Life After Surgery

Follow up Appointments

For two years following weight loss surgery, you will be expected to visit our office for follow-up appointments. It is extremely important that you keep these appointments. They will allow us to monitor your health closely and look for signs of malnutrition, dementia, anemia, muscle loss, stomach or intestinal bleeding, and reduced ability to fight off infections. When these problems are detected early, they can usually be treated before serious, irreversible damage occurs.


Other Surgery, Illnesses, and Pregnancy

Your body will undergo significant physiological changes after gastric bypass surgery. Following surgery you may become anemic, heal more slowly than before, be more susceptible to infections, and have less energy. It will take at least 18 months for these changes to stabilize.

Therefore, it is important that you contact us if you:

  • Get sick for more than just a few days
  • Are hospitalized
  • Need emergency surgery
  • Are considering any type of elective surgery elsewhere
  • Become pregnant

When you keep us informed about your health and allow us to communicate with your other physicians and surgeons, we can help you avoid potential problems.


Medications

Following surgery, you should resume your pre-hospital medications. Take medication on an empty stomach, even if your prescription says otherwise. Drink as much liquid as possible directly after taking the medication.

You may take any over-the-counter or prescription medication except the following:

  • Medications containing Aspirin, Ibuprofen, or Naproxen – Please take Tylenol instead.
  • Medications in the NSAID class – If you take prescription medications, ask your physician if any of them are in this class.
  • Almost all arthritis medications – If you take arthritis medication, please let us know. We may be able to work with your arthritis physician to arrange a new treatment plan that will work for you.
  • Sustained, extended, or time release forms of medication – You will not get the correct dose with this type of medication. Please let us know if you are taking any sustained, extended, or time release forms of medication and we will assist you in converting this medication to a regular release form.

As you start to lose weight, problems such as high blood pressure, diabetes, and high cholesterol may start to improve. When this happens, some of your routine medications may need to be adjusted. Please see your primary care physician regularly so you make sure you are taking the correct medications.


Activity

When you first return home after surgery, make sure that you take walks and do not stay in bed – the more walking, the better. You may climb steps and even go to the store if someone else goes with you and drives. You will find that your energy level is quite low during the first few weeks after surgery and that even a simple trip to the store will be exhausting. Don’t worry about your lack of energy; as time passes, your tolerance to activities will return to normal.



Returning To Work

You and Dr. Coon will decide together when it is an appropriate time for you to return to work. Typically, patients will want at least two weeks off work after being discharged from the hospital. Many patients take four to six weeks off, and eight weeks total disability time is not uncommon. It is impossible to predict exactly how long you will be off work because the amount of time varies from patient to patient.



Support Group

Our support group meets at 7 PM on the first Tuesday of every month at the Founders Center on the Parkview Hospital campus. Light refreshments are served, consistent with the type of food weight loss surgery patients eat. The range of topics discussed at the support group is varied and few things are “taboo.” In fact, the group is extremely candid about various problems and body functions. By attending the group, you will receive a tremendous amount of support as you learn about your new body and what to expect from it.

Attending our support group is an important part of the recovery process. Studies have shown that patients who participate actively in a support group have better outcomes than those who do not.

Diet Guidelines

Following weight loss surgery, your diet will change drastically. Not only will you eat less, but you will also eat different types of foods. Our goal is to help you follow a diet that aids your weight loss and provides you with adequate nutrition. Please see Post Op Diets #1 – #4 (available on the patient resources page) for specific instructions. Following these diet instructions carefully will ensure the healing of your pouch, promote weight loss, and protect your health. Failing to obey the guidelines could lead to serious complications or even death. Our diet guides are for patients receiving distal bypass as well as those receiving proximal bypass.
The following are rules that patients should keep in mind following surgery:
Chew food thoroughly – Failing to do so can lead to a blockage in your stomach pouch.
Eat meals slowly – In the first three months following surgery, you should take 20-30 minutes to eat a small meal.
Avoid overeating – Overeating can stretch out your stomach pouch, make you sick, and can even cause your pouch to rupture.
Take small sips of liquid all day long – Do not gulp liquid.


Post Op Diet Plans

Immediately following surgery

The day after surgery you will not be allowed to have anything to eat or drink. An I.V. will provide all the hydration you need. The following day, you will begin an all-liquid diet. You must be careful to drink slowly and take only small sips of liquid at a time. You will stay on an all-liquid diet for the remainder of your hospital stay.

Post Op Diets #1 – #4

Once you are discharged from the hospital, you will remain on Post Op Diet #1, an all-liquid diet. At this point, you will be able to drink any liquid you can pour through a kitchen strainer. You must take small sips of liquid all day long rather than gulping large amounts. You should never force yourself to eat. Once you feel full, do not eat anymore.
A few weeks later you will graduate to Post Op Diet #2, which allows you to eat mushy foods in addition to liquids.
Post Op Diet #3 will allow you to add semi-solid foods, such as some types of meat, to your diet. Make sure to chew all foods very well to avoid blockages in your pouch.
About six weeks after your surgery, you will move to Post Op Diet #4 . At this point, you will be able to eat anything you want. However, you must continue to take tiny bites, chew your food well, and eat slowly. There are no foods that are “bad” for your pouch, only foods that you may tolerate better than others. It is important that you pay close attention to your body and try to stick to foods that go down well. Everyone has good and bad days. If something makes you sick, you can always go back to an all-liquid diet for a day.
To download Post Op Diets #1 – #4, please visit the Patient Resources page.


Vitamins and Protein Supplements

Following surgery with the creation of your new smaller stomach pouch, food will bypass most of your stomach and parts of your small intestine. This means that you will absorb less vitamins and minerals from the food you eat. Therefore, you will need to begin taking vitamins, minerals, and calcium supplements for life.
We recommend that you take multivitamins, either liquid or chewable, that contain iron. Make sure you crush, chew, or drink the vitamins – do not swallow tablets whole. Most patients begin taking vitamins during Post Op Diet 2. You can find more information about vitamins in the downloadable Post Op Diet #2 guide.

Protein Supplements

It is important that you take protein supplements in order to stay healthy and reduce hair loss, which is common after weight loss surgery. You will usually start taking protein supplements about three to four weeks after your surgery. You can find specific information about protein supplements in the Post Op Diet #3 guide.


Eating Out

If you are careful, you can learn to make eating in restaurants a simple, stress-free part of your life. Making healthy food choices and paying attention when your body tells you it’s full are important ways to accomplish this. Planning ahead, sharing meals, and practicing moderation are some of the ways that you can make eating out an enjoyable experience.

Alcoholic Beverages

Alcohol is also absorbed quickly in both the pouch and the intestine, so be careful if you drink alcoholic beverages. A small amount will go a long way.


Digestive Problems

Nausea and Vomiting

The bad news is that almost one third of bypass patients will experience severe and/or persistent nausea. Furthermore, almost everyone will have some vomiting in the first few months after surgery. The good news is that it will typically go away by itself, usually no longer than four months after the surgery. We know how distressing this can be and we will do everything we can to make you more comfortable. However, only time will make nausea and vomiting go away completely. If you begin vomiting blood, please call us immediately. Vomiting blood is a very bad sign and may indicate that you have an ulcer. View the Post Op Diet #3 guide (on the Patient Resources page) for tips on preventing and relieving nausea.

Diarrhea

Diarrhea is common after gastric bypass surgery. Immediately following surgery, it is normal for patients to have up to four bowel movements a day. After several weeks, bowel movements will typically become more normal. The best drug for diarrhea is Imodium® AD. Pepto-Bismol® is fine, but is not as effective. Make sure you tell us about your diarrhea and notify us immediately if you have bloody bowel movements or a fever with your diarrhea.

Gas

Gas and bloating are normal in the first few weeks after surgery, especially when you are taking pain medication. You can help control gas by avoiding certain foods and taking an enzyme preparation such as Beano® or Omnigest™ . For more information about controlling gas, please see the Post Op Instructions guide, located on the Patient Resources page.

Dumping Syndrome

Dumping syndrome is caused when food containing a large amount of sugar enters the intestines too rapidly. When this happens, you may feel a drop in your blood pressure characterized by anxiety, dizziness, and nausea. Diarrhea, sweating, and cramps may also occur. Even though these symptoms are very uncomfortable, they will pass in a few hours. There is no specific treatment for dumping syndrome other than to avoid high-sugar foods.


Excess Skin

Following drastic weight loss, you may be left with a great deal of excess, saggy skin on your body. Many patients are uncomfortable with the appearance of this skin and choose to undergo plastic surgery in order to remove it. Since insurance generally does not cover plastic surgery, you should consider saving money for this procedure as soon as you commit to weight loss surgery.

Visit our Patient Resources page for additional information about life after surgery.