Sleeve Gastrectomy Guidelines For 6 Weeks To 3 Months After Surgery
What to expect 6 weeks to 3 months after sleeve gastrectomy?
Pain
You should have only minimal or no pain at all. Some patients with pre-existing gallbladder stones may experience gallbladder attacks with pain in the upper abdomen and the back. Occasionally patients can form stones in the gallbladder this early after surgery and develop pain. If you experience new onset of pain then please make an appointment to see Dr Zarrouk.
Vomiting
It is not usual to vomit at this stage. If you eat or drink quickly you may experience vomiting. Remember to take your time while eating, chewing well and not drinking while eating.
Acid Reflux (Heartburn)
Some patients may experience acid reflux beyond six weeks after surgery. As the stomach tube become more pliable and less stiff this will get better most of the time. In addition, not drinking or eating one hour before going to bed will reduce acid reflux. We recommend that you stay on Nexium if you are experiencing heartburn.
Hunger
You may start to feel hunger again. This is normal as the stomach start to recover. Food craving is not usual at this stage but can be brought by images of food such as tv commercials or cooking shows. This is another reason to cut down on watching tv.
Energy Level
Your energy level will start to get better after the period of slow down you had during the so called hibernation syndrome. This steady improvement in energy level and the overall sense of well-being is best seen in patients who have started a regular exercise program.
Hair Loss
All patients will experience hair loss usually starting 2 months after surgery and continuing for about 3 months. The hair loss can be profound with hairbrush, shower and car filling with hair. This is a normal stress response very similar to the hair loss experienced by women after childbirth. The stress of surgery and weight loss in the first few weeks after surgery cause the hair to mature at the same time. When the hair roots "wake up" , new growing hairs push out the old resulting in loss of many hairs at the same time. The hair loss is never severe to the extent seen in patients having chemotherapy and rarely patients need to wear a wig. Hair will regrow back to normal thickness and with improved texture by 9 months. Many patients buy hair and nail multivitamin combinations or take extra protein in an attempt to fight or prevent the hair loss. This does not make any difference. The hair loss is a normal process and will happen even while taking the most expensive multivitamins. Just make sure you are having adequate protein and the usual multivitamins.
Your main goals 6 weeks to 3 months after sleeve gastrectomy
1. Diet
You should starting introducing normal solid food. We recommend you start with fish then chicken and then red meat. Meat and other sources of proteins should become the foundation of you long term diet. Each time you introduce a new food item remember to test yourself with a small portion and allowing ample of time for your stomach to adjust. You should minimize carbohydrates such as potattoes, rice, bread and pasta. We encourage you to use the Portion Perfection Plate and Bowl that we gave you. The plate will help with your food selection and your portion control long term.
2. Multivitamins
Take mutivitamins tablets twice a day. At this stage you will find it easier to swallow tablets rather than have the chewable multivitamins. We recommend you take Elevet Women Multi or the Blockmore Concieve Well. Other multivitamins are also suitable just show them to Angela our dietitian. Some patients will require other supplements such as iron or calcium and vitamin D tablets.
3. Hydration
Drinking fluid should be getting much easier now. You still need to be make sure you are drinking enough. The best guide is the colour of your urine. It should be very light colour, almost like urine.
4. Exercise
Exercise is essential to achieve a good weight loss after surgery. Regular modest exercise is much better than rare intense sessions that can result in injury. You should aim to do 20-30 minutes of brisk exercise at least 5 times a week and at this stage you should introduce light weights. Weight training rebuild muscles and increase your metabolic rate allowing you to burn calories even while sleeping.
5. Weigh yourself once every week and take a photo once every month
Use the same scale every time preferably at the same time each week. Seeing the weight dropping will keep you motivated. Many patients find it difficult to change the self image of being obese. Talking photos and comparing them to older photos will help to demonstrate the dramatic change in appearance.
6. Attend the Weight Loss Surgery Support Group meetings
7. Blood tests
We will start doing blood tests before coming for your next visit. Please have the blood tests few days before your appointment using the form that we give you so we will receive the results. Your GP will receive a copy of the result as well.