Post Op Pointers

Post Op Pointers

Some questions people ask after they get home from hospital straight after Lap Band surgery are addressed in this section.jinx repellent magic formula foro

SHOULDER TIP PAIN AFTER SURGERYhondrocream

This is not uncommon after abdominal surgery as gas is sometimes left in the abdominal cavity despite the best efforts to remove it afterwards. This creates pressure under the diaphragm near the phrenic nerve causing irritation and referred pain to the shoulder. Another cause of shoulder tip pain can be swelling around liver from its being retracted during surgery causing swelling of the liver which also puts pressure on the phrenic nerve. The best way to deal with this is to lie flat on your back and rest. It can sometimes last as long as 24 to 48 hours after surgery if you’re unlucky, but it isn’t anything to worry about. If the pain continues or develops into something else, becomes much more intense, or you’re just plain worried, call Dr Nicholson’s rooms. A hot water bottle and/or some Aspirin can be very beneficial after the first 24 hours.

DEALING WITH YOUR SURGICAL WOUND SITES

Please refer to the informational sheet you have been given as part of your Lap Band package on the post-operative management of skin wounds. If you have any concerns at all about how the incision sites are healing please contact Dr Nicholson’s rooms. A general rule of thumb would be that if the site looks red, inflamed, is tender or feels hot, then you should definitely call the rooms for advice as to whether it is necessary for Dr Nicholson to see you.

NOT EVERYONE RECOVERS AT THE SAME RATE AFTER SURGERY

It is important to remember that you are an individual and that pain and injury is a very personal experience. Your ability to recuperate can be affected by many things. Feeling low emotionally, recently enduring stressful circumstances, a low pain threshold in general, and many other factors can mean your recovery time will be slow. If you’re positive and highly motivated to get moving you will often find that you recover quickly. It is also worth remembering, that even though physically you don’t have much to show for your Surgeon’s efforts (in the way of incisions etc) you have still undergone major abdominal surgery requiring the passing of instruments through layers of connective tissue, muscle and fat and your body needs time to readjust after the invasion. Conversely, and because it is laparoscopic surgery, your recovery time will be much faster than if the surgery had been done by open means (ie a large incision or cut).

CONSTIPATION POST OPERATIVELY

This is fairly common after any type of surgery. Prior to surgery you will have fasted for a minimum of 6 hours. This period of time usually extends out to even longer by the time you undergo the surgery. Coupled with general anaesthesia which sends all systems to sleep the emptiness of the bowel ensures that generally there will be no movement at the station for sometimes quite a few days after surgery. Do not overly concern yourself or become focused on not being able to go as this too prevents the desired results. Ensure you are drinking 2 litres of water a day. Use common sense, drink fluids including prune juice, apple juice or vegetable juice, keep active, take Agarol and if no results after four or five days you could try a suppository or Microlax or Rectalad enema. Remember also, that straight after Lap Banding your diet is straight fluid and has very little bulk so there will be very little to move through. Metamucil, Benefibre or Psyllium husks often have a place. As always, if worried telephone Doctor Nicholson’s room.

DIARRHOEA

Diarrhoea is not uncommon after surgery also. It is essentially the other side of the coin to constipation in that it is also caused by a lack of bulk (fibre) in the diet both before because of fasting, and after, because of the combination of fasting pre-operatively, and general anaesthesia. To treat the diarrhea you need to increase the fibre in your diet. How do you do this when you’re on fluids only you ask? Basically you need to add either Weetbix or Metamucil (half dose) to the fluids you’re having. You can thoroughly cook a mixture of vegetables until they’re completely soft, vitamise them and then water them down to fluid consistency. It is best not to take anti-diarrhoea medications as they will bind you up and cause the opposite problem. If you required an X-ray with oral dye intake, the “trots” invariably follow.

TAKING OF PRESCRIPTION AND OTHER MEDICATIONS

Be sure to crush tablets and wash them down with water or other liquids, do not take them whole. Very small tablets such as the contraceptive pill, or Thyroxine are okay not to crush. Capsules however, can be taken as is, washed down with a cup of hot tea. It might feel as if the capsule is stuck initially, however the hot tea should help it dissolve and wash it down into your stomach. Your Pharmacist can advise you whether you can crush your usual medications or have them dispensed in liquid or capsule form.

TAKING OF VITAMINS AND FISH OIL

It is only necessary to continue to take vitamin supplements and fish oil capsules whilst you might be getting sufficient nutrients in the liquids phase of the post-operative Lap Band diet. Once you begin the mushy phase and certainly once into the near normal diet phase, providing you are having a balanced diet that covers all the food groups, you should not need these extra supplements. Usually at 10 weeks post Lap Band surgery you can stop these supplements. If in doubt always discuss with your Doctor. Capsules of fish oil are best swallowed whole.

HEADACHES

Headaches are not unusual post operatively and right up until you return to a near normal diet. They are usually caused by insufficient fluids (dehydration) and nutrients. They can also be caused by the withdrawal of “drugs of addiction” like chocolate, coffee and tea, especially if you’ve been used to drinking three or four cups a day prior to surgery. If you need pain medication and don’t want to crush the tablets to take them with water, it is possible to buy a variety of the usual types (Panadol, Nurofen etc) in liquid or capsule form from your Pharmacy. If you do decide to use the tablet form – remember not to take it whole, but to crush and take with water. Capsules can be taken as is, washed down with a cup of hot tea.

POST OPERATIVE LETHARGY

Feeling tired and lethargic after surgery is very common. Because you have had general anaesthesia time is needed to process the anaesthetic out of your system. Obviously more anaesthetic is required to put a bigger person to sleep, consequently it will take longer for the effects of this to dissipate, sometimes days in fact. So don’t feel alarmed that you feel as if you can’t get your head off the pillow initially, this is a normal part of the healing process and once the anaesthetic has been eliminated you will begin to bounce back. Rather than fight against it, enjoy the rest! You may be tired for a couple of weeks, so give in, and go to bed early!

POST OPERATIVE BLUES

Post operative blues (depressive mood) can also be a side effect of major surgery and general anaesthesia. If you have a history of depression, this post operative state can be alarming, particularly if you have been enjoying recent good mental health. Be reassured, that in the vast majority of cases these feelings will pass after a few days as the effects of the surgery itself and the general anaesthesia are dealt with by the body. Remember that despite the Lap Band being placed laparoscopically (ie through small keyhole incisions) you have actually undergone major surgery and your body needs time to cope with the invasion. Add to this the lasting effects of the anaesthetic, and the realization that you have chosen to undertake a procedure that will drastically alter your eating behaviours at least three times a day, seven days a week for the rest of your life. This is a lot to take on board,

EXERCISE POST OPERATIVELY

Graduate your return to (or in some cases your initial foray into) exercise. If you sit about for days, then have a big outing (of any kind, be it exercise or just a social outing), then you will pay an exhausted price and quite possibly think you have taken a backwards step. To begin with, use common sense and set yourself small achievable goals like walking around inside the house from room to room doing small tasks like returning clothing or household items to where they belong. By moving around you get a sense of what you can cope with and therefore have a yardstick to go by. As the days go by extend the time during which you’re mobile until you have returned to your normal household, and beyond the home, duties. You might feel twinges of discomfort as your muscles repair themselves, however this will diminish over a period of weeks. Returning to formal exercise is a personal choice. Some people will feel happy to do this much sooner than others. You are the best judge of how your body feels and this should be the guide that determines just how far you should push yourself as your sessions increase in length and intensity. It is probably best initially to try walking and then work up from there. Don’t feel as if you’re going backwards if you find it takes you longer to recover between exercise sessions initially. Remember, your body is not only recovering from the exercise, but also from surgery. Movement, especially sit-ups, leg raises and stretching lengthens and shortens the “six-pack” muscle the rigid reservoir (the port through which fluid is added and removed) is fixed to, so this area may become very sore with too much movement in the early days.

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