Recovery in the Hospital
Patients spend an average of two to five days in the hospital following bariatric surgery, or longer if complications develop. Patients who undergo laparoscopic bariatric surgery usually have a shorter hospital stay.
When you return to your hospital room after surgery, you will be closely monitored by your nurses. Along with periodic monitoring of your vital signs — blood pressure, pulse, temperature and respiration — your nurses will encourage and help you to perform deep breathing, coughing, leg movement exercises and to get out of bed. These activities can help prevent complications. Report any symptoms of nausea, anxiety, muscle spasms, increased pain or shortness of breath to your nurse.
To varying degrees, it is normal to experience fatigue, nausea and vomiting, sleeplessness, surgical pain, weakness, light-headedness, loss of appetite, gas pain, flatulence, loose stools and emotional ups and downs in the early days and weeks after surgery. Please discuss any concerns you have with your doctors and nurses.
You may feel pain at your incision site or from the position your body was in during surgery. Some patients also experience neck and shoulder pain after laparoscopic bariatric surgery.
Your comfort is very important to us. Although it is normal to experience some discomfort after surgery, keeping your pain under control is necessary for recovery. When you are comfortable, you are more able to walk, breathe deeply and cough, all of which are essential for recovering as quickly as possible.
If you are feeling pain after surgery, you will be able to push a button on a cord to administer pain medication to yourself. This is called “patient-controlled analgesia,” or PCA. As soon as you are able to tolerate fluids, your medical team will add oral pain medication. Please know that you are not bothering the staff if you ask for pain medicine.
Your nurses and doctors will ask you to describe your pain. Two helpful ways to describe pain include the number scale (on a 0 to 10 scale, with 0 being no pain and 10 being the worst pain possible), or words to describe your pain as none, mild, moderate or severe.
No matter what form of pain control you receive, the following tips will help you stay comfortable:
Tell your nurses and doctors if you are experiencing pain, particularly if it keeps you from moving, taking deep breaths and generally feeling comfortable. Everyone is different, so keeping your nurses informed about how you feel will help them help you.
Plan ahead for pain; if you are comfortable lying down, you may still need pain medication to get up and walk around.
Keep ahead of the pain — don’t wait for the pain to be at its worst before you push the PCA button or ask for pain medicine. Pain medication works best when used to prevent pain.
The risk of becoming addicted to pain medicine is very low when it is used for a specific medical purpose, such as surgery.
Exercises to Speed Recovery
Activities such as walking and even changing positions in bed help promote circulation. Good blood flow discourages the formation of blood clots and enhances healing. Standing up, walking and doing your post-operative exercises may help speed up your recovery and minimize complications.
Repeat the following exercises at least once every hour after surgery. It’s a good idea to practice them before surgery as well, to increase lung function and agility.
The first night after surgery, with the help of your nurse or physical therapist, sit up and dangle your feet and stand at your bedside. This may hurt, but will get easier each time. Each day you will notice your strength returning and less pain.
You will be asked to get out of bed and walk the first day after surgery. After that, you will need to walk at least three times per day and perform your leg and breathing exercises hourly. You may not feel well enough to go for a walk, but it is very important to try your best and do as much as possible.
Your nurse will teach you how to cough and breathe deeply, and you will be shown how to use an “incentive spirometer” to help you expand your lungs. Coughing and deep breathing helps loosen any secretions that may be in your throat or lungs and helps prevent pneumonia. Deep breathing also increases circulation and helps to eliminate anesthesia.
How to breathe deeply:
- Inhale as deeply as you can.
- Hold the breath for two seconds.
- Exhale completely.
- Repeat three times.
How to cough:
- Inhale deeply.
- Cough. The cough should come from your abdomen, not from your throat. Hold a pillow on your abdomen for support.
How to exercise your feet and legs:
- Push your toes toward the end of the bed, as if you’re pressing down on a gas pedal.
- Pull your toes toward the head of your bed, then relax.
- Circle each ankle to the right, then to the left.
- Repeat three times.
Recovery at Home
Your surgeon will decide when you are ready to leave the hospital, based on your progress. Prior to your discharge, you will be given specific dietary and activity instructions, along with information about certain precautions and when to notify your surgeon. If you have any concerns about returning home, discuss them with your nurse or discharge coordinator.
When you return home, plan on taking things easy for a while. Your body will be recovering from major surgery and weight loss during the recovery period.
Planning Your Recovery at Home
It is important to think about your living environment and how you will manage it after surgery. Are there many steps in your home? Is your bedroom upstairs? How accessible is your bathroom? Please tell the hospital staff about your living environment, as they can prepare your going home plan with your specific needs in mind. A rubber shower head with a detachable hose, long sponge stick or kitchen tongs, and toilet lift are all useful items.
We care about your progress. Keep in communication with us, and we will do our best to ensure your recovery is as smooth as possible.
Your first office visit with your surgeon will be scheduled for 10 days to three weeks after surgery. Your discharge instructions will tell you when to return to the office for follow-up.
You will continue to see your surgeon periodically after the initial follow-up visit — usually six weeks, three months, six months and nine months after surgery. Thereafter, you will have an annual appointment. Please call your surgeon’s office with any surgical concerns between scheduled visits.
It is also important to keep your primary care doctor informed of your progress. Be sure to contact him or her with any medical concerns as well.