What questions would you askat the Bariatric seminar that you didn't think to ask the first time?

Yes, ask about post-op support. How many times do they see you the first 3 months? the first year? Frequency of support groups? Who runs the support groups? What happens after a year?

My girlfriend and I had surgery with 2 different local physicians - due to insurance reasons and there is night and day difference in follow up care. She is doing well and fine, but not nearly as much support....and the support groups they suggest she goes to aren't her physician specific groups. When I go to my groups there are nutritionists there of nurses that actually work in the office, so I have a quick question I can ask them, or they can say too- I think you should come in. It is nice to know I can always have theat opportunity for fave-to-face with people from his office even if I don't go in for a visit. I alos go to community based support groups as well- started by WLS patients, those are great too..probably even better.

What is the most common minor complications you see? Short and long term...

There is definitely a swing towards getting the sleeve, I see my surgeon doing so many more sleeves. So my question would be why sleeve over RNY... or Why RNY over sleeve if they do more RNYs....

I will definitely be asking about support groups as I live 3 hours away from the Bariatric surgeons office in Little Rock, AR.  I am hopeful I can find one in surrounding towns and definitely use OH as well.

All pouches are not created equally which I did not know. Ask your dr what size pouch he creates ... large small whatever just ask 

I would not have thought to ask that, Thank you!

Pouch size is an excellent question.  I had a micropouch, about the size of a grape.  Many surgeons create a pouch the size of an egg.  Some do them bigger.  I believe my small pouch was a big factor in my success.  The pouch does grow bigger as time goes by and usually end up holding between eight and twelve ounces at maturity.

The original stomach is about 32 ounces empty and can expand to hold up to about four quarts.

Hi ladysunbeam

Congrats on taking control of your health and moving forward. Here is a list of questions to ask when choosing a facility and surgeon.

Choosing a Bariatric Center - Questions to Ask Your Bariatric Surgery Program

• Are your bariatric surgery doctors board certified?
• Are the surgeons recognized as experts in the field?
• Are the bariatric surgeons experienced in laparoscopic techniques?
• Does the bariatric surgery program follow established guidelines in patient selection?
• Does the bariatric surgery program offer evaluation and treatment for conditions associated with obesity (e.g., diabetes, high blood pressure and sleep apnea)?
• Is there a dedicated facility and staff for my care?
• Does the program offer support services for psychological needs?
• Does the program offer dedicated registered dieticians?
• Are there a dedicated nursing staff and nurse practitioners for the program?
• Are the radiologists in the bariatric surgery program board certified?
• Are the anesthesiologists in the program board certified?
• Will you work with my primary care doctor to ensure my overall healthcare concerns are addressed?
• Will you work with me to gain insurance approval?
• If I am denied insurance coverage, do you offer payment options?
• Does the program offer support groups following weight-loss surgery?
• Can I have reconstructive surgery here after my weight loss?
• Do you offer accommodations and travel assistance for out-of-town patients?
• Does the program offer translation services for non-English speaking patients?

Questions to ask your surgeon

 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?

 

Thank you!!!!!

This list is incredible.  Thank you!  This should be in a sticky somewhere!

Hi LoCoMama  

We do posts with links to share information often.  Here is one we did just a few months ago.  

http://www.obesityhelp.com/forums/amos/6010823/Questions-to- ask-your-Bariatric-Surgeon-and-Plastic-Surgeon/

The best way to find info is to use the search feature to the left of your user name.  If you need any help let me know.  That is what I am here for 

Regards,

Kathy

Community Services

What surgeries do you do? Do you do the RNY only? The RNY, VSG only? The RNY, VSG, DS? Etc.

Surgeons are business men....they will sell you what they got...and most of the time sell you against what they don't have. You represent 10,000 dollars to them...and if you walk out there door....so does the chance of them collecting that money. It would be nice to say that every surgeon does what is best for the patient (most do), but some do not.

I'd go to the seminar with listening ears and also do a LOT of research on your own....about them as surgeons, their success rates, complication rates, etc. Also on the types of surgeries they offer (and the ones that they do not offer).

I went to a surgeon that only performed the lap band and the RNY. He sold me on the RNY because he said it was the best surgery for me- when I asked about the DS, he told me that it was a terrible surgery.

I went for a 2nd opinion. The surgeon performed (at the time) the Lap Band, RNY, and the DS. He didn't sell me on the RNY or the DS, but explained the advantages of disadvantages of each and explained that he thought i'd do better with the DS due to my weight and weight history. I agreed, and had the DS. 10 years later I'm still maintaining a huge weight loss.