What you need to know before undergo bariatric surgery
What can I expect when I first visit the hospital?
You will have a thorough history taken at the time of your visit, and as a candidate for weight loss surgery you can expect to go through a series of consultations with our multidisciplinary team that consists of a digestive surgeon, an anesthesiologist, a clinical nutrition specialist, an internal medicine specialist. Please make sure to bring any pertinent medical information and tests results from other physicians. Since the clinical nutrition specialist will evaluate your dietary habits, and discuss healthy lifestyle changes before and after surgery, it is also a good idea to bring a list of everything you have eaten and their amounts in the two days prior to your appointment. Your tests results, as well as your medical and dietary history, will be reviewed by the surgeon and any potential concerns will be discussed. The surgeon will then review with you the surgical procedures and potential risks of surgery as they pertain to your individual case.
How do you determine which bariatric operation is best for a patient?
The type of surgery that’s best for you will be determined by a team looking out for your best interest – not the surgeon’s best interest or the hospital’s best interest. Our team considers each patient individually, taking into account the patient’s physical condition and ability to exercise, dietary habits, lifestyle, emotional concerns, etc. The team guides each patient into making an informed decision and provides individualized long-term care after an operation is complete.
Will I need any preoperative tests?
To ensure the best possible outcome, we’ll administer specific blood tests, a chest x-ray, and an electrocardiogram (EKG). We’ll also test you for a bacteria that causes ulcers (known as H. pylori) and for gall stones. In some cases, we may also require a sleep study (for sleep apnea) or a psychological evaluation.
What are the risks of weight loss surgery?
The risk of death associated with weight loss surgery is extremely low — less than 0.5%. Risks, as all abdominal operations carry, may include:
- Bleeding
- Infection of the incision and abdomen
- Potential problems with the heart and/or lungs, including blood clots
- Obstruction (blockage) of the intestine caused by adhesions (scar tissue) or internal hernia
- Hernia through the incision or inside abdomen
- Rejection of suture material
- The risks associated with general anesthesia; anesthesia risks are not significantly greater in most
- morbidly obese patients than in normal weight patients
Will I be asked to stop smoking? Why ?
Patients are highly encouraged to stop smoking at least three months before surgery. Smoking increases the risk of lung problems after surgery, can reduce the rate of healing, increases rates of infection, and interferes with blood supply to the healing tissues.
Recovery, How long will I be in the hospital ?
The majority of patients only stay in the hospital for 2 or 3 nights for recovery, unless a complication develops.
How many follow-up visits are necessary after surgery ?
Typically, you’ll attend four to six follow-up meetings during your first post-surgery year. Then visits are scheduled at six to twelve month intervals for an indefinite period of time. The operating surgeon and nutritionist will meet together with you during each follow-up visit. Vitamin and mineral levels as well as protein intake are checked at regular intervals. After the first year, annual checkup visits are recommended for all patients.
When can I return to normal activity ?
After surgery, most patients return to work after two to four weeks. Some may be able to work from home as early as one week after surgery. Any pain related to the surgery should go away after 7-10 days or so. Because of the significantly reduced calorie intake, many patients have low energy for 1-2 weeks after surgery. However, most patients gain their energy back once they start to have soft food.
Can I get pregnant after bariatric surgery ?
Yes! Most women are much more fertile after surgery, even with moderate pre-op weight loss. However, most surgeons recommend waiting 12-18 months after surgery before getting pregnant.
Will I lose my hair ?
Some hair loss is common between 3 and 6 months following surgery, but it is temporary. Adequate intake of protein, vitamins and minerals will help to ensure hair re-growth, and avoid longer term thinning.
When can I start exercising ?
Patients need to start walking as soon as they return home, and should walk every day after surgery. Patients can expect to begin a weekly exercise routine after three to six weeks post-ops. However, it takes time to get there, so start with smaller goals as recovery is the immediate goal after surgery However, light physical activity is an important part of the recovery process. Avoid lifting heavy objects for the first 6 weeks. If you swim, your wounds need to be healed over before you get back in the water.
How soon can I drive after surgery ?
You should not drive until you can move quickly and alertly and are no longer taking medications associated with your surgery. Usually this takes about one to two weeks.
Life After Surgery, What kind of weight loss can I expect ?
The results from gastric sleeve vary from patient to patient but most can expect to lose 1 to 1 ½ kilograms per week until the normal weight range is reached. Most gastric bypass patients experience fairly rapid weight loss for three to six months after surgery. Weight loss slows but generally continues for 12 to 18 months after surgery. Results vary from patient to patient, with the best results coming from those who are committed to lifestyle change. After 18 months, it is critical to adhere to the low-fat, low-sugar diet and exercise recommendations to maintain your weight loss. The most important concept for patients to remember is that these operations only help you comply with your diet. Success depends on the individual, and each individual has a different goal.
Does weight loss surgery guarantee permanent weight loss ?
No. A small percentage of patients will regain a substantial portion of the weight that is lost. This is occurs primarily when the patient does not follow the dietary guidelines in the months and years following the procedure.
Do I have to take vitamins and minerals after surgery ?
Yes. we recommend that you take a daily multivitamin supplement containing the minerals necessary for good health. These should be taken for life. You will also need to have at least yearly lab checks.
Do I have to change my diet and exercise after surgery ?
Immediately after surgery, your doctor will provide you with special dietary guidelines. You will need to follow these guidelines closely. Allowing time for proper healing of your new stomach pouch is necessary and important. Eating soft sweets, such as chocolates, ice creams, or drinks/liquids high in calories can cause poor weight loss or weight gain.
Will I need to have plastic surgery?
You will have a lot of change between 6 and 18 months after surgery. Your individual appearance depends upon several things, including how much weight you lose, your age, your genetics and whether or not you exercise or smoke. Generally, loose skin is well-hidden by clothing. Many patients wear compression garments to help with appearance. Some patients will choose to have plastic surgery to remove excess skin. Most surgeons recommend waiting at least 18 months, but you can be evaluated before that.
