After Weight Loss Surgery: What You Need to Know

Day of Surgery

1. Drink 32 oz Gatorade or Clear Fast Preop drink 2 hours prior to hospital arrival time.
2. Don’t chew gum: surgery will be postponed 2 hours.
3. Arrive at designated time for surgery.
4. Register at Out Patient Surgery on 3rd floor – wait in waiting area until the nurse comes to get you.
5. Preop Holding:

• Change into gown
• Vital signs
• IV will be started
• Talk with Anesthesia
6. Surgery
7. Recovery Room – when awake will go to the 8th floor (Bariatric Floor).
8. You will be allowed ice chips and water immediately after surgery
9. To help prevent Pneumonia: Incentive Spirometer 10 times an hour while awake.

• This helps get the anesthesia out of your lungs as well as keep the little air sacks open in the base of your lungs to prevent pneumonia. Pneumonia means an extended hospital stay plus a set back in recovery from surgery.

10. To prevent blood clots that can develop in the legs, break loose and travel to the lungs and cause death:

• Wear SCDs (the squeezer things on your legs) while in bed. OK to take off when walking or sitting in chair. If you go back to bed ask your nurse to put them back on you.
• Lovenox shots in your stomach: thins your blood a little while you are in the hospital.
• Walk, walk, walk. Walk two to three times in the hall the day of surgery and at least 5 to 6 times the day after surgery and every day while in the hospital. Continue walking frequently after you go home.
11. Pain Control: You will have IV pain medication until you start to drink liquids at which time you will change to liquid pain medication.
12. You may have an Upper GI test to make sure there is no leak OR you may be started on a Bariatric Stage I Clear Liquid Diet.
13. You will be given a 1 ounce measuring cup. You will be expected to drink 1 ounce of water every 15 minutes while awake. You will be given a sheet of paper to record every time you drink one of these. Your goal is to drink 64 of these, or 64 fluid ounces.
14. You will receive a Bariatric Stage One Clear Liquid Diet tray for breakfast, lunch, and dinner. You need to write down what you drink off these trays. All these fluids count towards your total 64 fluid ounces daily.

Post OP Day 1:

1. The Nurse Practitioner will make rounds first thing in the morning to evaluate how you did overnight and discuss this with Dr. Johnson.
2. You are expected to walk in the hall 5 to 6 times on post op day 1. This will help prevent blood clots and help you start passing gas.
3. You are expected to use your Incentive Spirometer 10 times every hour while you are awake.
4. You are expected to sit up in the chair most of the day. Sitting in the chair will make it easier to drink your fluids as well as use your Incentive Spirometer.
5. One of the dietitians will see you sometime during the day and review your diet instructions with you one more time.
6. Dr. Johnson will make rounds in the evening of Post Op Day 1. She will evaluate your overall condition as well as how much fluid you are drinking, how much you have walked in the halls, and how well you are using your Incentive Spirometery. She will make a decision at this time as to whether you go home that evening or stay until the next day. If you stay until the next day you will continue to do all things listed for Post Op Day 1.
7. Summary of things to do on Post Op Day 1:

• Drink 64 fluid ounces
• Walk in the hall 5 or 6 times
• Use Incentive Spirometer 10 times an hour while awake
• Sit up in the chair most of the day

When You Go Home:

1. All medications must be chewables, liquids, or crushed for 2 weeks.
2. You will be given a prescription for liquid pain medication.
3. You will be given a prescription for Prilosec or Prevacid. These medications are known as Proton Pump Inhibitors (PPIs) They are medications that cut down on the acid production in your stomach. You will take one of these for at least a year after surgery.
4. If you are given a prescription for Prilosec (Omeprazole), you will open the capsule and mix the granules with a small amount of water and swallow them for 2 weeks. Do not crush the granules. After 2 weeks you will be able to swallow the Prilosec and other medications whole as long as they are smaller than an M&M. You will take Prilosec daily for one year after surgery.
5. If you are given a prescription for Prevacid (Lansoprazole) the tablet will dissolve on your tongue when you put it in your mouth. You just need to take one daily before breakfast for at least a year after surgery.
6. If you already take a PPI (Prilosec, Prevacid, Nexium, Protonix, or Dexilant) you may or may not be given a prescription for the above medications.
7. You will be expected to follow all the instructions in the Bariatric Discharge Handout.
8. You will be expected to follow the Bariatric Staged Diet.
9. Do not lift over 10 pounds for 6 weeks.
10. Take your Incentive Spirometer home with you and continue to use it 10 times an hour every day for at least 2 weeks.
11. Continue to walk frequently when you return home. Start walking at least 15 minutes daily.
12. You will follow up at the Bariatric Office one week after surgery.
13. You will receive Dr. Johnson’s cell phone number and are expected to call her for concerns such as:

• Leg pain, chest pain, excessive and pain.
• Nausea/vomiting.
• Rapid heart rate.
• Shortness of Breath.
• Fever greater than 101.
14. Drink at least 64 fluid ounces daily, drink 2 to 3 protein shakes, follow the Bariatric Staged Diet, and take your vitamins daily. Not doing these things can result in dehydration, malnutrition and readmission to the hospital. Dehydration can result in complications such as leak, pulmonary emboli, and death.