FAQ's

General

What is the youngest age for which weight loss surgery is recommended?
Generally accepted guidelines from the American Society for Bariatric Surgery and the National Institutes of Health indicate surgery only for those 18 years of age and older. Surgery has been performed on patients in their teens. There is a real concern that young patients may not have reached full developmental or emotional maturity to make this type of decision. It is important that young weight loss surgery patients have a full understanding of the lifelong commitment to the altered eating and lifestyle changes necessary for success.

What is the oldest patient for whom weight loss surgery is recommended?
Patients over 65 require very strong indications for surgery and must also meet stringent Medicare criteria. The risk of surgery in this age group is increased, and the benefits, in terms of reduced risk of mortality, are reduced.

Can Weight Loss Surgery prolong my life?
There is good evidence from scientific research that if you have Type 2 diabetes (or other serious obesity-related health conditions), are at least 100 lbs. over ideal body weight, and are able to comply with lifestyle changes (daily exercise and low-fat diet), then weight loss surgery may significantly prolong your life. A female smoker with a BMI of greater than 40 could lengthen her life expectancy by more than 15 years if she loses weight and quits smoking.

Can weight loss surgery help other physical conditions?
At one year after successful bariatric surgery, 96% of obesity related medical conditions are either completely resolved or significantly improved.

Preparation for Surgery

What are the routine tests before surgery?
Certain basic tests are done prior to surgery: a Complete Blood Count (CBC), a complete profile in terms of liver functions, kidney functions and lipid profile will be done, Thyroid Function Test, Iron levels, B12 levels. All patients but the very young get a chest X-ray and an electrocardiogram. Due to the high incidence of obstructive sleep apnea, most patients will require a polysomnography study. Patients will get an abdominal ultrasound. Other tests, such as pulmonary function testing, echocardiogram, GI evaluation, cardiology evaluation, or psychiatric evaluation, will be requested when indicated.

What is the purpose of all these tests?
An accurate assessment of your health is needed before surgery. The best way to avoid complications is to never have them in the first place. If you are diabetic, special steps must be taken to control your blood sugar. Our objective is to maximize your likelihood of success.

Why do I have to have a GI Evaluation?
Patients who have significant gastrointestinal symptoms such as upper abdominal pain, heartburn, belching sour fluid, etc., may have underlying problems such as a hiatas hernia, gastroesophageal reflux or peptic ulcer.

Why do I have to have a Sleep Study?
The sleep study detects a tendency for abnormal stopping of breathing, usually associated with airway blockage when the muscles relax during sleep. This condition is associated with a high mortality rate and can be present in nearly 70% of obese patients. It is important to have a clear picture of what to expect and how to handle it.

Why do I have to have a Psychiatric Evaluation?
Bariatric surgery will require significant changes in your lifestyle and will also change your life. A psychiatric evaluation will help prepare you for these changes by developing coping skills and encouraging behavior modification. Additionally, our psychiatrists will evaluate your understanding and knowledge of the risks and complications associated with weight loss surgery and your ability to follow the basic recovery plan.

What impact do my medical problems have on the decision for surgery, and how do the medical problems affect risk?
Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, if they are problems that are related to the patient's weight, they also increase the need for surgery. Severe medical problems may not dissuade the doctor from recommending gastric bypass surgery if it is appropriate, but those conditions will make a patient's risk higher than average.
 

What can I do before the appointment to speed up the process of getting ready for surgery?

• Make a list of all the diets you have tried (a diet history) and bring it to your doctor.

• Bring any pertinent medical data to your appointment with the surgeon - this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.

• Bring a list of your medications with dose and schedule.

• Stop smoking. Surgical patients who use tobacco products are at a higher surgical risk.

Surgery

Does Laparoscopic Surgery decrease the risk?
No. Laparoscopic operations carry the same risk as the procedure performed as an open operation. The benefits of laparoscopy are typically less discomfort, shorter hospital stay, decreased hernia and wound infection rates, earlier return to work and reduced scarring.

Will I have a lot of pain?
Every attempt is made to control pain after surgery to make it possible for you to move about quickly and become active. This helps avoid problems and speeds recovery. Often several drugs are used together to help manage your post-surgery pain. While you are still in the hospital, a Patient Controlled Analgesia (PCA), which allows you to give yourself an intravenous dose of pain medicine on demand, will be used to initially control your pain. When you are ready to go home, you will be given a prescription for pain medicine.

How long do I have to stay in the hospital?
As long as it takes to be self-sufficient. Although it can vary, the hospital stay (including the day of surgery) can be 1-2 days for a laparoscopic band, 3-4 days for a laparoscopic gastric bypass.

How soon will I be able to walk?
Almost immediately after, the doctor will require you to get up and move about. Patients are asked to walk or stand at the bedside on the night of surgery, take several walks down the halls the next day and thereafter. Walking is the most effective means to decrease your risk of having a pulmonary embolus. On leaving the hospital, you may be able to care for all your personal needs, but will need help with shopping, lifting and with transportation.

How soon can I drive?
For your own safety, you should not drive untixl you have stopped taking narcotic medications and can move quickly and alertly to stop your car, especially in an emergency. Usually this takes 3-5 days after surgery.
 

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