Most patients should plan on being off work one to two weeks, depending on how quickly you heal and how strenuous your job is. You will be sore and might feel a little weak both from the surgery and from the clear liquid diet you go on the first few days following your surgery. You should not drive while you are taking narcotic pain medicine. You will be fine to get up and walk and take care of your personal needs. We ask you not to get your incisions wet for 48 hours.

You will be given specific instructions prior to your surgery concerning the first four weeks of living with your lap-band. These dietary guidelines are to insure that the band heals in the proper position. Liquids and pureed foods are necessary to prevent any undo pressure on the band while it is healing into the correct position.

Four weeks after your surgery you will begin to eat normal, solid food. We ask you to be very careful at this time and make sure you do not eat more than 3/4 cup of food. The following are some suggestions to help you eat correctly.

1. Set aside 20 to 30 minutes to eat each meal.
2. Chew your food thoroughly.
3. Cut your food into pieces the size of a pea.
4. Stop eating as soon as you feel full.
5. Do not drink liquids with your meal.

The feeling of fullness may be different when you have a Lap-Band. You will need to learn to recognize the signal to stop eating. These may include:

1. A feeling of pressure or fullness in the center of your chest under your sternum.
2. Pain in your shoulder or upper chest.
3. Hiccups.
4. Nausea.

It is important to make changes in your eating patterns in order to produce the desired weight loss and also to prevent pain and vomiting. Inappropriate eating habits can lead to obstruction of the stoma (the opening for foods leaving the upper stomach) which can cause vomiting which can cause a complication known as a slip or gastric prolapse. Care needs to be taken to avoid vomiting whenever possible. Causes of vomiting include:

1. Eating too fast.
2. Not chewing food thoroughly.
3. Drinking liquids right after eating.
4. Lying down after a meal.
5. Eating foods that don't agree with you.

1. Eat three small meals a day.
   
   The Lap-Band System creates a small stomach that can only hold a certain amount of food. If you try to eat more than it will hold discomfort and/or vomiting will occur. Repetitive vomiting will contribute to complications such as "slippage" where some of the stomach slides up above the band causing heartburn and blockage. Treatment may require an operation to revise the position of the Lap-Band. It is important to learn how much your stomach can hold comfortably and then not exceed this amount.
   
   
2. Eat slowly and thoroughly.
   
   Food can only pass through the narrowed area in the stomach if it has been "chopped" into very small pieces. That is why you have to chew very well and plan to take more time for to eat meals.
   
   
3. Stop eating as soon as you feel full.
   
   Once the upper pouch above the band starts to stretch from food, the brain receives a signal that enough has been eaten. In other words, you have a feeling of satiety (fullness). But it takes a little while to become aware of these signals. So you may eat more than is good for you. This can lead to nausea and vomiting. Take your time over your meal and try to recognize the feeling of fullness in yourself. Then stop eating immediately.
   
   
4. Don't drink while you are eating.
   
   The Lap-Band will help you lose weight the most effectively with solid food. If you drink at mealtimes, the food becomes more liquid allowing more food to be consumed. It is preferable for you not to drink anything while eating and for two hours afterwards to retain the feeling of fullness for as long as possible. Try to avoid liquid calories as much as possible such as juice, sugary drinks, shakes, and alcohol.
   
   
5. Don't eat between meals.
   
   After you have had a meal, don't eat anything until the next meal. Eating snacks in between meals lessens successful weight loss. It is extremely important to follow this principle. Until your band is properly adjusted you may get hungry between meals. It is better to eat a nutritious snack than to increase your portion size at your meals. Eventually, as the band gets tighter you will lose your desire to snack.
   
   
6. Eat healthy, nutritious, and fresh food.
   
   Foods high in protein and vitamins, such as fresh vegetables, fruit, meat and cereals is recommended. Avoid foods high in fat and sugar. Eating small meals requires careful food choices to take in enough vitamins,minerals, and protein. (Consider proteins, vegetables and carbohydrates in that order.) Fruit is good to eat but avoid juices.
   
   Most of our patients take a vitamin supplement and a calcium supplement as well as some extra form of fiber. Note: Solid food is more important than liquid food. Liquids are transported directly through the band and do not make you feel full.
   
   
7. Avoid chunks of fibrous food.
   
   Food that is stringy or fibrous such as asparagus might block the narrow opening of the band. It is difficult to sufficiently chew this food into small enough pieces to pass through. Almost all food that is cut into tiny pieces and chewed well can be eaten.
   
   
8. Drink enough during the day.
   
   Water is required to breakdown fat. That is why you need to drink enough fluids each day. Remember, only water, tea, or coffee (without milk/cream and sugar) or diet, non-carbonated drinks are allowed! You have to keep the food and drinks completely separated during the day. Consider drinking 1-2 cups of water before starting each meal.
   
   
9. Exercise
   
   Exercise 30 to 60 minutes a day. This rule is just as important as the rules for dieting. In addition to a good low-calorie diet, physical exercise, which consumes energy and , thus, calories, has been shown to be very important to successful weight loss. Physical exercise can also help you to improve your general health. Excess weight makes it challenging to exercise as much as you should, but usually the more weight you lose, the easier it gets. Start with simple exercise such as walking or swimming, and gradually increase your program to include more intensive forms of exercise such as cycling, jogging and aerobics. Important: you should always check with your primary care physician regarding the amount and type of exercise you should do.