After Gastric Sleeve Surgery: What to Expect

Your new life begins after gastric sleeve surgery

After surgery, you will be required to commit to permanent changes in eating and drinking patterns. You will participate in long-term follow-up plans that include monitoring your nutrition, your eating behavior, and your medical conditions. Weight loss may be limited, and weight may be regained if long-term lifestyle changes are not made.

What to expect immediately after surgery

As soon as you are fully awake and oriented, you may be asked to perform certain activities and exercises that will help you recover more quickly and safely, and help to prevent complications. You may be asked to take deep breaths using a device called an incentive spirometer every one to two hours. This will help open up your lungs, and help prevent pneumonia. You will also be asked to get up and walk in the hallways of the hospital. This helps prevent blood clots from forming, and decreases pain and gas. It is very important to move adequately after surgery, even if you are scared. You may feel some weakness, nausea or pain when you first begin to move, but this will get better. Bowel function may take 7–10 days to return to normal. 

Constipation and bowel function

It may take 7–10 ten days for your bowels to return to normal functioning. You may take an over the counter stool softener if needed, and a mild laxative if you have not had a bowel movement after seven days. Your new normal for bowel movements may be as little as once per week, or more commonly, every two to three days. If you have gas, you may take chewable Gas-X® or Mylicon® drops. Walking also may help relieve the gas. You may experience some diarrhea after surgery. This is most commonly caused by the liquid protein supplements. This problem should resolve as you advance your diet.

Discomfort and pain

You will be given adequate pain medication to take home. You may experience periods where your surgical incisions hurt worse than others, which is normal. They may become inflamed as your activity level increases, but this is also normal. You may also note that your incisions hurt more in certain positions (like sitting for long periods or bending over).

Post-surgery diet:

  • Sugar-free, non-carbonated liquids for the first seven days
  • Shakes and pureed foods for two weeks
  • Soft foods for two months
  • Normal, solid food approximately three months after surgery

You will be required to take a specific vitamin regimen indefinitely. You will have frequent medical checkups to monitor your health in the first several months after weight-loss surgery. During this time, you may need laboratory testing, bloodwork and various exams.

Call your doctor if:

  • You develop a fever over 101 degrees
  • You have uncontrolled pain that medication does not help
  • You cannot keep fluids down
  • You have excessive vomiting not related to food or pain medications
  • You have sudden shortness of breath or have difficulty breathing
  • You notice dark or tarry (bloody) stools
  • Your incisions begin to leak pus
  • You develop severe swelling and pain in one leg
  • You develop new numbness or tingling in your hands or feet
  • You have any unusual events that concern you

Personal care and incision care

You may shower, and your incisions can get wet. You may take a bath (soak in a tub) and swim two weeks following your surgery. Always pat your incisions dry when they get wet. After your operation, your incisions will be covered by a transparent skin glue that serves not only to close the skin, but also to protect the incisions from water and bacteria. This glue should fall off in one to three weeks. A small rim of redness around the incision is normal. Routine use of antibiotics is not recommended after surgery. However, if redness extends greater than two finger widths from the incision or you have any drainage from incisions, call our office for advice.

Vitamins and supplements

You will begin your bariatric vitamins two weeks before surgery, along with your pre-operative liver shrink diet. You will not take vitamins for the first weeks after surgery, while your sleeve is more swollen and tight. Do not get discouraged or stressed if you cannot get the total amount of protein and water that is expected. Do the best you can, and remember, everything should get easier with time.

Activity

Your ability to resume pre-surgery levels of activity will vary according to your physical condition. You may resume activities of daily living gradually, making sure you do not lift anything over 20 pounds for four to six weeks. You may find that you tire quickly and need to rest frequently — this should get better with time. You may begin driving one to two weeks after surgery, but only if you are not experiencing pain and are not on any pain medication. You may resume sexual relations two weeks after surgery. You may discuss this on an individual basis with your surgeon.

For the first two weeks after surgery, make sure you stand and walk a short distance every one to two hours while awake. Then you may begin to take leisurely walks outside your home for about 20-30 minutes. After four to six weeks, you may begin an exercise program and begin lifting weights with no restrictions.

Hunger

Most patients are not hungry after surgery. However, you may begin to feel hungry a couple of days after surgery. Some patients never feel hungry again. This varies from patient to patient. If you are hungry from the beginning, this will subside significantly as you advance your diet to solid foods. You may also experience a desire to eat because you “miss” food.

Your recovery period

Recovery periods vary from patient to patient. Take time to follow your surgeon’s instructions, and be sure to use this time to practice healthy habits, such as diet and exercise. Remember, your health is worth the time it takes to fully recover. Try not to rush it. After all, your body will be healing from surgery.

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