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Discharge Instructions


Following Your Open Gastric Bypass Surgery

The postoperative phase of the gastric bypass can be very demanding of your mental, psychological and physical endurance. Follow the instructions below as you progress through the recovery period. Don't hesitate to call if you have questions.


Wound Care

For Roux-en-Y gastric bypass with gastric exclusion:
  • A dry dressing of 4x4 gauze may be applied over the incision if it continues to ooze fluid or blood.
  • Typically, we will apply white steri-strips over the incision. These should remain in place for 7-10 days. At that point, they can be removed at a post-op visit, or you may slowly peel them off while in the shower. These may get wet in the shower.
  • Some problems can develop at the incision, so notify your surgeon if:
    • There is bleeding from your suture line.
    • The skin starts to separate.
    • Pus or cloudy fluid leaks from the incision.
    • The incision or abdomen become increasingly painful and the medication is not controlling the discomfort.
    • You have a temperature over 101 °F.
    • You are unable to urinate or pass stool/gas.

Activity

  • No lifting over 10 lbs. After 3 weeks, you may start light housework or a desk-type job. Expect to be released to full activity by 6-8 weeks after surgery, if no problems arise.
  • Wear a binder at all times (except showers) for 30 days after the surgery. The binder can be washed with your other clothes.
  • You may shower once discharged, but no baths are allowed this early in the wound healing process.
  • Walk as much as tolerated.
  • Expect your endurance to be low initially. It will improve.
  • No driving until cleared by your surgeon.
  • During your preoperative physical therapy evaluation, several exercises were recommended. It is imperative that you continue these at home. They include:
    • Ankle Dorsiflexion and Plantarflexion
    • Quad Sets
    • Heel Slide
    • Ankle Pumps
    • General Strengthening and Long Arc Quads
    • Hip Flexion and Sitting

Medication

  • You may have been taking medicines preoperatively, and these are stopped while you are in the hospital. Resume taking these medications after hospital discharge. Remember the following:
    • Stop antacid medications, as they usually aren't necessary. (Ex. Prevacid or Pepcid)
    • Avoid blood thinners until cleared by your surgeon.
    • Do not take NSAIDS. (Ex. Ibuprofen, Relafen, Vioxx, Aspirin, etc.)
    • Use Imodium AD for post-operative diarrhea, as needed.
    • Take Tylenol or Tylenol-containing medications (ex. Lortab elixir), as needed. These are safe for consumption. Liquid Tylenol may have excess sugar, so be careful.
    • Try Gas-X for gas pains.
    • Take a fiber supplement, like Metamucil or Fibercon, once you are on the pureed diet.
    • Crush large pills, if possible. Some may be difficult to digest. Some medication dosages may even need to be altered to accommodate for the "altered" digestive tract.
  • Vitamins were recommended during your pre-operative nutrition meeting. For your safety and well being, you must take the multivitamin, iron and calcium, as directed. Your surgeon will provide a prescription for these supplements.

Diet

  • At the time of discharge, you will be on a full liquid diet. Maintain this regimen until you see the dietitian during your first post-operative visit.
  • Remember the goals:
    • 6-8 cups (48-64 oz.) of fluid per day. Higher water intake is beneficial.
    • Sip fluids slowly.
    • Record your fluid intake to verify the volume and content you consume.
    • Avoid carbonated beverages.
    • Do not use straws. This can cause you to swallow excess air.
  • See details of the diet and restrictions in your nutrition packet.
  • Expect to be advanced to a pureed diet at your first post-operative visit.

General Concerns

  • Contact your medical doctor or surgeon if you notice any of the following problems:
    • Sudden shortness of breath or tightness in your chest not relieved by resting.
    • Uncontrolled swelling in your legs.
    • Uncontrolled nausea with vomiting. (Nausea is a common side effect after the surgery, but if it interferes with adequate liquid intake, complications can develop.)
    • Constipation is common and can be treated with increased liquid intake, fleets enemas, glycerin suppositories, or increased fiber intake.

Follow-Up

  • Prior to hospital discharge, you will get an appointment to see the surgeon 7-10 days post-operatively. This visit will include time with the dietitian and, possibly, the exercise specialist. If you do not receive an appointment before leaving the hospital, please call the bariatric office on the next business day to schedule.
  • Support group meetings will be very important during the immediate post-operative healing stage. Remember to attend these meetings.

Who to Call

  • Bariatric office 24-hour phone number: 812/450-7419
  • If you have problems, as listed above, please call the bariatric office. The office secretary or nurse will direct your call or answer your questions. If the office is closed, call the same number. You will have the option to speak with a medical doctor or the surgeon. Either will be happy to help with your problem. After hours, you may reach an "on-call" doctor.