Diet

You can eat a regular diet including fatty foods without any restrictions after surgery. This of course will be limited by other illnesses you may have such as diabetes, heart disease and hypertension. On the first day, eat small, light meals and liquids. Progress to a normal diet as tolerated. Nausea and vomiting from anesthesia is not uncommon for 24 hours. If you feel nauseous, take clear liquids only. Call the office if the nausea and vomiting persists for greater than 36 hours. Do not take any alcoholic drinks for at least 24 hours and while you are taking narcotic pain killers such as Vicodin (hydrocodone), Tylenol (acetaminophen) with codeine, etc.

Activity

You can do whatever you are comfortable doing once you are discharged. You cannot cause any serious damage by your activities after your surgery. Nonetheless, use common sense, don't over exert yourself and don't lift more than 15-20 pounds. You will most likely not want to do much for 24 to 48 hours after surgery. Although you should get rest during this time, it is equally important to get up and walk. Do not drive while you are taking narcotic pain medicines or while your incisions hurt. This may reduce your ability to move quickly.

Your thought processes may take 24 to 48 hours to return to normal because of anesthesia Do not make any important business or personal decisions during this time. It is okay to go up and down stairs, and is encouraged. You can return to work when you feel comfortable, and when you can perform your job safely and at the level you and your employer expect. Usually this is a minimum of one week. Most people find they fatigue easily during the second and even the third week, so don't overload your schedule. If your job involves heavy lifting you should stay out of work for 2-4 weeks. Do not return to exercise or strenuous activity until you are seen in follow-up.

Pain and Discomfort

It is normal to have pain after your operation. How much pain you experience depends more on the individual than on the operation itself. Pain normally occurs in the abdomen, especially the right side and right flank. In addition, shoulder pain often occurs for 24 to 48 hours because of the gas used to expand your abdomen. You have been given a prescription for a narcotic: hydrocodone (Vicodin) or acetaminophen (Tylenol) codeine. You can take one or two tablets every six hours. Call the office immediately if you experience itching or a rash and stop the medication. If you don't like the drowsy feeling these medications cause or you no longer need as much pain medicine, you can try aspirin, extra strength Tylenol or ibuprofen. The dosages are ibuprofen 600 mg every 6 hours, two extra strength Tylenol every 6 hours, or two aspirin every 6 hours. If your pain is not controlled by the medication you have been given, call the office. It is helpful to take some type of pain medicine (narcotic or over the counter) before getting out of bed and before going to sleep the first few days after surgery.

Incisional Care

Your incisions are covered with Band-Aids or gauze pads. It is not uncommon for them to become saturated with blood during the first 24 hours. Do not become alarmed; simply change the Band-Aids or bandages as needed. You can take a shower 24-36 hours after surgery. Be sure to gently dry your incisions and replace the Band-Aids or bandages. After 2-3 days, it is not necessary to keep your incisions covered but it will usually make you more comfortable to do so. If you do not see metal clips or sutures, the sutures are in the skin itself and will dissolve. This occurs 3-4 weeks after surgery and may be associated with a little drainage from the incision. Occasionally patients may see a small string in the incision. That is the suture and nothing needs to be done. It is common for patients to notice some black and blue or maroon discoloration around the incision. This represents a small amount of blood and is normal. It should not alarm you. It is also common for this to only become apparent 2-3 days after surgery as blood in the tissues moves to the surface.

If your incision is red, hot and tender, you may have an infection. In that case call the office. You have been given antibiotics in the operating room prior to surgery, and unless discussed with you, you do not need them after surgery.

Miscellaneous

Following your surgery you may notice alterations in your bowel habits. Diarrhea can occur from the surgery itself or from the antibiotics you received. This is best treated with Metamucil, Amphogel, or yogurt. Constipation can occur from the narcotic pain medicine you are taking. To avoid this, take Haley's MO or Milk of Magnesia as directed on the bottle one time per day while you take narcotics. If you or your family were not informed of anything unusual after surgery, rest assured that everything is fine and went according to plan.

Follow-Up

Call the office after you get home to make arrangements for follow-up. Unless you or your family were instructed otherwise, this should be in 7-14 days.

Call the Office if You Experience:

• Significant bleeding
• Difficulty breathing
• Persistent light headedness
• Chills and/or fever greater than 101°F
• Pus or infection at the incisions
• Inability to pass urine
• Severe pain
• Any worrisome condition

If you are unable to reach the office, please call the Rhode Island Hospital at (401) 444-4000 and ask to speak to the Chief Surgical Resident on call.

Please remember that we are always available to take care of you and answer your questions. Do not view your calls as an inconvenience or bother to us. We want to help make your post operative period as easy as possible.