Bariatric Patient Information Admission & Post Op Advice

Transcription

1 Bariatric Patient Information Admission & Post Op Advice 1

2 Pre-Operative Preparation Approximately 2 weeks before your operation you will receive your hospital admission documents and copies of the pre/post op diets. The pre op diet is a high protein, low carbohydrate diet that reduces the size of your liver. This diet must be followed 10 days before your admission. Failure to comply with this diet could result in your operation not being carried out. You will be admitted to Ward 206, Pink Zone (which is a General Surgical Ward) on the morning of your surgery. The Specialist Nurse will normally admit you. You will be consented by your Surgeon and meet with your Anaesthetist. This is a good opportunity to ask any last minute questions that you may still have. You will have some routine tests carried out. Those will include: Blood Pressure Temperature Pulse Oxygen Saturation Respiration Rate Blood Sugar Urinalysis Weight You will be measured for compression socks (TEDS) to help maintain your circulation and to help stop blood clots forming in your legs. You will also receive a daily blood thinning injection during your stay in hospital. A member of the medical staff may also examine you and routine bloods will be taken. You will be required to Fast for your surgery and this information will be sent out with your hospital admission pack. 2

3 Post Operative Immediately post operatively you will go to Recovery so that your vital signs can be monitored. Once they are happy you will then go back to the Ward. An oxygen mask and intravenous fluids will be in place but you may also have: PCA (patient controlled analgesia) Abdominal drain Urinary catheter Nursing staff will be monitoring your blood pressure, temperature, pulse, & respiration rate closely for a while. You will be expected to mobilise within 3 hours of getting back to the Ward to prevent blood clots, chest infections and any other complications setting in. Post Op Diet It is important that you bring your post op diet information with you when you come into hospital, so that you understand what you can have post operatively. Medications/Nutritional Supplements You should continue with your normal medications, unless you are told otherwise. Immediately post operatively your medications will be dispensed in a liquid form (if available) and should remain in this form for approximately 2 weeks after your surgery. Nutritional Supplementation is required for life and currently those are: Forceval x1 capsule (daily) Calceos x 1 capsule (daily) Ferrous Fumarate 210mg (daily) Vitamin B12 injections (every 3 months) You will not be discharged home on nutritional supplementation; this will be prescribed at your first clinic appointment post operatively. Following bariatric surgery, NSAID s (non steroidal anti-inflammatory drugs) should be avoided. For further clarification seek advice from your GP. 3

4 Wounds Wound sites are normally glued, so there will be no stitches to be removed. Bruising, tingling and itching are normal signs of healing. Increased pain, redness, swelling or discharge, are not. You should consult your GP if you are in any doubt. Discharge/Follow up Generally you will be discharged home after 2-3 days. You will be contacted by the Specialist Nurse approximately 1 week after you get home to see how you are getting on. You will receive a follow up appointment for the Nutrition Clinic 6-8 weeks post operatively. Appointments in the 1 st year are: 6-8 weeks review appointment with the Consultant/Dietitian/Nurse nutritional supplementation prescribed. 3 months review appointment with Specialist Dietitian/Nurse. Full bloods/micronutrient screen. 6 months review appointment with Specialist Dietitian/Nurse. Full bloods/micronutrient screen. 6 months - Psychology review with Principle Clinical Psychologist 12 months review appointment with Specialist Dietitian/Nurse. Full bloods/micronutrient screen, then annual review. At 2 years you will be discharged back to your own GP who will carry out your annual bloods/micronutrient screen. Post Surgical Group Approximately 1 year post operatively you may be invited to attend post surgical group sessions. These sessions are designed to be an integral part of your post surgical follow up and although not mandatory, we would hope that you would attend. 4

5 General Information Back to Work Everyone will recover at a different rate. Generally you will need 6 to 8 weeks off your work, but this can vary dependant on what your job is. Remember Bariatric Surgery is major surgery, you will be tired; give yourself time to get over it. Driving You will not be able to drive for approximately 3 weeks, but you will need to contact your own Insurance Company to seek clarification on this. Body Image/Loose Skin Whilst weight loss surgery can help you reduce the fat in your body, it cannot make your skin revert to its pre obesity tightness and firmness. Although toning exercises can help tone the muscles underneath your skin it is likely that you will develop a degree of loose skin as your weight reduces. Skin reduction surgery is not something that is routinely offered within NHS Grampian. Currently the criteria for this are: BMI of 27 or under OR 50% weight loss with a functional issue Weight maintenance for at least 1 year Referral is made via your GP Pregnancy & Contraception It is not recommended that you become pregnant within the first 18 months following your bariatric surgery. This is to allow your weight to stabilise and for your body to get used to your new dietary regime. Nutritional deficiencies following bariatric surgery can be serious so it is important that you let us know immediately if you do become pregnant. Please be aware that Bariatric surgery can alter the way your contraception is absorbed into your body so it is advisable to make an appointment with your GP to discuss this. 5

6 In order to lose your maximum amount of weight and help maintain that weight loss it is extremely important to incorporate daily exercise into your day. Remember that exercise doesn t mean that you have to go to the gym. Find something that you can enjoy and doesn t feel like a chore. Why is Exercise Important A healthy lifestyle that incorporates some form of physical activity will offer you many benefits including: Reducing your risk of heart disease & some types of cancer Helps lower blood pressure Burns calories & boosts your metabolism Helps maintain weight loss Helps develop and maintain muscle strength, endurance & tone Improves mood & self esteem Improving your overall health, well being & mental outlook How soon can I Exercise after Surgery It is important that you start slow. Once you get home, walk around the house and garden and take the stairs as able. Remember you have just had surgery so light activity is recommended. As the weeks progress you will be able to increase your daily activity, start slowly with low impact exercise such as stationary bike riding, walking short distances either outside or on a treadmill and/or light housework. Eventually you should be trying to build up your activity to approximately 30 minutes of moderate activity daily. Swimming is something that should wait until you have been seen by your Consultant at your follow up appointment. 6

7 Top Exercise Tips Choose physical activities that you like as you will be more likely to continue them Set yourself a short term goal, you re more likely to achieve it if it s realistic Vary your activity so the boredom factor doesn t set in Aim to increase your steps per day gradually over a period of time get yourself a pedometer/fitness tracker Activities that can be fitted into your everyday life, such as gardening, walking to the shops and taking the stairs instead of the lift are easier to sustain and don t feel like exercise Drink plenty of water when you exercise. Remember it will be difficult with your new smaller stomach for your body to absorb the fluid it needs, especially during and after exercise. Always have water handy Always leave at least 2 hours after eating before you start exercising to help avoid indigestion, heartburn and getting a stitch. And last but not least, REMEMBER any form of physical activity is better than none!! Useful Activity Web Sites OR call