After your surgery, you will remain in the Recovery Room for up to two hours before going back to your room. Nurses will be monitoring your breathing, blood pressure, and heart rate closely. You will be asked to rate your pain a scale of 0-10 with a “0” representing no pain and “10” representing severe pain. It is important for you to communicate this information to your nurse. You will become aware of monitors and tubes such as intravenous (IV), oxygen or drainage tubes as you wake up. You may feel somewhat groggy, nauseated, and/or dizzy. Once you have met the discharge criteria, you will be transferred to your room.
The following pages will go over your post-operative surgery procedures. Most metabolic and bariatric patients are brought back to their room on the 2S surgical unit once fully awake. Upon arrival, the staff will be closely monitoring your vital signs and pain level. The staff will provide you with a copy of "Your Daily Recovery Goals" checklist. This will guide you and your family through your hospitalization.
- INTRAVENOUS THERAPY: You will have an intravenous line for hydration and administration of medication.
- PAIN The staff will assess your pain level on a scale of 1-10 with "0" being no pain and "10" being severe pain. Good pain control is important to ensure a quick recovery. It is our goal to keep your pain level less than "3" or at a level that is acceptable to you.
- DVT (Deep Vein Thrombosis) PREVENTION: You will have compression devices on your lower limbs. These devices are designed to compress the superficial veins in your legs to prevent blood clots from developing in your lower extremities. The compression devices will be removed while you are up and walking. Early ambulation is very important in preventing DVT's. You will also receive daily doses of a blood thinner to help prevent blood clots.
- ACTIVITY: Early activity is very important in preventing severe postoperative complications such as DVT's, pneumonia, and pulmonary embolism (a blood clot which develops in your legs and then travels to your lungs). You will be required to walk in the hall the first evening on your day of surgery. You will then be expected to walk in the halls at least 5-7 times daily.
- RESPIRATORY CARE: You will have oxygen delivered through a pain of small nasal cannulas placed in your nostrils. The staff will be monitoring your oxygen levels using an oximeter. This is a small clip like device which can be placed on a finger or earlobe. Patients with sleep apnea, you will be instructed on using your CPAP/BIPAP at night. You will also be placed on telemetry monitoring with continuous pulse oximetry. This means that both your heart rhythm and oxygen levels will be continuously monitored by staff in the critical care units. All patients will be expected to take deep breaths and cough every hour. The respiratory therapist or nursing staff will provide you with an incentive spirometer and Vibrapep. This deep breathing device is intended to assist you in your recovery and prevent respiratory complications. You will be expected to use your incentive spirometer and Vibrapep 10x every hour while awake as directed.
- INSTRUCTIONS FOR USING A SPIROMETER:
Follow these simple instructions:
- Sit up as straight as possible. While in bed, sit up as far as you can.
- Hold the incentive spirometer upright
- Breathe out normally.
- Place mouthpiece in your mouth and tightly seal your lips around it.
- Inhale slowly and deeply to raise the small floating disk as high as you can.
- Hold your breath for 5 seconds. Remove the mouthpiece from your lips and exhale normally.
- Allow the floating disk to fall back to the bottom of the chamber.
- Hold your breath for 5 seconds. Remove the mouth piece and exhale normally
- Allow the floating disk to fall back to the bottom of the chamber. Rest for a few seconds and repeat. Remember this must be done at least 10 times per hour. As you work at it, the distance you move the floating disk will increase. This means you are moving larger volumes of air in and out of your lungs. This is what we want! It is important to continue with your deep breathing and coughing and your incentive spirometer once you are discharged home.
Diet & Discharge
DIET: You will not be able to take anything by mouth for the day of surgery except for ice chips. On Post Op Day 1. You will be advanced to a Clear Bariatric Liquid Diet. You will be given small medicine cups to drink from. These cups are graduated so you can keep track of how much you are drinking. The small cups also ensure that you are sipping small amounts at a time. NO STRAWS ARE ALLOWED. SOME MEDICATIONS WILL BE CUT, CRUSHED, OR IN LIQUID FORM. Let the staff know if you are experiencing any nausea. Your physician will have ordered medication to help alleviate and prevent nausea.
Prior to your discharge from the hospital, the nursing staff will provide you with specific discharge instructions. They will review this information with you and answer any questions. You will received specific instructions regarding activity, diet, incision care, medications, and respiratory care. You will instructed when your follow up appointment is set with your surgeon. This follow up appointment is usually made during your pre-op visit.