What to Expect After Surgery

The following schedule is based on a typical course of recovery after Gastric Bypass, Gastric Sleeve, and/or Adjustable Gastric Banding. Your post operative course may differ slightly depending on your needs.

Day of Surgery

Surgery is performed in the hospital, under general anesthesia. When you wake up, you will be observed in the recovery room, and then transferred to a regular hospital room for the night. Patients are very rarely observed in the intensive care unit (ICU) after surgery. The most common problems after surgery are pain and nausea. To help prevent these, you will be given pain and nausea medications before you awake from anesthesia. You also may be instructed to take some medications before arriving at the hospital to control nausea after surgery. Everyone is different when it comes to how much pain they experience after surgery. A variety of pain medications are made available, given through an IV by your nurse. Your vital signs, urine output and lab tests will be monitored. You should be discharged home the day after surgery unless you are unable to tolerate sufficient amounts of liquids due to nausea or your surgeon determines it is necessary that you are monitored for another night. A leak test will completed during your hospital stay, most likely intra-operatively by your surgeon.

Once you arrive to your room for the evening, you will be expected to ambulate. You inevitably will be ambulating to the bathroom, as a foley catheter is not used during the surgery. You will wear sequential compression stockings while in bed to help protect against blood clots. You also will receive injections into your abdomen while in the hospital as another protective factor against blood clots. You will be allowed to consume water and ice chips 1 oz at a time every 15 minutes once you arrive to the floor after the recovery process. All pain and nausea medications will be given as needed through your IV on the day of surgery, and IV fluids will be given continuously throughout your hospital stay until you are discharged.

Post-op Day #1

In the morning, you may feel drowsy. You may feel nauseated, which is normal and expected. Serving size for clear fluids at this point will be 30 cc (1 oz, medicine cup size), every 15 minutes. This is a goal to work towards. Your stomach will be full after drinking only 1 oz of liquid at this stage. If you feel full or nauseated, but a 15 minute increment has passed since your last liquid was consumed, wait until this feeling passes to start drinking again. Eventually the inflammation will subside and you will feel comfortable with this serving size. Take it slowly during this period with drinking. Use the medication cups as a tool to know what it feels like to drink an ounce of fluid at a time.

You will now be allowed to start oral pain medications. It is a good idea to try the liquid pain medication at this point, as you will receive a prescription for this medication for home. Take this medication very slowly, as it will not have a pleasant taste.

You will be expected to be ambulating in the hallway today and using your incentive spirometer. We will take most of this day to ensure you are tolerating fluids in sufficient quantities before we clear you for discharge to home. You will be discharged later in the afternoon as long as you are tolerating clear liquids.

Medications

Before you are discharged, your surgeon will review your medications that you took before surgery. You will most likely be going home with a much shorter list of medications than which you came in on. We will discontinue many medications immediately following surgery including: diabetic medications, diuretics, hormones, NSAIDs and steroids. All pills must be smaller than a tic-tac, crushed, cut in half, or taken in liquid form. Your nurse will let you know if there are any medications that cannot be crushed or cut in half. Some medications are contraindicated after bariatric surgery for certain periods of time. Please avoid: NSAIDs (ibuprofen, naproxen, etc), arthritis medications, oral steroids (prednisone), aspirin- or caffeine-containing products, pseudophedrine, diuretics, or hormones (estrogen, testosterone, birth control pills). Please check with our office if you are unsure if a medication is safe to take after surgery.

Recovery

Most patients take one to three weeks off of work, depending on job duties. We expect you to fatigue easily in the first few weeks after surgery, so going back to work with a reduced work day or “light duty” restriction is a good idea at first. Staying hydrated is the main concern in the first few weeks after surgery, so make sure you will have constant access to liquids at work. You will return at 2 weeks after surgery to our office to see your surgeon for your post-operative visit.

Exercise

We do expect light activity for the first 2 weeks after surgery. Activities of daily living are recommended. Walk at least 5-10 minutes, 5 times per day. Do not plan strenuous activities or prolonged exercise until after your post-operative visit with your surgeon. Do not lift anything over 15 pounds for 4 weeks after surgery. At your post-operative visit, you will receive instructions on how to gradually increase your physical activity. Daily cardiovascular exercise is recommended, and resistance exercise is recommended long term to gradually build lean body mass which inevitably will help your metabolism.

Lifelong commitment

Obesity is a lifelong problem, and managing it takes a lifetime of effort. Weight loss surgery makes changes in the way your body reacts to food, but you have to work with these changes to achieve good weight loss. The goal of weight loss surgery is to improve health and well-being. You are expected to adhere to the dietary principles outlined in the following pages for the rest of your life.  We expect you to consume a low-fat, low-calorie, low-sugar, low-sodium, high protein diet for long term. Our team is available for questions at any stage of the process.