Recovery is gradual after gastric sleeve as well as other bariatric surgery. Surgery is stressful and traumatic for the body and series of hormonal and inflammatory responses are activated immediately after surgery aimed at maintaining body homeostasis as well as initiating the healing process. Therefore, the recovery from gastric sleeve starts once the operation is completed. Individual differences and presence of comorbidities may determine the rate and course of improvement.
Hospital stay/Length of recovery
This takes about 2-4days depending on the degree of improvement in pain, presence or absence of early postoperative complications. Length of recovery may be as early as 3weeks or may be as long as 6weeks. The number of obesity-associated disease conditions and level of care during the recovery has a significant impact on the length of recovery. If complications developed, the recovery may be prolonged as the hospital stay, diet and exercise may all be affected. Most patients can return to work after 6weeks.
Pain after surgery
Once you regain consciousness after surgery, you may begin to feel pain especially at the site(s) of the incision. This may be more if the gastric sleeve surgery is done by the open approach. During your stay in the hospital, your surgeon will take care of pain with strong analgesics usually opioid. This is given an injection before the commencement of oral intake. With adequate analgesia, you should feel little or no pain. Once the shock reduces in severity and oral intake has been commenced, the analgesic may be converted to oral, and this will continue for few days after discharge. While at home avoid indiscriminate use of analgesics, use as prescribed by your surgeon. If your pain suddenly becomes unbearable, inform your surgeon.
Appetite
Gastric sleeve surgery will significantly reduce your hunger. Hormone ghrelin which increases appetite is mostly produced in the fundus of the stomach. This part of the stomach is wholly resected during gastric sleeve surgery. Thus, don’t be surprised that your appetite reduced significantly after surgery.
Feeding
Despite the fact that gastric sleeve surgery does not alter or manipulate the small intestine, the stomach resection may cause temporary paralysis of the gut leading to abdominal distention and vomiting if feeding is initiated too early. You should wait for your surgeon to confirm that your gut function has returned before oral intake. Passage of flatus and feces may be a pointer to a regular bowel movement. Usually, feeding starts with sips of water followed by clear fluid and then a gradual transition to liquid, semisolid and solid diets over days to weeks. Stay away from alcohol and carbonated drinks. Avoid smoking as this may delay wound healing.
Wound
After discharge, you will be in-charge of your wound care. Your doctor will teach you how to clean the wound site(s) with disinfectants. You will also be shown signs of wound infection such as undue pain at the wound site, redness, and discharge from the wound site. All these calls for immediate presentation at the hospital. After stitches are removed, cleaning with disinfectants will continue till the wound is completely healed.
Exercise
Immobilization and sedentary lifestyle are counterproductive to the overall wellbeing and survival of an obese individual. Complications such as deep vein thrombosis and pulmonary embolism may occur after surgery due to immobilization and lack of prophylactic anticoagulant. Early mobilization out of bed is therefore encouraged.
Exercise is commenced with walking and gradually escalated to more energy demanding ones. Walking can be done in the first week after surgery. This can be followed by jogging, breathing exercise, light weight-lifting by the second weak. By the third week, you should be fit enough for running, swimming and muscle building workout. Training will improve your cardiovascular and respiratory fitness as well as help you burn some calories.
Return to work
This depends on the nature of your work. For light work, the patient can go back to work by the end of the third week while those whose work requires a high amount of energy may need to wait for another 3weeks for complete recovery before returning to work.
Weight loss/comorbidities
By the end of the first month and with dietary and exercise compliance, you should begin to notice gradual weight loss. Most people will lose up to 50% of their excess weight by the end of the 12th month and up to 60% by 18months.
As weight loss continues, the associated disease conditions will also begin to improve. Blood pressure will develop, and the need for antihypertensive drugs will also reduce. Those with type 2 diabetes will have better blood sugar control and may require fewer or no drugs. Other comorbidities such as sleep apnea, osteoarthritis, dyslipidemia will all improve.
Challenges during recovery
Some transient difficulties may be encountered during recovery either due to side effects of the surgery or body’s response to weight changes.
- Nausea/vomiting are frequent during the recovery period. This can be minimized by what and how you eat. Eat slowly and separate eating and drinking by at least 30minutes apart.
- Adequate fluid and high fiber diet will help prevent constipation
- Weight loss may be associated with cold intolerance as you gradually lose the insulating fat pad under your skin.
- You may also experience body aches and tiredness. Discuss this with your surgeon, do not abuse analgesics.
