HELP Sheet Sheet For Patients

Same Day Bariatric Surgery Daily Checklist
I will do the following:

After Your Bariatric Surgery
□ Keep a fluid log. Drink at least 50 ounces
HELP Sheet (6.25cups) of hydrating fluids daily
Bariatric Surgery MEDS & DIET □ Keep a protein log (working towards a
Post-Op Bariatric Medications: minimum goal of 60g/day)
Tylenol, and/or Oxycodone for pain (NO NSAIDS)
Zofran for nausea
□ Get up to walk every 1-3 hours
Omeprazole for stomach acid reduction
□ Use the incentive spirometer 10 times/hr x 2 weeks
Miralax as needed for bowel regularity &/or constipation
□ Stay ahead of the pain as directed

Focus on Hydration with the following:
Sip 1oz (shot glass size) of fluids every 15 minutes
□ Avoid lifting over 10 pounds x 4 weeks
Water or Crystal Light (no carbonated drinks, no coffee, no alcohol)
□ Contact Dr. Clive and/or Dr. Reyes as needed
Diet juice (<5 Calories/serv), Gatorade Zero, Powerade Zero, Propel,
Herbal decaf tea and coffee □ Follow up at 2 weeks, 6 weeks, 6 months, 1
Sugar-free Jell-O or Sugar-free popsicles
year and annually thereafter.
Chicken, Beef, or Vegetable Broth
After Your Bariatric Surgery
HELP Sheet
If you have ANY questions, problems or concerns, please contact us.
We want to hear from you sooner, rather than later.
If you experience any of the following, please contact us or seek emergency treatment
 Dehydration:  Incision site sign of infection:
 Lightheaded or dizzy  redness
 Nausea  swelling
 Dry mouth and tongue  increased pain
 Fatigue and/or weakness  warmth or foul smelling drainage
 Dark colored, concentrated urine  Shortness of breath
 Confusion  Chest pain
 Abdominal pain  “Sense of doom”
 Nausea and/or vomiting  Painful or swollen leg(s)
 Fever greater than 101 F  Redness/warmth/swelling or an extremity
 Rapid heart rate  Uncontrolled pain – left
 Pain that keeps getting worse, not better shoulder/chest/back/abdomen
HAVING AN EMERGENCY? NEED URGENT ADVICE?
Call 911 or go to the nearest Emergency Room immediately! Call Dr. Clive cell #: 513-907-9200 or Dr. Reyes cell #: 253-514-3604
Call the clinic nurse at 360-698-4505 from 8:00am-5:00pm, Mon-Fri.
NON-URGENT  Call Dr. Clive and/or Dr. Reyes office from 8:00am-5:00pm, Mon-Fri, 360-698-4505
QUESTIONS  Send a mychart message
 Contact Keri the Bariatric Coordinator 360-698-4520
Before Bariatric Surgery
Your SHOPPING List
PURCHASE BEFORE SURGERY
FOOD ITEMS:
1. A small variety of protein drinks and/or powders (ask Keri for samples if you want to try a few kinds)
2. Clear Liquids you prefer (no carbonated drinks, no coffee, no alcohol):
 Water, Crystal Light (look for Crystal Light Pure – it is made with Stevia), or Diet Juice (<5 Calories/serving)
 Gatorade Fit, Gatorade Zero, Powerade Zero, Propel, or sugar free sports drinks (prefer those made with Stevia).
 Herbal decaf tea or decaf coffee (peppermint and ginger are good choices for nausea)
 Sugar-free Jell-O and/or Sugar-free popsicles
 Chicken, Beef, or Vegetable Broth
3. A good water bottle that you know how much liquid it holds or has measurements on the side. HidrateSpark water bottle is a great option!
MEDICATIONS (some of these may vary slightly depending on your needs and your Surgeon):
4. Over The Counter (OTC) Medications – buy at any local drugstore, grocery store, Walmart, or even online at Amazon
□ Miralax – this is a powder found in the bowel care section
□ Tylenol – A caplet or tablet can be crushed, or look for dissolvable packets, or Amazon has a sugar free liquid for adults.
Avoid buying extended release or Arthritis Tylenol (this is extended release and not crushable).
□ Bariatric Multivitamin with Iron
□ Calcium Citrate (there are several types to choose from, please refer to your Bariatric Patient Guide for more information).
5. Prescription Medications (if they are not covered by your insurance, use a GoodRx discount card or app for a cash pay discount):
These 2 meds are used the morning of surgery: Save these for AFTER your surgery
□ Aprepitant (Emend) □ Zofran - oral disintegrating tablet
□ Scopolamine patch □ Omeprazole - capsule, may be swallowed whole or opened
and mixed with diet pudding
□ Oxycodone - for breakthrough pain relief only
Before Bariatric Surgery
Timeline to Surgery
1. Start the Liver Shrinking diet
2 weeks before 2. Stop Phentermine, herbal supplements, and NSAIDS (Ibuprofen ie Advil and/or Aleve)
surgery 3. Buy the shopping list items (see other side)
4. Do a deep clean of your fridge and pantry – get prepped for hydration & small portions
5. Prepare your family and home for your surgery recovery
2-3 days 1. Pre-admit phone call – they will call you sometime that day
2. Pick up prescribed medications at your pharmacy (if you haven’t done so already)
before surgery
1. Drink your first bottle of the CF Preop drink (given to you in the office) – unless directed otherwise.
2. Shower and use ½ the bottle of Hibiclense wash as directed. Go to bed with clean sheets and clean pajamas
Night before 3. Stop all food at midnight
surgery 4. Stop all meds as directed in your pre-admit call
5. Get your small bag ready for the morning. ID card and insurance card especially
1. Shower again using the second half of the Hibiclense bottle. Wear clean, comfy clothes to the hospital.
2. Drink second bottle of CF Preop drink 3 hours prior to surgery
Surgery DAY 3. Take Aprepitant medication (Emend) 3 hours prior to surgery and place Scopo patch on neck (behind ear)
4. Arrive at Mountain View Entrance at St Michael Medical Center, 1800 NW Myhre Rd, Silverdale WA 98383

HELP Sheet Sheet For Patients

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Same Day Bariatric Surgery Daily Checklist

I will do the following:

□ Stay ahead of the pain as directed

HAVING AN EMERGENCY? NEED URGENT ADVICE?

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