Good questions to ask at Pre-Op

Do I take my lasix and k-dur? or go off of it? ________________________________________________________ Is this surgery going to effect my thyroid? ________________________________________________________ What vitamins will I have to take post-op? ________________________________________________________ What bood work should my PCP do? and How often? ________________________________________________________ How much protein daily and does it matter in what form? ________________________________________________________ Of the patients who have died, did they have higher complication rates due to excessive problems or noncompliance? I understand that the death rate is 2%, but what are the causes? ________________________________________________________ How common is a gastric leak? Are there any warning signs? ________________________________________________________ What are the risks of developing a hernia after this type of surgery? ________________________________________________________ What are some of the warning signs that I need to be aware of that would be cause for alarm and requiring me to get emergency medical assistance? ________________________________________________________ I get up to six months off paid leave for surgery. What is the maximum that the doctor will write me off of work for, so that I can incorporate an exercise style into my daily routine as well as proper eating habits? ________________________________________________________ How long will it be after surgery that I will be able to go up and down stairs? ________________________________________________________ Do you know if insurance companys cover cosmetic operations after you have lost the weight and if so, what ones are covered? ________________________________________________________ Is there any type of groups during hospitalization that all patients get together sort of like an early support group? ________________________________________________________ Do I need to bring my own meds? ________________________________________________________ Where is the best place to get the protein Powder? ________________________________________________________ Is it worse for me to have a sugar free fudgsicle instead of a dish of applesauce?________________________________________________________ I have heard of people not being able to get the water or protein in after the surgery, Is there any way to avoid this situation? ________________________________________________________ Can I bring my own Aquafina FlavorSplash? ________________________________________________________ Are there any differences in the complication rates with Lap versus Open?________________________________________________________

Pre-op: 1. What pre-op testing do you require, such as blood tests, gall stone sonograms, upper GI, lung x-rays, etc? 2. Can I have these tests performed locally for insurance purposes? 3. What can I do to improve my fitness for surgery now? 4. Will I need to stop taking medication before surgery? How soon? Can I take Tylenol or Tylenol PM before surgery? 5. Can I take vitamins until surgery? 6. Do I have to do anything special the last few days before surgery, such as a clear diet, fasting, special soaps, or laxatives? 7. When will I be admitted to the hospital? The Surgery: 8. How are the incisions closed? Staples? Stitches? Other? 9. For the RNY, do you separate the stomach pouch from the distal bypassed stomach? 10.Is the anesthesiologist experienced with heavier people? 11.When will I talk with him/her before the surgery? 12.How much of the intestine do you bypass/What is the length of the common channel? 13.What size stomach pouch do you make/How large will the finished stomach be? 14.Do you consider it to be a distal or proximal surgery? Is this only applied to RNY? 15.Do you cut the acid producing nerve to prevent ulcers? 16.Do you instead prescribe an antacid post-op? 17.Will you do a liver biopsy? Is this only for open procedures? 18.During lap surgery, are you able to "check" other organs? 19.Do you automatically remove the gallbladder and/or appendix? 20.How long will I be in surgery? 21.Will you visit my loved ones in the waiting room after the surgery to tell them how the surgery went? After Surgery - In the Hospital: 22.How long will I be in recovery? 23.What types of pain management will you provide? 24.What are the alternatives to the pain management if what you initially prescribe doesn't work? 25.What are your standing orders re being contacted by nursing staff if I feel I need you or if prescribed pain management isn't working? 26.Will I have an epidural? 27.Will I be in ICU? 28.Will I have IV's? 29.Will I have a naso-gastric tube? 30.Will I be on a ventilator? 31.Do you insert a catheter? 32.Will I have drainage tubes in my incision or elsewhere? How many and for how long? 33.Will I need a binder and does the hospital provide them? 34.How soon will I be allowed to consume water after the surgery? 35.What about ice chips? 36.Will I eat in the hospital after surgery? 37.If I don't like the food, can I provide my own as long as it is the same sort prescribed? 38.How soon after surgery will I resume taking my regular medications? 39.How soon and how often should I walk after the surgery? 40.Will I have lung therapy? 41.Will I have a private room or will I share with someone else? 42.How long is the hospital stay? What needs to happen before discharge? 43.Am I required to stay in the hospital until I have a bowel movement? 44.Will I need to remain in a hotel near the hospital following discharge? How long? Complications: 45.What types of complications are associated with this particular surgery? 46.Are there any reasons why the procedure may not be performed after you open me up? 47.What kinds of things could prevent/delay the surgery? Flu? Cold? 48.If this is Lap surgery, is there any situation that might cause you to switch to an open? 49.What type of complications may I have post-op, such as vitamin or mineral deficiencies, hair loss, gall stones, infections, hernias, ulcers, etc? 50.Have you had any patients die on the table or post-op due to complications? Please explain: Recovery from Surgery: 51.Typical discharge instructions? 52.Follow-up care? Can a local Dr. provide this? What sort of Dr.? How can he/she communicate with you about my particular long-term needs? 53.How will I have to eat immediately post-op and down the road? 54.Will I have problems with diarrhea or gas post-op? How can this be treated? 55.Will I vomit a lot? 56.Recovery time for lap? for open? 57.What kind of post-op care/help will I require once I go home and for how long? Long-term Post-op Life: 58.How much weight should I expect to lose and how fast? 59.Should I expect to regain any of the lost weight? 60.Will there be medications that I can no longer take post-op, or medications I won't absorb normally? 61.Will I get sick eating sugars, natural or otherwise, or from eating fatty foods? 62.What percentage of calories and fat will my body absorb post-op? 63.How many calories and fat grams should I eat post-op? 64.How many grams of protein will I need to consume each day? 65.Do you recommend protein supplements? 66.Are there any specific foods I should not consume post-op? 67.What supplements and medications will I be taking post-op? Describe long-term follow-up: 68.What about pregnancy post-op? 69.How often should I get weighed? 70.What types of exercise do you recommend and at what stage post-op? 71.How can this surgery affect health problems I might develop later? cancer (treatment), need for stronger meds for arthritis, osteoporosis, etc.? 72.Is there any risk of cancer or other problems in the bypassed portion of the stomach? 73.How will these be detected post-op? 74.If it came down to life and death, can this surgery be reversed? Personal Questions: 75.Where did you receive your training? 76.How long have you been in practice? 77.How many of these surgeries have you performed? 78.How often do you perform this surgery? (Per week, month, etc.) 79.What percentage of your patients receiving this surgery have had major complications? What kind? Why do you think these happened? 80.As above, what percentage have minor complications? What kind? 81.Is there anything I can do to prevent these? 82.Can I speak to some of your post-op patients? Financial Considerations: 83.How much does the surgery cost and do you accept my insurance? 84.Do you think I will have problems getting insurance approval? 85.Will you help me in the appeals process, if necessary? 86.If I have to self-pay or pay a portion of the costs that insurance doesn't cover, will you accept payments? 87.Do you have a sliding pay scale? 88.Do you require a deposit? How much? 89.Does your fee include all aftercare? For how long? Communication: 90.I'm concerned about negative comments I've heard on-line about the communications skills of your office staff. What can I do (without being offensive) to make sure my paperwork is handled in a timely manner? 91.May I call the office to confirm that paperwork has been sent to my insurance company? 92.What should I do if I feel my needs are not being met? 93.How should I contact you if I have more questions? 94.Next step toward insurance approval? Steps after that?

ok, i really don't want to sound mean, but did you research this surgery at all? READ PROFILES!!! you can learn a lot! It took me a loooooooooooooooong time to figure out if this was right for me or not. Everyone is different, read and read and read some more. Start with my profile!!! Hugs Linda

Wow kimberly, you have some excellent questions there too! I am probably going to print them out and take some of them to my pre op appt. When you READ PROFILES, yes you get an idea of the answers to alot of questions, but I want to know what the answers are as they pertain to MY DR. and HOSPITAL. I just learned about this site last week and when you work 15 hours a day and have little ones, it does not leave alot of time for leisure reading, so forgive me guys if my questions seem stupid