Questions for the Doc?

Hi everyone, Hope everyone is doing well. I have been compiling a list of things I would like to ask my surgeon when I finally do get to meet him (I must attend a seminar on 2/15 before I can sit with him). I was curious if any of you had asked or wish you had asked any other questions. Here is what I have so far: Questions for the Surgeon regarding Lap-rny (in no particular order) Number of Lap Rny's he has performed His history of complications including mortalities Typical hospital stay length Catheter procedure? Used? When in/out? Eeeeek! Still gets me! Drainage tubes procedure Used? When out? Breathing tube used? What happens to the staples on the stomach/intestines? Dissolve? Removed? Pre surgery diet? Once again, thank you all for your help! Chris

Hi Chris, Here is my very long list of questions for my surgeon and his responses. He went through each question and took the time to answer them thoroughly.QUESTIONS TO ASK THE SURGEON 1. WHAT PRE-OP TESTS WILL I NEED AND WHO WILL SCHEDULE THEM? CAN THEY BE DONE IN MY HOME TOWN? Ultra sound of the gall bladder, blood test, EKG, chest x-ray 2. WILL I NEED TO STOP TAKING MEDICATION PRIOR TO SURGERY? HOW LONG? Stop taking HCTZ (diuretic) and aspirin prior to the surgery 3. DO I HAVE TO DO ANYTHING SPECIAL THE LAST FEW DAYS BEFORE SURGERY? Bowel prep (oh goody), clear liquid diet the day before surgery 4. WHAT CAN I DO TO PREPARE MYSELF FOR SURGERY TO BE SUCCESSFUL WITH AS EASY A RECOVERY AS POSSIBLE? Follow the program and give your all for a year 5. HOW LONG DOES IT TYPICALLY TAKE FOR THE LETTER OF NECESSITY FOR INSURANCE TO BE WRITTEN AND HOW SOON WILL BE BEFORE IT IS SUBMITTED TO INSURANCE? One to two weeks 6. DO YOU THINK I WILL HAVE A PROBLEM GETTING INSURANCE APPROVAL? No, usually they just go by your BMI 7. MAY I CALL YOUR OFFICE TO CONFIRM THE PAPERWORK HAS BEEN SENT TO MY INSURANCE PROVIDER? This is sent to insurance by the program staff at the hospital 8. WILL MY SLEEP APNEA AFFECT MY SURGERY, ANESTHESIA, OR AFTER SURGERY CARE WHILE IN THE HOSPITAL? It can. 9. IF I HAVE MY CPAP MACHINE BY THEN WILL I NEED TO BRING IT TO THE HOSPITAL? Yes, if I have it 10. DO YOU EVALUATE THE OTHER ORGANS WHILE YOU ARE DOING THIS SURGERY? Not really 11. WHAT SIZE STOMACH POUCH DO YOU MAKE? HOW LARGE WILL IT STRETCH? Starts out the size of an egg, ends up the size of a fist, approximately eight ounces 12. WILL I BE ON A VENTILATOR? Yes during surgery 13. WILL I HAVE A CATHETER? Yes, until the next day 14. DO YOU TYPICALLY HAVE TO LEAVE A DRAIN IN AFTER SURGERY? Yes, while in the hospital 15. ARE THERE ANY SPECIAL REQUIREMENTS BEFORE DISCHARGE FROM THE HOSPITAL? Must have a good blood count and walk every 4 hours, day and night 16. WHAT ARE THE MOST COMMON COMPLICATIONS FROM THIS SURGERY? Bleeding and leaks 17. WHAT IS THE MOST COMMON PROBLEM PATIENTS HAVE AFTER SURGERY? Psychological loss of food, over eating 18. DO YOU SPEAK TO MY WIFE AFTER SURGERY? Yes 19. WILL I NEED TO REMAIN NEAR THE HOSPITAL AFTER SURGERY? At least one night after surgery 20. HOW ACCESSIBLE ARE YOU FOR POST-OP PROBLEMS? If not him someone would be accessible for questions or problems 21. IF BLOOD WORK IS REQUIRED AFTER SURGERY CAN IT BE DONE AT MY HOME TOWN? Yes 22. HOW OFTEN WILL I NEED LAB WORK DONE? 2 months, 4 months, 6 months 23. WILL I BE GIVEN MEDICATION TO PREVENT GALL STONES? No 24. SHOULD I GET A MEDIC ALERT BRACELET? Yes 25. WHEN CAN I START EXERCISE AFTER SURGERY? Strenuous exercise after 4 weeks, not lift more then 15 pounds for 4 weeks 26. HOW FAR OUT ARE YOUR SURGERY DATES? 2 to 3 weeks 27. DO YOU ATTEND THE SUPPORT GROUP MEETINGS? Rarely 28. HOW MUCH WEIGHT SHOULD I EXPECT TO LOSE AND HOW FAST? 80% of excess weight by the end of one year Good luck, Life is good, Rick

Great list, thank you very much. I'm sure I will ask many of them. I hope the doc was a bit more informative than the answer you have written. I assume they are just shortened versions but if not he seemed rather short with you. Best wishes and thank you again, Chris

Hi Chris - Are you already sure that the Lap RNY is the procedure you are getting? When I had my face to face consultation I had thought I was going to get a Lap Band but after discussing all the types of WLS I ended up getting a VSG. JP

Based on my research and discussions with others in a similar situation (weight, age, etc) I fell like that would be best for me. I guess I still can change my mind as I haven't had my initial consultation yet.

Chris,-Re-post from the past............ Hope it's useful...................... __________________________________________ OK, this is the "BIG ASSED LIST OF QUESTIONS!" Pick your favorite 25- Write questions down on a sheet of paper and write answers are you are given them. This is a few that may be of interest to ask your surgeon. Any that you don't ask this time, ask the next, and the next, then call back, and so on... Ask the Doctor 1. Are you listed with the ASBS. What are the surgeries you do and why did you chose the surgeries you do? 2. Do you offer more than one type of procedure? What is the difference? 3. How long have you been performing this surgery and how many do you perform a year ? 4. What are the biggest risks/complications of this surgery? 5. Is the surgery reversible and how common are reversals? 6. How many staple line disruptions have you had? 7. What is the mortality rate for this surgery for you/at this hospital 8. What are the chances of getting an ulcer or hernia in my type surgery? 9. How common are spleenectomies at this hospital/doc? 10. Do you have a gallbladder policy? What is it? (I have noticed that many people have gall bladder problems after surgery). Specific Surgery Application questions- 11. Do you transect the stomach? 12. How much intestine will be bypassed? Feet length? 13. Is this called this distal or proximal? 14. How small will my stomach/pouch be after surgery? (Have the doctor draw a diagram of the exact way he will do your surgery on a piece of paper, because there is so many versions of each surgery. The doctors modify the surgery somewhat to what they feel is most successful. Some request the Fobi pouch style specifically because they want the restriction and less chance of staple disruption). 15. Do you use staples, stitches or blind stitches for the incision . How many staples/rows of staples do you use? Will the staples set up security alarms in airports? 16. Will my incision be covered with bandages and tape? (I'm allergic to traditional tape used on bandages and my skin welts up. Is there an alternative product you can use on my skin?) 17. Will a binder be used? How long do you recommend I use the binder? 18. Do you visit with my "loved ones" after the surgery to tell them how it went? 19. Does the hospital have a Bariatric Ward? 20. How many days is the usual hospital stay with my type surgery? 21. How many days/hours in ICU? Is a "loved one" be allowed in the recovery room? 22. Will I have a personal recovery room? Can a "loved ones" spend the night? 23. How many hours before I am awake and oriented and what kind of pain will I experience? 24. Will I have drainage tubes in my incision? a. How many? b. For how long? what if I'm allergic to plastics? 25. What are some reasons the surgery may not happen after you open me? 26. How long is the average recovery time for my type surgery? 27. Will I be allowed to shower the day after surgery? Can I get the stitches wet? 28. Do I need to purchase any special wound care products for after surgery like gauze or peroxide. What do you recommend using to speed the healing? 29. Will I have an opportunity to meet with the anesthesiologist before surgery? 30. Am I given something to calm me BEFORE entering the Operating Room? (this is the Good Stuff!) 31. How do you chose which anesthesia is better for me? Is the anesthesia gradually introduced by IV or am I given a shot? 32. Can I expect to experience any delayed reactions in the days following surgery? 33. Will I be on a ventilator? NG tube? 34. Will I need a catheter? 35. How does lap work? How do you remove anything through the small holes? Pain Control 36. What about pain medication? Will I have the option of an epidural? 37. What types of pain management do you provide: morphine pump? a. at the hospital? b. at home? ***38. What type meds for 'breakthrough pain' will be available to the nurses in case I need them and you're not around to prescribe them? Pre Op Testing and procedures.. 39. What kind of pre op testing is there? What pre-testing do you require? (Blood test, EKG, gall stone ultrasound, upper GI, lung testing, chest x-rays, etc.) 40. Will I meet with a nutritionist before and after surgery and is it arranged here? 41. What can I do to prepare myself for surgery and be successful with as easy recovery as possible. Exercise, lose weight, breathing machines? How can I prepare for surgery mentally- medications to keep me from anxiety? 42. How soon can we schedule surgery? Can I choose a specific date? 43. Will I have to have any blood transfusions during surgery? Can I donate my own blood for transfusions? 44. Will I need to begin taking an antibiotic prior to surgery? 45. What if I have had or during testing found to have H-Pylori? 46. How many trips will I make to the clinic before surgery and why? 47. Any special instructions 2 - 3 days before surgery? If you are on medications of any kind, you might want to ask whether you should keep taking them before and after surgery. Should I stop taking certain medicines like aspirin? POST- 48. What type BM's and how often are BM's in hospital and out? 49. If I do overeat, what should I expect? Risks? 50. What type of post-op diet do you recommend? Can i have a copy of this? 51. What type of after care does is provided? Maintenance - how often will you see me without charging me a fee? 52. Is there a list of other Post op patients that I may contact for referrals? 53. Where is the nearest support group to me? 54. What is your recommended menu for the first few months post op? a. Clear Liquids, what kind and for how long? b. Full Liquids, what kind and for how long? c. Pureed Foods, what kind and for how long? d. Real Soft Foods, what kind and for how long? 55. What will my protein requirements be? 56. What do you suggest for supplements if at all? 57. How can I combat hair loss, I've heard Biotin and Nioxin, do you agree? 58. How can we combat vitamin deficiencies and gall stones? 59. What do you recommend to avoid vitamin deficiencies? * multi-vitamin (morning and night) * calcium citrate (1200 - 1500 mg) * B-12 (500 mcg.) * 50 to 80 grams of protein? 60. Will there be medications that I will no longer be able to take after surgery? 62. What type of physical restrictions do I need to adhere to after surgery? 63. When can I return to work , sex, exercising, lifting, what weight? 64. What about: Exercise - How long before I am allowed to exercise my abdominal muscles? Lifting- How long before I can lift heavier items such as my laptop, groceries, children and how many pounds? Driving- a car, truck, etc...? 65. What about traveling after surgery? 66. (for your surgeon's billing person) And get their Name and make them your friend!!!) How does the insurance billing work? Do I just pay you the $$$$, that I know that will be coming? Can I make payments on that? Do I pay this now or later? Is there hidden costs? What if you have to remove gallbladder or other unexpected problems occur? -is that included? If my hospital stay is longer than expected is this included or extra? 67. I read some advice that I should not take certain meds...what are they and why can't I and is this permanent? Do you have a list of these medicines to avoid printed up? 68. Do I have to eliminate alcohol or how long? Could drinking damage my liver faster since bypass if over indulged? 69. Will there be a number for you /or a doctor on call that understands bariatric surgery complications once I've left the hospital? If I need someone after hours and emergencies who/how do I contact? These are some of the more common... I haven't combed through or organized them well, Just a bunch of questions..... Best Wishes- Dx

WOW, that's some list. Thank you very much!

Hey Chris... Well Dxe, hit the high points, now for the questions that you really need to know..... 1- what percentage of your patients require a SWAT intervention 3 weeks post surgery, due to drastic changes in eating habits...will the stun gun they use, effect my incision..... 2- how long post surgery will my hormones start to rage, and I turn into an AzzHole to everyone in ear shot.... 3-How long with the mental honeymoon phase last..the hey this is novel, I had WLS....When real life sets in, and I realize this is how I have to be forever, what percentage of your patients are instituionaized? 4-does the doctor have personal body guards to protect him from hungry patients... 5- How do I prepare my wife for the constant increase in sexualy activity.... Chris, you are going to do great...just jacking with you Russ

AWESOME, I'll have to bring them in for the consult! See if the Doc has a sense of humor! Thanks for the good laugh Russ.