Life is a Highway and I'm riding it my way.: Life After Surgery

Life After Surgery

4:48 PM |

Posted by Dawn

The Day After Surgery

Congratulations, YOU DID IT!!

Most people spend one night in the hospital. However there are some that come home the same day. You will find as you talk to others that all doctors are different. Which is why I say this is from my own experiences. Please ask your doctor what your guidelines on things will be.

So you've had your surgery and it's the day after. By now you are extremely thirsty. Not so much hungry but you haven't had anything to drink in 2 days so you REALLY want something to drink. But you have to wait for awhile longer.

First thing in the morning you will be taken down for an X-Ray, 'Swallow Test'. And let me tell you the barium swallow tastes horrible. Sorry this is your first liquid. After your 'Swallow Test' you are taken back up to your room where you will wait for your surgeon to visit you. You will then be given the results of your swallow test and your surgeon will check your incisions . If all went well with the 'Swallow Test' the doctor will give you clearance to have some fluids. You will start off with 1 ounce of clear liquids. Make sure you sip. It's very common to feel nausea after surgery. This may be due to anesthesia or to the pain medication (morphine) in the PCA pump. If you have nausea, request that an anti-nausea medication be ordered for you.

Your liquids in the hospital may consist of water, diet ice tea, broth and sherbert. As I said you will start off with 1 oz of fluids and gradually work yourself up to 4oz of fluids every hour. Even if you aren't hungry and don't feel like drinking anything, it's very important that you force yourself to get these fluids in or you will dehydrate.

     Usually after lunchtime you will be released from the hospital. You will be given a prescription for liquid or pill medication. If you are given pills you should crush them and try taking them in some sugar free jello. You can ask your doctor to give you the liquid form though.   The medication will usually be Percocet or Rixicet (Liquid Percocet). Unless of course you can't take it and then something else will be given to you.   You still may be experiencing some 'Gas' pains which is common for a few days after surgery. Try some Gas-X strips when you arrive home.
     You will be discharged from the hospital when you can tolerate enough liquids and are medically stable. Before you leave ask your nurse for a medicine cup. These are 1 oz medicine cups so it helps to measure your fluids in. In the next few hours you should be sipping 4 of these every hour. Before you leave the hospital you will be given instructions for your follow-up care. Don't forget to keep walking as much as possible when you go home but don't over due it. Also keep drinking those fluids but also get plenty of rest.
       Depending on how strenuous your job is, many people are able to return to work within 3-4 days. You won't be able to drive until you are off of the pain medication and you won't be able to do any heavy lifting for at least 6 weeks after you leave the hospital. So be sure to have someone at home to help you. Especially if you have young children to attend to. You will also be sent home on a clear liquid diet which will change an all liquid diet in a few days and will last for around 10 days. After that you will gradually move onto puree, then soft foods, then regular foods. During the recovery period, you will need to drink liquid protein supplements to make sure adequate protein requirements are met. The daily minimum protein requirement is approximately 50-80 grams of protein a day. Protein will also help you to stay full for longer periods of time.

Arriving Home From the Hospital

So your home from the hospital and everything went well and your excited to start your new life with the band. Your probably a little sore. The doctor should have sent you home with some prescriptions for pain pills. Make sure that you use them when needed. Don't wait until the pain is out of control before you use them because it takes awhile for them to get into your system and if you wait, you will be in tears. Continue your walking but try not to over do it. Three days after my surgery I felt pretty good so I thought I would take a walk down to my local super market. Even though it's just around the corner, I felt it when I came home. So even if you think that you feel better, don't push yourself. Take it slow. You won't be able to lift anything heavier than 10lbs for at least 6 weeks. And definitely no driving until you are off your pain medication.

The following is a check list of things that you should do when you come home.

Fill your pain medication at the drug store.

Make your follow-up appointment with your doctor.

Continue to get your fluids in. 1 oz working up to 4 ozs. Every hour.

Walk, Walk, Walk

And Finally get some rest.

   At this point you are on clear liquids for a few days. My doctor wanted me to put my protein supplement in my liquids. Your doctor may be different. At this point I was using Unjury Chicken Flavored protein mix (Unjury Protein Supplements). I would also recommend Sugar Free Ice Pops. I live on these things. They will help you get your fluids in and also help with the swelling after surgery. Later along they will also help with that sweet tooth that you might have once and awhile. You might not feel like drinking much but it's important to get the fluids in. You might ask "How can I get 4oz of fluids in an hour when it takes me almost an hour to drink that much?" My suggestion is to set a timer for 15 minutes. Every 15 minutes you should be able to consume a shot glass full of fluid. Please stick to the fluids. Eating things to soon that may cause you to throw up or makes your stomach churn as it tries to digest thicker foods, can cause the band to slip. Do not bath, swim or soak in a hot tub until your incisions are healed. Your doctor should tell you it's ok to take a shower.
   You may find that you are very sore and can't lie in your bed. There are several ways that others deal with this. Some may sleep in a recliner for a couple of days. How I dealt with the pain when I was lying down was to put a pillow along my left side. Body pillows also work well. And you probably won't be able to lie on your side for a few days. When I had to get up to go to the bathroom or walk around, I kind of rolled myself out of bed because sitting up was to hard to do. There are several different places that surgeons will place your port. Mine happens to be on the left side just bellow my rib cage. Your port is about the size of a stack of nickels. This is why it's good to put a pillow along the left side when you lie in bed.
   Your band is usually empty during surgery. This is because you will normally swell after surgery, giving you that normal 'full' feeling. As the swelling wears off you will feel more hungry. Please note that some doctors do give a small amount of fill during surgery.
   If you experience any of the following issues, call your surgeons office.

Surgical area is red, warm or tender.
Drainage
A Fever of 101 or higher
Serious belly pain
Dizzy or shortness of breath
Bad nausea and are vomiting

If you do need to go to the hospital be sure to tell them that you have the Lapband and have them call your surgeon.

Food Phases after Bariatric Surgery

There are typically 4 Phases of food after Bariatric Surgery. Make sure that you follow the plan that your doctor gives to you. Even though it's tempting to start eating something you really shouldn't when you are on a certain Phase. If you do move ahead to fast, you take then chance of stretching your band or getting stuck.

Phase 1

Clear Liquids/Full Liquids - Clear Liquids begin the day after you have your surgery in the hospital. Clear Liquids consist of Ice Chips, water, apple juice, broth, and Sugar Free Ice Pops. The clear liquid stage can last anywhere between 1 day to 1 week, depending on your doctor. Clear liquids are anything that you can see through. You should then progress to the Full Liquid stage. You should really have a protein supplement now. Whey protein Isolates are more exspensive then concentrated drinks such as Slim Fast or Atkins. Whey Protein Isolates are more pure then concentrated drinks and contain more protein and less fats then concentrated drinks. Whey protein is currently the highest yield of protein available, and it comes from milk. Because of it's chemicals, Whey protein is the easiest to absorb into your muscles. You should find a Whey protein that is made of either vegetable or soy. I use Dymatize Elite Whey Protein Isolate, which comes in different flavors. I bought mine on Amazon . Also Unjury makes a very good unflavored protein which you can put into anything you eat, and also a chicken flavored soup protein powder which you can drink warm Unjury Protein Powder.

The Full liquid stage consists of strained creamy soups (without chunks), Protein powder mixed with Skim Milk (I use Skim Plus milk because it's creamier and has higher protein then regular Skim Milk), plain yogurt (with no fruit), Sugar Free Ice Pops and Fat Free Jello. Pretty much anything that is liquid (not including alcohol).

Phase 2

Mushie - In this stage you will be eating food that has the consistency of Apple sauce. You can pretty much eat anything except that it has to be pureed. Most people find that buying Stage 1 baby food at this stage is easier. Make sure that you incorporate your higher protein foods in such as chicken and fish. This will keep you full longer. Mashed potatoes are good but make sure that you have protein with them. And always eat your protein first. You will be on this stage for around 2-4 weeks. 2-3 oz of food should be consumed.

Phase 3

Soft Foods- Foods in this phase include high protein soft foods and liquids, such as fat-free or low fat cottage cheese, no sugar added yogurt, fat-free refried beans, reduced fat cheese, eggs or egg substitutes, well blended canned fruits, vegetables or vegetable soups. These foods are eaten in addition to the foods included in the previous two phases. REMEMBER that fluids must be consumed BETWEEN meals, not with meals. Follow the 30-minute Rule: “Do no drink fluids 15 minutes before or 30 minutes after ANY meal". You will be on this phase for about 3-4 weeks up until your first fill (which we will get to soon). 3-4 oz of food should be consumed.

Phase 4

I live on this stuff with a little Fat Free Mayo

Regular Foods - YES!! Finally you are back to 'normal' foods. Usually this starts a day or two after your first fill. This doesn't mean run out and get a McDonalds cheeseburger and fries. In this stage you really have to be aware of small pieces and chewing your food. You don't want anything bigger than an M&M going down. You should chew your food at least 25-30 times before swallowing it. It's also easier if you use a baby spoon and a small dessert plate to put your food on. You should consume no more than 5-6oz (Not weight Ounces) of food with each meal. This is a learning stage. Meaning that there are certain foods that might not agree with you but you won't know unless you try them. Many people have trouble with beef and bread. This is where you may experience your first 'stuck' experience. DON'T PANIC. The best thing to do when you get stuck is to walk around. Yes it might hurt in the upper part of your chest a little but chances are the food will go down or you will unfortunately bring it back up. This is why it's VERY important to chew your food and eat slow. When I get stuck I walk around, sometimes I jump up and down. If you have a stuck feeling lasting more than a few hours then I would definitely call your doctor. Mine have only lasted for 10 minutes at the most. You may at this stage experience what is called 'Sliming'. Which is the thick mucous, slimy stuff that comes up when you get stuck. This is saliva. Although pretty gross looking, it's normal. Again, DON'T PANIC (What is PBing and Sliming?) Make sure that your meats are moist. You might want to add a little chicken or beef brother to your meats. Also a little Fat Free mayo to your tuna or chicken salads. Stuff like pasta, white rice and bread might not be good for you for awhile because they expand in your pouch when they get wet. They are also higher in carbohydrates. Carbohydrates in higher dosages are not good because sugars will stay in your system which won't really help with your weightloss.

It's Fill Time

During Lap Band Surgery, an access port is placed beneath the abdominal wall which is connected to the gastric band by a thin tube. This access port is used to add or remove saline from the balloon reservoirs which line the inner circle of the gastric band. The adjustments are made by the doctor using a thin needle, often under the guidance of an X-ray fluoroscope in order to view the level of restriction in the band and to check for any potential issues of concern.

The adjustment process is used to either inflate or deflate the band, depending on whether fluid is added or removed. Saline is added if the amount of weight loss is too low and the band is too loose. Saline can be removed if the band is too tight and causing too much pain or difficulty eating. Any issues of concern should be addressed with your doctor in order to arrive at the safest and most productive level of Lap Band fill.

Avoid COLD fluids for an hour before the fill (cold can temporarily shrink the stoma)

Avoid getting a fill either during or a few days before your menstrual period (fluid retention affects fill level.

If traveling from out of town, plan on staying in the area at least overnight, just in case there is a problem with the amount of fill .

After a fill, limit eating to a full liquid diet for 24 hours, then to soft foods for a day, before resuming a solid food diet (to help the stoma rest and heal)

Many people (like myself) are nervous about the first fill. After all they are sticking a needle in your stomach. Personally it was painless to me. Some doctors will numb the spot before the needle goes in. My doctor uses a very small needle so you can't really feel it.

This is an example of a Fluorscope X-ray. The needle is WAY bigger than my doctor uses so don't get squeemish!!

After surgery, follow-up visits are usually scheduled for every 6 weeks during the first year and then every three months for the next two years. During the appointment, the doctor will monitor your health and rate of weight loss as well as adjust the Lap Band if necessary.

There are several factors which help determine whether or not an adjustment is needed:

degree of hunger

amount off restriction

amount of weight loss

     Usually your doctor will ask you to sip a small cup of water before you leave the office to make sure that you are able to get the fluid down. This is especially useful when you aren't getting the fluoroscope done. I only had the fluoroscope done with my first fill and I had to drink that nasty Barium again. YUCK!! Doctors normally don't do fluoroscopes all of the time unless they expect something might be wrong, such as a band erosion, flipped port, leek in your band, or a stretched pouch.
   After your fill when you go home, if you can not get anything down including fluids, it could mean that you are to tight. Call your doctor and they will tell you what to do. Do not wait for a couple of days because without fluids you will quickly dehydrate. You trusted your doctor to operate on you, now trust your doctor to help you with this also.
   If you are scheduled for a fill and you are finding it VERY difficult and wanting to eat everything in site or not losing any weight, call your doctor. Do not feel ashamed. This is what your doctor is there for. You can't do this alone. Your doctor may tell you to come in earlier than your scheduled appointment for a fill.