Tag: <span>Post-Surgery</span>

I went to my GP yesterday to get my bloods done. This is part of the regular blood tests that I’ll have to get done, to check that the vitamin and mineral levels in blood are good following my bariatric surgery.

My bariatric team requires that I get bloods done:

  • Every 3 months for the first year
  • Every 6 months for the second year
  • Once a year thereafter

I could get my bloods done in the private hospital where I had my operation, but that’s really expensive. I’ve done it in the past, and it’s cost me around €70-100 for each visit. And the public hospital phlebotomy clinics are a bit hit and miss in terms of how long you have to wait.

It’s much easier for me to visit the nurse in my local GP surgery. It does cost me €35 to visit, but the benefit is that the surgery is only a 5 minute walk from my house, so it’s a quick visit.

I also needed to get an injection of Neo-Cytamen (vitamin B12) so I got that done as part of the same appointment. And for an added bonus the nurse also gave me a seasonal flu shot for free as well. So I have ended up with many holes in my arms!

Blood test protocol following bariatric surgery

  • FBC
  • U&E
  • LFTs (including Albumin)
  • Thyroid function tests (TSH, free T4)
  • Bone profile (calcium, phosphate, ALP)
  • Vitamin B12
  • Folate
  • Iron studies (ferritin, serum iron, TIBC)
  • Zinc
  • Lipid profile
  • Magnesium
  • 25-Hydroxyvitamin D

Medication Surgery

As a larger person I used to look on bemused when thinner colleagues in the office used to complain about being cold. I would check the thermometer and see that it was in the 20s, and wonder why they complained so much.

Now I understand what it’s like a lot more, because I’m cold all of the time!

I have a thermometer in front of me in the room, and it’s currently 23.5 degrees celsius – and yet my hands are like blocks of ice, and I’m contemplating putting another jumper on.

In the past before my surgery I used to eat between 3000 and 4000 calories a day, so I was consuming plenty of energy to convert into heat. Whereas now – five weeks after my weight-loss surgery – I’m only consuming about 600 – 1000 calories. My body seems to be thinking WTF and not wasting any of that precious energy on keeping me warm.

I guess as I continue to lose weight, I’m also going to lose the protective layer of fat around my body – my insulation – and so any heat I do have is going to escape even more easily.

I’ve heard that eventually the body will get used to the new weight and start to regulate temperature a bit better. But until then, I guess I’ll need to put on load of layers – especially as winter is on the way!

My Story Surgery

I thought I’d talk a little about the pain I experienced after surgery.

For the first two days, when I was still in hospital, I was in a lot of pain – particularly on my left hand side, which was the side (my surgeon explained to me) where most of the “work” was done during my bypass. Apparently there was a deep stitch in my muscle on that side, and that was the cause of a lot of the pain.

During these two days I couldn’t get enough pain medication inside of me. I must have been asking the nurses for drugs quite regularly, as they kept saying they couldn’t give me anything else for an hour or two. At the time I was rating the pain at about 7 or 8 out of ten.

Upon discharge from hospital I had a presription for Solpadeine Max, which is a combination of paracetemol and codeine. And for the next two days, I took three doses of them a day. During that time the rating for pain was more like 2 or 3 out of ten.

And then after that, I didn’t feel like I needed any more pain relief, so I stopped taking the drugs.

In total I only had pain for 4 days. After that I still had some discomfort when bending over to trying to lie on my side, but even that has continued to diminish over time, so that today – 12 days on – I don’t feel any discomfort at all.

A few days ago – on day 9 after surgery – I also got to take off the dressing on my surgical wounds, and they’re all fine and healing well. There were 5 incisions for the lapracopic surgery, but they’re all quite small – varying from 1cm to 2cm long.

The wounds aren’t sentitive at all, and don’t hurt if I touch them.

All in all, I was surprised at how quickly the pain went. I was expecting to be taking the pain medication for a couple of weeks.

My Story Surgery

I learned a valuable lesson today about not eating too quickly, and making sure I chew my food properly.

I had a call with my dietician yesterday, and she said that now that I’m a week after the surgery I can progress from a liquid to a soft food diet. I was pleased to hear that news because it meant that I could have a small amount of mashed potato with some baked beans for my dinner for the first time in about 3 weeks. And I love potatoes!

So this morning I was perhaps a little too excited to expand my culinary choices, and I ended up cooking myself a small mushroom omlet. I figured that both the eggs and mushrooms were soft foods, so I would be ok.

Unfortunately I tucked into it with a bit too much enthusiasm, and forgot to chew everything fully and to pace myself. So about halfway through eating it, I got a pain in my chest, and I knew pretty quickly that something was stuck. I guess maybe one of the bits of egg or mushroom got trapped in my new stomach pouch.

I wasn’t able to shift the blockage. Sipping water didn’t seem to help clear it either. And after another couple of minutes I got the sensation that I needed to throw up. Luckily I was near the bathroom at the time, because it came up quite quickly. In fact I vomited twice, about 5 minutes apart, and all of the egg and mushroom came back out.

And when I blew my nose after vomiting, there was egg in that too! Ew!

Anyway, so I guess I need to slow down a bit, in a number of ways:

  • I need to slow down when eating. I need to take really small mouthfuls, and also remember to chew everything about 20 times before swallowing. I also need to put down my fork between mouthfuls to slow everything down.
  • I need to slow down my enthusiasm about getting back to normal eating. It’s going to take a couple of months for my new smaller stomach to heal fully, and I need to be more careful about re-introducing foods into my diet, and not rush to reintroduce foods.

After all I hate vomiting. And I don’t want to be doing it too often because that can’t be good for the new stomach either.

Diet Surgery

As I prepare for my bariatric surgery, one of the things I’ve had to get my head around are vitamins and minerals.

I’ve learnt that in both the pre-surgery and post-surgery diets it’s important to have vitamins and minerals supplements, because I’m not going to get enough of them from food in the restricted diets.

Getting the right supplements

So here’s the basics of what I’ll need to start taking every day:

  • 1 or 2 Multivitamins (with a minimum of 14g of Iron)
  • 3 doses of Calcium Citrate, combined with Vitamin D

Some dietitians recommend special bariatric multivitamins, as they contain a balance of vitamins specially formulated for bariatric patients. However it also seems you can get away with standard multivitamins, if you can also add in an additional dose of vitamin B12 and vitamin D.

I bought a whole load of standard multivitamins before I even realised there are special bariatric ones available. I also bought calcium carbonate supplements instead of calcium citrate.

Apparently the calcium citrate is better absorbed by bariatric patients, as it doesn’t need stomach acid to breakdown, and it also helps avoid getting gallstones. So I might need to get new calcium tablets.

Pre-surgery

Pre-surgery diets seem to vary, but all of them seem to recommend starting on the multivitamin and calcium citrate supplements when the diet starts.

For two weeks before surgery I’m going to be limiting myself to just 800 calories a day. This restrictive diet helps shrink the liver and make the surgery easier and safer. But the diet also means that I’ll not be getting all the vitamins I need from food, so I need help from the supplements.

Post-surgery

For the post-surgery diet, I learned that it’s important to have chewable or liquid supplements. For the first few weeks after surgery I’m going to be on a liquid-only, and then a pureed-food diet. And during that time I’m not going to be able to swallow any pills or capsules.

I’ll need all my medication and supplements to either be crushed into powder. And some medications that are not intended to be chewed can taste really bad, so I might need to mix them with something else to disguise the taste. Or, just get them in a chewable form.

Some multivitamins are available as gummies, but I’ve heard they can cause problems unless they are chewed really well before swallowing.

For the first 2 months I’ll need to take three calcium supplements and two multivitamins – all spaced out by at least two hours.

Time / MealSupplement
8.00am BreakfastCalcium Citrate (500-600 mg)
11.00am SnackMultivitamin with Iron
1.00pm LunchCalcium Citrate (500-600 mg)
4.00pm SnackCalcium Citrate (500-600 mg)
7.00pm DinnerMultivitamin with Iron
Example pre-surgery supplement plan

After 2 months

When I’m back on real food, a couple of months after surgery, I believe I’ll be able to tolerate tablets again, so I won’t need chewable supplements. But I will need to continue taking the calcium citrate and multivitamin supplements for the rest of my life.

I’ll also need to get regular blood tests to make sure I have enough vitamins and minerals in my blood, as a gastric bypass permanently limits the absorption of iron, vitamin B12, calcium and vitamin D.

Medication Surgery