Going Home After Bariatric Surgery

Your Recovery Instructions and When to Call Us

Going home is an important step in your recovery. The first days and weeks after bariatric surgery require careful attention to hydration, nutrition, medications, activity, and warning signs.

Follow the instructions provided by your surgical and nutrition teams. If your personalized instructions differ from this guide, follow the instructions given directly by your care team.

Call Us Immediately—Day or Night

24-hour number: 786-635-0400

Do not wait until morning or your next appointment. Call us immediately if you experience any of the following:

A fast or increasing heart rate

A resting heart rate over 100 beats per minute—or a pulse that continues to climb—is one of the most important warning signs after bariatric surgery. It may be the first, and sometimes the only, sign of a serious complication.

Check your pulse twice a day for the first two weeks and write down the results.

Fever or chills

Call if your temperature is 101°F or higher, or if you have chills.

Trouble breathing or chest pain

Call immediately for:

• Shortness of breath
• Chest pain
• Breathing that feels more difficult than the day before

Severe or worsening abdominal pain

Some soreness is expected after surgery and should gradually improve. Severe pain—or pain that is getting worse rather than better—is not normal and should be reported.

Vomiting that will not stop

Call if vomiting continues, especially if you cannot keep fluids down for more than 8 to 12 hours.

Inability to drink

If you cannot keep sipping fluids, you can become dehydrated quickly. Dehydration is one of the most common reasons bariatric patients return to the hospital.

Possible blood clot

Call for pain, swelling, redness, or warmth in one calf or leg.

Incision or wound problems

Contact us for:

• Increasing redness
• Increasing swelling or warmth
• Pus or drainage
• Foul odor
• An incision that opens

Bleeding

Call for:

• Vomiting blood
• Vomiting material that resembles coffee grounds
• Black, tarry stools

Dizziness or fainting

Call if you feel dizzy, faint, or as though you may pass out when standing.

Decreased urination

Call if you have little or no urine, very dark urine, or no urination for more than 8 hours.

When in doubt, call. We would much rather hear from you about a minor concern than have you wait at home with a serious problem. No one on our team will make you feel foolish for calling.

Call 911 or go to the nearest emergency room for:

• Chest pain
• Severe shortness of breath
• Fainting
• Heavy bleeding

Tell the emergency department that you recently had bariatric surgery. Provide the date of your surgery and the procedure performed.

How to Check Your Pulse

1. Sit quietly for several minutes.
2. Place two fingers on the thumb side of your opposite wrist.
3. Count the beats for 30 seconds.
4. Multiply the number by two.
5. Record your heart rate twice a day for the first two weeks.

Do not check your pulse immediately after walking or other activity.

Bring your pulse log to your first follow-up appointment.

A resting heart rate over 100 beats per minute—or a steady upward trend over one or two days—means you should call us.

Pulse and Temperature Log

DayMorning pulseEvening pulseTemperature1234567

Drinking and Eating

Fluids come first

Your goal is at least 64 ounces of fluid every day, equal to eight 8-ounce cups.

• Take small, frequent sips.
• Do not gulp.
• Do not use straws.
• Avoid carbonated beverages.
• Keep a water bottle within arm’s reach.
• Set a timer or reminder if necessary.

Dehydration is one of the most common reasons patients return to the hospital during the first month. It is also one of the easiest problems to prevent.

Follow your diet stages

Follow the diet stages exactly as described in your nutrition guide. Do not advance to the next stage early, even if you feel well.

Your expected progression is:

• Clear liquids: Days 1 through 3
• Full liquids: Days 4 through 7
• Pureed foods: Beginning around Day 8
• Soft foods: Around Week 3
• Regular solid foods: Approximately Weeks 4 through 6

Your surgical or nutrition team may adjust this schedule according to your procedure and individual recovery.

Protein

Begin working toward at least 60 grams of protein each day when you advance to full liquids, unless your nutrition team gives you a different target.

Protein helps protect muscle while your body loses fat.

Eating habits

Once you begin eating food:

• Prioritize protein.
• Take small bites.
• Chew each bite approximately 20 to 30 times.
• Allow 20 to 30 minutes for each meal.
• Put your fork down between bites.
• Do not drink with meals.
• Stop drinking 30 minutes before eating.
• Wait 30 minutes after eating before drinking again.

Your Vitamins

Begin your bariatric vitamins as directed by your care team, usually within the first days or weeks after surgery.

You will need to take vitamins and minerals every day for the rest of your life. This requirement does not end. Missing supplements over the long term can cause serious—and sometimes permanent—problems involving your blood, bones, and nervous system.

Chewable or liquid vitamins may be recommended at first because larger pills can be difficult to tolerate or absorb during the early recovery period.

Follow the complete schedule provided in your separate vitamin guide.

Moving and Activity

Walk regularly

Begin walking the day you go home. Take short walks several times a day.

Walking helps:

• Reduce the risk of blood clots
• Reduce the risk of pneumonia
• Improve circulation
• Encourage normal bowel function

Begin with a few minutes at a time and increase your activity gradually.

Breathing exercises

Use your incentive spirometer 10 times every hour while awake during the first week, unless your care team gives you different instructions.

Take deep breaths and cough periodically. If your abdomen is sore, hold a pillow gently against it for support.

Lifting

Do not lift more than [10 to 20] pounds for [4 to 6] weeks, or for the period specified by your surgeon.

Driving

Do not drive while taking narcotic pain medication. You should also be able to move comfortably and react quickly before returning to driving.

Returning to work

Many patients return to desk work in approximately 1 to 3 weeks. Physical work may require more time. Ask your surgeon when it is safe for you to return.

Showering

You may shower approximately 24 to 48 hours after surgery, unless your surgeon gives you different instructions.

• Pat your incisions dry.
• Do not take baths.
• Do not use pools or hot tubs until your surgeon clears you.

Exercise

Ask your surgeon before beginning structured exercise. Many patients begin around 4 to 6 weeks, depending on their recovery and procedure.

Your Medications and Substances

Avoid NSAIDs

Do not take nonsteroidal anti-inflammatory drugs, also called NSAIDs, unless your surgical team specifically approves them.

Examples include:

• Ibuprofen
• Advil
• Motrin
• Naproxen
• Aleve
• Aspirin
• Goody’s powders
• BC powders

These medications can increase the risk of ulcers in your altered anatomy. After gastric bypass, this restriction may be permanent. Always contact us before starting a new medication.

Do not use nicotine

Do not smoke, vape, or use nicotine in any form. Nicotine significantly increases the risk of ulcers and poor healing.

Avoid alcohol

Do not drink alcohol for at least the first six months after surgery. Ask your care team whether alcohol is appropriate afterward. Alcohol may affect you more quickly and intensely after bariatric surgery.

Pills and medications

During the first several weeks, you may need to crush large pills or use liquid forms. Never crush extended-release or enteric-coated medications unless your prescribing clinician specifically tells you to do so.

Diabetes and blood-pressure medications

Your diabetes and blood-pressure medications may need to be reduced soon after surgery. Check your blood sugar and blood pressure as instructed, and call us with your readings when requested.

Blood thinners

If you were prescribed an injectable blood thinner after discharge, complete the entire course exactly as directed.

Bring all medication bottles—or an accurate medication list—to your first follow-up appointment.

Caring for Your Incisions

Some bruising and mild swelling around the incisions may be normal.

• Keep your incisions clean and dry.
• Follow your surgeon’s instructions regarding dressings.
• Allow surgical glue or Steri-Strips to come off on their own.
• Do not pull off glue or Steri-Strips.
• A small amount of clear or slightly pink drainage during the first few days may be normal.

Call us for pus, foul odor, increasing redness, or warmth that spreads around the incision.

What May Be Normal During the First Weeks

The following may occur during early recovery and do not necessarily require an emergency call:

• Fatigue, especially while calorie intake is low
• Mild nausea that improves when you sip more slowly
• Shoulder discomfort from the gas used during surgery
• Constipation
• Bruising around the incisions
• Little or no hunger
• Mood changes or moments of doubt
• Changes in the way food tastes

Walking may help with gas-related shoulder discomfort. Ask your care team whether a stool softener is appropriate for constipation.

If something does not feel right to you, call us anyway. Trust your instincts.

Your Follow-Up Appointments

Your follow-up schedule may include:

• First visit: __________________
  Usually 1 to 2 weeks after surgery
• Nutrition visit: __________________
• Additional visits: 3 months, 6 months, 12 months, and at least once each year for life

Laboratory testing is performed at scheduled visits to monitor vitamin, mineral, and other health levels.

Do not stop attending follow-up appointments, even when you feel well. Long-term follow-up helps identify nutritional deficiencies, weight changes, and other concerns before they become serious.

Support group information: __________________

Before You Leave the Hospital

Make sure you have:

• This instruction sheet and your nutrition guide
• Your prescriptions filled or sent to your pharmacy
• Your first follow-up appointment scheduled
• Protein drinks and approved clear liquids at home
• A thermometer
• Transportation home
• Someone available to stay with you for the first 24 to 48 hours
• The 24-hour phone number saved in your phone

Bariatric Surgery Emergency Card

Keep this section on your refrigerator

Call 24 hours a day: 786-635-0400

Surgery date: __________________
Procedure: __________________

Call right away if you have:

• Resting heart rate over 100 beats per minute
• Fever of 101°F or higher
• Trouble breathing or chest pain
• Severe or worsening abdominal pain
• Vomiting that will not stop
• Inability to keep fluids down for 8 to 12 hours
• Pain, swelling, redness, or warmth in one leg
• Redness, pus, foul odor, or drainage from an incision
• Vomiting blood or black, tarry stools
• Dizziness, fainting, or very little urine

Every day:

• Drink 64 ounces of fluid, sipping throughout the day.
• Consume at least 60 grams of protein, according to your nutrition plan.
• Take your vitamins.
• Walk regularly.
• Avoid straws, carbonation, NSAIDs, smoking, vaping, and nicotine.

If you go to an emergency department, show them this card.

I had bariatric surgery on the date listed above. Please contact my surgical team.

Real science. Real surgery. Real results.

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