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Weight Loss Team

FAQ

How soon after surgery can I bathe or shower?

Infections virtually always come from bacteria present in the wound at the time of closure. Wounds seal to the outside within hours after surgery so it is safe to bathe or shower the next day. Similarly, iv and drain sites can be cleansed and redressed with minimal likelihood of infection

Can I drive after surgery?

So long as discomfort does not prevent you from rapidly hitting the brake or steering effectively and you are not taking medications that impair your reflexes or judgment, it is safe to drive after surgery.

What happens to the bypassed stomach?

The only change that appears to be of clinical significance is a marked decrease in the production of ghrellin and a consequent marked decrease in hunger sensations.

Can I get pregnant after surgery?

As a generality weight loss increases fertility and improves the likelihood of a normal delivery. However, getting pregnant while rapid weight loss is occurring may not be safe and commonly results in less final weight loss.

How much time should I take off work?

f you have had laparoscopic surgery there are no limitations on your activity except the presence of a drain and your general energy level. Most people are quite ready to return to work once they arrive home from surgery. When circumstances permit some people choose not to return to work until they feel completely ‘on top of their game’ again and they may take considerably more time off work than a week or two. Following open or incision surgery, heavy lifting must be avoided for eight weeks, Otherwise the timing of a return to work is as for the laparoscopic patients.

What about drinking alcohol after surgery?

The amount of alcohol absorbed before gastric bypass is limited to about 50% by the presence of an enzyme in the stomach which breaks down the alcohol before absorption. After a gastric bypass this enzyme does not come into contact with ingested alcohol and more is absorbed, so it is easier to get drunk. Also alcohol is a significant source of calories: 7 calories per gram as compared to 5 with carbohydrates or protein. After the adjustable band alcohol is digested the same as before surgery.

Are carbonated drinks bad after surgery?

There is no evidence that carbonated drinks expand the pouch or otherwise impair the surgical result. The bubbles make some people feel ‘gassy’ and that seems to be commoner after weight loss surgery.

Will I lose more weight on some place of my body than others?

Yes. There is a general tendency for weight loss to occur from the head and neck first and thereafter from the upper body and abdomen but people differ and where you lost weight before is likely where you will experience the most weight loss again.

Can the surgery be reversed?

Yes, but it would take another operation. No one, in my experience, has asked to have the surgery reversed..

How can stomach surgery cause me not to crave ice cream or mayonnaise?

Food preferences change for many patients after surgery; others have to make do with discipline. The reasons for changes in food preferences are unknown.

I have irritable bowel syndrome. Will that go away after surgery?

Irritable bowel syndrome is neither improved nor worsened by surgery.

Will my sex life improve?

Not guaranteed, but it is a common experience.

Do all medications need to be crushed after surgery?

Yes, with a few exceptions. Small tablets, the size of the end of a pencil or smaller, will pass readily through the pouch into the intestine and are not a concern. Examples include thyroid medication, BDP’s, and other hormone tablets. Many larger tablets may stop in the pouch and sit in one spot, will slowly dissolve. As some are quite caustic, they will burn an ulcer, and cause pain that will last for days, until the ulcer is healed. It is therefore important to crush them prior to swallowing.

What is the reason for protein shakes after surgery?

The shakes ensure adequate protein and calorie intake after surgery which is important for healing and other reasons. A liquid diet ensures that the pouch and opening will not be stretched early on when that is more easily accomplished. The shakes also interpose a significant change between the way you have eaten and the way we hope that you will eat in the future. Because the shakes are somewhat monotonous when you switch to a low fat more healthy diet it is ‘tasty’ by comparison and therefore more likely to be preferred in the long run.

How long do I have to take the shakes?

Four weeks; and it is a good test of your willingness to make some dietary changes. Taking the shakes for a week or two before surgery will shrink the liver and make surgery easier and safer. This is advised in some very heavy patients.

How long do I have to take vitamins?

A daily multivitamin is probably a good idea for everyone to take to prevent the fairly common and widely varied deficiencies seen as people get older.. The iron, B12, and calcium supplements should be taken for life, if you have had a gastric bypass, but are not necessary if you have an adjustable band(LAP-BAND®).

How much food can I eat after surgery?

The gastric pouch although initially very small has a hole in the bottom so that a reasonable amount of food can be eaten if taken slowly. As time passes the pouch enlarges and where initially only one or two bites could be taken without a sense of fullness, later a small adult meal can be consumed. As it becomes possible to eat more food it becomes also more important to have developed good habits with regards to food choices.

Are there specific foods or drugs that I should avoid after surgery?

Except for the tiny hormone replacement pills most tablets should be crushed after surgery. Foods high in sugar and some fats will cause the intestine to release vasoactive chemicals which cause sweating, flushing, weakness, fatigue and sometimes abdominal cramps and diarrhea – a phenomenon called "dumping."

How can I prevent stretching out my new stomach?

Don’t eat after you feel full.

How long before I can go to work, Exercise, Drive a car, Have sex?

Dr. Hidalgo advocates walking and light weight lifting immediately after surgery. If you’ve had laparoscopic surgery you can lift weights immediately. If you’ve had open surgery, do not lift more than 10lbs for the first six weeks. After that, you can increase to 30 lbs. for 2 weeks and no limit after 8 weeks. This is because hernias almost never occur after laparoscopic surgery, but are quite common after open surgery with an incision. It is unlikely that effort that does not cause abdominal pain will affect the likelihood of hernia. Similarly, if you can hit the brake hard without discomfort and are not taking painkillers then it is ok to drive a car. The discomfort standard should be applied to sex as well: if it doesn’t hurt, go for it.

Will I ever eat normally again?

It depends on what you mean by normal. Many overweight people eat more and make higher calorie food choices than the rest of the population. So it is possible that you were not eating ‘normally’ to begin with. After surgery although you can eat small amounts of anything, we hope that you will choose low fat foods for the most part. Also you will in general consume fewer calories than someone your size who was not previously overweight. Your could eat frequent small amounts of high calorie foods and gain your weight back.

What kind of exercise should I do after surgery?

We advocate increasing two kinds of exercise as part of a post surgical lifestyle change: 1) Increase the difficulty of unscheduled everyday activities. For example, try to walk farther – a pedometer is helpful in this regard – climb the stairs instead of taking the elevator; volunteer for small tasks that you might not otherwise choose. 2) Schedule workouts two or three or four times a week simply for the purpose of exercising. Although any activity is helpful, weightlifting is the most efficient for extra weight loss.

How much weight can one expect to lose after surgery?

Most patients lose between 50 and 80% of their excess body weight over about 1-1 ½ years. Some reach their ideal weight, but some don’t, surgery is only a tool and you must be willing to work with it for success.

Can I make my scar go away or become smaller?

Except for using steroid injections to stop keloiding I have heard of no tested way to diminish scarring, but lots of remedies are tried and perhaps some work. In any case it seems harmless to try.

Will I need plastic surgery after I lose weight to remove loose skin?

Whether plastic surgery is desirable depends on how old you are (skin is less elastic with age) how much weight you lose (the more the more skin) and individual differences in elasticity. Loose skin bothers some more than others, but there is nothing shameful about wanting to look your best and we will try to help anyway that we can. Getting rid of loose skin requires plastic surgery, some types of which we do ourselves.

Does exercise help prevent loose skin?

Exercise is wonderful for many things but unfortunately does very little for loose skin.

What causes some people to regain their weight?

Most often it is forgetting that weight control is a lifelong project. But obviously the genetic pressure to gain is greater in some than others and although we cannot currently recognize it the surgery may be better for certain types of obesity than it is for others.

When is it safe to get pregnant?

Ideally, pregnancy should be delayed until weight loss is maximal, usually around 12 to 18 months after surgery. Weight loss makes women more fertile and decreases the likelihood of complications related to pregnancy. It is safest to get pregnant after weight loss is complete as there is some theoretical risk to the fetus with rapid weight loss.

How much weight should I gain?

Enough to account for the baby, the placenta, and some amniotic fluid – about 35 lbs. Ask your obstetrician.

Will I be able to lose my pregnancy weight?

Excess weight is hard to lose. It is best to gain only the amount necessary for a normal baby and pregnancy.

What post op blood tests are needed at each major post op visit?

The tests I do are Ferritin, B12, PTH (parathyroid hormone), Calcium and cbc. I usually do tests 6 months after surgery and repeat every 6 months to a year thereafter. I do it sooner if the patient is not taking supplements as they should, or if the patient has an abnormal result that I am trying to correct.

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