Care Protocol

Care Protocol

Pre-operative Preparation:

• Body Mass Index
• Assessment of co-morbid conditions
• Liquid Diet for 2 days before surgery
• Investigations on admission (one day prior to surgery):
• Blood Routine, RBS, RFT, HIV, HbsAg, TFT, PFT
• Chest X-ray, Echo, Ultrasound abdoman, Upper GI endoscopy
• Incentive spirometry / Mobilization
• Nil by mouth & Bowel preparation 6 hours prior to surgery
• Physician & Anesthetist fitness (cardiologist opinion if necessary)
• Dietary & Psychology counseling

The choice of ideal surgery will be recommended after assessing the BMI and co-morbidities at consultation.

Post-operative diet:

• Liquid Diet for 2 days
• Soft Diet for 2 weeks
• Regular Diet after 2 weeks

Liquid Diet:

• 6 times per day (3 protein supplements + 3 liquids) – Small amounts, go slow, when full, stop.
• Liquid diets include coffee, tea, buttermilk, (All milk products should be diluted) Juice, blended soup, porridge.

Soft diet:

• 6 meals per day (2 proteins supplements + 4 soft diet) No liquid with meals if soft food included.
• You must wait 30 – 45 minutes for the pouch to empty before drinking.
• CHEW WELL. The food must be almost like a liquid before swallowing.
• Soft diets includes mashed fruit, cooked vegetables, fish mashed rice, eggs, powdered biscuits, kanji.

Regular Diet:

• 3 meals a day with 1 snack.
• Eat at specific times on a regular basis.
• No liquids along with meals and for 30 minutes afterwards.
• Discontinue protein supplements
• Eat very slowly
• Chew well
• When you are full stop eating

Avoid calorie dense foods that are liquid or semisolid (like ice cream, sweets, and juices). These foods may not cause discomfort or feeling of fullness if taken in small quantities but make you gain weight. Solid food fills stomach pouch and empty slowly, so eat more solid food to relieve hunger. For the first two months you may experience a decrease in appetite but your body will readjust with time.

Follow-up

Patient will be followed up after a week, 1 month, 3 months, 6months & 1 year. Check on anemia, nutritional deficiencies, BMI & skin tone will be done at regular intervals. If necessary, body lift procedures might be added after a year.