Initial visit coming up...

On Wednesday, wifey and I are going to our initial visit with the dietician and surgeon. We've got our packets and questions ready - or so we think.

I was just curious as what to expect, so I'm not completely surprised.

Always appreciated!

Mike

Nothing too severe. You meet with the surgeon and he discusses the procedure and talks to you about football/baseball something else equally frivolent and then you meet the dietician who is the real brains behind the operation as she will be telling you all you need to know about the diet life pre- and post-op. Fun times!

My wife and I just had WLS also.  On our first visit, they let us do most of the steps together.  

The first thing done was a nurse checked our vital signs, weight, determined our BM, % Body fat and asked us questions about hour weight history, diets we tried etc.

Then we were separated for individual physicals by the PA.  Much less intensive than the one I have with my primary MD.  Basically listen to lungs, feel the abdomen, check you legs for edema, feel the neck etc for swollen glands.

Then we met our surgeon, he asked us questions about what we were considering for surgery.  He went into depth as to what to expect from RNY. He also reviewed the risks associated with surgery.  We asked him many questions.

After we were done meeting with the MD, he took us to his scheduler, she went over all the pro-op test we would have to get completed before the insurance company would approve our surgery.  She asked what days would be best for our appointments, we asked to have the schedule at the same time and to have them done in as few a days as possible so we would have to take the minimum time off from work.

A few days later we got our schedule in the mail all of our testing scheduled, the date we started our liquid diet and our tentative surgery date.  we just had to make appointments with our primary MD and for the Psych evaluation.

Hope all goes well with the visit.  I really feel that this process has been much easier for me, since both my wife and I are going through it together.

Jim 

Mike, At least you and your Mrs. are doing all this together.  Mine let me do it four months in front of her.  WTF?  How did I get suckered into that?  

Wow, didn't know there were so many of us doing it as a husband-wife team.

Be prepared for a lot of appointments. Be prepared to find out all kinds of stuff about your body you didn't know, like conditions you have, vitamin deficiencies, sleep apnea, fatty liver, etc.
Be prepared to spend a lot of money on copays.

LOAD UP on the water before you go to get weight up. Some Drs require you lose a certain % before they'll even schedule. Might as well pad the total a bit and make it easier to get it down, this is also the number they use when they submit to insurance. If you're boardline, load up. Congratz you both of you 1Gallon = 5-7Lbs approx

Mike,

This is a post I used to drop on the Men’s Forum. It’s a huge list of Questions (some of which are useful, some totally naive, but may trigger other thoughts) That people have found beneficial in the past.  Some of them I would assume, or consider naïve, while others are very appropriate. It could provide some reminders for questions and topics for the book…. Just a Thought _____________________________________________________________ One of the most valuable things I found when first starting my “Journey” Was from the Profile of a couple of the Older Post-Ops…..(Lei and WLS-Deb) I went looking, And I think in the “New-Format” (and some recent “absences,”) Those “Stores of Information” have been “Lost in Translation.” So- For any just starting- I had this List- And thought I’d Share………… (BTW- it’s best if you can figure out most of these from your Pre-Op seminars, materials from the surgeons office, etc.. By the time you get to your actual Meet to discuss your date for surgery, “the list” should be pretty short..yes?  For about 80% of these, there should be a simple- “Why?” added to the end…It’s not just about ‘following rules,’ but often about knowing why….)

 

OK, this is the - “BIG-AZZ-OLE 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? (if applicable) 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). Some Surgeons remove the GB at time of surgery. Specific Surgery Application questions- 11. Do you transect the stomach? 12. How much intestine will be bypassed? Feet length? 13. Is this called distal or proximal? 14. How small will my stomach/pouch be after surgery? (Maybe ask the doctor to draw a quick diagram of the way he will do your surgery on a piece of paper, because there are 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?  Or will the pouch be transected? (Separated completely from old stomach) 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 “spouse/family member” allowed in the recovery room? 22. Will I have a personal recovery room? Can a “spouse/family member” 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 induced 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? (get a brief yet clear explanation if knowing helps you.) Pain Control 36. What about pain medication? Will I have the option of an epidural? Post op pain pump? 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 should overeat, what should I expect? 50. What type of post-op diet do you recommend?  Do you have it in a printout?  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? 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 (1000? 1200? - 1500 mg?) * B-12 (500 mcg.) Shots? Sub-linguals? * 50 to 80 grams of protein supplement beyond food? 60. Will there be medications that I will no longer be able to take after surgery? Why? 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 size 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?  Ballpark range of costs? 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? How could drinking damage my liver faster after bypass? 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? I found some of it valuable, Hope some others do too… Best Wishes- Dx