Gastric Bypass and Gastric Sleeve

These instructions will serve as general guidelines to assist you in your recovery after surgery for severe obesity. If you have a question or problem do not hesitate to call our office for instructions. You should expect to feel better every day. You should have less pain, be able to tolerate the staged diet, and have easier time walking and performing daily activities.

Discharge Instructions:

  1. Check temperature twice daily for the first week - call if fever is 101 of higher.
  2. You may bathe or shower; do not scrub incisions for 3 weeks. (Notify us if redness or drainage from incisions occurs).
  3. It is normal to experience left side abdominal-wall pain for the first few weeks. This pain is mainly at the small incision sites.
    However:
  4. Contact us for vomiting or diarrhea, which lasts over 24 hours, or persistent inside abdominal pain, which does not resolve in 4 hours.
  5. Use incentive spirometry bottle four times daily for 7 days.
  6. Walk daily until you can walk 30 minutes at a time
  7. Make sure you are well hydrated. Drink plenty of fluids. Your urine should be pale to light yellow. Dehydration can make you feel weak and tired. Also, it may cause vein clots.
  8. Increased gas is common the first 3-6 weeks; we recommend gas-x or DiGel for relief.
  9. Do not take any anti-inflammatory pain medications unless approved by Dr. Spivak (i.e. Ibuprofen, Advil, Motrin, Naprosyn, Alieve, Day pro etc.). You may take TYLENOL, Lortab Elixir (Hydrocodone Bitartrate and Acetaminophen Oral Solution, or Darvocet-N 100.
  10. Take vitamin  supplement as instructed by Dr. Spivak
  11. Female patients should not become pregnant for 18 months until weight loss has stabilized.
  12. If you encounter a problem contact Dr. Spivak, or return to the Emergency Room where you had your surgery, or have the physician where you are contact Dr. Spivak immediately if you present for treatment. There are many physicians that are unfamiliar with weight loss surgery and serious errors in treatment could occur. DO NOT ALLOW THEM TO INSERT A STOMACH TUBE FOR ANY REASON.
  13. Check with your medical doctor if you can crush/break/chew your medications.  Don't swallow a whole pill or a capsule.

POST-OP DIET INSTRUCTIONS:

The post-op diet is divided into 3 stages to allow a gradual adjustment.
Stage I: Liquid diet of few (3-6) small meals per day (total 400-800 kcal) x 2 weeks with up to 3 protein supplements per day
Stage II: Soft diet of few (3-6) small meals per day x 2 weeks with 1-2 protein supplements per day
Stage III: Regular diet of 2-3 meals per day (total 800-1200 kcal)+ 1 Afternoon Snack

STAGE I FIRST 2 WEEKS POST-OP

1) Liquids only from list below six times daily at set times (i.e. 8am, 10am, noon, 2pm, 5pm, 8pm)
2) Liquid protein supplements up to 3 times daily for 3 of your meals.
* Note: Most people can only drink 1 protein drink per day, the first 2-3 days due to swelling.
Remember: small amounts (4-6 ounces)
- Go Slow ( 30 minute to drink 6 ounces )
- When you feel full STOP!
- No carbonated drinks for 2 weeks

LIQUID DIET
• coffee, tea, fruit juice
• crystal light, Nutrasweet Koolaid
• diet drinks
• broth
• blenderized soup
• skim milk or Lactaid milk
• sugar free Jello, Popsicle's
• mashed potatoes
• yogurt
• sugarfree pudding
• cottage cheese
• apple sauce, oatmeal, grits, cream of wheat

PROTEIN SUPPLEMENTS: designer protein from GNC, carnation instant breakfast, slimfast, pure pro powder or any protein powder supplement from a health food store.

These are best mixed with skim milk or Lactaid milk as lactose intolerance can occur the first few weeks after surgery. The protein powder can also be mixed with yogurt or with fruit and fruit juice if blenderized.

STAGE II SOFT DIET FOR 3 - 6 WEEKS

Soft foods from the list below can now gradually be added to your diet:
1. Six meals per day with a liquid protein supplement twice daily for two of the meals
2. No liquids with meals if soft food is included. You must wait 30-45 minutes for the pouch to empty before drinking.
3. CHEW WELL! - The food must be almost liquefied before swallowing

SOFT DIET
• Soft fruit ( banana, melon, strawberries)
• cooked vegetables and fish
• soft pasta (well chewed)
• eggs
• toast or crackers

STAGE III REGULAR DIET OF 3 MEALS PER DAY AFTER 6 WEEKS

Gradually add regular foods and remember:
- Eat only at set meal times and at set snack time
- NO LIQUIDS with meals or for 30 minutes afterwards.
- Avoid cheap calories: fats, high calorie liquid, sweets, ice cream, junk food, cookies
- Discontinue protein supplements drinks

SUMMARY
• Follow three stage diet plan to allow gradual adjustment
• Eat only at set meal time
• Go slow
• Chew well
• When you feel full: STOP!
* Liquids, junk food and sweets do not relieve hunger! Only solid food, which fills the pouch and empties slowly, will relieve hunger.