|
Post
Operation Follow Up
After you are discharged from the hospital you will need to
be seen in our office in one week. Call our office to schedule the visit. You will be scheduled
for a one, three and six months checkupand then at one year. If you move out of the
area we will forward your records to your new physician. It is very important that you are
monitored by a physician. If you cannot commit to follow up you should not agree to have
the surgery.
Gastric bypass surgery has no guarantee of success. It is up to you the patient to
fully cooperate with your surgeon and primary care physician in changing your eating
habits and getting regular exercise.
You will be given a full set of discharge instructions as to what and when to eat,
especially for the first two weeks. Your cooperation is essential to your success. Each
patient is an individual and you may be on a liquid diet for up to a month depending on
your individual recovery.
Please do not hesitate to call our office if you have any questions. Monday - Thursday
call (559) 431- THIN (8446) this line is just for our bariatric patients.
If at any time you have a medical emergency call (559) 432-3434 a physician is on call at
all times.
Discharge Instructions
Cautions:
 If a problem arises, call our office
and we will do our best to help.
You should NOT have high fevers over 101.5, night sweats or shaking chills at
home.
You should be able to breathe comfortably without pain or shortness of
breath. You should NOT be coughing up sputum or blood. Remember to breathe deeply and to
cough and clear your lungs to help them to recover from your operation. Use your incentive
spirometer (breathing toy) that was given to you at the hospital for 2 weeks following
your surgery.
Watch carefully for the signs and symptoms of infection: Rapid pulse rate of over
100 beats per minute that does not slow down. Fever greater than 101.5 degrees,
chills, increased redness or pus draining from the incision sites. Increasing abdominal
pain, nausea, vomiting, or shortness of breath. Excessive bleeding at the incision site.
Please call our office immediately if any of these symptoms occur.
For the first week after discharge, to avoid dehydration you should sip 4-6
ounces (1/2 to 3/4 cup) of a liquid diet" through the waking hours to take
in enough fluid each day. Two quarts per day is minimum. If you get behind do not try to
take in large amounts to " catch up". Anything that will pass through a straw is
considered a liquid diet. These include: coffee, tea, fi-uit juice, broth, thin soup, Slim
Fast or Ensure plus, (diluted with 1/2 water). Cream of Wheat, mashed potatoes or pureed
foods, without any lumps. Baby first foods are o.k. Avoid milk and dairy products for the
first two weeks it causes cramping and diarrhea in some patients.
Family members may think you are not getting enough to eat and will tempt or urge
you to eat more. Resist this: if you are 100 pounds overweight you have enough extra
calories in storage to support you for 6 months or more.
You and your family need to be aware of the risk of depression in the recovery period and
if these symptoms occur we need to be aware of them to discuss possible treatments - Watch
for signs of depression: Difficulty concentrating, remembering or making decisions'
Persistent feelings of sadness, anxiety, irritability or excessive crying. Sleeping too
much or too little. Excessive fatigue, decreased energy. Thoughts of suicide or death.
Feelings of helplessness, worthlessness, hopelessness, guilt. Decreased interest in
activities or pleasure, including sex. Call our office if you experience these symptoms.
Do NOT Smoke. Smoking even a little causes narrowing of your blood vessels which
decreases circulation. This slows down the healing process
You should not have burning, bleeding or hesitancy when you pass urine, if this
occurs call our office.
Discharge medications: You
will be given three prescriptions. Follow the instructions carefully and do not allow
others to use your medications.
The first prescription will be for pain and will be in liquid form. Actigall and
Tagamet will also be prescribed.
Multivitamins need to be taken three times daily. For the first two to three weeks liquid,
or chewable are best. If you have any question regarding brands our staff will be happy to
help. Vitamins are not covered by your insurance.
What to expect:
You should be alert and oriented,
almost back to normal the day of discharge.
You should be able to walk often during the day and move about without dizziness
or lightheartedness, or excessive pain. Your amount of activity will be regulated by how
good you feel. Light housework as tolerated, no heavy lifting or strenuous activity until
you see Dr. Felix for your first post operative visit.
You will tire more quickly for a few weeks after surgery, but your energy level
will increase as you recover.
Remember that you have a new and very small stomach. Eat and drink very slowly
and small amounts at a time. Don't rush it. Take time to chew your food very thoroughly,
and take small sips of water or diluted juices. If you have pain or vomiting or a
sensation that food is "stuck" stop eating and remain in an upright position for
1-2 hours. If symptoms subside, start with liquids again after this time and take Mylanta
or similar antacid 1 tablespoon every two hours. If vomiting persists, call Dr.
Felix.
If you experience faintness, confusion,
sweating, rapid pulse and anxiety, with or without cramps, diarrhea, stomach
upset or
nausea, you may be suffering from 'dumping syndrome'. The solution is to eat more slowly,
avoid high calorie liquids i.e. - soda, milk shakes, or adding sugar, to tea or coffee.
Allow at least half an hour between taking liquids and solids.
There may be some clear or slightly bloody
discharge from your wounds. This is normal. Shower without bandages, and pat the areas
dry. You will not need to apply further bandages. The sterile-strips that are directly on
the skin will fall off on their own, this is not a problem. There should be no foul odor
or green colored discharge from your wounds. If there is, call our office.
Bruising around the wounds is normal and should decrease daily after the first
week.
There will be no restrictions on physical activity such as driving, household
chores or sex, but you should expect to be off work for 1 to 3 weeks depending on your
occupation.
After the first three weeks you should be able to start a solid diet. Start
slowly and eat 4-6 times a day. About 1/2 cup per sitting will be all you require. Avoid
meat that has not been ground, fibrous foods such as canned spinach and citrus fruit pulp.
Watch out for pits and seeds. Remember to leave a 1/2 hour between your solids and
liquids as this could cause "dwnping syndrome". This prohibition may be relaxed
over time. Remember Chew, Chew, Chew, your new stomach and the opening to the intestine
are very small and only well chewed foods will pass through without causing problems.
|
|
