GENERAL RECOMMENDATIONS FOR REHABILITATION PERIOD

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Dr.Weight // BEFORE and AFTER bariatric operation - practical guidelines // General recommendations for rehabilitation period

Rehabilitation period

General recommendations for rehabilitation period

Bariatric Surgery - DoctorWeight.com – 2008

Discharge from hospital

Laparoscopic gastric banding patients are discharged the day after surgery. After laparoscopic gastric bypass the patient stays in hospital for 3-5 days. If the patient has other chronic diseases which can complicate the postoperative period, the stay in hospital may be prolonged.

It is not advisable to drive immediately after discharge.

If any questions or problems arise after discharge, please contact your surgeon by telephone or e-mail.

Eating

No universal rules apply to what patients can eat immediately after bariatric operations. The general principle is to go forward slowly and step-by-step. At home you can eat the same food as in hospital. If you want to eat something new, do so carefully: bite a very small piece, chew it thoroughly, swallow and wait for 5-10 minutes. If this does not cause discomfort in your new small stomach, then continue eating till you are full. Examples of food that you can try after surgery are here. If any food causes discomfort, stop eating it or reduce its amount.

Many previous patients recommend baby food, which is of the ideal consistency and available in chicken, meat, vegetable and other varieties.

We will be happy to answer by e-mail any other eating-related questions.

Physical exercise

Bariatric procedures do not influence negatively your ability to perform physical activity; on the contrary, after losing weight this ability can and must grow. Nevertheless, there are some limitations during the early postoperative period:

Don’t:

lift objects weighing more than 10 kg, including bags, children and pets.
do house work connected with furniture moving or other lifting of weights.

Sex

Sex is fine 2 weeks after surgery, but avoid positions which require abdominal muscle strength.

Hygiene

On arriving home, take a shower if you have a dressings like Tegaderm on your stomach. Otherwise please avoid wetting your abdominal stiches.

You can take a bath and go to a swimming pool 2 weeks after surgery.

How to take care of your abdominal stiches

There will be a few small punctures on your belly, closed with very reliable suturing material. You can move as you wish without danger, but it is advisable to show your sutures to a surgeon or a surgical nurse. If the dressings are wet or dislocated, change them. If you live near the clinic you can come for dressing, or you can change them by yourself: wash your hands, remove the old dressings, rub the puncture sites with a cotton swab wetted in 70% alcohol, and when the alcohol dries apply new dressings. If your dressings are clean and not dislocated, it is not necessary to change them.

We usually use absorbable skin sutures after laparoscopic operations, and these do not require removal. In two weeks you can remove all the dressings. If any knots or threads are left in the skin, remove them yourself or cut them at skin level.

Please inform us if you notice pain, redness or swelling, or if you have a high temperature.

Tablets and capsules

If you need to take any tablets or capsules, grind them and take them with a small amount of water, especially if they are large. You may need to take analgetics for 3-4 days and antibiotics for 7 days (the length of time varies according to the individual).

Going to work

We suggest returning to work a week after laparoscopic gastric banding, and two weeks after gastric bypass. If your work is connected with heavy physical effort, please avoid it for two months. On the other hand, this matter is a subject for discussion in every individual case: if you work in an office with a personal computer, you can start working as early as you wish.

Contact your doctor in case of:

Pain, oedema or redness in the sutures.
Discharge of opaque or smelly fluid from the wounds.
Temperature 38º or higher occurring twice or more during the first 3 weeks after surgery.
Tachicardia, or heart rate over 120 beats per minute. To measure, count your pulse beats for 15 seconds, then multiply this number by 4.
Shivering and night sweats not suffered before the operation. Permanent pain in the abdomen.
Pains in the back, chest or left shoulder not previously present. Some pain in the lower back is normal for a few days.
Frequent nausea and vomiting.
Permanent diarrhoea for more than one week after surgery.
Frequent hiccupping lasting for more than two hours.
Marked or unusual weakness, disorientation, dizziness or depression.
Signs of urinary infection such as burning, blood in the urine, frequent urination.

Pregnancy

Obesity is a common cause of infertility. Many women with excessive weight have irregular menstrual cycles and bleeding. Very often this is solved by successful surgical weight loss.

As pregnancy entails increased caloric consumption, we recommend waiting for 1-2 years until your weight is stabilised at the lower level. This must anyway be discussed with your family doctor or gynaecologist. Many women who followed these recommendations and lost weight as a first step later became pregnant and now have healthy children.

If a woman undergoes gastric banding, she may get pregnant any time after surgery. In this case the band must be deflated for the whole period of pregnancy and lactation. This provides a baby with adequate feeding. When pregnancy and lactation are over, the bandage is reinflated, and the woman loses the weight again.

Emotional changes

Mood swings may occur but will disappear after weight loss.

Drugs to avoid after surgery

Omeprazole or other drugs reducing gastric acidity are sometimes administered for 2 weeks to prevent or treat heartburn after surgery.
Analgetics are necessary only in the infrequent event of strong pain.
Avoid aspirin and aspirin-like drugs, also called Non-Steroidal Anti-Inflamatory Drugs (NSAID). These can damage the mucosa of the stomach to cause ulcers and gastric bleeding. If you need to take these, do so only in minimal dosage 1-3 times and simultaneously take protectors for your gastric mucosa. The simplest protector is milk and cream.

Please read instructions carefully before taking any medication. Avoid any drug that can negatively affect the stomach, or contact us in case of uncertainty.

After gastric bypass

After adjustable gastric banding

After other restrictive operations

Preparation for bariatric operation

The operation and days after

General recommendations for rehabilitation period

Grand questions after gastric banding

Grand questions after gastric bypass

Potential problems following all types of bariatric surgery

Rules for a new life after bariatric operations