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Listing your medicines prior to having gastric bypass or Lap-band weight loss surgery
—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 surgeon asked you to skip certain medicines before surgery, make a note of that.
Also, note if you were instructed to take any medicines with a sip of water before surgery
You will be asked to stop some medications a week, or even a month before 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 surgery without any problem at all, and some patients need to be converted onto another shorter acting medicine before surgery.
Your physician may ask you to stop some medicines, such as hormones like Premarin, two weeks or a month before surgery because stopping them will reduce the risk of developing a blood clot. Your surgeon may wish you to stop other medicines you might not think about, such as aspirin, a week before surgery. Herbs and supplements should also be stopped before surgery, including vitamin E.
The following table lists various medications and how they might affect surgery and surgical aftercare.
| Drug | Potential Surgical Effect |
| Aspirin | Will decrease the ability of the body to clot. Should be stopped one week prior to surgery, or according to your surgeon’s recommendations. |
| Anti cholesterol drugs: Lescol, Lipitor, Pravachol | Stop one week before surgery. There is some evidence that people who have these might develop an increased problem with muscle breakdown during the operation. |
| Coumadin | Will decrease the ability to clot. Should be stopped four to seven days before surgery. This should only be stopped with extreme care by the physician who prescribes it for you. |
| Estrogen, Premarin, other hormone replacement therapies | Increase the chance of developing a deep venous thrombosis and possibly pulmonary embolus. Should be stopped two to four weeks before surgery, under the care of your prescribing physician. |
| Vitamin E | Can decrease the ability of the body to clot. Stop one week before surgery. |
Prevention Is Easier Than a Cure
It is easier to prevent a wound infection after weight loss surgery than it is to cure it. There are several things you can do before surgery to prevent an infection afterwards. Soap and water are the best preventatives against wound infections. Some surgeons want you to wash with special soaps, such as Hibicleans®, for several days before surgery. Hibicleans decreases the bacterial count on the skin, and every time you use it, the bacterial count is lowered even more. Some surgeons use Hibicleans as a prep solution before surgery.
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 surgery. If you can’t find them, use any antibacterial bath soap and water and keep your skin clean before surgery. This is a key to preventing wound infections after surgery.
To Shave or Not to Shave...before having weight loss surgery
—that is the question
Should a hairy man shave his belly before 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 patients the night before surgery, 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.
