Bariatric surgery is a literal lifesaver for some patients. It is a serious matter that should not be undertaken without a thorough risk assessment of the patient’s fitness for surgery and their access to post-operative care, which can make an immense difference to the patient’s long-term prognosis. Ireland currently offers around 100 bariatric operations each year. Funding of €80 million has been sourced to train 44 new dieticians and fund around 1,200 operations per year in order to keep up with the increasing demand for bariatric surgery in Ireland. This is, in part, to counteract the growing tendency of Irish people to travel abroad for more immediate access to such surgeries, often returning home and then requiring medical treatment for complications, either from the surgery being incorrectly performed or caused by the rigors of traveling too soon after said surgery. Approximately three percent of the Irish population has a body mass index of over 40, which means that they are in the most severely overweight category and therefore at risk of Type II diabetes, and the attendant issues that cause, and a host of cardiac, digestive and other health conditions.
What is Bariatric Surgery?
Bariatric as a medical term refers to obesity. Bariatric surgery refers to medical operations performed on heavily overweight patients, usually in order to aid in weight loss and management. This type of surgery includes gastric bypasses and gastric band surgery, which can sometimes be done via laparoscope.
What is Appropriate Bariatric Surgery Care?
Bariatric surgery is, performed on overweight patients. Being bariatric automatically increases the risk of post-surgical complications, due to a lack of mobility increased risk of skin infections and to generally being in poorer health than someone in their ideal weight range. Therefore, bariatric post-operative care requires an extra degree of attention to detail, scrupulous hygiene, and the use of specialised medical-grade bariatric equipment.
Some Bariatric Equipment to Aid Post-Surgical Recovery
Bariatric patients tend to be large both in width and height and also heavy, which makes it harder for clinical teams to tend to and examine and care for them. They can also suffer from reduced mobility which means that they need extra help with things like sitting up in bed, going to the toilet, and keeping clean.
1) Bariatric Beds
Bariatric beds are designed to accommodate both wider, taller, and heavier patients. The mattresses tend to be supportive and firm, the controls are designed to easily raise and lower larger weight ranges (up to 70 Stone normally) than are usually allowed for. The bed and mattress are considerably wider and longer to allow a larger patient to sleep comfortably without the risk of falling out of bed. A variety of bed widths are available to suit the patient’s width. This helps avoid moving and handling issues for the clinical teams.
These beds are often teamed with other bariatric equipment such as hoists, turning mattresses that enable a medical team to safely maneuver their bariatric patient to greater comfort, perform bed baths, and prevent the formation of bed sores and other skin infections.
2) Standing and Mobility Aids
At the very extreme end of obesity, patients can begin to suffer from poor mobility and difficulty with simply standing up. Greater weight distribution can make these patients prone to falls, which can cause further medical issues, even before bariatric surgery is taken into consideration. Wide and sturdy walking frames, hoists to allow bariatric patients to be moved from bed to wheelchair, or even to a bath-chair or similar, work to keep not only the patient but their carers and nurses safe. All of these products are tools to help prevent healthcare professionals suffering from muscular strains and other injuries from trying to move their patients.
3) Toileting and Hygiene
Following surgery, there is a need to keep incisions dry that is very much tempered by an equal need to keep the patient scrupulously clean. Commode chairs for bariatric patients allow them to use the toilet in comfort and with dignity, and can be wheeled into a large wet room that has a detachable shower head so that the patient can be washed from head to toe, if necessary, without wetting the incision dressing. Patients mobile enough to toilet by themselves can still be aided by the installation of raised toilet seats, which are less of an effort to use and rise from than regular, knee-height toilets.
Should the bariatric patient be too frail to move from the bed, there are aids that help carers and nurses to roll them safely within the bed, in order to access as much of their skin as possible. As a rule of thumb, all bariatric equipment tends to be able to support a weight much heavier than the patient.
Getting Back on Their Feet
Once the surgery has been completed and the patient is well on the road to recovery, they will not be able to go from being bed-bound or poorly mobile to regular fitness without some rehab and exercises which might, themselves, require the use of bariatric mobility equipment. This can range from products like large walking frames, designed to support weights of up to 52 stone (325kg), to reinforced walking sticks that will not slip or break under the weight of a newly mobile bariatric patient.
Buy? Or Rent…
Bariatric medical equipment is expensive, but a good investment for any healthcare facility. For a one-time user, the idea of purchasing these aids and pieces of equipment for use for a maximum of six months or so can be off-putting. The balance between offering the bariatric patient a good and safe standard of care has to be weighed against the cost of buying such equipment, which can be prohibitive. Renting the necessary equipment from companies such as O’Flynn Medical can be the ideal solution, allowing for short to medium-term bariatric care that will keep the patient safe and not inflict too much stress or strain on the carers or nurses, and all for a relatively modest daily rate – one that includes repairs or maintenance that might be needed during the period that the equipment is required.
Aftercare for Bariatric Surgery
Along with encouragement to begin to exercise or to increase the exercise undertaken, aftercare for bariatrics includes a list of other features that should be taken into account.
- Keeping hydrated. Bigger bodies need more water in order to stay properly hydrated, and bariatric post-surgery patients should drink a minimum of 1.8 litres of water per day.
- Nourishment. Post-surgical patients need high-quality healthy nourishment to break the cycle that led to their ill health in the first place. Bariatric surgery usually affects the stomach and this means that food intake must be carefully monitored in the days following the operation. Usually, patients will begin with liquid meals, moving onto very soft foods after a few weeks, and from there adding in more ‘normal’ foods, albeit in much-reduced quantities than before. Fluid intake is vital to prevent a host of complaints from constipation to fatigue and nausea, to kidney problems. So too is protein – the body uses protein to repair the body and after post-bariatric surgery, patients need to take in between 60 to 100 grams of protein per day in order to aid recovery.
- Supplements. Bariatric patients must take vitamin supplements for life to ensure that they don’t suffer from any of the complications that arise from vitamin deficiencies – some of which can be exceedingly unpleasant and even life-limiting. These can be over-the-counter options, but the regimen must be adhered to. Each patient will be given a list which usually includes Vitamins D and B12, a multivitamin, Iron, and Calcium.
- Other. Bariatric patients should have given up drinking alcohol and smoking before their surgery and should continue to avoid alcohol after their operation. Smoking interferes with the healing process and should never be taken up again. Female bariatric patients should avoid becoming pregnant for one to two years following the surgery. Existing medications, usually tailored to dose the larger body, must be reassessed as the patient sheds their excess weight.
After the need for bariatric medical equipment has passed, continuing to manage their weight and diet is a long-term and ongoing process for many bariatric patients. Obesity is a chronic illness and will recur without a readjustment of the patient’s lifestyle.
The following blogs may also be of interest :
- The best bariatric products for home use
- Choosing the right bariatric bed
- Best Practice & Guidelines for Falls Prevention