Doctor’s Corner: Preparing for Bariatric Surgery

by Dr. Robert Smith

Let me begin by telling you a few things to prepare you for your bariatric surgery. By following these guidelines, you will have a much better chance of a successful weight loss surgery.

First, you will need to stop taking certain medications one week before your bariatric procedure. These medications include aspirin and anti-coagulants or blood thinners like Coumadin and Plavix, as well as herbal products like fish oil and omega-3.

No heart medications aside from diuretics and certain anti-hypertension medications should be taken on the day of your surgery.

For Bariatric Surgery Patients with Diabetes

You should stop all of your oral diabetes medications 24 hours hours before surgery. Don’t take any of your short-acting insulin on the day your bowel prep is started.

The recommendations for the use of your long-acting insulin will be discussed during your pre-op visit. Please check with your doctor regarding other medications to be avoided before surgery.

All other prescribed medications should be continued up to and including the morning of surgery. Take them with a sip of water.

Specific medications that you should not take on the day of surgery will be discussed during your pre-op visit.

Begin a Clear Liquid Diet Two Days Before Surgery

Beginning the morning two days before your surgery, you need to go on a clear liquid diet. For example, if your surgery is scheduled for Wednesday, you need to begin a clear liquid diet on Monday morning.

By clear liquids, I mean anything you can see through – water, broth, white juices, and other liquids with no sugar added. And remember – don’t drink anything that’s colored red:

• Water
• Clear broth or bouillon
• Apple juice (no sugar added)
• White grape juice (no sugar or pulp)
• Coffee or tea (no milk, creamer or sugar)
• Sugar-free Kool-Aid, Propel, Gatorade, Crystal Light
• Sugar-free plain Jello
• Sugar-free popsicles

The same day that you begin your liquid diet you will also need to take the bowel prep prescribed by your physician. Prepare it as instructed on the package, then pour 8 ounces (one cup) into a glass and drink it.

Drink one glass every ten minutes until you’ve had four glasses in total. You can dump the rest out.

Continue with your clear liquid diet until midnight the day before your surgery.

You will also need to call your physician’s office to speak to the surgery scheduler to confirm your arrival time.

Things to Bring with You to the Hospital

If you haven’t done so already, please make a checklist of things to bring with you to the hospital.

This includes comfortable clothing, dentures, hearing aids and glasses. If you wear contact lenses, please feel free to bring them as well.

You will also want to bring some reading materials and other items to keep you occupied while you wait for your procedure and during your hospital stay.

You won’t want to bring any medication, and you should leave all jewelry and other valuables at home.

The Night Before Your Bariatric Surgery

The night before your surgery take a shower or bath using Hibiclens, a special surgical wash.

You can put on a small amount of deodorant afterwards but don’t wear any perfumes, makeup, powders, lotions, and it’s important that you don’t wear nail polish.

Take a second shower with Hibiclens cleanse the morning of your procedure and concentrate on cleansing your abdomen. Again, no lotions or powders should be applied afterward.

The day of your surgery you can take your prescription medications with a small sip of water.

This includes your medications for heart, asthma, anti-seizure, cholesterol, psychiatrics, and narcotics for pain. Your specific list should be reviewed with the nurse in charge.

A summary of the pre-op steps for weight loss surgery:

• 2 Days Before: Clear liquid diet and bowel prep.
• 1 Day Before: Call the hospital to confirm your arrival time.
• Night Before: Shower with Hibiclens.
• After midnight: Nothing to eat or drink.

It’s important that you follow these instructions carefully. By doing so, you increase the chances of a successful bariatric surgery result.

(published February 15, 2014)