LMarie1

I often times get asked what is the biggest piece of advice I could give someone for surviving their hospital stay. For me the answer is a hands down no brainer. CONTROL YOUR PAIN MEDS! Nurses and hospital staff will be in and out to see you, but you need to realize that each nurse probably has four to six other patients all vying for attention. It is your responsibility to take your pain management into your own hands. You do not want to mess around when it comes to managing your pain! If you are in pain you will be unable to get up and walk. The longer you take to begin walking the greater your risk of complication and the longer your hospital stay. In this case DO NOT BE A TOUGH GUY! Wuss out and take the meds.




You will be constantly asked during you hospital stay what your pain level is. It will be on a scale of 1 to 10 with 1 being no pain at all and 10 being the worst pain you have ever felt in your life. Be sure to answer honestly. DO NOT TRY TO BE MACHO! 3 to 5 on this scale is considered pain, but tolerable. If you drop below a 3 many doctors will begin reducing pain medication. Above 5 and they may begin increasing. The doctors and nurses want you in the blissful middle zone of 4 to 5. It should feel as though you have a bad muscle pull in your stomach, but no sharp or stabbing pain on a continual basis.

Your pain post-surgery will most likely be controlled in one of a two ways. The first is with a gloriously blissful device known as a PCA pump. This is a machine in which a syringe of Morphine or Fentanyl (depending on what your doctor and a hospital pharmacist deem to be appropriate) is placed to be administered to you at the push of a button. The best part is that you have control of the button! The machine can be set to allow you to administer the dose yourself every so many minutes; usually half an hour. The other way your pain will be managed is with an injection of morphine or fentanyl? This is pretty straight forward and don’t worry if you are scared of needles. This pain candy is injected into your IV.



Once you get past the injections or PCA pumps, usually once they take out your IV, you will most likely be weaned onto an oral pain medication of some kind. Many surgeons prefer Percocet for this application, but you may also be given an oral morphine. There is really no major difference between these in terms of effectiveness though there are other consideration that your doctor and a hospital pharmacist will use in consideration of which to give you.




It will be your job in the hospital to stay on top of when you get your pain medications. Here is what you need to know from an insider. I work as a pharmacy technician in a hospital so I am familiar with the workarounds. Here is the rule of thumb. The PCA pump will be available to you at your discretion and will most likely be hooked up before you wake up from surgery or shortly after, but injectables last about two hours and the oral liquid lasts about four. That is a very short window and you need to be sure to talk with your nurses and find out how long each medication is good for.

I made it a point to let my nurse know half an hour before each medication was due. This will allow them plenty of time to get your medication to you before time runs out. If the medication is not stocked on the floor then it will be delivered from the pharmacy and will take time. You want to give your nurse plenty of time to make this happen. Your nurse will not always remember when your pain meds are due so it will be your job to remind them. Remember, they have five other six people all needed medicines and all needing extra special attention so it is possible that you could be forgotten if you do not speak up. I am positive some nurses found me annoying, but other said they really appreciated the fact I was trying to stay so consistent with things and remind them. They key here is to be very nice and just let them know you are trying to stay on top of things since you know how the pharmacy works. Nurse’s love blaming the pharmacy for delays and they will love you for not blaming them. Far too many people do.

Running out of pain medication is a lot like falling off a cliff. You go down fast and it takes a while to climb back on top of it. So do yourself a favor and make sure you understand how long your pain medication will last and what types you are on. Make it a point with one of your final doctors’ visits prior to surgery to discuss what their plan for pain management will be and specifically which drugs he likes to use and why. With this in particular and your weight loss journey in general, KNOWLEDGE IS POWER! The power to finally begin taking control of your life. That is what this amazing journey is all about. This will be a great way to practice in the hospital before you get home and the real work begins!

With the New Year comes the New Year Resolutions. For many people, one of the largest resolutions is a change in lifestyle - that includes losing weight! I remember my resolution in 2012 was to lose weight and get healthy. And I was able to do that with the help of the vertical sleeve. 2015 is going to hold that for many people and thousands of people undergo weight loss surgery to help them achieve their healthy goals for the new year.
For those of you that are just thinking about surgery, I want to encourage you to know that you are not alone! You have a wealth of resources at your fingertips. I wanted to take a moment to share with you some amazing resources that you may find helpful on your journey!
Websites
BariatricPal.com Of course, BariatricPal is one of the very best websites to find information and support. Here there are “rooms” geared for each surgery as well as pages for recipes, articles, and much more. You will find information on everything you might want to know from before surgery to years after. I suggest checking out the Before/After pages for a good dose of motivation and inspiration!
7BitesShow.com 7 Bites is the first cooking series on YouTube geared specifically toward the bariatric community. The website has videos, recipes and blog posts.
weightlosssurgerychannel.com Weight Loss Surgery Channel has a collection of videos on everything WLS related weather it be health, food and recipes, and more.
BariatricFoodie The Bariatric Foodie has some great recipes for those that still love food, but want to stay on track
TheWorldAccordingToEggface Eggface is one of the most popular of the bariatric cooking blogs. You will find great recipes, blog posts and giveaways on her blog.
BariatricCookery.com This is a great resource page for everything from recipes to products.
Books
The “Big Book” series by Alex Breacher and Natalie Stein. There are four books in the series and all are great reads. They have a wealth of information on everything you need to know before, during and after surgery. The very best thing about these books is that they include personal stories from people that have been there.
Breaking The Chains: A Guide To Bariatric Surgery by Jennifer DeMoss and Suzette Munson. The ladies of 7Bites pull from their and others’ experiences with weight loss surgery to provide a simplified, but comprehensive guide. Information on everything from how to pick your surgery and doctor to how to survive the first two weeks after surgery are included.
The Sleeved Life by Pennie Nicola. This book tells about Pennie’s experience with the Vertical Sleeve procedure and discusses the ins and outs of the surgery from start to finish.
Weight Loss Surgery For Dummies. The everything you ever wanted to know and then some guide to all things weight loss surgery. Many, MANY doctors and nurses recommend this book to their patients.
Another great resource not listed here is your local bariatric support group! If you haven’t found one yet, contact your Surgery Center of Excellence or your nutritionist, they should be able to give you a good idea of one or two in your area. Or you can check out the list here on Bariatric Pal - it’s a very comprehensive list of support groups around the world!

Pre-Op Diet
The pre-op diet has a few purposes. The critical one is to shrink your liver so it’s not blocking your surgeon’s view of your insides during surgery. That makes your operation easier and safer.
The pre-op diet also helps you lose weight. That may be surprising since you’re expecting to start your weight loss after surgery, but it’s actually a good idea to start losing weight beforehand. In fact, the more you lose before surgery, the safer surgery will be, and the better you’ll feel afterwards.
Different surgeons suggest different pre-op diets. The diet has about 1,000 calories. It could depend on lean proteins and other nutrient-rich foods, or it could be a liquid diet with protein shakes. Or, it could be a combination of the two, with each day including two protein shakes as meal replacements plus one meal with vegetables and protein.
The pre-op diet can last from a few days to several weeks or even months. In general, the longer you’re on it, the better. You’ll lose more weight, shrink your liver more, and gain confidence that you’ll be able to continue a strict eating program long-term after surgery.
Get in Shape
Why exercise before surgery? One reason is that, like with a good diet, it can make surgery safer. In this case, it’s because exercising can strengthen your heart, lungs, and blood vessels. Of course, exercise also burns calories and can help you lose a little extra weight before surgery.
Another reason to get in shape before surgery is because it will make recovery easier. Many weight loss surgery patients find that walking around the house and then the neighborhood is their best tool for fighting post-op pain. If you’re used to being active before surgery, you’ll have an easier time walking after surgery.
You don’t need to go crazy on your pre-op exercise regimen. If you’re not used to exercising, start small. As long as your doctor approves you to be active, just find a few minutes each day to walk at a comfortable pace.
Clean and Stock the Kitchen
Fact: you can’t eat food that’s not there.
So, clean out your kitchen. Get rid of sugary desserts, starchy snacks, and fatty meats and cheeses. Anything you know you shouldn’t be eating shouldn’t be in your kitchen. Get rid of it before surgery because for weeks after surgery, you won’t be physically able to carry out heavy trash bags filled with forbidden foods.
Once your kitchen is cleaned out, stock it up! At least get the protein shakes and powders you’ll need for weeks or more after surgery. Consider getting some flavored water in case you’re unable to tolerate water post-op. You can also stock up on non-perishable staples, such as canned chicken and tuna, frozen fruit and vegetables, and instant oatmeal packets.
Take Your Nutritional Supplements
You know you’ll be taking nutritional supplements post-op. If you have the sleeve or bypass, you’ll be taking them for life. With the band, you’ll need supplements for months, years, or life. Did you know you shouldn’t wait until after surgery to start taking your supplements?
At a minimum, take a multivitamin beginning when you start your pre-op diet. Even if you’re eating a balanced diet, the supplement helps make sure your body has the nutrients it needs to heal your surgery wound. Also, it’s an insurance policy so that if you have trouble eating and swallowing supplements for a few weeks after surgery, your body will still have a good store of nutrients in reserve.
Practice Your Healthy Eating Habits
Consider the pre-op period practice for the post-op diet. That includes eating slowly, measuring portions, and choosing nutrient-dense instead of processed, high-calorie foods. Also consider making exercise a habit now, so it’s easier to get back to it after surgery.
You cannot guarantee an easy surgery, but you can certainly do a few things to improve your chances. Use these tips to take control of your pre-op prep as soon as you’re ready to lose weight and get healthy!