Eating foods that are unusually distressful to the stomach
2. Dumping Syndrome
This occurs when food is dumped from the stomach into the intestine, which may result in a feeling of abdominal fullness, nausea, weakness, warmth, rapid pulse, or cold sweats.
Dumping syndrome can be avoided by eliminating concentrated sweets and taking fluids 30 to 40 minutes before or after meals.
3. Blockage of the Stoma
The opening created by the surgery is smaller than the original opening that released food from the stomach into the small intestine. This new opening may become blocked when food has not been thoroughly chewed, resulting in vomiting. Chew all food to the consistency of applesauce before swallowing to prevent blockage from occurring.
4. Overeating
The purpose of this drastic procedure is to create a smaller stomach. Therefore, the stomach cannot hold the large volumes of food it once did. Constant overeating can stretch the pouch and tear the staple line. To prevent this from occurring, you must follow the nutritional instructions prescribed for you. These instructions would normally include:
Eat only three or four small meals each day, measuring the foods before consumption to prevent overfilling the stomach; eat slowly to allow the nerve receptors in stomach area time to relay the message to the brain that the stomach is full; and stop eating as soon as a full feeling is experienced.
Requirement for Bariatric Support Group Attendance Prior to Surgery
The best preparation for surgery is through education. We advise you to talk to as many gastric bypass patients as possible and ask about their experiences. Also, you are strongly encouraged to browse Web sites, such as obesityhelp.com., for "Bariatric Surgery."
Bariatric Patient Support Group
This support group was established to help with some of the issues you might face as you lose weight. Some of these issues are dietary, others are social, and some are cosmetic (loose skin, etc.). These meetings provide a forum for you to meet and discuss solutions with other patients who may have gained insight through personal experience.
The support group is an important part of your recovery process. Studies have shown patients who actively participate in a support group have better outcomes than those who do not. Our staff attends most meetings and are available to answer questions.
The Pre-Operative Appointment
The surgeon will perform a complete history and physical examination, and review all consultations and lab results. He will explain the detailed surgical procedure and associated risks. Your surgery date will be scheduled. Pre-operative teaching will be provided by the program manager, and a post-operative follow-up appointment will be planned.
Patients check in at the Surgical Pre-Admissions Department (SPD) located in Suite 107 on the first floor of the DePaul Building at Sacred Heart Hospital-Pensacola. You will complete pre-admission forms and receive pre-operative teaching, and meet with anesthesia staff. Anesthesia staff will take your medical history and discuss possible anesthetic complications and immediate post-operative pain control methods. This pre-admit visit will take from one-and-a-half hours to three hours.
This pre-admit visit will take from one-and-a-half hours to three hours.
The Surgery
The pre-admit nurse will provide you with instructions for pre-operative preparation and check-in time for surgery.
You will check in to Suite 107 the morning of your surgery date. Once admitted, you will be taken to the pre-operative holding area. An I.V. line is started for fluid and antibiotic administration. Special pneumatic devices are applied to your legs to help prevent blood clots from forming. A medication to help prevent blood clots will be given to you at this time.
The operating staff will verify completion of all necessary papers and will perform a final check of surgery preparations. You are then taken to the operating room. At this time, a tube is placed your bladder to drain urine. The tube will be removed the following day.
The operation takes from one-and-a-half to three hours. An open procedure incision extends from the breast bones to the belly button of the abdomen. Laparoscopic procedures require six 1/2-inch incisions. Your gallbladder remains, unless it shows signs of disease.
Bleeding and use of blood products are very rare. Use of blood products occurs only when absolutely necessary.
After the operation, you are taken to Recovery for approximately two hours, and then you are taken back to the Bariatric Surgical Unit.
Post-Operative Care
You will be asked to cough, breathe deeply, and walk as soon as possible. This activity is important to prevent pneumonia and blood clots. Pain management is usually accomplished using a Patient Controlled Analgesic (PCA) machine. If you experience nausea, the nurse will provide additional medication. Once you recover from the anesthesia, you may begin clear liquids. You should only take what is comfortable and prescribed.
Most patients are discharged from the hospital two - four days after the laparoscopic surgery and four to five days after the open surgery. You are discharged only when the surgeon feels it is safe for you to go home.
At home, you will be expected to begin to take short walks for exercise. You may take short showers — no baths. There may be some oozing from the incision and bruising of the skin, but these will disappear over time. If you had an “open” procedure, sometimes a collection of pink fluid develops under the skin. This fluid may suddenly “squirt” from between the sutures. This is not dangerous, but the case manager should be informed.
If you are on routine medications, you should discuss with the surgeon which ones to take, prior to being discharged from the hospital. We may need to coordinate your medication with your primary care physician. In addition, as you lose weight, the dosages of certain medications will need to be adjusted. This will require close follow-up with the primary care physician.
You should do absolutely no driving or operating of mechanical equipment until authorized by your surgeon. You will be seen in the clinic within seven to ten days of discharge and should contact the clinic by telephone if questions or problems arise.
Your return to work will depend on many factors. Most patients are able to return to work within 21 days after laparoscopic surgery or four to six weeks after open surgery, if the occupation does not require strenuous activity. Your particular occupation and recovery progress will determine when you are able to return to work.
