The Program

For those of you who have had the surgery or are a few steps in, I am wondering what is coming next.

My family doctor referred me through the Bariatric Network in July. I had my first consultation appointment with my bariatric doctor at St. Michael's Hospital August 29th. Is that also called the orientation or is that different?

I know someone is going to contact me to start the program but I'm not sure when or how. How did you start the program? What is the program?

I have HYPERthyroid. I was put on medication to suppress my thyroid, which in turn, also slows my metabolism. I gained about 30lbs. Once that stabilized, my endocrinologist at Women's College Hospital recommended WLS as I've been overweight or obese my adult life. They tried to refer me, but it didn't work. So I asked my family doctor to refer me. This was the summer of 2017. In about 4 weeks, I got a package in the mail from Toronto Western Hospital. It contained a questionnaire. It included questions about my medical background, lifestyle, finances/job, etc. Then a few weeks after that I got a letter for an appointment for an orientation in November. At the orientation, they covered the basics of surgery, we watched some videos, talked about the commitment, provided an overview of the program etc. If you wanted to continue, you were given a sheet with appointments. The sheet included an appointment for a nutritionist class and nurse assessment appointment. Depending on your situation it may include a social work appointment. For the nurse assessment you're required to complete blood work, bring a list of meds, and provide medical history. For the nutrition appointment you're required to complete a 3 day food journal. I also had a social work appointment. They just wanted to ensure that I had someone to take care of me and the financial resources to keep up with vitamins, get opti fast etc. I'm sure this was triggered cause I was in between jobs at time I got the questionnaire. At my nurse's assessment, my neck circumference was over a specific # so I had to a sleep study for sleep apnea (didn't have sleep apnea). I also tested positive for h pylori so I had to take meds (worst week of my life). I also had to do a 2nd nutritional appointment cause I wasn't reaching my protein goal at first (generally 60g to 80g for women). Additionally, I had to do a psychological assessment. I don't have any addictions, eating disorders (aside from just general overeating), or mental health issues except for mild anxiety which is related to my thyroid. They tell how if you self-medicated with food that that won't be an option, talk about potential for depression etc. Now, I have my surgeon appointment next month to meet the surgeon and order optifast.

TLDR - Too long didn't read:

• Referral - Summer 2017
• Orientation - November 8, 2017
• Social Work Assessment - January 16, 2018
• Nurse Practitioner Assessment - January 17, 2018
• Nutritional Class - February 12, 2018
• Sleep Study - March 4, 2018
• H Plyori Breath Test - March 7, 2018
• Psych Assessment - June 1, 2018
• Follow Up Consult Sleep Study - June 28, 2018
• Nutritional Follow Up - July 12, 2018
• Surgeon Appointment - October 19, 2018
• Additional Steps - ???????
• Surgery (assuming December 2018 or early 2019)

I had to do a second appointment nutritional appointment. I don't know if this delayed my process. I also did not take advantage of cancellations.

How many cases or how often do you need to order Optifast?

It's 4 shakes per day. The amount of weeks you do depend on how much you weigh. I think it's 1 week per 100 pounds. I'm in the 200s, so I'm assuming I'll have to do 2 weeks, who knows. I may have to do 3. I don't find out till October.

Ok, not horrible. Good to know now so I can plan for it.

I am 268lb and i on opti for 2 week

Your steps may be different because you're going through St Mikes and I'm going through Toronto Western Hospital. Also, a lot of the steps are dependent on your health/medical history.

This is exactly the information I was looking for! Thank you so much for sharing. This has really helped me understand where I am in the entire process.

I know it's different for everyone but just a general idea is great. Now I know that I haven't had my orientation yet. I've only met the doctor who told me I am in the program and will receive more information soon.

Welcome!

I initially didn't want to chime in because it seems that although the process is somewhat similar from centre to centre things are different.

I came through the Wharton Clinic in Hamilton so my experience has been quite different in the initial process however the "PROGRAM" is the same.

The one thing that I want to bring to your attention is that, if you haven't heard back from the clinic etc. etc., CALL THEM. Do follow ups. Don't assume they're doing stuff on your behalf. Referrals get lost, phone calls get missed and mail gets misdirected. Take control and advocate for yourself every step of the way.

You can even start doing some of the medical tests now through your family Doctor while you wait for Orientation etc. If you have sleep apnea you need to do a sleep study. A full bloodwork panel will be needed including all nutritional components. I had to do an endoscopy as well as a colonoscopy. I also had an abdominal ultrasound. If you can get moving and get some of those things scheduled you will be ahead of the curve.

Good Luck!

Hey Sweetride1 - My doctor said that she referred me to some main center for the surgery and also referred me to Wharton Clinic. Unlike the original poster, my doctor didn't ask me what clinic I would prefer and I haven't heard from anyone. Is it not normal that my doctor didn't ask me or that I haven't heard from anyone?

Still have 2 weeks before my initial Wharton intake appointment.