post operative care

+ STAGE 1 POST OP: WEEK 1

STAGE 1: BARIATRIC CLEAR LIQUIDS

• Discharge from hospital 1st week
• Use protein supplement 1-2 per day (goal 40-60 grams daily) along with clear liquids listed above. All protein shakes must be low in sugar high in protein.
• Make sure to keep in minimum of 48 oz. of fluid in daily, but STOP when you feel full!
• Each meal will equal about 2-4 oz or, or ¼ - ½ cup in volume (1 ounce= 2 Tbsp)
• Small amounts (1oz every 15min.). Sip slowly and stop when you feel full or nauseated.

NO CARBONATED BEVERAGES. Start with very thin liquids and advance slowly to thicker liquids. Remember to walk, walk, walk! It is the key to faster recovery.

CLEAR LIQUIDS POST SURGERY FOR 3 WEEKS:

• Protein shakes: Ex: Bariatric Advantage, Advocare, Slim Fast-low carb, Adkins Advantage Edge, Isopure, Premier protein, New Whey Shots, Whey protein powder mix, etc.
• Protein shakes will be your meal replacements and you’re allowed up to 4 per day, even though they’re considered a full liquid we allow you to have them during the clear liquid diet. They will give you the energy that you need.
• Water / ice chips, Tea, Coffee, Crystal Light, Sugar free Kool-aid, Tang, lemonade, ect.,
• Diet Snapple
• Mild, clear juices ex: cranberry, apple or grape.
• Skim milk, light soy, or lactose free milk
• Sugar-free or no sugar added popsicles or jello.
• Low sodium broths

+ STAGE 2 POST OP: WEEK 2-3

FULL LIQUIDS

• Continue multivitamin & mineral
• Add cream/ blended soups and drinkable yogurts (NO chunks or lumps)
• Use protein supplement 1-2 per day (goal 40-60 grams daily) 48oz of fluid daily
• Avoid sugar sweetened drinks, Carbonation, Caffeine, & Alcohol

+ STAGE 3 POST OP: WEEK 4-6

SOFT FOODS

• Continue all supplements (vitamins, minerals, protein)
• Begin calcium citrate supplement 1000 to 1200 mg daily (500mg doses with at least 1hr in between doses. (DO NOT take at same time as multi- vitamin or iron.)
• Continue 48 oz- 64 oz of fluid daily

GOAL: at least 60 grams of protein daily and exercise 20 minutes 5 times a week.

• SOFT FOODS INCLUDE:
• Cooked cereal, Cream of rice, Cream of wheat, Malt-O-Meal, Thinned grits or oatmeal
• Mashed potatoes
• Crispy toasted bread
• Low fat cottage cheese or ricotta, Low fat yogurt, Low fat cheese
• Egg, Tuna
• Canned chicken or tuna ( with light mayo only)
• Shaved deli meats
• Flakey fish like tilapia or salmon
• Vegetables (cooked, canned or pureed only if able to be mashed with fork)
• Fruits (Cooked, canned or pureed. Unsweetened applesauce, and bananas, Fruits only occasionally.)

+ STAGE 4 POST OP: WEEK 7 - 3 MONTHS

REGULAR FOOD

• Ground beef & meats (Moist cooking)
• Continue all supplements (vitamins, minerals, protein) & fluids.
• May continue protein supplement (protein shake) if you’re unable to get 60grams of protein with regular diet.

GOAL: Exercise/ planned activity 20- 30 minutes 5 times weekly.

REGULAR DIET INCLUDES:

• Low fat soups
• Wild rice, angel hair pasta, whole wheat pasta
• Meats (Chicken, turkey, pork, beef, seafood. Cooking method same as above.)
• Cooked, canned or pureed vegetables
• Cooked, canned or pureed, unsweetened applesause, fresh fruit, bananas, some melons, citrus. (only eat fruits rarely)

+ STAGE 5 POST OP: 3 MONTHS +

3 MONTHS- Lean beef & raw veggies

• Continue all supplements, fluids, protein, and exercise.

GOAL: protein & produce. Lean beef now ok and raw veggies. Exercise/planned activity 45 min 6 times weekly.

+ THINGS TO EXPECT AFTER SURGERY +

• Up and walking shortly after surgery
• Discomfort and drowsiness
• Possible Upper GI study to check for problems about 1 hour after surgery
• Nothing to drink until clearance from surgeon
• Metallic taste and very dry mouth
• Surgery can be inpatient and most likely you are discharged from hospital the following day.

+ POST-OP MEDICATION +

• Begin a multivitamin and mineral supplement (liquid or chewable preferably)
• Begin sublingual (under the tongue) B12 2500mcg daily or Nascobal Nasal Spray B12 is available by prescription only taken once a week.
• Begin Pepcid Complete chewable OTC or Dexilant 60mg prescription only for 6weeks after surgery (acid reducer) Directions for Dexilant: open capsule and mix with ½ teaspoon of yogurt or applesauce.
• Hycet: Liquid pain medication.
• Phenergan Syrup or Zofran: To prevent nausea and vomiting.
• Compounded Pain Cream: Apply 1-2 pumps, 3-4 times a day around the incision with a maximum of 6 pumps per day for pain relief. Wash hands before and after application. Do NOT apply cream to open wounds.
• Scar Gel: At 6 weeks post op you may start to apply 1-2 pumps to the incision 2-3 times per day for scar reduction.

+ INCISIONAL CARE +

• Staples, sutures (stitches), skin glue, or possibly steri-strips
• Pinkness or redness around incisions is normal ( bruising near incision or in abdominal area is normal)
• May have some clear drainage
• May have hardness around or under incision site(s)
• Ok to wash with antibacterial soap but do not scrub or attempt to take glue off do not use alcohol or peroxide
• No ointments or creams (such as Mederma) for 6 weeks. If pain cream is prescribed make sure to apply AROUND incision not on open wound.

+ THINGS TO HAVE WAITING AT HOME +

• Chewable Gas-X & Milk of Magnesia ( for intestinal gas pain)
• Extra Strength Liquid Tylenol ( or generic equivalent)
• Liquid or chewable vitamins and calcium citrate
• Protein drink or shakes and clear liquids
• Comfortable walking shoes
• Help and support around the house for at least 1 to 2 days