WHAT TO EXPECT AFTER SURGERY:
· Up and walking shortly after surgery
· Discomfort and drowsiness
· Metallic taste and very dry mouth
· Expect some pain, but it should be tolerable –
5 or less on a scale of 1 to 10.
· If pain medication is not working, tell your
· If pain medication is not working once you
get home, call 806-677-7952 and have your pharmacy number available.
· Left shoulder pain and incisional pain is
· If drinking your fluids is painful, take pain
medication or Tylenol prior to drinking to coat suture line on inside of
· You may shower and wash your incisions with
antibacterial soap but do not scrub or attempt to pull off drainage or scabs.
Let the warm soapy water run over the incisions.
· Do not use alcohol or peroxide to clean
· Your surgeon will instruct you on resuming
your regular medications after surgery.
· You will be required to take acid blocker
daily for 3-6 months after surgery to protect your pouch and reduce stricture
or narrowing of the pouch outlet.
· No lifting anything over 10 lbs. for 3 weeks
· No strenuous exercise for 4 weeks after
surgery. Work up to walking 30 minutes a day.
· Return to work when ready - Usually 1 week
· When back at work, be sure to get up every
hour and walk to help prevent blood clots for first 4 weeks.
· You may resume driving as soon as you feel
comfortable – As long as you are not taking any pain medications.
· No baths, hot tubs, or swimming for 10 days
· You may continue to have some mild abdominal
pain for up to 4 weeks after surgery, especially if twisting or bending certain
· Productive burp or belching is caused by
eating too fast, not chewing well, or taking bites that are too big.
· If you do not chew your food well or food
becomes stuck, you will experience sliming or frothing, which is excessive
saliva production in the mouth.
· Do not get discouraged by not seeing weight
loss on scale weekly, you will experience weight loss but also as your weight
plateaus, you will be loosing inches.
· Weigh weekly and record.
SUCCESSFUL STRATEGIES AND HELPFUL HINTS
• Stay hydrated
• Take your supplements
• Make healthy food choices! Protein first – protein promotes healing and weight loss, minimum of 60 GRAMS/day
• Try to differentiate head hunger from real hunger. Ask yourself if you have eaten in the last couple of hours? Did you see a food commercial? Did you just smell food? If the answer to these questions is yes, then it is probably head hunger.
• Change is stressful.
• Learn new coping strategies that don’t involve eating.
• Change your eating habits to be successful.
• When you feel full stop immediately, put your food aside and save it for another meal. If you try to force it down you may stretch your pouch or vomit. Do not eat more than 1 cup of food per meal.
• Remember do not drink with your meals.
• Use a medicine cup to learn how to sip versus gulp.
• You may want to use a teaspoon to keep you from taking too large of bites.
• Read nutrition labels, stay away from high fats, sugars and sugar alcohols.
• If food gets stuck, get up and walk and try room temperature pineapple juice in small amounts. Never attempt to wash food down; this will only make the situation worse.
• Do not drink out of straws in the beginning. This may cause air bubbles that can cause gas pain or discomfort.
WHEN TO NOTIFY YOUR SURGEON:
• Bright red blood in your vomit or stools
• Excessive pain in chest or pain/swelling in legs
• Difficulty breathing or increased shortness of breath
• Inability to keep fluids down and no urination
• Frequent vomiting or diarrhea lasting more than 24 hrs or abdominal pain that persists for more than 4 hrs
• No bowel movements, even after Colace or Milk or Magnesia
• Uncontrollable pain or severe unusual pain around incisions
• Increasing redness or milky, malodorous discharge from incisions
• Fever over 101
On rare occasions, Gastric Sleeve patients may experience dumping syndrome. Some signs or dumping can be palpitations or racing heart, a sweaty and clammy feeling, and abdominal pain and or cramping, weakness, fatigue, dizziness and sometimes diarrhea. Dumping syndrome is not dangerous, but it feels awful and once you react to a certain food in this way you do not want to eat that food again. Dumping syndrome is typically associated with foods high in sugar, high in fat, very rich foods, or a meal made up of too many carbohydrates. Dumping syndrome affects each person differently and you may feel any combination of the above signs.
Many patients experience food intolerances, especially to red meat, milk and high fiber foods. It is a good idea to keep a food journal with a list of foods that are and are not well tolerated. Often time food intolerances are temporary, so you may try a food again in a couple of months that was not well tolerated the first time.
Lactose is a particular type of sugar found in milk and dairy products. Some of our patients, who did not have problems with milk before surgery, find that after surgery, dairy products cause abdominal cramping and gas. This can be treated by Lactaid, an over-the-counter enzyme supplement. The body also tends to adapt over time and this is less of a problem in most patients 6 months after surgery.
Most patients notice some increase in hair loss around 3-5 months after surgery. This occurs as part of the body’s response to sudden calorie and protein deprivation just after surgery. It is rare for patients to have thinner hair one year after surgery than they did prior to surgery. In fact, at 18 months after surgery, most patients have fuller and healthier hair because the body’s hormone balance has been significantly improved.
Most patients are left with areas of excess skin, especially the abdomen, upper arms, upper thighs, and breasts. Exercise is very important for the patient’s overall success, but is not effective in shrinking skin. Many patients choose to undergo plastic surgery to remove excess skin. We recommend that our patients wait at least 18 months following weight loss surgery. This delay is because the skin removal surgery works best for the long-term if it is done when your weight is stable. Also, the skin may shrink a bit and does not finish shrinking until about 18-24 months after surgery.
Most patients experience some form of “buyer’s remorse”. This generally occurs within the first 1-2 months after surgery. A depressed mood may also develop due to the loss of the previous relationship with food. The good news is that this is not unusual and should resolve within 3 months after weight loss surgery. If you continue to feel emotionally volatile (tearful or irritable) or depressed, then please see your physician.
Every relationship in which the patient participates will change substantially as the dramatic weight loss occurs. This change will affect all relationships. The drastic changes put stress on relationships as the patient changes physically and emotionally and it is sometimes necessary to seek outside counseling.
FREQUENTLY ASKED QUESTIONS:
When can I get pregnant after surgery?
It is strongly recommended you wait at least 18 months after surgery before trying to conceive. Approximately 18 months post-op, you body will be fairly stable from a weight and nutrition standpoint. You should also know that fertility usually increases with weight loss so be sure to take extra precautions.
What do I do about gas?
Gas is very common in the first few weeks after surgery. You can take Gas-X strips, Mylicon Drops, or Simethicone (generic) to help relieve gas pains.
What do I do about constipation?
Constipation can be caused by pain medication or dehydration. If constipation becomes a problem, you may try 30cc (6 teaspoons) of Milk of Magnesia. You may also need to increase your fluid intake. Constipation can also be relieved through insoluble fiber supplements such as Fiber-con/Benefiber or Metamucil. We recommend starting with about ¼ to ½ the recommended amount. Half a cup of warm prune juice will also help with constipation. Call your doctor’s office if the constipation persists more than 2-3 days.
What do I do about diarrhea?
For the first few weeks after surgery, it is normal to feel cramping or diarrhea. You may take Imodium AD or try some yogurt. However, later on some patients may experience these symptoms due to sugar found in milk products called lactose. If you are lactose intolerant it will cause gas, bloating and diarrhea. Symptoms should be resolved by switching to lactose free products. Call your doctor’s office if the diarrhea persists past 2-3 days.
What do I do if I am feeling nauseous or vomiting?
Nausea can be expected in the first few weeks after surgery. Watch your eating behavior. Are you eating too much, too fast or foods high in sugar or fat? Are you drinking with your meals? You may also be dealing with food intolerances. If you are feeling nauseous or vomiting wait about two hours until symptoms subside then go back to full liquids again. If vomiting continues for more than a 24-hour period call your doctor.
Why do I need to drink so much water?
Proper hydration is critical during recovery from surgery. When food intake is low, it becomes even more important to drink fluids to meet the needs of your body. Dehydration is one of the most common reasons for re hospitalization. It can cause weakness, fatigue, light-headedness, dizziness and constipation. Shrinking cells are buoyed by water, which plumps the skin and leaves it clear, healthy and resilient. Water helps rid the body or waste. During weight loss, the body has a lot more waste to get rid of. You should sip constantly on water between meals your goal is to get up to 64 ounces of water a day. In the first few weeks after surgery it is difficult to drink a lot of water but you can add plenty of sugar free Popsicles and ice chips.
Why do I sometimes feel tightness in my chest area after eating?
This can be caused by eating too fast, not chewing well enough, taking too big of a bite or drinking with meals. Stop what you are doing. Stand up and pace the floor. This may help tightness to go away sooner.
What do I do if I get something stuck in the pouch?
If you get food stuck in the pouch you will feel an intense pressure or tightness in your diaphragm and your mouth will begin to water. This pressure can sometimes be felt in your upper back. You can drink about ¼ cup of pineapple juice to help dislodge the food or you can try walking or standing to see of the food will move through the pouch or come back up. If this doesn’t work, try again in an hour or two. If after the second attempt you are not feeling any relief, call your surgeon. Having had food stuck in the pouch can cause the pouch irritation and inflammation. If you have difficulty
tolerating solid foods after this, revert back to full liquids for 48 hours then advance to soft foods for 48 hours before trying solids again. If you are unable to tolerate solid foods after this please notify the office.