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POST-SURGERY

1. What can I eat?

From the first five days to a week after gastric bypass, only clear liquids and protein drinks are allowed. After the first visit your diet will be modified at the discretion of your surgeon.
 

2. Can I advance my diet before seeing the doctor?

No. Usually the bariatric surgeon will see the patient within five to seven days after the surgery and at that time, if everything is going well and the doctor’s examination is satisfactory, the patient will then progress to a Level 4 diet.
 

3. What can I take for gas?

A variety of simethicone-related products are available for gas such as Gas-X, Mylicon-80, etc. Gas and gas pains are most often related to swallowed air that is taken in by mouth accumulating in the colon or the bowel forming gas bubbles. At times this needs to be relieved with an enema, hot tub baths, or other means. Should the gas pain not respond to such measures, the patient should see a physician or contact your bariatric surgeon.
 

4. Why am I burping so much?

Again, burping represents the expulsion of gas that is swallowed by the mouth. In the early period after surgery, the anastomosis of the small upper stomach to the intestine is quite small and will remain so.
 

5. When can I swim?

Ordinarily, the incisions heal quite satisfactorily within a period of seven days and swimming can be allowed thereafter. It is advisable that for the first several days to a week after the patient gets back in the pool that water aerobics be undertaken in the shallow end of the pool rather than swimming in the deep end, due to the possibility of cramps.
 

6. What can I take for nausea?

Some nausea in the early aftermath of weight loss surgery, for the first two to three weeks, is very common. The use of peppermint extract is helpful. On occasion, one-half teaspoon of soda bicarbonate in a half glass of lukewarm water will relieve the nausea; sometimes antacids of Mylanta II are helpful. The use of ginger (made into a tea) is very helpful when a patient is nauseated. If nausea is excessive or persistent for a significant amount of time after weight loss surgery, please contact your physician.
 

7. How do I use peppermint extract?

Place two or three drops of peppermint extract on crushed ice along with two or three ounces of water and sipped very slowly. This is very tolerable.
 

8. How long do I take Prevacid ® / Prilosec /Aciphex / Nexium / Protonix?

As a rule, Prevacid ®, as well as similar products should be taken after the surgery for a period of thirty to forty-five days.
 

9. Can I have crackers?

The critical thing here is that crackers, cookies or such snacks must not be taken between meals (i.e., as a snack or fourth meal) at any time after gastric bypass surgery. They are, especially crackers, one of the causes of failure of the gastric bypass to maintain weight reduction.
 

10. When can I drive?

Ordinarily, the incision is very well healed and the patient is well on the way to recovery within two weeks after gastric bypass surgery and at that time driving is permitted. The patient must use reasonable caution and good judgment and should not drive after taking medications, when in a state of pain or reduced alertness, or when other problems occur. Always check with your surgeon after gastric bypass surgery for confirmation.
 

11. What can I take for a cold?

After Roux en Y gastric bypass, any of the usual cold medications may be taken, with the exception of those that contain nonsteroidal anti-inflammatory drugs (e.g., Advil Cold and Sinus ™, Motrin Cold and Sinus ®, etc.), alcohol, or aspirin. More specifically, the following drugs cannot be taken after gastric bypass:
  • Aspirin
  • Any form of nonsteroidal anti-inflammatory drugs with the exceptions mentioned above in Answer 3 (gas products).
  • Alcohol

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12. How long will I feel weak and tired?

After gastric bypass surgery, and for the first three to six months following the surgery, there is very rapid breakdown of the toxic metabolic products of fat in the body. These materials reach the body’s circulation in the form of uric acid, urea and various ketones and acetones. While this rapid phase of weight loss is occurring and these materials are circulating in the blood, before the kidneys can excrete them, there is an associated group of common observations that patients have:
  • A feeling of fatigue and weakness
  • Temporary hair loss
  • A metallic odor of the breath
  • Change in the odor or feel of the skin
These changes are temporary and will begin to fade after the most rapid phase (the first six months) of weight loss is over.
 

13. Why am I losing so much hair?

This is one of the most common gastric bypass side effects. The best explanation is mentioned above. The hair follicles throughout the body are sensitive to circulating levels of acidic components such as uric acid, ketones and acetones, and urea nitrogen. Consuming large amounts of water advised in the protocol, vitamins, and the combination of intensive exercise can reduce many gastric bypass complications, especially this one. If symptoms persist, increase the protein shake to twice a day and contact your doctor.
 

14. Why have I stopped losing weight?

In the first six months after the surgery, approximately two thirds of all the excess weight will be lost provided that the patient observes the following:
  • No snacking between meals
  • Exercise at least one hour four days a week
  • Take protein supplements, at least 30 grams daily
  • Take vitamins + B12
Even during the three to six month period, and particularly after the first six month period, the patient will observe periods of two to four weeks or more where there is "a plateau effect.” This is common, to be expected, and as long as the above four principles of dietary and lifestyle change are observed, should not be worrisome.