General
| |
Not
every patient requires to undergo surgery. Many of the overweight
patients can reduce their weight by supervised diet and exercise
management. |
Preparation for Surgery
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Before surgery your surgeon requires to know
your physiological status and asses your co morbid conditions. Hence
you are required to do few investigations
Pre
Operative Investigations :
BLOOD : Hemogram
Blood sugar levels, both fasting and after lunch Blood urea levels
& S. creatine Lipid profile Liver function tests Thyroid
function tests
URINE : Routine and Microscopic Abdominal
sonography, X ray chest ECG Pulmonary function tests Upper GI
endoscopy
Visit to a Nutritionist :
Your nutritionist is one of the important
part of your team who will be guiding you towards weight reduction.
Preoperatively she will instruct about a suitable diet to reduce the
size of your liver. She will also brief you about post operative
diet modifications.
Visit to a Psychiatrist :
To make your life
comfortable after surgery, psychiatrist also is a important part of
the team. He will advise you about lie style modifications as well
as behavioral modifications.
Visit to a Anaesthetist :
Obesity
surgery is a major surgery. It requires general anaesthesia during
the procedure. To make yourself safe for surgery, anaesthetist
will evaluate before surgery with respect to general anaesthesia.
During this visit anaesthetist will go through all your
investigations allready done. He may advise you according to
your physiological
status.
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Surgery
| | Is it
safe :
Obesity surgery carries risks
not more than any other major surgery .By doing various tests and
your evaluations before surgery it reduces the disease related
risks.
What do I expect from Surgery
:
Obesity surgery is a tool and not a complete treatment for
obesity. It is important to have a regular follow up, controlled
supervised diet, and regular exercise for weight loss. It is
possible that your diabetes as well as hypertension may get
partially or even completely resolved
Will obesity surgery work for me ?
Nothing can be guaranteed. However, obesity surgery has
proven track record of success in achieving sustained weight
loss over long period of time. Lapband will cause wt loss at
average of about 55 % of excess body weight over long period
of time. The incidence of failure of obesity surgery is
rare.
How
much weight will I loose ?
It is not
predictable. But after lapband one looses 60% of excess weight
in 18 months.
Types of
Surgery :
Adjustable gastric banding
Sleeve gastrectomy
Gastric by pass procedure
Advantages of
laproscopic surgery:
It causes less
discomfort
Requires a very short stay after surgery
Early resumption of work
What will be my diet after surgery :
On
a day after surgery, if your swallow study is ok you will begin sips
of water. However you will Not use straws or
carbonated beverages. You will start only with small amount of water
to avoid over filling of the gastric pouch. If you tolerate clear
water, you may be allowed to have lime water or electral water. On
the third day when you tolerate clear lyquids without vomiting
you will be shifted to caloric dense liquids and with clear lyquids.
Gradually over the period of days you will drink more quantity
of calric dense liquid with water.
Your first priority will
be to drink enough fluid to prevent dehydration. Protein rich fluid
is your second priority supplementing with appropriate vitamins and
minerals. However always avoid food stuff that is high in fat, fibre
(fruits & vegetable) and sugar.
Success to adopt to this
modified food lies only with you. Always eat slowly and avoid over
eating. Chew well your food & avoid drinking fluids 30 minutes
before and with meals. Avoid sticky foods like cheese, pasta or
bread. Also avoid any hard to digest food. Never have airated
beverages and foods at extremes of temperature. And lastly try one
new
food at a time. |
Hospital Stay
| | Generally you are required to get admitted in
hospital few days in advance. Depending upon type of surgery
performed your stay in hospital vary. However, generally most of the
patients go home three to four days after
surgery. |
Life after surgery
| | Immediately after surgery you will be put on liquid only
diet. Your nutritionist will be with you to guide you about your
diet.
Will I have any difficulty in
medications :
Generally when you start loosing weight,
your requirement of medication for control of diabetes or high blood
pressure starts reducing, the dosage modification will be done by
your physician. Sometimes large pills may require to be crushed
before swallowing.
Pregnancy after
weight loss surgery :
Obesity surgery is a major surgery.
after surgery during a weight loss phase major metabolic as well as
hormonal changes are occurring in the body. Hence it is advisable to
delay the pregnancy for at least by one year.
Which type of food ?
In beginning you will be on liquid diet, gradually going
to solids. However you will not eat solid tough, dry meat
,high fiber containing vegetables, skinny fruits like grapes.
Bandsters can have anything but in small
quantity.
What should I
eat ?
Any high quality protein produce is
advisable. Chicken, fish and certain vegetables is good
combination. Although red meet is high in protein content it
is a fibrous type of food stuff, hence avoid red
meat.
Will I suffer from
constipation ?
Not necessarily. As your intake
is less, stool volume also be less. You will be given a mild
laxative but a large quantity of water is good
idea.
Can I have
alcohol ?
Alcohol is a stomach irritant. It
also provides lots of calories, which is not advisable. Since
beer is a carbonated drink it stretches the stomach pouch so
avoid it. Very occasional intake of alcohol may be
allowed.
What happens
when I am sick ?
If you have a gastric band,
important advantage is it is adjustable. If your condition
requires to have large quantity of food, one can always remove
water from the band thus deflating it. The band can be
readjusted when you come to normal.
Do I need to remove the band if
my weight is optimal ?
Most patients will
plateau in their weight loss when their weight approach to
normal. However band may be adjusted appropriately if you
continue to loose weight beyond your ideal weight. Most banded
patients will regain most of all their excess weight when band
is removed.
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