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Get the Facts on Duodenal Switch.

Post Surgery Advice

Elizabeth N.

Post surgery advice: A Patient’s Perspective.

1. In order to lose weight, a patient should heal first. The weight loss will come in due time. The first time on a scale at home may also be scary because it may show a weight higher than before the surgery. This is because of the fluid that has been administered while at the hospital. Focus on, "I must heal from a major surgery, and I must do that with maintaining my hydration and nutrition.”

2. WATER and hydration is the most critical component of healthy recovery. Food comes next.

3. PROTEIN is the source of building blocks for healing. Some of the proteins are not pleasant and even less so since sense of taste and smell has been heightened. Do whatever makes it possible to take some protein. Be creative by adding protein powder to different foods that can be tolerated. There is also mediation that can be used short term to help with the nausea associated with the protein supplements. This does get better over time.

4. MOVE. This helps with healing faster and making one feel better the more the patients moves around. Any movement is good. Every step taken gets a patient one step closer to their weight loss goal, and makes them so much healthier. Set small and practical goals, and increase it on a daily basis. [E.g. walk down a driveway and back then increase from there.] But don't dive into a full-fledged exercise program until cleared to do so by a surgeon. Keep in mind that a patient must be taking in enough protein to support the activity level. Otherwise, a patient will lose muscle mass rather than gain it, because the body will eat the muscles for fuel.

5. The sooner vitamins are taken, the better. Start with a multivitamin. Do not panic if the vitamins are difficult to handle at first. The body has stored some of these vitamins already, so it is impossible to become instantly deficient. Having said this, do not take vitamins when feeling noxious or it can make the situation worse which will in turn cause a patient unable to tolerate the protein.

6. REST. It is natural to feel exhausted and tired with little stamina after recovering from the surgery. It is important to rest and sleep. Don't skimp on sleep.

7. Note that eating patterns and behavior will change. Patients have to train their body to eat all over again. This is because the GI track has an altered anatomy, the sense of taste and smell is changed, and the relationship with food is being challenged. Do not try to eat like someone who's two years out from surgery. Patients need to set realistic short term expectations. This postoperative time frame should also be used to reaffirm, re-emphasize a new healthy lifestyle, eating behaviors, and examine potential poor dietary behavior that could jeopardize the long-term outcome.

It is important to understand that recovery will take some time and effort to boost the protein intake that the body will need. It may be very difficult at the beginning to find any protein that is tolerated well, but persistence and variety will be needed. Over time the diet will broaden with time, probably almost without a patient realizing it.

Don’t be surprised if food tastes very different from what was expected, it may also not sit well, but these will change eventually.

8. Surgery hurts. Expect to be sore, tired and have low energy. It is important to distinguish between surgical pain and the discomfort of bloating. Surgical pain needs pain medication, but gas pain and bloating should be helped with walking, and Gas –X.

9. The bowels functions will be different than they were before surgery. They will look and smell different and they will change almost daily as a patient gets more recovery time as well as the diet changes. The "new normal" might be months away. Constant diarrhea is not normal and requires medical attention, and in almost all cases is self-inflicted by dietary indiscretion. Constipation is also not normal and requires, more fluids, more fat, probiotics, and in extreme cases some fiber, also possibly some laxatives. Uncontrollable foul gas is not normal and may require medication like Flagyl, followed up by probiotics once the underlying cause has been eliminated. These may include carbohydrates, artificial sweeteners, fiber, vegetables, and carbonated drinks, which should not be consumed at all after. It is not acceptable to maintain poor dietary choices and expect the antibiotics to resolve the significant gas and diarrhea issues.

10. Some patients may also experience mood swings. This may go from being happy like the ability to wear clothes that were not fitting before and being able to do things that were impossible prior to surgery, then to extreme sadness of not being able to eat different types and portions of food that were tolerated before. A major contributing factor may be the underlying relationship changes between significant others after weight loss surgery. See a doctor for initiation of treatment or adjustments if medication was being taken before the surgery.

11. Please don't get pregnant, ladies. Even if you a patient has never been fertile, that could change even if they are "more or less" post-menopausal because this could change. If a patient is 65 and hasn’t seen a period since they were 52, then chances are they’re in the clear. Everyone else who has not had a hysterectomy MUST USE BIRTH CONTROL. Preferably two forms and DO NOT use birth control pills. Getting pregnant while rapidly losing weight is so dangerous.