Gastric Banding. Liquid Diet - Two weeks post-operatively. Fawkner Park Nutrition Services. The Avenue Clinic, 42 The Avenue, Windsor.

Transcription

1 LAP BANDING - INITIAL 2 WEEKS POST GP Gastric Banding Liquid Diet - Two weeks post-operatively Fawkner Park Nutrition Services The Avenue Clinic, 42 The Avenue, Windsor Phone FAWKNER' PARK NUTRITION SERVICES, 42 THE AVENUE, WINDSOR

2 A GUIDE TO FLUID INTAKE The First 2 Weeks after Operation After the Lap Band operation, our initial concern is to allow the band to settle into the correct position and become secure in that position. We believe that this settling-in process takes about two months and we therefore have a program covering this period during which we focus very much on a pattern of drinking and eating which will not put any strain on the band. In particular we are seeking to avoid vomiting. The program consists of an initial phase of having liquids only, and then after about TWO weeks a phase of gentle transition from liquids through to solid food (Refer to 'The Transition to Solids'). The following guide is an extension of the dietary information provided in the 'Patient Information Booklet'. It provides more detail on a suitable drinking and eating pattern during the first 3 weeks after operation and offers a range of suggestions to help make this phase more tolerable. At all times throughout this phase (and through subsequent months and years when you are on solid food) you should seek to identity when you have had enough and stop any oral intake before it generates a feeling of discomfort or nausea or a wish vomit. You must take fluids slowly so that you can develop sensitivity to how easily they pass into the stomach area and through the band. Clear fluids should pass easily at all times without any hindrance. If you are having difficulty with clear fluids then something is wrong. Either the band is too tight, there is a piece of food blocking the opening or there has been movement of the band through the stomach to cause distortion. Therefore, if you are having trouble with clear fluid you should always contact your doctor. FAWKNER PARK NUTRITION SERVICES 42 THE AVENUE, WINDSOR

3 On The Day of the Operation After you are fully awake from the anaesthetic you will be able to have sips of fluid and ice to suck. You will have an intravenous drip in the arm and this will provide all the volume of fluid that you need. Once OK with sips, you will proceed to clear fluids orally. On the First Day after the Operation, For patients who stayed in hospital overnight, a special x-ray will be performed which involves you drinking a special fluid and medical staff watching that it passes normally through the area of the band. This helps to confirm that the band is in the correct position, that there is a clear pathway through the band area and that there are no leaks or other abnormalities as a result of the operation. This X-Ray may be performed prior to your 5 week check if you were treated as a day-stay patient. Clear fluids should be steadily drunk rather than gulping them down to minimise pressure on the stomach area above the band and to prevent vomiting. There is no restriction on the total volume of fluid you can take, but all the time checking that you feel comfortable and that you are not inducing any nausea. Once the ward staff are happy that you can take these fluids without difficulty, the intravenous drip will be removed. These fluids should pass easily through the band and we would not therefore expect you to get any feeling of fullness. On the Second Day after the Operation We now start to provide nutritional fluids in addition to the clear fluids. The hospital will provide you with a menu of clear and nutritional fluids (refer to list over) so that you can select your meals. Try to include nutritional fluids at three meal times with a milk drink or yoghurt between each breakfast-lunch and lunch-dinner. Clear fluids can also be included as you desire throughout the day Breakfast Morning tea Lunch Afternoon tea Dinner Nutritional fluids Glass skim milk/yoghurt Nutritional Fluids Glass skim milk/yoghurt Nutritional Fluids FAWKNER PARK NUTRITION SERVICES 42 THE AVENUE, WINDSOR

4 LAP BANDING- INITIAL 2 WEEKS POST OP For the Remainder of the Two Weeks This program of fluids needs to continue for about two weeks from the day of operation. The idea during this period is to continue to minimise strain on the stomach just above the band at all times. The final test of whether a food is appropriately liquid is whether you can suck it up a straw. The amount of fluid tolerate at anyone time will vary between individuals. However, aim for a total fluid intake of at least 2 litres each day to prevent dehydration. You may need to sip slowly on clear fluids between meal times to achieve this without putting strain on your band area. Any medicines that you take must be liquid or finely crushed. Tablets such as Panadol and Aspirin can be used in the soluble form. Other tablets need to be broken down to a powder and mixed with yoghurt or water. Some capsules are satisfactory in the intact form as their outer coating dissolves easily. Inevitably the fluid diet is low in roughage (or fibre) so you could expect the frequency of bowel activity to decrease. Alternatively, some people experience fluid bowel actions. If you are concerned about your bowel habit contact, a member of the Bariatric Surgery team. FAWKNER PARK NUTRITION SERVICES 42 THE AVENUE,WINDSOR

5 CLEAR FLUIDS Water, plain mineral water soda water (not too fizzy) Tea or coffee Low calorie soft drinks or cordial NUTRITIONAL FLUIDS Milk 'Physical No Fat and 'Skinny Milk' are the most suitable milks. You may take milk plain or flavoured. Try flavouring milk with "Quick", topping or blended with fresh fruit to make a "Smoothie". Low calorie hot chocolate powders (eg. 'Jarrah' brand) are also available for preparing warm milk drinks. Fruit Smoothie 400ml skim milk 200ml skim yoghurt 200gms fresh fruit such as banana or strawberries Combine all ingredients in a blender and blend until smooth. Serve chilled on ice. Custard Homemade custards and commercial custards are suitable so long as they are liquid enough to pass through a straw. Yoghurt Low fat yoghurt is preferable (0.1 g fat per 100g) Yoghurt should be taken in a liquid form. Commercial drinking yoghurt is suitable and so is standard yoghurt so long as it is can be taken via a straw. Danone Diet Lite is an acceptable consistency. Other brands may be purchased and diluted with milk or water. If yoghurt contains fruit, the fruit will need to be thoroughly blended through the yoghurt. FAWKNER PARK NUTRITION SERVICES_ 42 THE AVENUE, WINDSOR

6 Eggs Eggs may only be taken in liquid form such as egg flip or egg nog. Egg Flip (serves one) 1 egg 250mls warm or cold milk (3/4 cup) 4 drops vanilla nutmeg Beat egg, milk and vanilla with an electric blender. Pour into a glass and sprinkle with nutmeg. Fruit Fruit may be taken in liquid form only. Any commercial fruit juice is suitable but try a range of different juices to add variety to your liquid diet. Pineapple juice, apricoj nectar and tomato juices are available in addition to apple and orange juices. Try preparing your own fruit juices but be sure to strain them prior to drinking to avoid unwanted pips. A blend of several fruits can produce a delightful flavour. Tinned fruits are also suitable if they are vitamised to a liquid and can be passed through a straw. Vegetables All vegetables must be taken in liquid form. Commercial vegetable juices are available that combine a mixture of different vegetables. Campbell's 'V8' vegetable juice is a nourishing juice available at most supermarkets. You may like to prepare your own vegetable juices using a juicer, to develop a range of tasty combinations. FAWKNER PARK NUTRITION SERVICES_42 THE AVENUE, WINDSOR

7 LAP BANDING -INITIAL 2 WEEKS POST OP Soups All soups must be of a liquid consistency without any lumps. One way of testing whether soup is of a suitable consistency is to ensure it can be sucked up through a straw. To thin soups add stock, milk or water and re-blend. Commercial, canned soups are suitable so long as they do not contain unblended lumps. Vitamising chunky soups will ensure their suitability.,. Hearty Vegetable Soup 1 bunch celery 2 onions 1 turnip 4 cups water 1 can baked beans (425g) 2 leeks 4 carrots 1 parsnip 1 cup stock salt and pepper Prepare all vegetables and chop roughly. Place in a large saucepan with water and bring to boil. Simmer until vegetables are tender. Add baked beans, salt and pepper to taste. Vitamise until smooth. Add stock to thin soup to required consistency. Less Nutritious Alternatives Jelly, ice-cream, frozen yoghurt and icy poles are suitable during the liquid phase because they melt in the mouth to become liquid before reaching the stomach. These foods contain little nutrition so use them only to add variety to your diet rather than to replace nourishing fluids. FAWKNER PARK NUTRITION SERVICES_ 42 THE AVENUE, WINDSOR

8 OTHER INFORMATION For more advice regarding your diet during the first 3 weeks after operation, you can contact the following people: NAME POSITION LOCATION PHONE Nicole Bando Dietitian Alfred Hospital* Please note: Dietician Nicole Bando see patients in one of the Consulting Rooms at 42 The Avenue, Windsor You must arrange your initial appointment with the Dietician, to receive your tailored nutrition plan for the 'Transition onto Solid Foods', after your band is placed. PLEASE CONTACT: THE NUTRITION DEPARTMENT AT THE ALFRED HOSPITAL ON (03) WITHIN THE FIRST WEEK AFTER YOUR SURGERY TO ARRANGE YOUR APPOINTMENT. 8