Post-Surgery Aftercare

Weight loss surgery can bring unexpected as well as expected changes to your lifestyle and overall health. Post bariatric surgery, your weight loss can cause temporary hair thinning, you have a new diet to adjust to, and you may have to contend with loose skin after shedding excess weight. Plus, there are other do’s and don’ts your doctor may recommend as you participate in post-surgery aftercare and adjust to your new lifestyle and heal from your procedure.

What to Do About Gas Pains

Immediately after surgery, you may have gas pains from the gas used during surgery to inflate the inside of your abdomen as well as gas build up inside your stomach and intestines. The best remedy is to get up and walk.

As you recover, you may experience gas pains that are related to the required change in diet as well as the type of surgery, especially if it involves rerouting the digestive tract. When food and nutrients pass from the stomach into the colon, enzymes and gut bacteria may not adequately absorb it. A by-product of this problem is gas.

The following are some tips for relieving (and reducing the chance of) gas pains:

• Eat slowly to avoid sending food into the colon to quickly
• Avoid gas-causing trigger foods that contain alcohol, lactose, and sorbitol
• Do not overeat which can cause dumping syndrome

If gas becomes a bigger problem, check with your doctor for solutions like warm lemon water or peppermint tea.

Avoid Immersing Yourself in Water

While your doctor will give you the okay to shower after surgery, you should not take a bath, get into a hot tub, or go swimming for three to four weeks after weight loss surgery. By taking these precautions, you will give your incisions time to heal and will reduce the risk of infection.

The typical signs of incision site infection include redness, drainage, and swelling. If you notice any of these signs, contact your doctor.

Daily Activity Restrictions

Your activity level will gradually increase as you recover. Immediately after surgery do not lift anything over ten pounds for ten days. You also should not perform any strenuous exercise or lift anything over 25 pounds for four weeks following surgery.

As you gradually begin incorporating an exercise regimen into your schedule, start slowly with just getting around for the first few days to working up to a fast walk for at least 30 minutes three times a week. You can add abdominal exercises into your routine eight to 12 weeks after surgery. Exercise not only helps your lungs, but it also rids your body of the gas build-up, increases circulation, and helps you lose weight.

Your doctor may recommend that you avoid driving for at least seven days after surgery or while on narcotics.

Follow Your New Diet

Because weight loss surgery limits the types of food you can eat and the nutrients your body can absorb, the quality of your diet is essential. Immediately after surgery, you won’t be able to eat anything and will transition to a clear liquid diet while you are in the hospital and for after you are discharged home. Then, you will gradually reintroduce solid food back into your diet.

Your chances for long-term success hinge on following your new diet. Your doctor will give you guidelines for a calorie-restricted diet that focuses on healthy nutrients and avoids the following:

• Caffeinated, alcoholic, and carbonated beverages
• Greasy, high-fat foods
• Heavily seasoned or spicy foods
• Microwaved food
• Tough or dry meat

If you have questions about your diet and what you should or should not eat, consult your doctor, and follow their suggestions.

Dealing with Dental Health Issues

Dental health issues are post bariatric surgery problems that some patients experience. These are usually a result of dumping syndrome, acid reflux, and nutritional deficiencies such as calcium, which is essential to teeth health.

Some common dental issues include:

• More cavities
• Tooth erosion and weakened tooth enamel because of increased acid and pH
• Tooth sensitivity to hot and cold temperatures
• Pressure while biting and chewing
• Brittle teeth and fractures, including chips and cracks

You can promote dental health by brushing and flossing regularly, following the recommended diet, and following the steps to avoid dumping syndrome. It’s also essential to take vitamins and nutritional supplements like calcium. Calcium is essential for strong bones and teeth as well as for blood clotting, muscle contraction, and the expansion and contraction of blood vessels. Not getting enough calcium can lead to long-term health problems as well as weakened bones and poor teeth.

If you do run into dental health issues, dentists rely on restorative procedures to rebuild damaged teeth as well as the typical fillings and caps to protect your teeth from further harm.

Coping with Bad Breath

Bad breath does not affect everyone post bariatric surgery, but it can be a side effect as your body adjusts and recovers, even if you practice good oral hygiene. The most common reasons why bad breath occurs are dehydration, a build-up of ketones (or acids) in your body caused by rapid weight loss, and food not exiting your stomach pouch quickly enough.

Bad breath isn’t a severe postoperative health issue, but it can cause discomfort. The good news is that there are ways to cope:

• Drink 64 ounces of water a day. Dehydration is one of the leading causes of bad breath following bariatric surgery.
• Brush your teeth and floss after every meal. Be sure to brush your tongue to clean it of bacteria and food particles.
• Chew sugar-free gum. This can help you deal with the insecurity bad breath can cause.

In rare instances, bad breath may be a sign of a more serious problem like an infection. If you have concerns, reach out to your healthcare professional.

Resuming Care with Your Primary Care Physician

For many weight loss patients, they will continue to see their bariatric surgeon and healthcare team for up to a year following surgery. After this time, primary care physicians (PCP) typically resume the role of monitoring your medication, blood pressure, chronic conditions, and psychologic state.

In many instances, the bariatric care team keeps a patient’s PCP up to date about their progress through the program so there is a smooth transition of care.

Even with the best communication between care teams, there have been instances when patients find that their PCP, and other non-bariatric doctors, do not understand their struggle of obesity and how the surgery was not “elective.” Also, they may not realize the postoperative restrictions you must follow like no extended release medications and no nonsteroidal anti-inflammatory medicine.

Your health post bariatric surgery and having a care team to support you is vital for long-term success. If you are facing challenges with your PCP or other non-bariatric doctors, seek help and referrals from your bariatric care team.