Home Care After Bariatric Surgery

Now you have been discharged from the hospital and have reached home and are feeling relieved but apprehensive too, because you think stitches could break, or you are afraid of pain at home, or how much to walk, whether or not to take bath and so on. These are some helpful points for your guidance

Wound Care

  • Change the dressings every day, if your doctor tells you to do so. Be sure to change your dressing always whenever it gets dirty or wet.
  • You may have bruising around your wound or redness around the incisions, do not  panic, this is normal.
  • Avoid wearing tight clothing to prevent rubbing against your incisions.
  • Stitches or staples are usually removed within 7 to 10 days after surgery. some stitches dissolve on their own. Your doctor will tell you if you have them.
  • You can have shower when advised by your doctor, let water run over your incision, do not scrub over the incisions.

Personal hygiene

  • Take shower daily.do not rub the wounds. let only water run on your incisions
  • You can oil massage and wash your hairs daily to feel fresh and active
  • Change your clothes daily
  • Clean your skin folds well with soap and water once a day and keep them dry specially during the rainy season

Activity

  • Walk as much as you can, move around and use stairs at home
  • Do not lift things heavier than 5 to 7 kgs in the initial months
  • Increase your exercise slowly
  • Take short walks
  • Get up and move around if you some pain in your belly, it may help
  • Do not join gym until recommended by your doctor.

Follow-up

  • To help recover from surgery and changes in your lifestyle ,see your surgeon regularly and other health care providers.
  • The dietitian will teach you to eat correctly with your small stomach.
  • The psychologist can help you deal with the feelings or concerns you may have after surgery.
  • Blood tests are important as recommended by your surgeon, get them done timely to prevent vitamins and mineral deficiencies.

When to Call the Doctor

  • Temperature is above 100°F .
  • You have redness, pain, swelling or bleeding around your incision
  • You have pain that your pain medicine is not helping
  • You have breathing difficulty
  • You cannot eat or drink
  • You are vomiting after eating

These simple precautions will help you tide over the initial difficult time at home after your bariatric surgery. Bariatric surgery is the best way to lose weight and regain health.

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Infertility in Women and Bariatric Surgery

The relationship between PCOS, obesity and infertility has been documented for many years. Anovulation, miscarriage, impairment in follicle formation and altered activity are the known effects of these. These women also face difficulty in managing diabetes, pre-eclampsia, growth disorders, higher rates of caesarean delivery, higher maternal mortality, and increase their children’s risks for metabolic disease in the future.

A considerable weight loss can increases the chances of spontaneous ovulation, which is why the solution – bariatric surgery. This surgery is known to improve both fertility and pregnancy in women with reproductive concerns, polycystic ovarian syndrome (PCOS), along with metabolic syndrome (MS).

Bariatric surgery’s positive effect on women

Bariatric surgery in reproductive age women has been shown to decrease menstrual irregularities. Women suffering from hormonal imbalance show considerable improvement post operatively, and chances of conceiving increases after this surgery. Sensitivity to leptin levels increases post-surgery, reflecting improved reproductive metabolic status. Many women (about 10%-25%) with subclinical hypothyroidism, haven also shown a significant improvement following surgical weight loss.

Women already take pregnancy into consideration when electing for bariatric surgery. Nowadays women undergoing surgery are aware of their own reproductive risks and a significant number of these women are thinking ahead.

Studies on infertility in women and bariatric surgery

Bariatric surgery has attracted interest of many scholars with more individuals showing improved fertility post weight loss treatment. An older study, implied that a BMI drop greater than 5 kg/m2 was a significant predictor of fertility within 2.5 years of follow up after surgery. There was also a trend to a reduced need for fertility treatment in women conceiving within 3 years of weight loss surgery compared to their need for fertility treatment prior to surgery. Reports also show previously anovulatory women conceiving post-operatively without ovulation induction agents.

A study comparing pregnancy outcomes in women before and after weight loss surgery showed improvements in pregnancy related hypertension and diabetes mellitus, and a significant drop in caesarean delivery rate too. Moreover, bariatric surgery did not result in increase rates of post-partum haemorrhage, infection, shoulder dystocia or foetal demise.

The benefits of bariatric surgery in women suffering from PCOS with metabolic syndrome are discussed extensively on various platforms, leading in favour of surgery in such cases. Nutritional and vitamin deficiencies in these women during that time frame of rapid weight loss can be dealt with supervised supplementation, regular follow-ups with the surgeon and obstetrician. There were no differences in maternal complications, foetal outcomes or delivery complications, making bariatric surgery a highly recommended solution and one of the best way to lose weight in morbidly obese people.

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The Gulf Obesity Crisis

Obesity is now the biggest healthcare challenge world wide, approximately one in three is either obese or overweight. It has overtaken malnutrition and infectious diseases as the worlds no.1 heath problem. The problem is even bigger in middle east. According to one study, 51 million people in the Gulf are classed as obese. An epidemic indeed. In the same study, Qatar is reported to have the highest incidence of obese men (44 per cent) in the Middle East and North Africa region, followed by Kuwait (43 per cent) and Bahrain (31 per cent), while the prevalence of obesity among women exceeded 50 per cent in three Middle Eastern countries; Kuwait (59 per cent), Libya (57 per cent) and Qatar (55 per cent).

Not only does obesity carry serious consequences for people’s health, it  also carries a global cost of $2 trillion, consuming 2.8 per cent of global Gross Domestic Product and demanding approximately 15 per cent from the healthcare budgets of developed countries, according to the authors of the McKinsey report.

Researchers have produced the startling forecast that if current obesity rates continue, almost half of the world’s adult population will be overweight or obese by 2030.

The demand for bariatric surgery is increasing by 20 per cent annually in Gulf countries, however in many cases it is out of necessity rather than choice. Bariatric surgery is proven to reduce the risk of serious health complications associated with obesity such as cardiovascular disease, sleep apnea, certain cancers and perhaps most pressing for the region, type 2 diabetes. According to experts, we must not believe that obesity is not self-inflicted or a lifestyle choice, rather than a critical health issue.

It is these damaging perceptions which have led to widespread criticism of bariatric surgery, which can cost between $8,000 and $15,000, as many claim that the procedure is becoming a substitute for a lifestyle overhaul. It is from this viewpoint that a serious stigma has emerged.

An increase in bariatric procedures could also realize financial savings for governments and healthcare systems alike, as patients who have undergone surgery, are more likely to avoid life-threatening and costly conditions such as heart disease and diabetes, which currently affects approximately one in ten adults in the Middle East and North Africa region

More young patients end up undergoing bariatric surgery in UAE

Doctors advise weight-loss procedures if children have high BMI and other health issues

Abu Dhabi: With obesity cases rising in the UAE, more and more younger patients are being recommended for weight-loss surgeries, experts have said.

The surgeries are a last resort in the fight against obesity and its related complications. They are often a better choice than letting children’s health get progressively worse.

Statistics compiled by regulator Health Authority Abu Dhabi (Haad), indicate that nearly 30 per cent of school going children in Abu Dhabi are overweight or obese and the proportion rises to 40 per cent among teenagers. Worldwide obesity has nearly doubled since 1980 and in 2011 more than 40 million children under the age of five were overweight (WHO).

Unless we take some drastic and wide ranging measures, the obesity will soon become worlds biggest and most expensive health issue ever.

A food for thought,shall we say.

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