Home Again

Going Home
Your date of discharge will be determined by your surgeon based on your individual progress.  Prior to your discharge, specific dietary and activity instructions will be reviewed with you, along with precautions and situations when your surgeon should be notified.  Please give some thought to your living environment and tell the hospital staff so they can prepare your discharge home with your specific needs in mind. 

Preparing Your Home
You should take time before your surgery to make sure your home is equipped for you return.  Make sure you have tried several protein shakes and found one you like for use after surgery.  You should have this available when you get home.  Keep a phone list ready with important numbers.  You may want to add numbers of some member of your support network to the back page of your patient handbook where important numbers are listed.  When possible you may want to have some friends available to check on you your first few days home if you live alone.

Follow Up Care
Your first office visit with your surgical team should be two weeks after your surgery.   Your surgeon’s discharge instructions will give your specific information to make an appointment.  Our office will contact you following your discharge to check on your progress.  You will be seen by your surgical team on a periodic basis after that, usually at 4 weeks, 6 weeks, 3 months, 6 months, 9 months, 12 months, and then annually thereafter.  Please call your surgeon’s office with any concerns between scheduled visits.  Also, don’t hesitate to contact your primary care physician with medical concerns. 

Urgent Symptoms
If you experience any of these symptoms, contact your surgeon right away.

     - Fever of 101 degrees Fahrenheit or above
     - Yellow/green, purulent and/or odorous wound drainage
     - Chest or shoulder pain
     - Shortness of breath
                    - Rapid breathing or pulse
                    - Vomiting for more than 24 hours
                    - Leg pain or swelling
                    - Any unusual symptom

Specific Recovery Instructions
When you get home, your activity will be restricted to no strenuous activity for 3 to 6 weeks after the operation.  Change positions frequently while sitting, and walk around while standing to help prevent blood clots from forming in your legs.  You may walk and perform light household duties as tolerated upon your return home. Avoid lifting anything heavier than 20 to 30 pounds during the first six weeks.

Patients undergoing the laparoscopic method are more frequently able to return to all activities within a shorter time frame. You may be tired, weak, nauseated or have vomiting the first few weeks after surgery.  Keep up your fluid intake with small, frequent sips as necessary.  1 ˝ to 2 Liters a day is the recommended minimum intake.  We suggest carrying a bottle of water with you at all times to help you achieve this. 

Resume traveling short distances as soon as you feel strong enough to make the trip.  Do not drive a motor vehicle until you are off the prescription pain medicines, usually about one week after your surgery.

Personal Hygiene
Due to the nature of abdominal surgery, you may need some help with toileting.  Flushable baby wipes tend to be gentler for personal hygiene, as is a peri-bottle.  You can use a small sports-top water bottle as well.  A long sponge stick can also be very helpful.

Wound Care
Your wound needs minimal care.  If sutures were used, they dissolve, so there is no need to remove any stitches.  You will notice some tape called “steri-strips®” on your wound.  They will fall off on their own. 

It is important to keep the wound clean and dry to promote faster healing.  You may shower, but pat dry the incision area well.  After about three weeks, the incision is usually ready for immersion. Ask your surgeon before you take a bath. 

Despite the greatest care, any wound can become infected.  If your wound becomes reddened, swollen, shows pus or red streaks, has yellow/green, purulent and/or odorous drainage, feels increasingly sore or you have a fever above 101°F, you must report to your surgeon right away.  Please do not use any Neosporin® or other occlusive ointment on your incision.

Sexuality / Pregnancy
The following questions and answers respond to common concerns of patients and their partners after obesity surgery.

When will I be able to resume sexual relations? You may resume sexual activity when you feel physically and emotionally stable.  Women need to use a mechanical form of birth control, as fertility may be increased with weight loss and oral contraceptives may not be fully absorbed. 

Why am I more likely to conceive now if I was infertile before the surgery?  Many severely obese women are also infertile, because the fatty tissue soaks up the normal hormones and makes some of its own as well.  This completely confuses the ovaries and uterus, and causes a lack of ovulation.  However, as weight loss occurs, this situation may change quickly. 

How soon after surgery is it safe to become pregnant?  Following the operation your body will be undergoing may rapid changes.  For this reason we recommend you delay pregnancy until your body is adjusted and adequate nutrition has been established.   You may start planning a pregnancy after 18 months.  It is important not to become pregnant before this time, since we want both you and the baby to be healthy and safe.