Before and After Weight Loss Surgery
Pre-op phone call
You will receive a pre-op call from the Practice Nurse (myself) approximately one to two weeks prior to your scheduled surgery. This phone call confirms your operation date, surgery, admission time into hospital and fasting time. An overview of your medical history and list of current medications will also be obtained and instructions regarding the management of your medications will be provided. All pre-op work up such as blood tests, consent, dietician education and any diagnostic tests/images will be reviewed and confirmed.
What do I bring to hospital?
- Medicare card
- Health fund details
- Medications in original packaging clearly labelled.
- Sleep wear/loose comfortable clothing & protective, non slip footwear.
- Medical devices or walking aids.
- You may take electronic devices such as as a laptop or ipad but this is at your own risk and responsibility.
What about pain and pain management?
Post-operatively, each individual perceives and tolerates pain differently. While some patients may describe pain as an ache, others may experience greater discomfort. The goal is to minimise the level of your pain and discomfort to keep you comfortable and enable you to mobilise with little effort. Once achieved, this is beneficial for your overall recovery and well being.
Wound discomfort and pain after surgery is expected and normal. Other complaints of pain including shoulder tip pain is also normal. This occurs because during surgery carbon dioxide gas is used and this stretches the diaphragm. This should settle down within 24 to 48 hrs.
During your hospital stay, your pain will be assessed and analgesic medications will be prescribed and regularly offered and administered to you. Remember experiencing some discomfort is normal providing it is TOLERABLE. If your perceived pain become intolerable notify your attending nurse so they can give you additional pain relief.
It is is also important that prior to discharge, it is crucial that you discuss with your surgeon what analgesic medications you will be prescribed to take home with you.
What routine medication can I take?
If you take blood thinning medications like Asprin, Warfarin or Plavix your surgeon may have advised you to stop taking these prior to you surgery. Therefore, prior to your discharge from hospital please ensure to check with your surgeon when to recommence these medications.
If you are diabetic and take oral hypoglycaemics or insulin you must ask your surgeon during your pre-operative consultation if you are required to make any changes to the dosages of your medication or withhold any prior to your surgery. Additionally, post operative and prior to your discharge from hospital please ensure to check with your surgeon if you recommence any of diabetic medications or continue to withhold these. If your diabetes is managed by a endocrinologist please inform your surgeon during your pre-op consultation.
How do I do wound care?
Your wounds are closed with dis-solvable sutures and covered with a waterproof dressing. If soiled, the dressings should be changed by the nursing staff from the hospital prior to your discharge. You are required to leave these dressings in place for 5 days and then remove and expose to air. When removing the primary dressing you may also remove the white strips called steri strips underneath. This is okay. All remaining steri strips may remain in place and will fall off themselves. You may continue to shower and pat dry. If your wounds continue to ooze please contact your specialist or local doctor as they may need to be redressed. Please report any signs of infection. This includes, redness, increase in pain at the surgical sites and the presence of pus.
What is my post-operative diet?
For patients having weight loss surgery a diet plan and relevant information would have already been provided for you by our dietician Helen. I encourage you if you have any issues, concerns or questions regarding your diet and fluid intake please do not hesitate and call or email Helen to assist you as soon as possible.
For patients who have had other gastrointestinal surgery it is a good idea to commence small frequent meals of a soft diet which is easy to digest.
For all other general surgical patients you may eat and drink as tolerated , aiming 2- 3 litres of water daily.
What about excercise?
Early mobilsation and normal physical activity is allowed and highly encouraged. This not only assists in your recovery and well being but it also prevents the development of chest infections and DVTs (deep vein thrombosis ) in the legs and lungs. For the first 2 weeks after your surgery we encourage starting with a gentle walking routine. Avoid heavy lifting and strenuous activity. You will be advised regarding commencing other activities at your 2 week post operative follow up appointment with your surgeon.
During your hospital stay its important to walk within the ward and sit out in the chair and practice deep breathing and coughing exercises. These exercises expand your chest and allow good air entry into your lungs. This helps with your breathing, clear your lungs, and lower the risk of developing a chest infection.
You may find you are feeling fatigued easily for a week or two after your surgery. This can be a side effect of the surgery, general anaesthetic and analgesic medications. Rest, as necessary but remember it is important to mobilise as much as possible.
How soon can I return to work?
This is dependent upon the type of surgery you have had done and the nature of your occupation. I encourage you to discuss this during your pre-operative consultation with you surgeon. The surgeon will advise you on how soon you may return to work.
If you require a medical certificate or a carers certificate please advise your surgeon during your hospital stay or at your 2 week follow up post operative appointment.
Is constipation normal?
It is normal and common for your normal bowel regime or routine to be disrupted post-operatively. This is a result of a number of factors including fasting prior to your surgery, dietary changes, general anaethesia, not being as mobile and certain analgesia that have constipation effects.
If you have not had a bowel motion for 3 days post surgery you may want to consider drinking prune juice or adding a gentle laxative . I recommend benefibre, lactulose or movicol. All available at pharmacies without a prescription. Also, ensure you are drinking adequate amounts of water daily.
When can I drive?
Depending on the type of surgery you have had , anesthesia and the analgesics prescribed will determine how long you have to wait till you can resume driving. Generally, the recommendation ranges from 72 hrs post procedure to one week post procedure. Please ensure to ask and clarify with your specialist when it is safe for you can resume driving.
How do I do Clexane injections?
For weight loss patients, your surgeon may ask you to self administer a blood thinning injection called clexane for 2 weeks after your surgery. This is to prevent DVT (deep vein thrombosis ) from developing. This involves one subcutaneous injection administered at the same time daily. Nursing staff from the hospital will provide you with the education and demonstrate how to self administer the clexane injection. Supplies will be provided for you for you to take home prior to your discharge from hospital. If you feel that you are unable to self administer the injections you may nominate a family member or friend to do so for you. If this is the case please inform the nursing staff. Alternatively, you may organise daily visits to your local doctor.