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After your discharge from the hospital, you will have two main goals:
Note about diabetic monitoring: Patients with a history of diabetes should monitor their blood sugar several times each day and record these values. Some patients with diabetes may require small doses of insulin once they home; but there is almost always rapid and dramatic improvement in the control of their blood sugars.
After your hospital discharge and indefinitely, you will need to follow postoperative dietary guidelines and take vitamin and mineral supplements as recommended. Patients need to follow all of the rules for the best results: small portions of healthy meals eaten slowly, and taking all vitamin and mineral supplements as directed.
Patients also need to make follow-up visits to our office, starting soon after surgery and continuing indefinitely. These visits check your health and that you are achieving the expected weight-loss goals.
After surgery, you should drink at least 2 liters of fluid each day. Patients lose weight very quickly after surgery, especially after gastric bypass:
- Women typically lose about one pound a day within the first 2 weeks after gastric bypass.
- Men typically lose 2 (or more) pounds a day within the first 2 weeks after gastric bypass.
- Weight loss after band surgery is at a slower rate.
Most of this weight is due to loss of fat. The fat is metabolized into ketones, which your body will now use as a 'fuel'. Ketones can build up in your body and make you feel nauseated and your breath and urine smell 'funny'. It is necessary to 'flush' out the ketones by drinking plenty of fluids, especially water. We also recommend that patients drink diluted sports drinks or fat-free milk; these add a little sugar to the diet and this helps to avoid build-up of ketones (called ketosis).
It is important to stay on clear liquids for a full 2 weeks after your surgery. Rushing things doesn't help; it actually can hurt you.
It is important to keep active after surgery to avoid blood clots from forming in your legs. This means don't sit for a long period of time (>2 hours). On any long car or airplane rides, get up and walk around every hour or two.
You will be tired for the first few weeks, but it does get better. You can get back to normal activities as you feel like it. For most patients:
- You can drive after you are off of the pain medicine.
- People typically go back to work 10 days to 2 weeks after surgery, but some people go back sooner.
It is important to follow an exercise plan, even something as simple as walking, when this is possible, and having specific goals to increase the distance you walk . Activity not only helps to keep your metabolism increased, but it prevents muscle loss. If you don't use your muscles while losing weight, your body will use them for energy and you will lose muscle mass, strength, and tone.
People who exercise will have better weight loss and look better (with better muscle tone) than those who do not exercise.
You will need to come in for your first postoperative visit 2 to 3 weeks after surgery.
At this visit, we will see how you are doing and check your incisions. We will also check that you have started your vitamins and if you have started exercising.
At that visit, we will let you know when we want to see you next. However, the typical schedule is at months 3, 6, 9, 12, 18, and 24 after surgery, and then yearly after that.
It is very important that you do not miss any follow-up appointments. If you need to reschedule, that is fine, but please don't simply skip any appointments. We need to monitor your weight loss closely and catch any problems as they are beginning, not months later, when it will take a lot more to correct the problem.
After gastric bypass, the typical rate of weight loss that patients should expect is rapid: 20% of their excess weight at 2 months, 30% at 3 months, 40% at 4 months.
As weight loss slows down, people tend to lose weight in a step-wise fashion. You may plateau for a week or two, sometimes more, then drop a few pounds all at once. This is normal. Try not to get discouraged. One thing to do is to measure yourself monthly and keep track of clothing size. Seeing the decreasing inches may be just the motivation that you need.