In Hospital Recovery After Weight Loss Surgery

What to Bring to Hospital

• Any medications you take (in their original boxes/bottles).
• Scans you've had done with Dr. Zarrouk or Dr. Kirby.
• Comfortable clothes or pyjamas to walk around the ward.
• Comfortable shoes/slippers.
• Toiletries.
• Fiji water (many people find Fiji water easier to drink than regular water).
• Diet cordial or similar to mix into water, making it easier to drink.
• CPAP machine if you use one for sleep apnoea.

Admission Through to Post-Op

1. Day Before Surgery: The hospital will inform you of your arrival and fasting times.
2. Arrival: Go to the front desk to be admitted through the Day Surgery Unit.
3. Preparation:
   • Change into a hospital gown.
   • Put on TED stockings.
4. Transfer to Surgery:
   • A wardsman will take you on a bed to the anaesthetic bay.
   • Wait until they are ready to begin surgery.
5. Recovery:
   • Spend at least 1 hour in the Recovery Ward post-surgery.
   • You will be transferred to either the High Dependency Unit (HDU) or a monitored surgical bed.
6. After Arrival at Surgical/HDU Ward:
   • Nurses will notify your Next of Kin.
   • You will be connected to a heart monitor, blood pressure monitor, and oxygen saturation monitor until the following day (can be disconnected for walking).
   • Intravenous fluids will be provided to keep you hydrated.

Triflow Incentive Spirometer

• Purpose: Helps open small air spaces in the lungs and clear secretions, preventing chest infections.
• How to Use:
  1. Exhale completely.
  2. Place your lips around the mouthpiece.
  3. Inhale deeply, aiming to lift all three balls and hold for a few seconds.
  4. Use 5 times every hour while awake.
• Reminder: Take the device home and continue using it for at least 2 weeks.

Mobility

• Importance: Start mobilizing as soon as it is safe after surgery.
  • Helps expand your lungs.
  • Restores circulation to your legs and extremities.
  • Alleviates gas pain.

Medications

• Paracetamol:
  • Initially given through IV.
  • From the day after surgery, given in liquid form to drink.
• Pain Relief:
  • Gas pain may occur (usually in the chest or shoulder tips) due to carbon dioxide gas from surgery.
  • Ask your nurse for Oxynorm Liquid if strong pain relief is needed.
• Anti-Nausea Medication:
  • Given through IV.
  • Ask your nurse if you still feel nauseous.
• Nexium (for reflux and staple line healing):
  • Given through IV twice a day while in hospital.
  • Switch to tablet form for 3 months after discharge.
• Blood Thinning Injections:
  • Prevent blood clots.
  • Administered during the hospital stay.
• Diabetic Patients:
  • May be put on a sliding scale of insulin (even if not normally required).
  • Blood sugar levels will be checked every 4-6 hours, and insulin will be given as needed.

Prevention of Blood Clots (DVT & PE)

• TED Stockings: Wear in the hospital and continue wearing for 2 weeks at home.
• Pneumatic Calf Compressors: Worn during the operation and remain on until the morning after surgery.
• Blood Thinners:
  • Heparin or Clexane administered in hospital.
  • Clexane injections to be continued at home once a day for 2 weeks.

Diet

1. After Surgery: Begin with clear fluids.
2. Day After Surgery:
   • Progress to free fluids.
   • Take small sips only.
   • Avoid straws to prevent gas buildup.
3. Discharge Requirement:
   • Drink at least 1L of water in 24 hours.
   • Mix apple juice or diet cordial with water to make it easier to drink.

General Post-Operative Advice

• Start slowly with sipping water and other clear fluids.
• Be aware that your stomach is swollen and tender, so it may be difficult to consume large quantities at first.
• Tips for Drinking:
  • Take small sips and stop if you feel nauseous or full.
  • Avoid gulping or drinking a whole glass quickly.
  • Sip other liquids like clear soups, jellies, milk, custard, diet cordials, tea, and coffee slowly.
  • Suck on ice cubes if feeling dehydrated.

Discharge

1. Instructions: Refer to the Bariatric Surgery Discharge and First 2 Weeks Instructions.
2. Medications: The hospital will provide scripts for medications upon discharge.
3. Appointments: You will be given your first follow-up appointments before leaving the hospital.

Key Reminders

• Sip, Sip, Sip: Stay hydrated by sipping fluids slowly.
• Walk, Walk, Walk: Mobilize as soon as it is safe.
• Breathe, Breathe, Breathe: Use your triflow device regularly.