Before and After Surgery

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Now that you are only 30 days away from your surgery date, it’s time to start getting ready for the big day. Download a pre-surgery preparation sheet by selecting the surgery that you will be undergoing.

The Big Day

The waiting is finally over. You’ve gone through all the steps, prepared yourself fully, and now it is time to come to Good Samaritan Hospital to have your surgery. Your stay in the hospital will be as long as it takes you to be self-sufficient. Although it can vary, the hospital stay (including the day of surgery) can be one to two days for a laparoscopic band, two to three days for a laparoscopic gastric bypass, five to seven days for an open gastric bypass, and three days for a sleeve gastrectomy.

Then your new life will begin!

After Discharge

From what and how much you eat to what medications you take, your life will be different when you return home after your surgery. During the first few days after you are discharged from the hospital, you can expect:

  • Pain: The amount of pain each patient experiences is different. You will be given a prescription for Roxicet (liquid Percocet) for pain relief.
  • Nausea: Nausea can last for approximately six weeks as your body adjusts to the new, smaller stomach pouch. You will be given a prescription for Phenergan for nausea relief.
  • Gas and bloating: If you experience gas and/or bloating, you can use an over-the-counter chewable gas relief product such as GasX or Mylicon.
  • Diarrhea: Your first several bowel movements will be watery and dark and will have a very strong odor – a result of blood in your intestinal tract following surgery, as well as the post-operative liquid diet. If you experience diarrhea, you can use Immodium.
  • Constipation: If you experience constipation, be sure you are getting sufficient fluids daily (48 to 64 ounces). You can take Milk of Magnesia or an over-the-counter stool softener for constipation.
  • Incision drainage: Most patients experience some incision drainage. The drainage should be clear, yellowish/tan, and possibly blood-tinged in color and appearance. If your incision is red, hot and/or painful and/or the drainage is pus-like with a foul odor, call Dr. Kerlakian’s office, as you may have a wound infection.

It is important, however, to be aware of the following signs and symptoms, and to call Dr. Kerlakian’s office if any of them are present*:

  • Fever greater than 101.5 degrees Fahrenheit
  • Uncontrolled pain (pain that does not improve with pain medication)
  • Uncontrolled nausea (nausea that does not improve with nausea medication)
  • Vomiting
  • Shortness of breath
  • Chest pain
  • Pus-like, foul-smelling drainage from incision
  • Red, hot painful incision
  • Bloody bowel movements

*If you need to go to the emergency room, it is preferred that you return to Good Samaritan Hospital unless it is believed to be a life-threatening emergency, at which time you should call 911.

To avoid these and other complications, pay special attention to the following instructions regarding:

Incision Care

  • All of your stitches are under the skin. They are absorbable.
  • You will have little tapes (steri-strips) over the incisions. They will stay on for seven to 10 days. You then can remove them, or they will be removed during your post-operative visit to Dr. Kerlakian’s office.
  • You do not need to keep a dressing/gauze over the incisions unless you are experiencing drainage.
  • If you experience drainage, use a warm, moist compress over the incision for 20 to 30 minutes at a time, three to four times a day. Call Dr. Kerlakian’s office and make the bariatric staff aware of any drainage.

Activity

  • Do not lift, pull or push anything that weighs more than 15 pounds.
  • Walk as much as possible and increase your level of activity as tolerated.
  • Continue with deep breathing, coughing and using your incentive spirometer (the breathing apparatus you received from the hospital) until your abdominal pain is minimal. You will subconsciously take shallow breaths as a result of abdominal pain, which can result in development of pneumonia.

Other Considerations

  • Be sure to contact your primary care physician regarding any necessary dosage adjustments of your medications (blood pressure, diabetes, etc.), as some medication dosages may need to be decreased following surgery.
  • Small pills can be swallowed. Larger pills will need to be crushed for the first month after surgery. Some pills, such as extended release (XR) and long acting (LA), cannot be crushed. Please discuss medications with your primary care physician, Dr. Kerlakian and/or pharmacist.
  • Begin taking your vitamins one week after surgery.
  • Gastric bypass patients only, begin taking your Actigal one week after surgery if you still have your gallbladder. This medication helps prevent the development of gallstones. The capsule must be opened and mixed with drink/food for the first month. After the first month, it can be swallowed.
  • Unless you were told otherwise when you were discharged from the hospital, you will need to make an appointment for your post-operative visits with Dr. Kerlakian and your dietician for two weeks after surgery.

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