—Including any herbs or supplements

There are endless lists of what to bring to the hospital available to everyone, but one of the most important items is a list of any medication you are taking. Bring a list of all your medicines, including non-prescription vitamins and herbs. Make a note of the dosages and how often you take them. If your weight loss surgeon asked you to skip certain medicines before your bariatric operation, make a note of that.

You will be asked to stop some medications a week, or even a month before weight loss surgery. Some of these medications need to be regulated by other members of your medical team, and closely watched by them during the surgical experience. For example, Coumadin (also known as Warfarin) is a medicine that helps keep the blood a bit on the thin side (you will bleed easily). Some patients can stop this for a week before weight loss surgery without any problem at all, and some patients need to be converted onto another shorter acting medicine before their procedure.

Your weight loss surgeon may ask you to stop some medicines, such as hormoneslike Premarin, two weeks or a month before the operation because stopping them will reduce the risk of developing a blood clot. Your weight loss surgeon may wish you to stop other medicines you might not think about, such as aspirin, a week before your procedure. Herbs and supplements should also be stopped before weight loss surgery, including vitamin E.

The following table lists various medications and how they might affect your procedure and surgical aftercare.

DrugPotential Surgical Effect
AspirinWill decrease the ability of the body to clot. Should be stopped one week prior to weight loss surgery, or according to your bariatric surgeon’s recommendations.
Anti cholesterol drugs: Lescol, Lipitor, PravacholStop one week before weight loss surgery. There is some evidence that people who have these might develop an increased problem with muscle breakdown during the operation.
CoumadinWill decrease the ability to clot. Should be stopped four to seven days before the operation. This should only be stopped with extreme care by the physician who prescribes it for you.
Estrogen, Premarin, other hormone replacement therapiesIncrease the chance of developing a deep venous thrombosis and possibly pulmonary embolus. Should be stopped two to four weeks before weight loss surgery, under the care of your prescribing physician.
Vitamin ECan decrease the ability of the body to clot. Stop one week before weight loss surgery.

Prevention Is Easier Than a Cure

It is easier to prevent a wound infection after bariatric surgery than it is to cure it. There are several things you can do before weight loss surgery to prevent an infection afterwards. Soap and water are the best preventatives against wound infections. Some weight loss surgeons want you to wash with special soaps, such as Hibicleans®, for several days before the procedure. Hibicleans decreases the bacterial count on the skin, and every time you use it, the bacterial count is lowered even more. Some weight loss surgeons use Hibicleans as a prep solution before the operation.

Another popular product is Avagard®, which is made by 3M Company. This is an alcohol-based soap that quickly reduces the bacterial count on the skin, and it is combined with moisturizers, so the skin the skin doesn’t dry out so quickly. Both products work well, and if you can get them, then by all means, use them before your weight loss surgery. If you can’t find them, use any antibacterial bath soap and water and keep your skin clean before your operation. This is a key to preventing wound infections after the bariatric procedure.

To Shave or Not to Shave…before having weight loss surgery

—that is the question

Should a hairy man shave his belly before weight loss surgery? No. If you are a hairy woman, still don’t shave. Shaving can cause microscopic nicks in the skin that can become colonized with bacteria. Years ago, when we admitted bariatric patients the night before the procedure, we had the nurses “shave and prep” the skin. When we stopped shaving the skin, we discovered that the wound infection rates went down. Now we shave patients on the operating room table, or sometimes just before you get to the operating room. We use a clipper on your belly, so—if you are hairy, don’t worry, just use soap and water.