These instructions will serve as general guidelines to assist you in your recovery after surgery for severe obesity. If you have a question or problem, do not hesitate to call our office for instructions.Discharge instructions:

  • Check temperature twice daily for the first week. Call if fever is 101 or higher.
  • You may take a bath or a shower. Do not scrub incisions for three weeks. Notify our office if significant redness or drainage from incisions occur (small amount of drainage from around the JP drain site may be expected).
  • Contact us for vomiting or diarrhea, which lasts over 24 hours, or persistent abdominal pain, which does not resolve in 4 hours.
    Use incentive spirometry device four times daily for 10 days.
  • Walk daily until you can walk 30 minutes at a time.
  • Increased gas is common for the first 3-6 weeks. We recommend Gas-x, Digel, or Milk of Magnesia(MOM) for relief.
  • Do not take any anti-inflammatory pain medications (i.e. Ibuprofen, Advil, Motrin, Naprosyn, Aleve, etc.) unless approved by Dr. Gorecki. Tylenol is the pain medication which has the least potential to upset your stomach therefore you can use it if needed.
  • Take vitamin and calcium supplements daily.
    • Flintstone Complete chewable with iron, or Centrum Kids Complete, two each day.
    • Three Tums daily for calcium or two Viactiv chews (it will provide you with 1000-mg of calcium every day).
    • You may need to take Iron (liquid Ferrous Sulfate 300 mg) orally three times a day. Begin medication upon our approval.
  • Pepcid chewable 20 mg orally twice a day for five months. Begin medication upon our approval.
  • Actigall 300 mg orally twice daily for five months (reduces the chance of gallstone formation if you do have gallbladder). Begin medication upon our approval.
  • Female patients should not become pregnant for 18 months, until weight loss has stabilized, to prevent injury to the unborn child.
  • DO NOT CONSUME ANY ALCOHOL.
  • Liquid pain medication Lortab Elixir 15 cc (1 table spoon) orally every 4 to 6 hours for pain as needed. If the pain is not intense, liquid Tylenol 500 mg every 4-6 hours would be more appropriate.

Postoperative Dietary Instructions

The diet after surgery is divided into three stages to allow a gradual adjustment.

  • Stage I – Liquid diet throughout the day for two weeks with 1-3 protein supplements per day.
  • Stage II – Soft diet of 4-6 meals a day for two weeks. Stop protein supplements.
  • Stage III – High quality regular diet (solid food) of three meals per day (no snacking).

Remember  your stomach pouch is 1 oz in size do not take portions more then 1-2 oz at a time. Always stop when you feel full.

STAGE I: FIRST 10-14 DAYS AFTER SURGERY

  • Liquids and semi-liquids (only from list on the next page) throughout the day.
  • Liquid protein supplements* 1-3 times daily for 3 of your meals, such as Ensure HP, Ensure light (one can a day).

Remember:

  • Small amounts (1-2 ounces at a time)
  • Go slow (15 minutes to drink 2 ounces)
  • When you feel full STOP!
  • No carbonated drinks for 2 weeks
  • Do not use a straw when drinking for two weeks, as it can increase the amount of gas swallowed.
  • Avoid caffeinated beverages, as caffeine will increase water loss from the body, resulting in dehydration.
  • You need at least the same amount of fluids as before surgery drink water!

*PROTEIN SUPPLEMENTS:

High protein shakes from GNC such as Ultra Pure Protein Shake, White Lightning, Fuel Plex or Lean Body. Met Rx Protein Powder which can be purchased at CVS can also be used. Check with your dietician if you choose other brands of protein supplements from a health food store, since the protein content of these supplements can vary significantly.

Powdered supplements are best mixed with skim milk Plus. Lactaid milk can be used if you experience excess bloating or gas since lactose intolerance can occur the first few weeks after surgery. The protein powder can also be mixed with yogurt, fruit juice, fruits if blenderized, hot cereal, mashed potatoes or apple sauce.

Examples of Liquid / Semi Liquid Diet

  • Decaffeinated coffee or tea
  • Crystal light, sugar free Kool-Aid, Diet Snapple
  • Diluted fruit juice (half juice, half water)
  • Broth
  • Blenderized soup
  • Skim milk Plus or Lactaid milk
  • Sugar free Jell-O, Popsicle’s

STAGE II. SOFT DIET FOR 3 WEEKS (starting 10-14 days after surgery)

  • Soft foods from the list below can now be added to your diet:
  • Stop protein supplements.
  • 3-4 meals per day each meal should include a protein (at least twice daily for two of the meals).
  • No liquids with meals if soft food is included. You must wait 30-45 minutes for the pouch to empty before drinking.
  • CHEW WELL! The food must be almost liquefied before swallowing.

Soft Diet

  • Soft fruit (bananas, melon, strawberries), canned fruit
  • Cooked vegetables, fish, ground turkey, cheese
  • Soft pasta (well chewed), rice
  • Soft boiled eggs, half a toast or cracker
  • Mashed potatoes
  • Light Yogurt (made with Nutrasweet)
  • Sugar free pudding
  • Cottage cheese
  • Apple sauce, baby fruit
  • Oatmeal, grits, cream of wheat

STAGE III. 5-6 WEEKS POST SURGERY – REGULAR DIET OF THREE MEALS PER DAY

  • (Gradually add regular high quality foods, chicken, turkey, fish) and remember:
  • Eat solid foods only (not pureed).
  • NO SNACKS  eat only at meal times
  • DO NOT TAKE ANY LIQUIDS with meals

AVOID empty calories and foods high in fat such as:

  • Fats (Butter, mayonaise, regular salad dressings, sour cream, etc.)
  • High calorie liquids (milkshakes, regular sodas, etc.)
  • Sweets, chocolate, ice cream, cookies, cakes, pies, pastries, and chips
  • Red meats and non-toasted bread

SUMMARY

Follow three stage diet plan to allow general adjustment

  • Eat only at set meal time
  • Go slow (over 20-30 min.)
  • Take small bites
  • Chew well
  • Take liquid form of medications if available (crush or chew all pills)
  • Maintain a food diary
  • Monitor the color of your urine (it should be clear to pale yellow signifying good hydration)
  • Avoid chewing gum
  • When you feel full: STOP!
  • Exercise!!! (This will help to reduce weight and will maintain your muscle mass and strength – remember you do not want to lose muscle before losing fat)

Remember! Liquids, junk food and sweets do not relieve hunger! Only solid food, which fills the pouch and empties slowly, will relieve hunger.

IF YOU ARE A DIABETIC

  • Check your blood sugar at least 3 times per day
  • Carry identification at all times
  • Carry glucose tabs or other form of quickly absorbed sugar

Remember! – It is very important to schedule and attend your follow-up visits after surgery. They will be scheduled at; 1 week, 1 month, 3 months, 6 months, 1 year, 18 months after surgery and on a yearly basis thereafter. Weight loss, nutritional intake and mineral/vitamin supplementation will be monitored, including periodic blood work. Put these dates in your calendar and make the appropriate appointments. If you are not able to attend your visit(for an important reason), please phone us to cancel