surgical technique changed and is there a way now to access the back of the stomach (not previously accessed because of it's proximity to the spinal nerves) and suture the band (I haven't heard of it and cannot find it in any videos)?

Time for a lesson in digestion and anatomy: The reason for the liquid diet is because the band gets "seated" on the stomach and held in place by scar tissue in the back and a sort of "rut" or "groove" in the front that forms during the weeks we are taking in liquids. The stomach is a muscle, and that muscle has to churn and undulate to digest and move food through. Liquid requires little stomach movement to process. When we start to chew something, or ingest something with residue in it like purees, etc, that lets our digestive system know that food is coming down, fluids begin to be secreted to aid in digestion and the stomach starts moving in preparation to start the breakdown of food. The band is held in place on the front of the stomach by sutures in the stomach where it is pulled up and over the top of the band (called the pars flaccida technique), then sutured to itself (Allergan bands-can't find anything re: surgical technique for Realize band, by their animation, there is no suturing on the front, which leaves it MORE susceptible to slippage, but perhaps they just didn't include that in the video). There is nothing holding the back in place, the surgeon tunnels behind the stomach to pull the band around and then scar tissue forms to hold it. That scar tissue can't form properly or as well if the stomach is churning and moving to digest. The "rut" or "groove" can't form well around your stomach with the churning and movement, either. The more your stomach moves, the wider that groove will be, and you want it small and form fitting, not big so the band can slide around. On the back you want the scar tissue to heal and form itself tight around the band to hold it securely in position, it's kind of like getting a paper cut on a joint, everytime you move it even slightly, it pulls apart.

At least that's what the band folks have said for years that is how it all happens.

Perhaps someone somewhere has done a new study and what we've always believed is actually not right. It's possible.

Do you see now why I'd be hesitant to do much of anything but liquids very early on?

Of course, if someone can show me concrete good data from a few years post-banding showing no increase in slips (not just a study with a sample of a few patients) with the shorter time on liquids showing the longer liquid diet is not necessary, then I'll be happy to change my thought process.

One last thing if you've actually read through all of this, but something tells me most "newbs" won't: We are not trying to be rude, and we will not hold your hand and stroke you and say, "It's alright, go ahead, do it because Becky said she could." We will also not sit and say (or at least I won't) "We all make mistakes, it's okay, you'll be fine," because you know what? Maybe you won't. I would never support a newly banded person's "testing" their limits or their "messing up a few times" because that would be irresponsible of me. I do not know the inside of your body and I do not know what your healing will be like. I do not know if eating those few bites of "really soft chicken" has done anything to your band and I won't tell you it's alright.

This will be a little extreme of an example, but I think it will drive home my point:

If you were pregnant (or your wife/SO were pregnant) and the OB told you you had to be on a certain diet to protect your fetus for X amount of weeks, I'm guessing you'd be on that diet for EXTRA time just to be sure, wouldn't you? Why do we not protect our own bodies in the same way?

Edited April 8, 2008 by faithmd

[faithmd 14]

I believe people are asking us our opinions of what we may have done. This isn't advice to anyone to do it. The reason for the board is to get that honesty. Should people follow their physicians' advice? Of course but obviously it is clear that all physicians' have different approaches to the same surgery. That is the point...

sharon:)

Sharona,

While I do really appreciate what you are saying about how the OP was asking about what everyone else has done, you need to understand why we (in my case slightly) more experienced bandsters jump right in and put a stop to the bad behavior with food. We have learned in our months or years here that even though someone may be asking an opinion, they are really testing the waters and seeking validation for "cheating" on their diets. Somehow it makes folks feel better if they can say, "There was this person on LBT whose doctor told her to start soft foods on day two, so I'm okay."

But it's not okay. It really isn't and we cannot simply sit back and hold our tongues (or fingers) and let it go by. We know what can happen, we've consoled many of us who have had slips or lost their bands. Do we know why, not usually, but one cannot help but wonder if in some cases it wasn't the post-op diet that did it. I know in a few situations where you can see someone post about a slip and then look at thier previous posts and they were one that cheated one time or ate something and it went down "okay." You can't help but wonder if that's what set them up for the slip.

And you are correct, different surgeons have different approaches. I would always ask what that surgeon's slip rate is, and how many bands they have PERSONALLY performed, what their surgical technique is, are they J&J and/or Allergan certified, etc.

Perhaps one surgeon might do a few extra stitches in the band that they have found to be helpful in securing it, in that case, perhaps they are comfortable letting thier patients eat a bit earlier, but we don't know the particualrs of each surgeon.

I know that you are aware of the different schools of thought out there in the medical world on just about everything. Sometimes those differences are based on experience, sometimes they are based on reading a journal article (it's true), and sometimes they are actually based on inexperience or arrogance.

What it all boils down to is that it is never bad to go longer on liquids, it definitely CAN be BAD to advance to food faster and anyone that asks, I'll recommend a longer liquid stage to them any day.