Bariatric Patient Discharge Instructions

Appointments: You’ll receive texts for your 2-week, 2-month, and 4-month visits. If you have diabetes, hypertension, or take warfarin, book with your PCP within 2 weeks; otherwise within the first month.

Medication guidance: Follow the pharmacy’s medication sheet. If unclear, call (208) 782-3993. Empower-provided meds and pain meds may be swallowed whole unless told otherwise.

• Celecoxib 100 mg twice daily as needed (sleeve patients only).
• Acetaminophen 325 mg every 4 hours as needed.
• If you already take pain meds, continue as directed.

Binder: Dr. Zhang’s patients leave with an abdominal binder—wear for comfort. Ice or heat may help. You may take acetaminophen even if prescribed a narcotic (ensure your narcotic doesn’t already contain acetaminophen).

Bypass patients: Avoid all NSAIDs lifelong (ibuprofen, naproxen, meloxicam). Aspirin only if cardiology directs.

Hydration goals: 64 oz fluids/day (shakes & soups count). Sip slowly, no straws. Target ~60 g protein/day (CKD: ~30 g). Early meals are 2–4 tbsp.

• Stage 1 (Day 0–2): Clear liquids; protein shakes allowed.
• Stage 2 (Day 3–14): Full liquids (pourable) x 2 weeks.
• Stage 3 (Days 14–21): Puréed (baby-food consistency).
• Stage 4 (Days 22–28): Soft foods (mashed-potato consistency).
• Stage 5 (Day 29 → Month 2): Regular diet starts.

If a new stage causes nausea, vomiting, or pain, step back one stage and retry in a few days. Add new foods/textures cautiously.

Clot prevention: Wear compression stockings during waking hours for 4 weeks. Walk hourly while awake; build to 30 minutes daily. Some patients go home with Lovenox 40 mg once daily x 7 days—you’ll be shown how to inject.

Breathing: Use CPAP/BiPAP when sleeping (if prescribed). Use the incentive spirometer and AerobiKa/flutter valve 10 times per hour while awake for the first 2 weeks.

Incisions: Skin glue is waterproof; it peels off in 1–3 weeks—trim loose edges. Shower daily (don’t scrub). No baths/hot tubs/pools until cleared at your first post-op visit.

Drain care: If you had a drain, keep the dressing for 24 hours, then remove. (Not everyone has a drain.)

Watch for infection: Redness, heat, swelling, tenderness, or purulent/foul drainage—call the Empower Clinic (208) 782-3993 or send a portal message.

Allergic reactions: Rash/itching/hives at incisions or injection sites—consider OTC hydrocortisone cream twice daily and an oral antihistamine (e.g., Allegra or Zyrtec daily; optional Benadryl). Don’t apply creams to incisions unless directed.

Activity: No driving until comfortable and off opiate pain meds. No lifting > 10–15 lbs for 4–6 weeks. Discuss return to work at the 1st post-op visit. Walk hourly and increase as tolerated.

Vitamins: Start with your regular diet. If vitamins cause nausea, pause and restart at 1-month visit; taking with food may help. Use bariatric-specific vitamins (lifelong).

• Omeprazole (Prilosec) 40 mg once daily x 90 days.
• Ursodiol 300 mg twice daily x 6 months (start 1 month after surgery) if gallbladder present.

Irregularity is common after surgery.

Constipation options:

• Miralax 1–3 doses daily
• Magnesium supplement once daily
• Fiber gummies 1–4 twice daily
• Colace 100 mg twice daily
• Hydrate well

Diarrhea: Imodium per label; call if > 7 days.

Gas/burping: Simethicone per label.

Empower Clinic: (208) 782-3993
Hours: Mon–Thu 8:00 a.m.–5:00 p.m.

After hours (urgent, not emergent): Call the office number and choose the on-call nurse option. For emergencies, go to the nearest ER. Bingham Memorial Hospital ER: (208) 785-3813.

Call the clinic if you have:

• Fever ≥ 101°F
• Worsening pain, swelling, redness, or drainage at incisions
• Nausea/vomiting needing meds or persistent despite meds
• Abdominal or leg swelling
• Urinary burning/pain
• Trouble breathing or chest pain
• Coughing up blood
• Pain not improving with medicine
• Black or bloody stools
• Any concerns about your condition or care

FAQ:

• Periods after surgery: Changes are common; discuss at follow-ups.
• FMLA forms: Yes—allow 3–4 business days after we receive them.