Life After Surgery
What about my diet after surgery?
After weight-loss surgery, you will be seen by our dietician or nutritionist, who will provide special dietary guidelines just for you. You will need to follow these dietary guidelines very closely, as failure to do so could be harmful to your health.
You will begin with a special clear-liquid diet for approximately two weeks following surgery. If you’re able to tolerate these clear liquids, you will advance to a semi-solid or gastric soft diet. It is important to maintain proper nutrition, including adequate hydration, protein intake, and vitamins and minerals consumption as part of your new lifestyle. More solid foods will be introduced as tolerated.
What about exercising?
Aerobic exercise is encouraged, as it causes your body to become more efficient in its use of fatty tissues. After weight-loss surgery, you should lose weight as a result of the difference between the amount of food energy (calories) you are able to eat versus the amount your body requires to perform its daily tasks. Your body should make up this difference in calories by using fat or muscle tissue reserves, with the tendency to burn muscle before accessing fat stores. Daily aerobic exercise communicates to your body that you want to use your muscles, forcing it to preserve them and burn excess fatty tissues instead. If you do not exercise, you risk losing muscle mass and strength.
Can I get pregnant after weight-loss surgery?
It is strongly recommended that women wait at least one year before becoming pregnant after weight-loss surgery. At the one-year, post-operative point, your body should be more stable in terms of weight-loss, diet and nutrition. Consult with your obstetrician-gynecologist before becoming pregnant.
What happens to the part of the stomach that is bypassed?
In Roux-n-Y gastric bypass surgery, the stomach remnant is left in place with an intact blood supply. In some cases it may shrink a bit, but for the most part it remains unchanged. This bypassed stomach remnant still contributes to the function of the gastrointestinal system, even though it does not receive or process food.
How big will my stomach pouch really be in the long run?
The stomach pouch varies in size with each individual patient. Some expansion of the pouch post-surgery is normal.
What will the staples do inside my abdomen? Is it okay in the future to have an MRI test? Will I set off metal detectors in airports?
The staples used on the stomach and the intestines are very small. Each staple is usually made from stainless steel or titanium, which are inert. This means the body is not likely to have an allergic reaction to them. These metals also are non-magnetic, so they will not be affected by MRI. The staples will not set off airport metal detectors.
What if I'm not hungry after surgery?
It's fairly common to lack an appetite following weight-loss surgery. This condition is usually short-lived and resolves without any intervention. It is important to follow the after-surgery dietary guidelines given to you. If you are able to consume liquids, it’s likely a healthy appetite will return.
Is there any difficulty in taking medications?
Most pills or capsules are small enough to pass through the new stomach pouch. Initially, we may suggest that medications be crushed or taken in liquid form.
Will I be able to take oral contraception after surgery?
Most patients have no difficulty swallowing oral contraception pills.
Is sexual activity restricted?
Patients can return to normal sexual intimacy when wound healing and discomfort permit. Many patients experience a reduction in sex drive (libido), but this is usually temporary.
Is there a difference in the outcome of surgery between men and women?
Both men and women respond well to this surgery, however, men do lose weight slightly faster than women.
Will I be asked to stop smoking?
Patients are strongly encouraged to stop smoking at least one month before surgery. Patients who continue to smoke do so against medical advice.
If I continue to smoke, what happens?
Smoking increases the risk of lung problems after surgery and may reduce the rate of healing and increase the chance of infection. Patients are strongly encouraged to stop smoking.
What if I just keep losing weight until I waste away to nothing?
Some patients begin to wonder about this unlikely scenario soon after the surgery. Two things happen to cause your body weight to stabilize. First, your ongoing metabolic needs (calories burned) decrease as the body sheds excess pounds. Second, there is a natural progressive increase in calorie and nutrient intake over the months following weight-loss surgery. The stomach pouch and attached small intestine begin to better work together, and there is some expansion in pouch size over a period of months. The bottom line is that, in the absence of a surgical complication, it’s highly improbable you’ll lose weight to the point of malnutrition.
What can I do to avoid excess hanging skin?
Many people who are heavy enough to meet the surgical criteria for weight-loss surgery have skin that is stretched beyond the point from which it can "snap back." Some patients choose plastic surgery to remove loose skin after they reach their goal weight. Insurance typically does not pay for this type of surgery, which often is viewed as elective, however, some insurances do pay for certain types of surgery to remove excess skin when if its presence causes medical complications for the patient. Ask your surgeon about your need for a skin removal procedure.
Will exercise help with excess skin?
We recommend a regular exercise program because it is good for you in so many ways. Unfortunately, exercise will not eliminate the large flaps of loose skin most patients have following weight-loss surgery.
Will I be hungry after weight-loss surgery, due to reduced calorie intake?
Many patients report that they have almost no appetite immediately following surgery and for a short time after. These patients say that over the next several months, their appetite returns, but not as a ravenous type of hunger.
Will I have to change my medications?
Your physician and surgeon will determine whether medications for blood pressure, diabetes, etc., can be stopped following weight-loss surgery. These medications may no longer be required if the conditions for which they are taken improve or resolve after weight-loss surgery. These medical conditions will need to be followed by your physician after surgery. For medications that need to be continued after weight-loss surgery, many can be swallowed, absorbed and will work the same as before weight-loss surgery. Usually no change or a reduction in the dosage regimen is all that is required. Medications that are extended-release or timed-release may need to be changed.
Two classes of medications that should be used only in consultation with your surgeon are diuretics (water pills) and NSAIDs (most over-the-counter pain medicines). NSAIDs (ibuprofen, naproxen, etc.) may create ulcers in the small pouch or the attached small bowel. Diuretics cause the body to lose fluid, compromising the adequate hydration necessary following weight-loss surgery and resulting in potassium deficiency. When potassium levels are too low, heart rhythm problems may result.
What is a hernia and what is the probability of an abdominal hernia after surgery?
A hernia is a weakness in the muscle wall through which an organ, usually the small bowel, can advance. With the use of laparoscopic surgical techniques, the incidence of hernia following weight-loss surgery is dramatically reduced.
Is blood transfusion required?
Blood transfusions may be given after surgery to promote healing; however, they are infrequently required.
How can I prevent hair loss after surgery?
Many patients experience some hair loss or thinning, usually between the fourth and eighth month after surgery. Consistent intake of protein at mealtime is the most important prevention method. Also recommended are a daily zinc supplement and a good daily volume of fluid intake.
Does hair growth recover?
Yes. Most patients experience natural hair re-growth after the initial period of loss.
What are adhesions and do they form after this surgery?
Adhesions are scar tissues formed inside the abdomen after surgery or injury. Adhesions can form with any surgery in the abdomen. For most patients, they are not extensive enough to cause problems.