Bariatric (Gastric Bypass) Surgery

The surgeon
The anesthesiologist who will administer the anesthetic during your surgery
A physician’s assistant, a specially trained professional able to help the physician in many tasks
Your primary care physician
Consult physicians, if your medical condition so requires
Nurses
Lab and X-ray personnel
An exercise physiologist who will work with you on rehabilitation after your surgery
A social worker who will help you with planning needs after you go home
A dietitian

Many others who are here to make sure you receive the best possible care

Before the surgery…
You will be asked to drink high protein-filled liquids 10 days before your operation. This diet helps shrink the liver and gets you used to diet you will be living on for several weeks following the surgery.

The day of your surgery…
Arrive at Mercy Health Partners at least 2 hours before your scheduled surgery. You may take any medications you need, but do so with only a sip of water. You are NOT to take aspirin, blood thinners, diuretics, insulin or blood sugar lower drugs. Call the doctor’s office for special instructions regarding these medications.

What can I expect to experience immediately after surgery?
On the day of your surgery, you will only be allowed to eat ice chips. One day after your surgery, you begin Phase 1 of your post-surgical diet. This diet consists of clear, sugar-free or no sugar added liquids and continues for the duration of your hospital stay.

You MUST:

Walk a little the evening of the surgery
Do Range of Motion exercises (your nurse or exercise physiologist will guide you through this)
Cough and do deep breathing exercises
Use the Incentive Spirometer (a machine that helps clear the lungs to avoid the onset of pneumonia)

Your nurse will instruct you on pain management and you will be given a prescription for nausea.
You must NOT cross your legs.
Your family and friends may visit you from noon to 8 p.m. during your hospital stay.

How long will my hospital stay be?
Laparoscopic gastric bypass surgery requires a hospital stay of 2-3 days. Open gastric bypass surgery requires up to a 5-day stay.

How much weight can I expect to lose and in what time frame?
Gastric Bypass Surgery is only a tool to help you in your weight loss effort. Since no two people are alike, weight loss varies from patient to patient depending on a number of factors: age, weight before surgery, overall health, ability to exercise, your motivation and the cooperation of your family, friends and other people with whom you associate. The biggest secret to success is adhering to the dietary guidelines and exercise routines developed for you by your physician and exercise physiologist and continuing your long-term follow-up care.

Weight loss surgery success has been defined as achieving a loss of 50 percent or more of excess body weight and maintaining that loss for at least five years.

What will my diet be like after surgery?

The modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss. Post-surgery dietary guidelines will vary by bariatric surgeon. You may hear of other patients who are given different guidelines following their morbid obesity surgery. It is important to remember that not every bariatric surgeon performs the exact same weight-loss surgery procedure and that the dietary guidelines will be different for each surgeon and each type of procedure. What is most important is that you adhere strictly to your surgeon's recommended guidelines. The following dietary guidelines are what a patient of Mercy Health Partners ’s Gastric Bypass Surgery must follow to ensure proper nutrition for optimum recovery and results:

Phase 1: Clear, sugar-free or no sugar added liquids
You will be given a clear liquids diet while still in the hospital. Such a diet includes: water, ice chips, 100% juice diluted 50/50, decaffeinated coffee and tea, low sodium broth, and sugar free Popsicles.

Phase 2: Full liquids
This phase begins the day after your discharge from the hospital and lasts about three weeks. This phase consists of high protein liquids such as fat-free milk, 1% or 2% milk mixed with protein powder. Other options are high protein clear soups, high protein hot cocoas, high protein shakes, high protein gelatins, high protein fruits drinks or strained cream soups with fat-free or 1% milk.

Phase 3: Soft foods
The dietician determines when you are ready for Phase 3 with this phase lasting another 3 to 4 weeks. Foods in this phase include high protein soft foods and liquids, such as fat-free or low fat cottage cheese, no sugar added yogurt, fat-free refried beans, reduced fat cheese, eggs or egg substitutes, well blended canned fruits, vegetables or vegetable soups. These foods are eaten in addition to the foods included in the previous two phases. REMEMBER that fluids must be consumed BETWEEN meals, not with meals. Follow the 30-minute Rule: “Do no drink fluids 30 minutes before or 30 minutes after ANY meal.”

Phase 4: Regular foods
The dietician decides when you are ready for this phase and takes you into it under his/her guidance. This phase includes eating smaller amounts of food much more slowly and eating 3-4 small meals a day. You should eat your protein-rich foods first, then follow with vegetables and then fruit if your stomach still has room. Again, follow the 30-minute Rule.

When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.
Follow guidelines so as to maintain a fluid intake of 64 ounces each day.
Take your multi-vitamin supplements—it’s vital to your overall health and wellbeing and must be taken every day for the rest of your life.
Eliminate desserts and other items with sugar listed as one of the first three ingredients.
Eliminate carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.
Eliminate citrus fruits (oranges, grapefruits, pineapples, tomatoes, etc)
Eliminate refined starches and starchy vegetables (white rice, white bread, bagels, muffins, grits, rice cakes, popcorn, rolls, pancakes, waffles, mashed potatoes, peas, and corn)
Avoid alcohol. Alcohol increases your risk of dehydration and it has absolutely NO nutritional value.
Limit snacking between meals.

Is it possible to become obese again?
Yes it is possible to “out eat” your pouch. That is why you much continue to follow new dietary guidelines for the rest of your life.

When will I be able to return to work?
Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity and the type of weight loss surgery you had. Many patients return to full pre-surgery levels of activity within six weeks of their morbid obesity procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a few weeks.

How long must I wait before I try to get pregnant?
Because of the added demands pregnancy places on your body and the potential for fetal damage you MUST wait 12-18 months before conceiving.

What about my follow-up visits with the doctor?
You will have your first post surgical official follow-up about 7 days after your surgery. At this time, you will meet with the surgeon and nurse coordinator to discuss any problems you may be having. You will also be scheduled to meet with a dietician to discuss your individual diet.

What about long-term follow-up?
You will be required to attend long-term office follow-up in our program to track your post-surgical and behavior modification progress. Typically, these post-operative follow-up visits are at 7 days, 3 weeks, 7 weeks, 3 months, 6 months, and again at 12 months after surgery. You will have to have annual follow-up visits after that. However, this follow-up schedule may vary from person to person. You will be advised to go to the psychologist for behavioral health counseling to help you develop strategies to make and maintain the necessary lifestyle changes after your surgery.

Are there any support groups in the area that can help me when I feel I am losing my weight loss battle?
Yes, MHP also has Bariatric Support Group to help you achieve the greatest level of success and recommends you attend meetings as often as possible before and after your surgery. The widespread use of support groups has provided weight-loss surgery patients an excellent opportunity to discuss their various personal and professional issues. Most patients learn, for example, that weight loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being.

What exercises are best to help me achieve my weight loss goal?
Everyone is unique and because of this, your exercise program may differ from other people who have undergone this surgery. At MHP, you will undergo a post-operative consultation with an exercise specialist at the Mercy Heart Center 3-6 weeks after your surgery, depending on the procedure used to perform your surgery (open or laproscopic). Your exercise advisor will evaluate your current physical ability and exercise needs and tailor an exercise program for you. As your strength and endurance increases, your advisor will adjust the program.

Will my insurance carrier cover the cost of this surgery?
Each insurance policy is different so it is up to you to check with your insurance carrier to make certain bariatric surgery is covered.