General Surgery Minimally Invasive Surgery Breast Surgery Hernia Surgery Carney T. DeSarno, M.D., F.A.C.S. Seth M. Kipnis, M.D., F.A.C.S. Sleeve Gastrectomy Surgery Discharge Instructions What medicines must I take and how do I take them? Crush all non-chewable tablets and open all capsules. Mix powder with food or liquid. Chew any chewable tablets completely then wash them down with liquid. You may take liquid forms of your medicines, when available. Shake the bottle well before you pour the medicine dose. Diabetics must check blood sugars frequently and modify the doses if necessary. Do not take aspirin or aspirin-containing products. Do not take non-steroidal antiinflammatories such as ibuprofen (Advil®, Motrin®, etc.) and naproxen (Naprosyn, Aleve®, etc.). They may cause ulcers in your pouch. Check with us if you are not sure which medicines you can take. How do I care for my incision? Remove the clear bandage 2 days after surgery if it is still on. Leave the Steri-strips® [strips of tape over the incision (cut)] in place; they will curl and fall off. If they are still in place 2 weeks after your surgery, gently peel them off. You can do this in the shower. The incision (cut) may itch during healing; this is normal. Do not scratch the area. Can I shower or bathe? It is OK to shower with soap. Pat the incision dry after showering. Do not take a bath or soak in water for one month. What kind of activity is allowed? Do not drive until your pain is resolved and does not require medication. Pain can make it hard to move quickly. Stop any strenuous activity if it is uncomfortable during the first month. Walk as much as is comfortable for you. Your goal for the first 4 weeks after surgery is to walk 30 minutes per day, 7 days per week. How do I manage constipation? If you do not have a bowel movement within 5 days of surgery, try Milk of Magnesia ® (2 Tablespoons, twice a day). If this does not work after one day, try a Dulcolax® suppository or Fleets® enema. If none of these measures help, call our office. What do I do if I vomit? Phone: (732) 775-5005 Fax: (732) 775-0065 Imperial Suites Avenue 1706 Neptune, NJ Corlies 07753 General Surgery Minimally Invasive Surgery Breast Surgery Hernia Surgery Carney T. DeSarno, M.D., F.A.C.S. Seth M. Kipnis, M.D., F.A.C.S. If you vomit, you have probably eaten or drunk too quickly and/or too much or the food may have been too solid. Wait four hours and then try one ounce of liquid. If this liquid does not make you nauseous or vomit, then take only liquids until the next day. Then you can try pureed foods again. If vomiting continues, call our office. Sleeve Gastrectomy Surgery Discharge Instructions (cont'd) When should I call Jersey Shore Advanced Surgical Associates? Call us if you notice: Increasing redness, swelling, heat or pain at an incision. Drainage from an incision that soaks through your bandages. A fever greater than 101ºF. Worsening abdominal pain that is not relieved with medication. Frequent vomiting. Shortness of breath. Generally not feeling or doing well Post-Operative Discharge Instructions & Follow-Up You should be ready to go home on the second or third day after surgery unless your surgeon tells you that he/she plans to extend your hospital stay. It is fairly common to feel weak and tired immediately after discharge from the hospital. The body is recovering from the stress of a major operation and because weight loss is occurring during this time the feeling of weakness may be somewhat prolonged. Follow up after surgery is extremely important. The operation is only one part of the course to a good result. Success is not determined at the time of discharge. Weight loss will occur for 12 to 18 months following the operation. Participation in the support group program is VITAL to the long term maintenance of weight loss achieved. CONSUMING TOO MANY CALORIES CAN DEFEAT ALL GASTRIC REDUCTION OPERATIONS. Phone: (732) 775-5005 Fax: (732) 775-0065 Imperial Suites Avenue 1706 Neptune, NJ Corlies 07753 General Surgery Minimally Invasive Surgery Breast Surgery Hernia Surgery Carney T. DeSarno, M.D., F.A.C.S. Seth M. Kipnis, M.D., F.A.C.S. Sleeve Gastrectomy Surgery Discharge Instructions (cont'd) Long Term Expectations Weight loss after surgery is gradual and occurs at the greatest rate in the first several months after surgery. The consistency rather than the rate of weight loss is most important in the long run. After the first few months the rate of weight loss will decrease, this is related to the decrease in the amount of fat. Very few patients will reach ideal body weight. Patients who come within 50 percent of the ideal body weight are considered successes. The heaviest patients must lose the most weight to become successful. THE MOST COMMON REASONS FOR FAILURE ARE POOR FOOD SELECTIONS, GRAZING AND LACK OF EXERCISE. Patients may lose track of the new eating habits and return to some of the bad eating habits which contributed to their obesity in the first place. In most cases, these bad habits can be corrected through early intervention by a dietician and minor changes in the diet. This is why regular follow-up is so important after this type of surgery. Follow-up with your regular medical doctors. As your weight changes many of your medication or medication doses will need to be modified. This is more critical if you have diabetes. Good follow-up will ensure that your other medications are being modified correctly. If any questions arise you may always call this office. Phone: (732) 775-5005 Fax: (732) 775-0065 Imperial Suites Avenue 1706 Neptune, NJ Corlies 07753 General Surgery Minimally Invasive Surgery Breast Surgery Hernia Surgery Carney T. DeSarno, M.D., F.A.C.S. Seth M. Kipnis, M.D., F.A.C.S. When do I follow-up after surgery? You will meet with your surgeon 2 to 3 weeks after. You will then follow-up with your surgeon at 3 months and 6 months after surgery, every 6 months for 1½ years and then every year. You should have received dates and times for your first follow-up visits with your pre-operative instructions. If not, please call our office to schedule them. Phone: (732) 775-5005 Fax: (732) 775-0065 Imperial Suites Avenue 1706 Neptune, NJ Corlies 07753