Central Carolina Surgery
Gastric Bypass Surgery Frequently Asked Questions ? ? ? ?
1. I am nauseated and don't want to eat. I haven't vomited. What should I do?
2. How much fluid should I drink?
3. I am vomiting without eating anything. What shoud I do?
4. When I eat, I develop a pain in my breast bone and then I vomit. What is going on?
6. What foods should I try to eat?
7. What quantity of foods should I eat?
8. I am constipated. What can I take?
9. When can I start an exercise program?
10. How do I take my medications?
11. When does the support group meet?
12. When does hair loss occur and how might I prevent it?
13. When should I be concerned about fever?
14. I am having black, tarry, diarrhea. What does that mean?
16. When should I call the doctor?
17. What are the dietary cheating habits?
1. Your mind may be playing a head game with you. You may be confusing nausea and hunger pains. When you are nauseated (not vomiting), try drinking some kind of protein shake —Isopure, or Adkins Protein shakes (GNC or Wal Mart).
2. Drink at least 64 ounces of fluid a day (minimum) for the first 3 months then we want you to increase this to about 8 ounces per hour. Goal is 100 + ounces per day.
3. You need to call Central Carolina Surgery 336-387-8100 for further evaluation.
4. If associated with eating it is because you ate too much especially if you felt pain beneath your breastbone before you vomited. You felt much better after vomiting. Go back to liquid proteins shakes or soft foods like cottage cheese and yogurt for 24 hrs.
5. No-No foods: Breads, pasta, rice, and potatoes. Avoid all vegetables and fruits until you have lost 75 lbs. Avoid cakes, pies, chewing gum, donuts, sweet drinks, candy, fruit juices, and carbonated beverages.
6. Just say yes to: Tuna, white fish, salmon, canned chicken, scallops, eat all beef hotdogs carefully (processed have too many carbs), cheese, sugar freee yogurt, eggs, ground burger with gravy mix. Game meats—venison or quail as long as they have a gravy mix.
7. For the first month and a half you can handle only 1.5 -2 ounces. Second month thru the third to sixth month, you should be up to 6 ounces of protein a meal (4x day). Six ounces is two drumsticks. Two ounces is 2 wings. Do not drink 1 hour before eating or 1 hour after eating.
8. Treat with liquid milk of magnesia. Miralax works if milk of magnesia doesn't work.
9. After their first month, start an exercise program. Swimming is easy on the joints. Get the women to curves and men to the gym to lift weights.
10. For the first month, they should be crushed. If women are on birth control pills or hormones, stop 1 month preop and restart 1-month post op (to avoid DVT potential--use alternate birth control). NSAIDs should be stopped 1 month preop. Take liquid Tylenol after you get out of the liquid oxycodone. Six months out, you may take aspirin or Advil—it is OK if you don't take it too often. Take chewable ones. Vitamins can be bought at the dieticians—NDMC (nutrition diabetes management center)—Beriblends. Chewable Centrums or Flintstones as long as they say iron complete. Take calcium citrate not calcium carbonate and take at least 1000 mg / day. Take a B12 sublingually or PO or the shots. The POs(by mouth) and sublingually are daily and the shots are monthly. Women who are premenopausal should take 30 mg/day of iron. Postmenopausal women should take at least 15 mg/day. Never take the calcium and iron together—it interferes with absorbption of iron.
11. Support group!!! It is the 4 th Thursday of every month in Wesley Long Hospital classroom 3 from 6 – 7:30 pm.
12 Hair loss occurs between 6-9 months and is a symptom of not enough protein. Bypass patients need at least 60 – 100 grams of protein/ day. This cannot come from just food alone. They HAVE to supplement with protein shakes.
13 101.5 is our threshold for fevers.
14 Stools—if you have black tarry stools and diarrhea, see your CCS surgeon.
15 Dumping—ice cream, donuts, candy bars PRODUCE—>>flushing, rapid heart beat, abdominal cramps, and rapid diarrhea. BAAD!!!
16 Call the doctor if: persistant nausea and vomiting that doesn't go away, abdominal pain that is not relieved by any pain med, fever greater than 101.5, redness at incisions, shortness of breath, tarry stools. If you find yourself in the ER, have the nurse call the CCS surgeon on call.
17. Cheating habits: Preop closet eaters will revert to eating and hiding the evidence. Picker eaters—eat a pinch of this and that and they don't realize that it is undermining the ketotic state that we are trying to put them in. Who are they fooling?