Discharge post bariatric surgery

Discharge post bariatric surgery

What to expect at home

You will lose weight quickly over the next 3-6 months. You may feel very tired, and you may experience dry skin, mood changes and hair loss.  As your weight loss slows down you should feel better. It is important that you follow the nutritional information we give you and take your vitamins & minerals as instructed by your Dietitian.

Feeling upset or anxious is normal after surgery. These feelings usually go away after a few weeks, but if you are worried please talk to a member of the bariatric surgery team or your GP.

Compression Stockings and Injections

You will be advised to wear compression stockings after surgery. Please take these home with you and continue to wear them for the next four weeks.

You will be given blood-thinning medication in the form of injections to administer at home for up to 4 weeks following surgery. Please take the full course as directed by your surgeon.

You will also have a yellow sharps bin to dispose of the syringes and needles safely. Take it to your GP practice when you have finished using it or bring it back to the hospital when you see us.

Smoking significantly increases the risk of blood clotting, slows wound healing, and increases complications after surgery. Please refrain from smoking for life after surgery.

Eating and Drinking

On discharge you need to have thin fluids only for the next two weeks. If you have any concerns, please contact your Dietitian or Specialist Nurse.

Rememberto drink slowly, do not use a straw and do not take fizzy drinks as this will lead to discomfort.

When you start eating solid foods you need to drink 30 minutes before a meal, and not drink again until 30 minutes after.

Sexual activity may be resumed as soon as you feel comfortable enough. It is important that women use effective birth control for at least 18 months post-surgery to avoid pregnancy.  Be aware that the contraceptive pill is not reliable after surgery.  Discuss with your GP or family planning clinic.

Driving

Check with your insurance company for their advice about driving after keyhole surgery. We advise you to wait until you can wear a seatbelt comfortably and can perform an emergency stop safely.

Wound care

Keep wound sites clean and dry, and change any dressings that become wet or dirty. Inspect the wound sites daily. It is normal to have paper strips over the wounds. These may curl up after 5 days and can be removed if they have not already fallen off.

When you take a shower, let the water run over the wounds but do not scrub them. Pat dry and do not rub. Avoid soaking in a bath for at least one week after surgery or going into a swimming pool or hot tub until your wounds are completely healed.

It is expected that your wound sites will have redness around them and sometimes some bruising. Itching and a small amount of discharge is normal.

If you suffer from the following signs Please contact your doctor, nurse or out of hours services, as you may have an infection and may need treatment with antibiotics.

• Increased redness, warm to the touch, swelling or pain at the wound sites.
• Thick drainage or pus or a smell coming from the wound site.
• High temperature.

If your wound site separates and opens, apply a clean gauze dressing and fix it firmly with tape and contact your doctor for advice.

Medications

You might be able to manage very small tablets straight after surgery, but are likely to struggle to tolerate larger tablets in the early days.  Some tablets can be crushed with a pill crusher but some may need to be changed to liquid, chewable or dispersible alternatives if you are struggling to manage tablets. 

Sometimes medication may be changed or stopped running up to or after surgery. Please make sure you are clear about any changes required. It is a good idea to see your GP in the few weeks after surgery to check if changes in your medications are needed.

After surgery we do not recommend non steroidal anti-inflammatory drugs (NSAIDs), for example Ibuprofen, Naproxen, Diclofenac, and high dose aspirin due to increased risk of ulcers and bleeding. 

You will be given a gastro protection medicine to protect your new stomach from stomach acid during the healing process, for example lansoprazole orodispersible 30mg once per day. Contact your GP to get further supplies and continue taking it until at least 6 weeks after surgery. 

Vitamins & minerals

You will be given a calcium and vitamin D supplement, and an iron supplement with your discharge medicines. You should continue taking your chewable multivitamin and mineral supplement.

It is important to take your multivitamin and mineral supplements as prescribed.  We recommend that you take calcium and Vitamin D supplements in split doses through the day rather than together.  You can take your multivitamin and mineral and iron supplements together, but leave a 2 hour gap between these and your Calcium and Vitamin D supplements.

If you are taking Thyroxine, avoid taking this at the same time as your multivitamins and minerals, iron and calcium, as they can prevent you from absorbing Thyroxine. Leave a 4 hour gap.  Please do not stop or change your medications unless you have been instructed to do so by your Surgeon or Doctor.

Activity

Being mobile soon after surgery will help you recover more quickly.  Avoid sitting around for long periods, this may increase the risks of getting a blood clot, and elevate your legs when sitting. During the first week move around your home at least hourly while you are awake. You can slowly increase your activity level as you feel comfortable.

Following keyhole surgery most people can do regular activities after 4 weeks. It can take longer if your procedure was an open procedure.

Depending on your employment you may need 4 weeks or longer off from work.

As a guide:

• Avoid heavy lifting for one month following surgery and do not lift anything heavier than 2Kg for the first 2 weeks.

• Increase activities slowly and listen to your body.  Stop if you experience pain.

• Do not participate in contact sports until you have spoken to your surgeon.

Seek urgent medical advice if you have

• A temperature above 98.6˚F or 37˚C.
• Severe abdominal pain not relieved by analgesia.
• Persistent vomiting after drinking or eating.
• Difficulty breathing or coughing up blood.
• A fast heart beat not due to anxiety.
• Pain/swelling in the calf of your legs.
• A cough or hiccups that won’t go away.
• Abdominal distension and cannot pass wind.
• Diabetes and blood sugars continue to rise above 10mmol/l.
• Changes in your wounds (increased redness, pain, swelling, feeling hot, bleeding, pus, change in size, depth, or if the wound opens).
• Difficulty keeping hydrated.
• Frequent uncontrollable diarrhoea leading to dehydration.

If you have any of the symptoms above and are unable to contact a member of your bariatric surgery team, or your GP please phone NHS 111 for advice or visit your nearest Accident & Emergency Department for their opinion.

You will be telephoned by the team each week and will be seen in clinic in approximately 4 weeks by the Dietitian & Nurse and at approximately 8 weeks after surgery by your Surgeon.

Contact Number

Bariatric Specialist Nurses and Dietitians (Tier 4)

01905 733965

You can leave a message for your team on the above numbers or you can bleep your team via switchboard on 01905 763333.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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