Caring for Yourself at Home
Support Groups
Nutritional needs
Free Fitness Education Program for SJH BariatricCare Patients
For Yourself at Home
When your surgeon has determined that you are able to return home, specific instructions will be given to you that are based upon your individual needs. You will be receiving written instructions from your surgeon as well as your nurse and clinical dietitian.
Comfort
You may experience some abdominal cramping, shoulder pain or nausea. This will usually pass in a couple of days. If this persists after your first office visit (usually within one week of being discharged), you should call your surgeon. Pain medication will be ordered based upon your individual needs. As individuals have different pain tolerance levels, your surgeon will order a medication specific to your needs.
Activity
Usually, individuals may return to normal activities within three to five weeks after surgery. During your office visits, your surgeon will review with you the timeline of when to resume specific activities. It is important that you get permission from your surgeon before starting any new activity. Your surgeon will guide you on what is best
for you.
Until you are able to resume your normal activities, it is important that you continue doing your ankle pumps several times a day. This will help the blood flow in your legs and help prevent the development of blood clots. You should do your ankle pumps at least every hour during your first couple of days at home. Most people plan their ankle pumps around their favorite TV shows. If you do your ankle pumps at the beginning and end of your favorite TV programs, you will find it easier to remember to do them.
Wound care
You will need to keep a light, dry dressing over your incision until the staples are removed. If you notice that your skin is becoming red from the adhesive tape holding your dressing on, you can use paper tape, which is less irritating to the skin. Paper tapes can be found in drug stores, near the regular adhesive tape.
Your surgeon may advise you to continue using the abdominal binder. The best way to apply the binder is while you are lying down. Place the binder on your bed then lie on the center part of the binder. You will then pull one side over your abdomen (the side without the Velcro) and then pull the Velcro side overtop and firmly press it against the binder. This will keep the binder in place.
Depending upon how you are healing after your surgery, your surgeon may need to send you home with the drain (JP, Jackson Pratt) still in. Don’t worry. If you are sent home with the drain it does not mean that you are not healing well or not doing well after your surgery. Each person’s body responds differently to surgery. If you are sent home with the drain, your surgeon will remove it during your office visit. Before you are discharged, your nurse will teach you how to empty the container attached to the drain. This is very easy and will not hurt.
Usually your surgeon will remove your staples in 10 to 14 days. This will be done during an office visit.
When should I call my surgeon?
Most people who follow the directions of their surgeon do well after gastric bypass surgery. You should call your surgeon if:
-
you have fever over 101 degrees or the chills
-
your incision becomes red and very uncomfortable
-
you have persistent vomiting
-
you experience severe leg pain or difficulty breathing
-
you experience any other symptoms that worry you
Support groups
Individuals tend to have better outcomes when they can share their stories with people going through similar experiences. There are many psychosocial issues that you will experience as you are on your way to a healthier lifestyle. We strongly encourage you to join a support group for gastric bypass patients. Our support group is free and meets on the third Wednesday of each month at SJH Bridgeton Hospital at 7pm.
People who attend the support group often find that it helps them deal with the psychological issues related to obesity, gastric bypass surgery and adapting to a healthier lifestyle.
You may register for the support group online
Nutritional Needs
In this section we will discuss guidelines to healthy eating in detail. It is important that you follow these guidelines to assist you in achieving a healthier lifestyle.
As a result of your gastric bypass surgery, the absorption of vitamins and minerals that the body requires has been altered. You will be required to take supplemental vitamins and/or minerals as prescribed by your surgeon. Your clinical dietitian is available to assist you in making healthy food choices. As you are on your way to a healthier lifestyle, it is important for you to use the resources that are available for you. You can reach your dietician during the day by contacting him or her at the hospital.
Nutrition: Your Way to a Healthier Lifestyle
Making the right food choices now will be the most important part of your recovery. Your new eating habits will help assure your success.
You will gradually re-introduce healthier foods through a carefully staged process that will be monitored and advanced by your surgeon. It is very important that you follow the guidelines discussed with you by your surgeon and Clinical Dietitian. Your diet will be advanced based upon your individual tolerance of food after your surgery.It is important to remember that everyone heals at a different rate. Please do not be discouraged if you are progressing at a different rate than someone you know.
You will need to change or modify some behaviors to help you achieve and maintain your desired weight.
Support from family, friends, or counselors can help you to stay focused on your goals. We strongly encourage you to attend a Bariatric Support Group. This can provide emotional support through your post-operative process.
An exercise program is an important part of your weight loss plan. Ask your surgeon when to begin your exercise program. The amount of time you spend exercising is more important than how fast you can walk, run, or ride a bike. You should plan on spending 30 minutes a day exercising. The first stage of your exercise program may be walking. This would be an excellent time to join the SJH Fitness Connection, a service of South Jersey Healthcare.
Starting to eat following your surgery
You will start the re-introduction of food and fluids by using a small cup (2 ounces in size, or about the equivalent of four tablespoons or 1/4 cup) to help you portion your food. This will help you learn the portions that you should be eating. Using the small cup will also help you estimate the amount of food that should be on your plate when you start eating again.
Nutritional supplement
Your surgeon will advise you to take a multivitamin with iron and a calcium supplement with vitamin D. It is important to take these supplements everyday. These supplements are available in chewable form. You may also require additional vitamin B12. Prior to your discharge, your surgeon will instruct you on what you need to take, how often you need to take them, and when to start taking them.
Learning to eat again
You need to plan your day so that you can eat at regularly scheduled times. Skipping meals will not help you lose weight, since this will only slow down your metabolism. If you skip meals, you may feel more tired, and you may tend to eat more at the next meal. If you overeat, you might vomit. Therefore, plan your day to allow enough time to eat properly.
The portions of food that you will eat after your surgery will be different than what you are currently eating. The portions will most likely be much smaller than what your family or friends are eating. Remember your entire meal may consist of 1/4 to 1/2 cup (4 to 8 tablespoons). Using smaller plates and utensils may help your plate look full.
You should not eat and drink at the same time. Remember to sip on liquids all day long, but stop drinking 30 minutes before a meal, and then resume drinking 30 minutes after a meal. Drinking at meals can cause bloating, vomiting, and/or dumping syndrome. Your goal is to consume at least 8 cups (64 ounces) of fluid a day. Acceptable fluids include water, decaffeinated or herbal tea, skim or 1% milk, vegetable juice, and other no-sugar- added, caffeine-free, non-carbonated beverages, such as Crystal Light®, and Wylers® Light.
Sometimes patients can experience nausea or vomiting. This often is a temporary problem. If you are unable to tolerate food or liquids for 24 hours, immediately call your surgeon. Prior to surgery, ask your surgeon what your plan should be if you encounter nausea or vomiting.
You need to eat slowly and chew your food thoroughly, so that you can avoid upsetting your stomach.
What to expect as you begin losing weight
You should begin to lose weight steadily after your surgery. You should continue to lose weight over the next 1 1/2 years. Most people should lose close to half of their excess weight in the first 6 months. Your success will depend on your commitment to a healthier lifestyle.
Your eating habits
-
Changing your eating habits now is essential to maintaining your weight loss. Below are some hints to help improve your eating habits:
-
Eating at a designated spot, such as the dining room or kitchen table.
-
Avoid reading or watching TV while eating. This will help you enjoy your food, concentrate on eating more slowly, and help you realize when you feel full.
-
Use smaller plates and utensils. You could even buy a salad plate that is the right size for your portions.
Chewing
You can block the outlet of your new stomach if your food is not chewed properly. If this happens, it will cause pain, discomfort, nausea and/or vomiting. To avoid this, you should:
-
Chew each bite until it feels like mush in your mouth (usually 20 times).
-
Use a smaller fork and place less food in your mouth.
-
Learn to enjoy what you are eating. Take the time to savor the flavor.
-
Do not be rushed by others at the table.
The Different Stages of Your Meal Plan
Stage 1: Clear Liquids
Clear liquids are generally liquids that you can see through. You will be able to drink 1 to 2 ounces of liquid at a time. Your surgeon will instruct you on how often you can drink this amount.
Some examples of clear liquids are broth, artificially sweetened gelatin, and diluted unsweetened fruit juice, such as apple, grape, and cranberry. Remember to avoid sugar-sweetened liquids.
Stage 2: Full Liquids
Your surgeon will instruct you on when to advance to this stage.
Some examples of full liquids are skim or 1% milk, strained creamed soups, plain low-fat yogurt or artificially sweetened low-fat yogurt, and refined cereals such as Cream of Wheat®, Malt-O-Meal®, and grits. You can still have clear liquids. The important thing to remember is to stop eating when you feel full.
Stage 3: Pureed/Blended Foods
Pureed/blended foods are smooth enough to prevent large particles of food from blocking the opening to and from the stomach. Some examples of pureed/blended foods include pureed chicken, applesauce, oatmeal, and low-fat cottage cheese.
It is important that you add no more than one new food at each meal. If you have added more than one new food at a meal and you have some stomach upset, it will be difficult to identify what your body is not tolerating.
One of the most important factors in your meal plan is eating enough protein. You may need to eat 50 to 60 grams or more of protein each day. Measure your food to help meet your protein needs.
Stages 4 and 5: Soft Foods to Regular Foods
This is your first exposure to solid foods after your surgery. Remember to chew your food thoroughly, and take your time when eating. Mealtimes may take longer now than in previous stages.
Your surgeon will modify the above regimen according to your individual needs.
Important DOs and DON’Ts
As you learn how to make healthy food choices, there are a few behaviors you may need to change. Some examples include:
|
Do |
Don’t |
|
Do…Sip your liquids |
Don’t…Gulp your liquids or use a straw |
|
Do…STOP eating at the first sign of feeling full |
Don’t…Continue to eat or drink when your body has told you it is full. |
|
Do…Crush all pills or tablets (ask your surgeon for more details) |
Don’t…Swallow whole tablets or pills, which may block the stomach outlet (this may be temporary) |
|
Do…Spend more time eating |
Don’t…Rush while eating and drinking (this will cause you to over eat) |
|
Do…Drink adequate fluids (goal is 64 ounces per day) |
Don’t…Drink alcohol, carbonated, or caffeinated beverages |
|
Do…Have regularly scheduled meal times |
Don’t…Snack between meals on inappropriate foods |
|
Do…Choose high protein foods |
Don’t…Choose high fat or sugary foods |