After Surgery

Once patients are home, there are two main goals:

            1) Drink plenty of liquids

            2) Keep active

Patients should drink at least 2 liters of fluid each day. Depending on the surgery, patients lose weight very quickly, especially after gastric bypass: women typically lose about one pound a day within the first 2 weeks after gastric bypass; men typically lose 2 (or more) pounds a day within the first 2 weeks after gastric bypass. Band patients will lose weight at a slower rate.

Most of this weight that is lost is fat. The fat is metabolized into ketones, which your body will now use as a 'fuel'. Ketones can build up in your body and make you feel nauseated and your breath and urine smell 'funny'. It is necessary to 'flush' these out by drinking plenty of fluids, especially water. We also recommend that patients drink diluted sports drinks or fat-free milk to add a little sugar to their post-op diet to avoid ketosis.

It is important to keep active after surgery to avoid blood clots from forming in your legs. This means don't sit for a long period of time (>2 hours). If you will be taking any long car or airplane rides, get up and walk around every couple of hours.

Patients with a history of diabetes should monitor their blood sugar several times each day and record these values. Some patients with diabetes may require small doses of insulin once they home; but there is almost always rapid and dramatic improvement in the control of their blood sugars.

You will be tired for the first few weeks, but it does get better. You can get back to normal activities as you feel like it. You can drive after you are off of the pain medicine. People typically go back to work 10 days to 2 weeks after surgery, but some people go back sooner. It is also important to stay on clear liquids for a full 2 weeks after your surgery. Rushing things doesn't help; it actually can hurt you. Complete dietary instructions for after surgery are listed below. The most important thing is to call us, not your primary care physician, if you are having any problems, or even if you simply have any questions. We can't read your mind. You need to call us!

You will need to come in for a post-op visit 2-3 weeks after surgery. At this time, we will see how you are doing and check your incisions. We will also see if you have started your vitamins and if you have started exercising. At that time, we will let you know when we want to see you next, but the schedule is typically at months 3, 6, 9, 12, 18, and 24, then yearly after that. It is very important that you do not miss any follow-up appointments. If you need to reschedule, that is fine, but please don't simply skip any appointments. We need to monitor your weight loss closely and catch any problems as they are beginning, not months later, when it will take a lot more to correct the problem.

After gastric bypass, the typical rate of weight loss that patients should expect is rapid: 20% of their excess weight at 2 months, 30% at 3 months, 40% at 4 months.

As weight loss slows down, people tend to lose weight in a step-wise fashion. You may plateau for a week or two, sometimes more, then drop a few pounds all at once. This is normal. Try not to get discouraged. One thing to do is to measure yourself monthly and keep track og clothing size. Seeing the decreasing inches may be just the motivation that you need.

It is important that you follow the dietary guidelines that we recommend. Patients need to follow all of the rules for the best results: small portions of healthy meals eaten slowly.

It is also important to try to develop some sort of exercise plan, even something as simple as walking more when possible. This not only helps to keep your metabolism increased, but it prevents muscle loss. If you don't use your muscles while losing weight, your body will use them for energy and patients will lose mucscle mass.

People that exercise will have better weight loss than those that do not exercise.

Another important task is taking vitamins and mineral supplements as scheduled: daily multivitamins, calcium, vitamin D, B12, and iron.