The sleeve gastrectomy is a popular bariatric surgical procedure that can assist patients in achieving considerable weight reduction and enhancing their overall health. This procedure involves removing a portion of the stomach and reshaping it into a smaller, banana-shaped organ.
This helps patients lose weight in two primary ways. First, the decreased size of the stomach causes you to eat less, thus reducing caloric intake. Second, it modifies your gastrointestinal hormones, lowering your appetite and allowing your body to metabolize food in a healthier manner.
The changes you feel after a sleeve gastrectomy may be profound, so it’s vital to understand what to expect in the first 30 days following the procedure.
In the Hospital
You can expect to experience some discomfort, but it’s not a test of your pain threshold. I’ve had patients tell me that gallbladder surgery was more painful. Another patient said it was like she had done a thousand sit-ups.
You’ll be given medication to alleviate pain, and you will also be sent home with medication. Today, we understand the disadvantages of opioids, which include the addictive potential, respiratory depression, gastrointestinal impacts, effects on cognition, and other potential side effects. Due to this, we attempt to treat pain with numerous kinds of analgesics in addition to opioids.
Immediately after surgery, nausea is a possibility. General anesthesia alone can cause nausea. Add to that the fact that we’re literally operating on your stomach and you get pretty good chances for nausea. Your surgeon is fully aware of this and will make every effort to keep it under control.
All surgeons who have made a significant commitment to bariatric surgery, including myself, have postoperative nausea pathways. We give patients medications before surgery, during surgery, and immediately after surgery, all in an effort to keep you comfortable. Anesthesia teams also work to try to decrease the likelihood of nausea.
In my practice, the majority of patients do not experience significant or prolonged nausea, but a minority of individuals do. You’ll be sent home with anti-nausea medications. Try to treat your nausea before it becomes too severe; otherwise, your oral intake could be compromised.
Drinking is a vital component of the recovery process following sleeve gastrectomy since appropriate hydration is critical for healing and general health. In fact, dehydration is the most common complication after a sleeve gastrectomy.
In the immediate postoperative period, your surgeon will likely instruct you to consume only clear liquids, such as water, broth, and sugar-free beverages. Be sure to follow their instructions during this healing process.
Drinking will feel quite different. It’s essential that you work through this new sensation in order to obtain the proper amount of liquids. If you experience nausea, take your nausea medicine and keep on drinking. If you vomit, slow down and start over.
In my practice, we strive for a minimum of 64 ounces a day. Prior to leaving the hospital, we need our patients to consume at least 32 ounces of fluid. If you get a one-ounce medicine dispenser, you can try to drink one ounce every 15 minutes. That’s a reasonable guide that will assist in making sure you stay appropriately hydrated.
Walking is an important aspect of the recovery process after a sleeve gastrectomy. Despite the fact that it may be difficult or unpleasant to walk immediately after surgery, it’s crucial to start walking as soon as possible.
Reducing the risk of blood clots is one of the most important reasons to walk. In addition, walking improves healing, opens your lungs, stimulates your bowels, and enhances your sense of well-being.
The single most important thing to prevent blood clots in your legs isn’t blood thinners, compression hose, or the “pumpers” on your legs: it’s you getting out of bed and walking. This isn’t something your physician or family can do for you! As soon as your medical team gives you the green light to walk, get out of bed and begin walking.
Walk once each hour when you’re awake (you don’t have to wake up at night to walk). Even 50 to 100 yards is adequate. Keep doing that for the next 30 days.
Advance Your Diet
After the sleeve gastrectomy, your stomach has a fresh staple line. It’s important to protect that staple line until it’s completely healed. This is done by starting with clear, thin liquids and advancing all the way to an appropriate regular diet within about 6 to 8 weeks after surgery.
It’s essential to adhere to your surgeon’s suggestions. Dietary progression following surgery varies greatly from surgeon to surgeon, but despite this diversity, I believe most surgeons would agree on a few points. If you follow these steps, you will encounter very few problems as your diet progresses:
- Take small bites (about the size of your thumbnail).
- Chew every bite for 2 minutes.
- Wait 30 seconds between bites.
Advance Your Activity
Your activity is another area that is highly variable. You have straw holes that allowed access to your abdominal cavity. If you begin lifting items too soon, you may develop a hernia or experience greater stomach pain.
We often instruct patients not to lift more than 10 pounds for two weeks, then 30 pounds for weeks three and four after surgery. After that, they’re free to do anything within reason. You will need to consult your surgeon regarding your unique circumstances.
Follow Up with Your Primary Care Provider
We think it’s critical for certain patients to have a short-term follow-up with their primary care physician (PCP). I’m a surgeon—I don’t follow chronic conditions over the long term. I want to keep the patient safe and get them back to the professionals who can manage certain chronic conditions.
Diabetics, for instance, can be challenging since their blood sugars will normalize rapidly. At discharge, we will discontinue most or all of the patient’s diabetes medications. Then, we request that they monitor their blood sugar four times a day and share those results with their PCP.
Those with hypertension might experience blood pressure fluctuations owing to fluid changes and reduced oral intake. We need them to monitor their blood pressure four times a day and bring the results to their PCP.
There are many other complex medical conditions where a short-term follow-up would be needed. If you have one of these conditions, your specific instructions will vary.
Follow Up with Your Surgeon
It’s imperative that you follow up with your surgeon following your sleeve gastrectomy. I usually have patients back two weeks after surgery so I can see that they’re advancing appropriately and aren’t developing signs of complications.
It’s also important to contact your surgeon about things that concern you. If you experience the following after your procedure, call your surgeon or proceed to the nearest emergency room:
- Chest pain
- Shortness of breath
- Persistent nausea and vomiting
- Unusual discharge from your incisions
Keep Walking & Drinking
Focus on the basics: walking and drinking. If you do both of these, you will prevent many of the complications that might emerge following sleeve gastrectomy.
Again, you should aim to consume at least 64 ounces each day. Your walking aim is to cover 50 to 100 yards each hour when awake. If you’d like to start a walking program, discuss it with your surgeon. I think it’s a good idea as long as you don’t overdo it.
Sleeve Gastrectomy Recovery
Sleeve gastrectomy can be a highly effective and safe option for individuals seeking to achieve significant weight loss and improve their overall health. However, the first month after a sleeve gastrectomy can be challenging.
If you do your part by walking, drinking, advancing your diet, staying active as directed by your surgeon, following up with your PCP when necessary, and seeing your surgeon at the scheduled appointment times, you will be doing what you can to make the first month after sleeve gastrectomy a safe period of health improvement.