Lap-band Surgery Pain Control
The pain associated with surgery is much less with the Lap-band than other surgeries. This is because the lap-band is far less invasive than other weight loss surgeries. None of your intestines are bypassed or removed. Your stomach also remains in tact untouched by surgery with only the addition of the soft and supple Lap-band. Comparatively speaking the Lap-band is easy to heal from, allowing you to more quickly get back into your life.
For the first three days you may find that Ibuprofen, or other non-steroidal anti-inflammatories (NSAID) work better for pain than narcotic pain relievers. You can use use up to 800 mg of Ibuprofen (Motrin or Advil are the trade names) every six hours (four tablets of 200 mg Advil). Try to not take ibuprofen on an empty stomach and make sure you are well hydrated. You should not take ibuprofen if you get dehydrated or if you have a history of stomach ulcers. If you have trouble swallowing pills, you can use an equivalent amount of liquid ibuprofen or liquid Motrin. Whenever you take any NSAID it is helpful to take an antacid such as Pepcid, Nexium, to reduce acid in the stomach and reduce the chances of developing an ulcer. Those of you who have an allergy to aspirin or Motrin can use Tylenol. It is not unusual to have some shoulder pain after surgery. This pain is from irritation to the diaphragm during the surgery either from the band or the presence of gas after surgery. A heating pad on your shoulder blades or the upper abdomen may help. This pain, if you have it, should gradually subside over several days, but occasionally lasts longer.
You need to take a daily multi-vitamin. The easiest is Flintstones chewable vitamins. Any multi- vitamin will do realizing that it may be hard to take large pills. Some patients prefer liquid adult vitamins, chewable adult vitamins or breaking regular vitamins in half.
If you go more than two days without a bowel movement, it is time to get things moving. The majority of time this means you are not drinking enough liquids. Start drinking more. Even if you think you are drinking enough, try to drink a little more. You need to drink two liters a day just to keep up with what your body uses. Over- the-counter stool softeners (Colace, DSS, or docusate sodium) are mild and a good first choice for relief. If this doesn't work, take Phillips Milk of Magnesia two tablespoons once or twice per day. This tends to work really well so make sure you have ready access to a bathroom. Once you are eating regular food it will be important to have plenty of fiber in your diet to promote good bowel function. Examples of high fiber foods are bran cereal, fruits, vegetables, and beans.
At the outset you will be on a liquid diet. On a liquid diet, you can expect loose stools. This is normal, and you do not need to do anything about it. Liquids in liquids out. Kaopectate, which can be found in your grocery store or pharmacy, is a good medication to take because it simply gels the stool as opposed to constipating you. If you are having more than 6 watery stools per day for more than one week after surgery, you may have antibiotic associated colitis a special kind of diarrhea associated with the antibiotics your doctor will give to you prior to surgery. In this case you should contact your doctor's office. You may call our office and talk to our nurse or email us.
Bleeding from Incisions
A small amount of bleeding, or bloody colored fluid around the incision is normal because of the blood thinners given to you during surgery. Apply firm pressure with a gauze for five minutes and leave an ice pack on it. Contact your surgeon if this problem persists. Please call the office if you have any questions, or are concerned about drainage. Email us if you have any drainage or redness around the wound, or call our nurse.
Bandages, sutures and staples
There are a variety of ways that your incisions are closed. Most of the time surgeons use dissolving sutures and glue to keep the wound closed. Sometimes we use staples, other types of sutures, or even steri-strips. If you have a bandage over your wound please change the bandage as often as needed over the first 24 hours. Then leave the wounds open to air. Do not apply ointments, creams, or anything other than soap and water for the first 48 hours. It is ok to shower using soap and water as they will not hurt your incisions. In fact, washing with soap and water helps prevent bacterial build up that may lead to wound infection. To minimize scarring, after the first week, you may apply Vitamin E oil, Scar Guard or Mederma to the incisions twice daily for two months. You can get Vitamin E oil by poking a hole in the end of a gel Vitamin E capsule and squeezing the oil onto the incision. Vitamin E oil is very sticky. Scar Guard or Mederma are topical skin care products designed to reduce scarring after surgery. They should be available at your local pharmacy without a prescription.
We want you walking from the moment you leave the hospital. Bottom line...the faster you are up and moving, the faster you will recover. The faster you walk the faster you will feel better.
Get in some walking or other physical exercise every day. Start out slowly and build up gradually. A simple walking program is a good place to start if you have not been physically active before surgery. Start out walking for 5 or 10 minutes and build gradually to 30 minutes per day. After your recovery as you lose weight, you will likely find a more effective calorie burning activity that you enjoy. Our fitness section is a good place to learn how to start an exercise program.
Most people go back to work within 1 to 5 days, depending on the type of job they have. You can resume sexual activity whenever you feel ready. You can begin exercising moderately after a week or 10 days. We do not want you lifting more than about 15 pounds for six weeks after surgery. Typically the port incision is the most tender due to the fact that the port is stitched to the muscle. This pain will resolve with time.
Showers are okay. Do not rub the bandages vigorously with a washcloth. Blot the bandages dry with a towel after a shower. No underwater submersion of the incisions or swimming for two weeks (no baths, swimming or hot tubs). Sitting in the tub with the incisions above water is okay.
We like to avoid vomiting because vomiting can cause the stomach lining to thicken leading to more vomiting. If you are vomiting stop eating and drinking for two hours. Then begin to drink some warm clear liquids (hot tea) again. Sip the liquid, you must drink it very slowly. If you vomit again, stop drinking for four hours and try clear liquids again. If you cannot tolerate clear liquids without vomiting, please call your surgeon immediately. Prolonged vomiting for more than 12 hours is not normal. Contact your doctor if this occurs. Sometimes the pain medicine (Vicodin) can cause nausea and vomiting, if this is the case please call your doctor's office and request a different medication, or stop taking it and use Tylenol or Advil instead. Remember, you must remain on a liquid diet the first two weeks after surgery. This means you must avoid all solid foods, including the solids such as meat and vegetables in soups.