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Sanford Weight-Loss Surgery

Post-surgery

What can I eat after surgery?

Most patients can eat anything—just remember to chew very thoroughly. Some patients cannot tolerate certain foods they ate before the operation. Each patient is different.

How often do post-surgery patients need to eat a day?

It is recommended that they eat small quantities at least four to five times a day for the first six months. After six months, three to four small meals a day at regular intervals is necessary to avoid episodes of hypoglycemia.

Are there any foods that cannot be eaten after this operation?

Vegetables, fruits and meats should be avoided during the first six weeks. Patients may have certain food intolerances but it varies from patient to patient. If you try something and it does not agree with you, stop eating it and try again in a few months.

Am I really going to be able to eat only a tablespoon of food at a time forever?

No. After a while when you have learned to eat and chew properly, your typical meal will be approximately 25 percent or less of what you could eat before the operation.

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Since portions have to be so much smaller after surgery, will I ever feel full?

Yes. The nerve endings in your stomach that tell your brain you are full remain intact after surgery and work just like they did before the procedure. Essentially, your brain doesn't even know that your stomach is smaller.

What happens if I eat too much?

You will regurgitate. Be sure to stop eating when you feel full.

Can I drink alcohol or smoke after surgery?

We strongly recommend that you do not. However, there is some merit in an occasional glass of wine.

Can I drink eight glasses of fluids a day as recommended?

We do not recommend that you drink eight glasses of any fluid a day. If you must, it can be done, but drink small amounts at a time. We recommend drinking between meals in quantities necessary to quench your thirst. It is not advisable to eat and drink at the same time. Most patients have learned to carry a water bottle and take sips between meals.

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What is the popcorn test?

Some patients think the opening out of the stomach pouch is too small, thus causing them to regurgitate. To differentiate whether the vomiting or regurgitation is due to the patient eating or drinking too fast or the patient not chewing adequately before swallowing versus there being a technical problem, the patient is advised to eat some popcorn. If the patient eats the popcorn with no regurgitation or vomiting, then there is no mechanically obstructive problem with the operation. The patient is eating too fast, chewing inadequately or swallowing large quantities at a time. Popcorn can only be swallowed after chewing well and swallowing small quantities.

Is hair loss common?

Yes. Hair is a product of protein breakdown. Any time you go through rapid weight loss, you can experience hair loss. Interestingly, some patients don't experience this at all. This is a temporary problem. It is usually during the third through the eleventh months after the operation, the period of rapid weight loss. Then it returns to normal.

Is there anything I can take to prevent or minimize hair loss?

Increasing protein and zinc supplement intake can help.

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What is the follow-up routine for post-surgery patients?

Usually patients are scheduled for a follow-up office visit between seven and 10 days after discharge from the hospital, then again at four to six weeks. You can make appointments to be seen at intervals more frequently if needed.

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What is hypoglycemia?

It is a condition of low sugar in the blood.

What are the symptoms of hypoglycemia?

Pounding heart beat, light-headedness, sweaty, clammy palms and a queasy feeling. One or any combination of the above can occur.

What is the cause of hypoglycemia?

Usually it is due to not eating enough calories and going for long intervals without eating. Sometimes it is caused as a reaction to eating sweets.

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What is a hypoglycemic attack?

It is very similar to the dumping syndrome in that the person experiences the same queasy feeling. The person is nauseous, shaky, clammy and sweaty. The patient may experience a rapid and pounding heart beat. However, the cramps and the urge to have a bowel movement are not part of the reaction. The attack usually occurs between meals and is due to inadequate food intake or a long interval between meals. The best treatment is prevention by eating a balanced diet at regular intervals.

What should I do if I am having a hypoglycemia attack?

Find a place to sit down or lie down. Eat as regular a meal as possible after the attack.

What is dumping?

Dumping is when, after eating or drinking, you hear or feel your heart pounding and you feel clammy, sweaty or shaky. You may also feel the urge to use the bathroom. Any combination of the above symptoms can occur either mildly or severely depending on what you ate. Some patients experience it after too much sugar intake and others after much fat or greasy food intake. Try to avoid sweets.

How do hypoglycemic attacks differ from dumping syndrome?

Dumping syndrome usually occurs after eating or during eating, whereas a hypoglycemic attack is usually between meals or due to lack of meals.

What do I do when I experience dumping?

Sit or lay down. It normally goes away in less than 30 minutes. Make a note of what you just drank or ate. After several episodes of dumping you will know what foods or drinks to avoid.

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Will I experience phlegm or mucus build up?

Usually you will experience this in the morning when you wake up. Also, if you're not eating often enough during the day, you might experience mucus build up. This will decrease after the first year of surgery.

Will I vomit or have diahrrhea after surgery?

These are not expected outcomes, but they do occur. Call the clinic if you experience vomiting or diarrhea frequently. Certain foods can cause diarrhea. Also, you can still vomit if for example you are sick, eat too fast or swallow poorly chewed foods.

When I get ill, do I vomit with acid and/or bile?

No. In this operation, the stomach and the area where the bile empties to the bowel is bypassed. You will probably have the dry heaves. If you vomit bile or acid you should contact the clinic immediately.

Do I have to take vitamins for the rest of my life?

Yes. Surgery reroutes your food's pathway, decreasing nutrient absorption from ingested food; therefore, it is highly recommended.

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What vitamins should I take and why?

You should take a multivitamin with an emphasis on vitamins A, D, E, calcium, iron, B1 and B12. Important parts of the stomach and small bowel intended to absorb vitamins have been bypassed in surgery.

Do I need to crush my pills?

Not necessarily. Some patients can swallow pills whole. Others crush them or cut them up before swallowing.

Can I buy vitamins from regular drug stores or does it have to be the ones from the pharmacy?

You can purchase them at any drug store. Just make sure they're the same type of vitamins and the same quantity as recommended by your surgeon.

What happens if I don't take vitamins?

You can develop vitamin deficiencies, including neurological alterations, skin changes and other metabolic abnormalities. They are difficult to diagnose and may take time to correct. Vitamins, calcium and iron supplements should be taken life long after this operation.

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