Begin the Myocel protein supplement two-three weeks before your surgery. Take two scoops 2-3 times each day. This will prevent your liver from tearing during surgery. If Dr. Benavides feels there is a chance your liver might tear, we will reschedule your surgery.

DECREASE THESE IN YOUR DIET:

• All fats including butter, fatty meats, fried foods, whole milk products
• High sugar foods
• Carbonated drinks
• High carbohydrate foods such as breads, starches

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Discharge Instructions:
These instructions will serve as general guidelines to assist you in your recovery after surgery for severe obesity. If you have any questions or problems, do not hesitate to call our office for instructions.

Discharge instructions:

1. Call if you have a fever of 101 or higher.

2. You may shower daily- NO tub baths for 1 week. Do not scrub incisions for 3 weeks.
    (Notify us if redness or drainage from incision occurs.)

3. Contact us if you experience any vomiting.

4. Walk daily until you can walk 30 minutes at a time.

5. Increased gas is common for the first 3-6 weeks. We recommend Gas-X or Digel for relief.

6. You may take liquid tylenol.

7. Take chewable vitamin supplements daily when advised.

8. Female patients should NOT become pregnant for 18 months until weight loss has stabilized or
    injury could occur to the unborn child.

9. If you encounter a problem contact Dr. Benavides or return to the emergency room where you had
    your surgery, or have the physician where you are immediately contact Dr. Benavides
    (972-331-8100) if you are present for treatment. There are many physicians that are unfamiliar
    with weight loss surgery and serious errors could occur. DO NOT ALLOW THEM TO INSERT A
    STOMACH TUBE FOR ANY REASON

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Post-Op Diet Instructions:
The post-op diet is divided into 3 stages to allow a gradual adjustment.

STAGE I
Liquid protein supplements (Myocel) 3 times a day.

STAGE II
Soft foods from the list below can now gradually be added to your diet

STAGE III
Gradually add regular foods to your diet.

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STAGE I – FIRST 2 WEEKS POST-OP

1. Liquid protein supplements (Myocel) 3 times a day.
    NOTE: Most people can only drink 1 protein drink per day the first 2-3 days due to swelling.

    PROTEIN SUPPLEMENTS
    We suggest Myocel.  Myocel is best mixed with skim milk or Lactaid as lactose intolerance can occur
    the first few weeks after surgery.  The protein powder (Myocel) can also be mixed with yogurt or
    blended in a blender with fruit and fruit juice.

2. Liquids from list below.

LIQUID DIET:

• Coffee, tea, fruit juice (NO orange or grapefruit)
• Crystal light, Nutrasweet, Sugar free Kool-Aid
• Diet drinks
• Protein drinks as advised by the doctor (Myocel)
• Broth
• Skim milk or Lactaid milk
• Sugar free Jell-O or Sugar free popsicles
• Low fat yogurt
• Sugar free pudding
• Applesauce or baby food fruit

3. In addition, you may incorporate Jell-o, sugar free pudding, yogurt, baby food or sugar free
    popsicles 2 to 3 times a day between protein shakes.

• Remember: small amounts (4-6 ounces)
• GO SLOWLY (30 minutes to drink 6 ounces)
• Stop when you feel full.
• NO carbonated drinks for 4 weeks

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STAGE II - LIQUIDS FOR 2 WEEKS with the INTRODUCTION OF SOFT FOODS
Soft foods from the list below can now gradually be added to your diet

1. Reduce shakes to two per day.

2. Choose three 3 to 6 ounce servings of soft and mushy items from the list below.

SOFT FOODS

• Mashed potatoes
• Creamy soups
• Soup with noodles
• Cottage cheese
• Oatmeal
• Cream of wheat
• Soft canned fruit
• Well cooked mushy vegetables – no stalks or crunchy vegetables
• Thinned scrambled eggs
• Baby food
• Soft sweet potatoes or yams
• Thinned grits
• Thinned low-fat refried beans
• Soft ripe bananas
• Cauliflower blended with broth

CHEW WELL- the food must be almost liquefied before swallowing.

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STAGE III – SOFT DIET with the INTRODUCTION OF REGULAR FOODS
Gradually add regular foods to your diet.

1. Eat proteins first, followed by vegetables and then carbs.

2. You may sip beverages with your meal.

3. Avoid cheap calories
    Fats
    High calorie liquids
    Sweets, ice cream, junk food, cookies

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Summary

• Follow three-stage diet plan to allow gradual adjustment.
• Eat only at set mealtime.
• Go slowly!
• Chew well!
• When you feel full STOP!

Liquids, junk food, and sweets do not relieve hunger! Only solid food, which fills the pouch and empties slowly, will relieve the hunger.

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Post – Fill Instructions

1. Stay on clear liquids for 48 hours. Protein shakes (Myocel) before meals are ok.
2. After 48 hours incorporate soft mushy food.
3. Advance slowly to solid food.
4. Notify us immediately if you develop vomiting.
5. See us back in a month for a follow up visit.

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