
Post Surgery
The dietary program after the surgery
You will lose most of the excess weight within the first year of the surgery.
But you need to keep your new eating habits to avoid going back to your old weight.
- Take multi-vitamins like Centrum and you can take fat free milk powder commercially known as Bini Protein and that is if you suffer from Lactose intolerance.
- Take other supplements containing calcium and iron, but not at the same time, take them at least two hours apart.
- Do not take iron pills after having dairy products or tea.
- You can take other medication containing Pantoprazole or Arthrodial if you suffer from inflammation of the gallbladder.
- You need to consult your doctor if you are diabetic or suffering from high blood pressure.
- You can take painkillers and laxatives when needed and you can consult your medical team for any other concerns.
Physical and sexual activities post surgery
The first month after the operation, you can play sports like bike riding, dancing, swimming or going to the gym
- Keep a walking routine for 30 minutes plus daily.
- Refrain from using the elevators and whenever possible use the stairs.
- Do not do violent exercises like weight lifting and alike for the first 4 weeks after the operation.
- Alternate between various sports to avoid boredom.
- Exercise with friends.
Sex Post-Surgery
There is no warning about sex after the operation, but preferably wait for at least 2 weeks to insure there is no pain.
The chances of pregnancy increase after the surgery so pay better attention to the contraception methods and the effect of the contraception pill after the bypass surgery become less reliable.
It is also important to avoid pregnancy for one year after the surgery to prevent any health complications for the mother and baby.

Lower movement of the intestines for the first month after the operation causes constipation. You can take laxatives when needed and drink plenty of water. It will become better as you start eating solid foods. Consult your doctor if the constipation lasts after 7 continuous days or if you don’t feel better after taking laxatives.
If you have stool over 3 times daily consult your doctor and you need to compensate by drinking plenty of liquids, especially water. After the mini bypass surgery the likelihood of having a diarea or constipation is high and the intestines need some time to adjust to the new situation and to avoid these problems lessen your intake of fatty foods and deserts.
To avoid this, split you meals; eat smaller and more frequently
Especially for the first 6 months after the operation you might suffer from hair loss, but your hair will grow back to normal after as you stick to your dietary routine and eat enough protein. If hair loss continues 8 months after the surgery refer to your nutritional specialist as this signals lack in protein consumptions or vitamins

Possible causes: not eating or drinking enough What to do: First drink more, especially soup, stock or vegetable juice then water and eat regularly
What to do: see your doctor
What to do: see your doctor
Possible causes: Eating fast, not chewing enough, eating too much in one meal, too much fat, drinking while eating, immediately lying down after eating What to do: chew well, eat more frequently, and eat small meals
Possible causes: not chewing enough and eating big bites
What to do: see your doctor to check your stomach’s size
Possible causes: you eat a lot of high calorie foods and beverages like cokes and fruit juices, energy drink or other sweetened beverages and sweet and fatty desert. What to do: Limit your intake of these foods and if you do that eat small amounts and limit it to few times a month and try to stick to your nutritional diet

You will need to have some clinical tests periodically to insure that you do not have any mineral or vitamin deficiencies. And you will need to take multi-vitamins. You need to have these tests every three months after the surgery and two weeks before your follow-up appointment, except if you have had a sleeve gastrectomy, in which case you will need to do the test 6 months after the surgery
Zink – Calcium (Total, Ionized) – CBC – PTH – Vit B12 – Vit D3 – Albumin – Ferritin – Urea Creatinine

POST-SURGICAL RECOMMENDATIONS
The following illustrate how your daily food intake journal will be arranged in the first few days and weeks after the gastric sleeve surgery. You will eat between 3 to 5 meals per day, according to your height, age and activity.
It’s important to:
- Eat regularly throughout the day
- Not drink while eating your meals
- Eat slowly
- Allocate 30 minutes for each meal
- Chew your food thoroughly Eat in small bites
- Stop drinking 30 minutes before your meal
- Start drinking again 30 minutes after eating
- It is very important to manage & control pain after surgery as it will help you to breathe easily, sleep well, recover quickly and move easily.
- Eating better and doing the necessary activities in a more comfortable way.
- You will be asked to rate your pain on a scale of 0 to 10.The number zero means no pain whatsoever while the number 10 means severe pain.
- The medical staff will help you keep your pain level below 4 out of 10.
Activities to maintain during your hospital stay in the evening of surgery
- Deep breathing exercises.
- Stand and sit on the chair with the help of a nurse.
- Get out of bed and move in the hospital corridors at least every two hours.
- Doing leg exercise
- During this time, you will receive some options for drinking fluids. You can eat whatever you accept, but you have to drink slowly for about 30 minutes. Among these liquids (transparent drink – coffee or tea – fruit juice – lemon).
- It is important to move your body after the surgery to avoid blood clots, muscle weakness and tuberculosis.
- You can start moving right away and keep moving a lot during your stay in the hospital.
- Most patients leave the hospital the day after surgery and some may need to stay for another day.
- It is advised to eat low-calorie food for two weeks before the surgery, as this helps to reduce the size of the liver and this contributes greatly to the success of the operation.

EXERCISE AND PHYSICAL ACTIVITY
- Do not engage in advanced (vigorous) sport activities such as aerobic and weightlifting in the first 4 weeks after the surgery.
- Do not lift more than 15 pounds during the first month, but you can walk daily then increase the distance gradually whenever you can.
- After the first month, you can practice any sport or physical activities such as cycling, dancing, swimming, or joining the gym. You can do more intense exercises whenever you can.
- Physical activity helps you maintain your muscle mass percentage, especially if you started right after the surgery.
- You can seek professional help from a trainer if you suffer from some health problems that might stop you from exercising.
- If you suffer from a heart disease, consult your doctor before practicing any sport.
- You can exercise for 150 minutes per week, which can be divided into 30 minutes a day for five days.
- If you can’t keep exercising for 30 minutes, you can divide it into three periods of 10 minutes each.

WHEN YOU FEEL ANY OF THE FOLLOWING HEAD TO THE EMERGENCY:
- Fever over 38 degrees
- Chest pain and trouble breathing
- Leg pain, swelling or redness
- Strong abdominal or shoulder pain that does not go away with painkillers
- Continuous vomiting

TIPS TO HELP YOU KEEP UP AN ACTIVE LIFESTYLE
- Start with simple goals and evolve it over time.
- Do different kinds of sports to avoid getting bored.
- Set realistic and achievable athletic goals.
- Prepare your sportswear to use it anytime.
- Allocate a daily time for exercising and maintaining your active habits.
LEGS EXERCISES
- Move the foot in a circular motion from right to left.
- Slide and tilt the toes forward and backward.
- Straighten your legs straight forward.
- Leg exercises help you maintain good blood circulation in the limbs. Each exercise should be repeated 4-5 times every half hour during the waking periods.

DEEP BREATHING EXERCISES
- You can use a device called (inspirometer) that helps you breathe deeply to prevent TB infection.
- To use the device, breathing is carried out deeply in the designated part of the device, then leaves it, expels air and rest for a few seconds, then re-exercises 10 times every hour in the waking periods.