What’s Normal and When Do You Need to Call the Office?
Recovery for every bariatric patient is slightly different and therefore there are no hard and fast rules about what is normal and what is not. Generally early recovery is similar no matter which weight loss surgery procedure you choose. However, we are most concerned about three potential adverse outcomes after surgery.
First is infection. Infection is rare, but can occur, especially at the incision sites if proper wound care is not followed. The most common signs of infection are a fever persisting at 101 or above, increasing redness and swelling at any of the incision sites, foul-smelling discharge from an incision site and/or red streaks emanating from the wound. An infection is also usually accompanied by increasing pain that is not well-managed with over-the-counter medication.
Another very concerning potential complication is a blood clot in the veins, known as deep vein thrombosis or DVT. Anyone who has major surgery is at a higher risk of DVT in the few weeks after the procedure. We take every reasonable precaution to reduce this risk, including getting you to ambulate at the hospital or surgery center and impressing upon you the need to walk at home. The most common symptoms of DVT are pain or discomfort behind the knee cap, swelling or redness, typically in the back of the leg, swelling lower down in the ankles or the lower calf. The biggest concern with DVT is that part of the clot breaks off and travel to long where it can cause a pulmonary embolism. Pulmonary embolism’s can be fatal. We further reduce the risk of a blood clot in high-risk patients by prescribing anti-clotting medication after surgery.
Staple Line Leak
A leak in the newly formed stomach can potentially lead to an infection in the abdominal cavity known as peritonitis. This is an emergency condition that requires follow on surgery. If left untreated, it can become fatal. Fortunately, staple line leaks are rare, but if they do occur patients are usually well aware of the symptoms and know something needs to be addressed. Signs of a leak include a sudden increase in heart rate to above 120 beats per minute, severe breathing distress and a sudden increase in abdominal pain in the upper left abdomen, especially with consumption of food or liquids.
And one more:
Often overlooked is dehydration. Staying hydrated after surgery is a critical component of proper recovery, but many of us do not drink enough. If you begin to feel tired all the time, find yourself craving food even if you may have just had some or notice that when pinching your skin it does not snap back as quickly as it normally would, think about how much water you have consumed that day. Other signs of dehydration also include dizziness, dry mouth, and weakness. Especially in the dry air of Las Vegas, NV, it’s easy to get dehydrated. We recommend always carrying a bottle of cool water with you and taking small sips throughout the day and evening.
So, what is normal?
Everyone will have some pain, swelling, bruising and scarring after their bariatric procedure. This is perfectly normal. We encourage you to listen to your body when deciding if something feels normal or not. However, if you’re ever in doubt, we want you to call our office and ask for more information.
Odd sensations including very localized numbness or itchiness can also occur due to the irritation of nerves during surgery.
Scars are perfectly normal and depending on your skin may be one of several different colors or even raised. Once again, depending on your particular circumstance, the scars will become less visible over time and may even eventually disappear. Avoid exposing your scar to the sun as it may discolor.
You may find that your bowel movements have changed after surgery. Some patients will contend with bouts of diarrhea or alternately constipation. This should be transient. If you are having longer-term bowel movement issues, please speak to your surgeon. Depending on the procedure, you may also experience mild to moderate flatulence. This is especially true for gastric bypass patients that have bypassed part of their small intestine. Longer-term, gas can be controlled with diet.