Discharge Instructions
 When
you are discharged from the hospital it is important
to have help at home. We suggest either a family
member or friend stay with you for the first week.
A visiting nurse will also be arranged by the
hospital to ensure you are healing well at home.
The visiting nurse will work with you two to three
days a week for two weeks (this varies by insurance
company).
It is very important to follow all of your discharge
instructions:
Wound Care
Activity
Medication
Off-Limit Medication
Comprehensive Diet
If you have any questions or concerns while at
home you can reach the Bariatric Surgery Program
at (215) 615-7500. After 5 pm or during the weekend
call (215) 662-4000 and ask for the GI surgery
resident on call.
Wound Care
 Shower
Daily - Wash the incisions with soap and water and
pat dry.
- Do not apply lotions or creams to the incisions
- Notify the physician office if the wounds
are red, swollen, or draining pus
- Drain care:
- Empty JP drain twice daily. Record output.
- Change dry guaze around drain daily, or
as needed if there is leakage around the drain.
- Notify the physician if the color of the
drainage becomes green, or dark red.
Activity
- You are strongly encouraged to walk at least
three times daily. Stop when you become fatigued.
- You may walk up and down stairs. Take your
time, and rest if you need to.
- Do not lift anything greater than 10 pounds
until you have your post-operative visit.
Medication
 Below
you will find information regarding medications
required post-surgery and instructions regarding
medications taken prior to surgery.
- Standard discharge medications:
- Ant-acid medication (either Nexium, Protonix,
or Prevacid). This is necessary to prevent
ulcers in the new small stomach. You will
be on this medicine for at least three months.
- Pain medication: Dilaudid or Percocet as
needed.
- Stool softener: Colace twice daily (this
is necessary while you are on pain medication
to prevent constipation)
- Resume pre-operative medication:
- You will be instructed to resume most pre-operative
medications.
- If you are on diabetic medication, you
will need to monitor your blood sugar closely
at home. Some patient’s blood sugar
decreases significantly and you will only
need a portion (or none) of your diabetic
medications.
- Diuretics (water pills): Many patients
are instructed to hold off on resuming diuretics
after surgery. It is important to avoid dehydration
after gastric bypass surgery. This will be
decided on an individual patient basis
Off-Limit Medication
- NSAID (non steroidal anti inflammatory) medications
are prohibited after gastric bypass surgery.
These include Motrin, Advil, & Ibuprofen.
- If you take these medications frequently
before surgery you should discuss a replacement
medication with your primary care physician.
Medications such as Celebrex are often an
effective alternative.
Comprehensive Diet
 Consume
a full liquid diet for 10 to 14 days. Supplement
your diet with 16 to 24 ounces of high protein/low
sugar supplements (Ensure Light, Low Sugar Carnation
Instant Breakfast, etc.).
- Allowed Beverages:
- Water
- 1 percent or skim milk
- 100 percent fruit juice
- Broth/thin soups
- Sugar-free beverages
- Sugar-free Jello
- Sugar-free/low sugar Popsicles
- Coffee, Tea
- Drink 48 to 64 ounces (six to eight glasses)
of liquid each day.
- Swallow slowly
- Avoid sweetened beverages
- Avoid carbonation as it can make you feel
bloated or full of gas
- Avoid using a straw as it can overfill
your pouch with air
- Limit caffeine intake
- Drink slowly to avoid discomfort or vomiting.
Start with 30cc (one ounce) every 15 minutes.
Increase as tolerated.
- Stop if you feel full.
- Begin vitamin supplements: multivitamin,
calcium carbonate or citrate (exact form of
calcium and dosage is dependant on your type
of surgery and medical history), ferrous sulfate
325mg/day for (pre menopausal women), Vitamin
B 12 sublingual 500mcg/day or injections 1000
micrograms monthly (gastric bypass patients
only, to start 2 months after surgery).
- When you return to the doctor’s office
for your follow up visit, the bariatric nutritionist
will evaluate you. If you are progressing well,
you will be advanced to a pureed diet at this
time.
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