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Post-Op Guidelines

The big picture concept, and the long-term goal, is to change from "living to eat" to "eating to live”.

Immediately after your surgery, for the first 2 or 3 days, you will be on a sugar-free, clear liquid diet (water, broth, Jell-O, popsicles, unsweetened tea, etc.). Then, you'll advance into sugar-free full liquids (thicker soups without chunks, protein “shakes,” pudding, yogurt, etc.). No carbonation.

For the first two weeks, the most important nutrition goal is hydration. 32 ounces of fluids per day is a minimum. Again, no carbonation.

After two weeks, you gradually introduce solid foods that are low in fat and sugar. Start with softer foods and easy to digest protein sources like tuna, shrimp, egg, deli meats and low-fat dairy. Every person reacts a little differently to the surgery and has to learn by trial and error just how much food and which types of food they can tolerate. Long term, your goal is to eat a variety of healthy foods that are high in nutrition and low in calories. You will strive to have 60-80 grams of protein per day from meat, fish, dairy, vegetarian sources, and/or “protein shakes” or “protein bars,” if they are low-fat, low-sugar. You need to take vitamin and mineral supplements daily. All of your drinks should be non-carbonated and sugar free. You should include fruits, vegetables, and whole-foods, and avoid processed foods with added sugar or fat.

For more information, read our Post-Op Guidelines below or click here to download as a PDF.

 

After Gastric Bypass Surgery and Sleeve Gastrectomy

  • May shower 48 hours after surgery. Just wash incisions with mild soap and water, pat dry. No bandages needed. No tub baths or soaking for 2 weeks.
  • Avoid heavy lifting. OK to lift: babies, a gallon of milk, a TV remote, etc. Avoid lifting over 40 pounds until 6 weeks after surgery. Follow the “if it hurts, don’t do it rule.”
  • Exercise: Start with walking right away. Jogging, stationary bike, low-impact aerobics are fine at 2 weeks, then you can increase as tolerated. Avoid abdominal crunches and weight lifting for 6 weeks. Follow the “if it hurts, don’t do it rule.”
  • Prescription medications: Resume usual medications unless you have been directed otherwise. Most pills should go down fine, but you may not be able to take all of them at once.
  • Gastric Bypass patients should avoid NSAIDs (non-steroidal anti-inflammatories). These include ibuprofen (Advil or Motrin), naproxen (Aleve, Naprosyn), indomethacin (Indocin), meloxicam (Mobic), ketorolac (Toradol). Short-term use is OK (2 days in 2 weeks) but more use could lead to a dangerous ulcer. Consult with our office if a physician is needing to prescribe NSAID use. Aspirin is an NSAID but one aspirin daily for heart or vascular risk is OK.
  • Vitamins - Gastric Bypass and Sleeve: Two multivitamins with iron and B12 and a calcium citrate supplement daily. Use chewables for the first month. We recommend the Bariatric Advantage or Bari-Life vitamins available from us or online.
  • For pain, acetaminophen (Tylenol) over the counter, as directed on package, is usually enough. If not, use the prescription medication given to you by our office.
  • Over-the-counter medications (such as cold and sinus medications): may be used according to the directions on the packaging.
  • Driving: Try to wait one week. Do not drive if you are taking any of the prescription pain medications we gave you. Take a short drive first to make sure you are comfortable. Avoid long trips for first six weeks; if you do take a trip longer than one hour, you need to stop and walk at least every hour.
  • Returning to work: The general recommendation is to wait one or two weeks for Gastric Bypass or Sleeve.
  • Attend support groups and nutrition classes. Check with office for times.
  • Call the office number with questions or concerns, including after hours if you think it is an emergency. Dr. Babineau or another surgeon is always on call. Come to the Emergency Room or call 911 if you have to, but usually it is best to try calling us first.

Diet Instructions

First 2 Weeks After Surgery

Liquids or pureed consistency diet, no carbonation

  • If it can go through a straw, or even a little thicker, its OK (but don’t actually use a straw, because this can make you drink too fast and have discomfort).
  • Examples: Broth, cream soups, yogurt, pudding, thin mashed potatoes, thin cream of wheat or malt-o-meal (no oatmeal for now), Sugar-free Carnation Instant Breakfast, Atkins Shakes, Jello, Coffee, tea, milk. Low fat, low sugar protein drinks, like Isopure or Bariatric Advantage.
  • You can put food in a blender or food processor to make puree if you want.
  • Drink enough fluids. Drink small amounts frequently. Work up to 64 ounces per day of sugar free liquids (water, tea, Crystal Lite, etc.) It might be a few weeks before you can manage 64 ounces.

After 2 Weeks

Regular food, no carbonation, no liquid calories

Do not drink with your meals

  • Regular food means: Eat lean meats, fruits, vegetables, eggs, dairy, limited starches, limited cheeses, limited fatty foods. Avoid fast food, junk food, chips, dressings, dips, ice cream, and so on. You should generally be eating the same foods as anyone else should, only much smaller amounts. Low fat and low sugar is your goal. There may be some things you have trouble with, such as oatmeal, breads, and dryer, tougher meats.
  • No liquid calories means: When you drink something, it should be sugar-free or sweetened with artificial sweeteners like Splenda, Sweet-N-Low and Nutra-Sweet. Examples: WATER, unsweet tea, tea with Splenda, Crystal Lite, black coffee or coffee with artificial sweeteners, and don’t forget… WATER!
  • Protein bars and protein drinks are OK, but only if you count them as meals. A protein bar for breakfast, protein drink and piece of fruit for lunch, and then a small dinner of regular food, is a very reasonable way to lose weight.
  • The reason we say not to drink with your meals, is to help you stay full on less food. When people eat a little, then drink a little, then eat a little, and so on, they tend to wash more food down. That is one example of how a person can “eat around” the surgery. So, have your fluids at least 30 minutes before, or 30 minutes after your meal.

Frequently asked questions

Why not carbonation?
For most people, it doesn’t feel good, and it can possibly stretch the “pouch.”

What about alcohol?
In moderation, alcohol is OK. Twelve ounces of beer, six ounces of wine or two ounces of liquor per day is considered “moderate.” Remember that alcohol has calories, so the more you drink, the less weight you are likely to lose. Also, alcohol is absorbed more quickly, so you may reach a legal impairment level on much less.

When can sexual activity resume?
Wait one week. As for exercise, and lifting, follow the “if it hurts, don’t do it” rule, and wait another week to try again for any activity that causes pain.

How much weight should I be losing?
One to two pounds per week is enough. Losing faster than this is OK, as long as you are getting in protein three times per day and are not having frequent vomiting.

What if I eat ice cream, chips and dip, and pudding with whipped cream?
You will not feel as full on foods like this, and will probably not lose weight.

For more information call our office at 903-593-0230.