Preparing for Surgery

Personal Preparation

Now that you have decided to proceed with surgery, there are certain steps to take before your operation to ensure that you are as prepared as possible for the procedure. Start taking multivitamins once daily to improve your general health. Further, take 500 mg of Calcium Citrate three times daily. Vitamin and mineral intake is especially important after bariatric surgery in order to maintain good nutrition and health. We have found that if you start taking these supplements before surgery, it will be easier remembering them after surgery.

Another important way to prepare for surgery is exercise. The best time to begin your exercise program is before your surgery. We’re not kidding. The sooner you start exercising the easier it will be after you have surgery. Success in gastric bypass is all about choosing the right habits, with the support of the surgery to improve your success. We want you to start moving more, but we don’t want you to injure yourself. Walking on a daily basis improves your circulation and makes breathing easier during recovery. You will also benefit from having a plan in place, so you don’t have to figure out your walking route during the confused recovery phase. A pedometer is a recommended purchase to keep you informed of your walking progress. Should you be unable to walk daily due to joint pain, then you may want to look into an aquatics program. Every town has classes for arthritic or cardiac patients that are held in a safe and clinical environment. Water exercises still condition your breathing, but are not weight bearing and are therefore easier for people who have joint problems. You can also practice the exercises that speed up your recovery.

Good skin integrity is essential for the operative site. It is important to maintain good hygiene, by keeping skin clean and dry, especially in the days before surgery. Skin breakdown could possibly cause your surgery to be delayed.

Medicines
It is important to avoid aspirin and all aspirin-containing medicines for at least 10 days prior to surgery. Herbal medications such as St. John’s Wort, Gingko Biloba, Garlic, etc, should be discontinued, as these have blood-thinning properties. Other herbal supplements such as Kava and Valerian Root are known to interact with anesthesia and should also be stopped at least 10 days before surgery. Again, remember to tell your surgeon all the medicines and herbal supplements you are taking. Do not forget to check the label of your multivitamin; many times they can contain herbal supplements as well. Remember to check all labels of over-the-counter medicines, since certain over-the-counter medicines can contain aspirin, too. If in doubt, please check with your pharmacist or your surgeon.

Alcohol and Tobacco

Since smoking hinders proper lung function, it can increase the possibility of anesthetic complications. Smoking can increase your risk of complications such as deep vein thrombosis (blood clots in the legs). Smoking also reduces circulation to the skin and impedes healing. Patients are required to stop smoking eight weeks before surgery. Smokers who undergo anesthesia are at increased risk for developing cardiopulmonary complications (pulmonary embolism, pneumonia and the collapsing of the tiny air sacs in the lungs) and infection. Besides the well-known risks to the heart and lungs, smoking stimulates stomach acid production, leading to possible ulcer formation. Patients must agree to permanently refrain from smoking after surgery. Ask your Primary Care Physician to write you a prescription for a smoking cessation aid, if necessary.

Alcohol causes gastric irritation and can cause liver damage. During periods of rapid weight loss the liver becomes especially vulnerable to toxins such as alcohol. You may find that only a couple of sips of wine can give you unusually quick and strong effects of alcohol intolerance. In addition, alcoholic beverages are high in empty calories and may cause “dumping syndrome”. For these reasons, we recommend complete abstinence from alcohol for one year after surgery and avoiding frequent consumption thereafter.

Work and Disability

Expected return to work time is about two to four weeks. This may vary greatly. The time you take off from work depends on many things. These include the kind of work you do, your general state of health, how badly your work needs you, how badly you need your work (i.e. the money), your general state of motivation, the surgical approach (laparoscopic versus open) and your energy level. It is important to remember that one is not just recovering from surgery, but one is eating very little and losing weight rapidly. You may have heard that someone went back to work full time in just two weeks.

We would, however, caution you not to rush back to full time work too quickly. The first few weeks are a precious time to get to know your new digestive system, to rest, exercise and meet with other post-operative patients in support group meetings. If financially feasible, take this time to focus on your recovery.