Strictures do not happen because you do anything wrong. It is not exactly known why, but the thought is that the area where the stomach and the intestine join up is lacking in a little bit of blood flow to the area (ischemic due to dividing the blood supply to that part during the surgery) which makes the healing process different and you get a narrowing and scar rather then normal healing. That is why they are usually started 4-12 weeks after surgery (Unless you are Vanessa who was diagnosed after over a year!!). It is a techinical aspect of surgery as there are different width openings a surgeon can make. Smaller ones have a better weight loss, but a higher stricture rate. Larger ones have a lower stricture rate, but also less weight loss.
One thing is for sure, the earlier it is caught, and the less it has narrowed at the time of treatment, the easier it is to treat and possibly the fewer dilitations are required.
In terms of the protein....I think fluids are more important right after, but you can get protein malnourshment easily and you need it to heal.
If a doctor is only doing open procedures, they are not really up on the standard of care. Doing it open is acceptable under certain circumstances, but is not the best for the patient. Think of this...if you needed your gall bladder out would you have it open for no other reason other than the surgeon wasn't proficient at lap?? You would find another surgeon as lap is lower risk and evolved into the standard of care as it is evolving for GBP as well. The only reasons to do GBP open from the start are numerous previous abd. surgeries or the only surgeon you can use only knows the open way. It is always acceptable to convert from lap to open intra op.
There is my 2 cents
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 DYANN
Lap RNY 1/4/06....
46/ 19.8/23.5 BMI's 167.9 pounds gone forever as of 9/12/07 116.3%to goal
294.4/ 126.5/150
5' 7''
Jupiter, Florida
Dr. Jefferson Vaughan: GBP
Dr. P Duddly Giles: Plastic surgeon TT/BL 03.20.2007
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