Pre-Op FAQ
|
Pre-Op FAQ
|
|
Pre-Ops First Visit
Question List
Pre-Surgery
a. What pre-testing do you
require?
Possible tests would be blood
work, glucose tolerance test, EKG, gall bladder ultrasound, upper GI,
PFT, chest x-rays, sleep study
and psych evaluation.
If you were on phen-fen some surgeons require a cardiac clearance
b. What should I do to
prepare for the surgery?
I
have heard deep
breathing helps, what does you suggest?
c. Do I have to do anything
special the day(s) before surgery?
For example, have a clear
liquid diet or wash with special soap? Some surgeons
require a bowel cleansing, do you?
d. Do you require
psychological testing? Do I do it through your office or on my own?
e. If I smoke, how will that
effect the pre and post surgery?
f. If I have asthma and/or
sleep apnea, how will this effect the pre, during and post surgery?
g. I am allergic to
_________ how will this effect my surgery?
Surgery
a. Can you describe the
surgery you perform?
b. How is the surgery
performed? Will you do it laparoscopically or open?
c. What do you do
to the
stomach?
Transect or not? What about an
adjustable band?
d. Is the anesthesiologist
experienced with big people?
We have special requirements
due to the fact that fat cells retain the sedative, and since we have more fat
cells.
e. How much of the
intestines are by-passed? Is it proximal or distal?
This has a lot to do with the
side effects that can occur.
f. Do you cut the acid
producing nerve to prevent ulcers? Along those lines, will you prescribe an
acid reducer after the surgery? How long will I need to take it?
g. What do you do about the
gall bladder?
(Gallstones are a common side
effect -- 30% of patients.)
1.
Will you go ahead and remove it
(best choice) or will he prescribe bile salts to prevent them?
2.
How long will I need to take
them?
h. Will you do a liver
biopsy?
I've heard that this is a
common practice to show any irregularities.
i. Will I be in ICU?
j How long will I be in
recovery?
K. Will I get a morphine
pump or some sort of pain pump? When will it come out?
l. Where will the IV be
(neck or arm)?
When will it come out?
(personally, the
best IV that I ever had was in the neck, easy to move around, it never
infiltrated and best of all it didn't hurt on bit!)
m. Will you have a nasal
tube or intubation tube?
When will it come out?
n. Will I have a catheter?
When will it come out?
o. Will I have an epidural?
When will it come out?
p. Will I have a drainage
tube in my incision?
When will it come out?
q. Will I have a drainage
tube in my stomach?
When will it come out?
r. Do you prescribe a stomach binder?
Some do and some don't. The
support of the binder will help a lot with the pain.
s. How soon do you allow
water, juice, broth, etc., after the surgery?
t. Will you perform the
operation with an assistant or a resident?
u. Will you visit with my
family to let them know how the surgery went?
v. I am concerned about
telling my family. This is a private choice for me, but I know they will
want to be at the hospital. If I ask you to, will you assure them that I am
doing OK, but not tell them specifics about the surgery? I do not want them to
know that I have had obesity surgery. This is my decision and will you
support me?
Hospital Stay
a. Which hospital will you
be using? What is the reputation of the hospital?
b. Will I go into the
hospital the day before or day of the surgery?
If it's the day
of surgery, do they have any "deals" with local hotels?
c. Can I pre-register at the
hospital to save time?
d. How long is the hospital
stay?
e. Are the gowns in the
hospital for large people?
(Yes, they will fit. I had one
and I weighed 500 lbs.)
f. What about any medicines
I already take, do I bring them to the hospital?
g.
I
have heard of some
people not having a bowel movement for several days after surgery. Will I have to stay in the hospital until I do?
I have heard some people say that they had to stay and others who didn't. What
is your policy?
h. Will I have a private
room or will I share?
i. Can my support person
stay with me at the hospital?
j. How often should I be
walking?
k. Will I have lung therapy?
l. I have bracelets/rings
that won't come off. Will I need to have these cut off or can the hospital
work around them?
m. What is the nurse/patient
ratio for ICU and the regular floor I will be on?
Complications
a. Have you ever had a case
where the surgery had started and you couldn't complete it?
What were the
circumstances?
b. What type of
complications have you seen during surgery and post-op?
(Ulcers,
hernias, vitamin/mineral nutritional deficiencies, iron deficiency, hair loss,
gall stones, leaky
staples,
incision infection, blockage of the connection between the stomach and the
intestines, etc.)
c. What is your mortality
rate?
d. I have heard that it is
harder to detect stomach cancer and ulcers after this surgery, especially
in the "unused" portion of the stomach.
Do you agree? How concerned should I be about
this risk?
Will you leave a
surgical marker that will show the location of my unused stomach?
e. Will my hair fall out?
1.
Does chewable zinc help?
2.
When will it start falling out?
3.
How much?
4.
When will it grow back?
f. I have heard that there is a
lot of diarrhea and real stinky gas after the surgery. How can I minimize
this? Are the
diarrhea and gas permanent or will it go away eventually?
g. Will I vomit a lot?
h. How will I know when to
stop eating?
i. I am really concerned
with my eating. Can I "out eat" this surgery?
j. I have heard of surgeries
canceled due to the H. Pylori bacteria being present in your stomach. What
is this and can I do anything to prevent it?
Miscellaneous
a. How long will the staples
stay in?
b. I have to travel X miles
by car/train/plane, should I take any precautions?
c. How long will I have to
be off work/school?
d. How long do I need
someone to stay with me?
e. When can I resume my
normal activities?
f. Do I have a limit on how
much I can carry or lift? For how long?
g. What will the scar look
like?
h. How much should I lose
and how fast?
i. What will be my
absorption rate after surgery?
j. How small will my stomach
be?
k. Will it stretch back out?
After how long?
l. Will I have "dumping"
after eating a lot of sugar? How painful is it?
m. How much sugar is a lot?
n. How much calories,
nutrients, minerals, etc., percentage wise will my body absorb? 50%? 60-80%?
After
Surgery Care
a. What is your after surgery diet?
I've heard different diets.
Some only clear liquids for 4 weeks, some liquids 1-week, pureed for 4, then
regular food adding one item per day. What is your policy? (different for
each doctor, Be sure to follow your surgeon's program!)
b. Are there any foods I
need to stay away from?
(Nuts peels, etc.)
Can I never have these or is it just at first?
c. Does you have a live support
group? And when do they meet?
d. What are your follow-up
requirements? How often will you run blood work and
labs on me?
e. Do you require vitamin
and protein supplements?
f. Will I need to get
monthly B-12 shots?
g. Will I need to take the
vitamins, supplements; B-12 shots for the rest of my life?
h. How much water should I
try to drink?
i. How often should I weigh?
Will I be subject to plateaus?
j. What kind of exercise do
you recommend after surgery and how soon can I start?
k. After the weight loss,
are tummy tucks common?
Do you perform those?
Medical Conditions After Surgery
a. What about medications
after surgery?
I take such and such and such.
Should I be OK with these? Since my absorption rate will be #%, how will that
affect my dosages? Should I contact the prescribing doctor?
b. I have heard I will never
be able to take aspirin or anti-inflammatory drugs ever again.
What should I take instead? Do
you have a list of what I can and cannot take?
c. What about pregnancy
after the surgery?
When can I have
children without risk to my unborn child or myself? Is it
considered a high-risk pregnancy?
d. I have heard that this
surgery will really help my blood pressure/diabetes/joint pain/etc.
How
soon can I stop taking my medicine for these?
e. Should I get a
medic-alert bracelet?
I have heard of cases where
when the person went to the ER and the doctors there put in a "tube" and
punctured the stomach.
f. If worst comes to
worst and I have severe nutritional problems or if I am in accident with
abdominal injuries,
is this surgery reversible?
g. I have a lot of sinus
drainage. I have heard that this will sometimes collect in the stomach and not
"go down." What do you suggest to minimize this problem?
About
the Doctor
a. How many operations have
you performed?
b. Have you performed the
surgery on anyone my size? Were they successful?
c. Can I have some patient
referrals?
If he/she says no out right, go
to another surgeon.
d. Do you have any
malpractice suits?
I have checked my state medical
board or consumer protection group and it says...I found this lawsuit, can you
tell me about it? (Give the guy the benefit of the doubt if you find anything,
doctors are getting sued over everything)
Insurance/Payment
a. How much will be the
total cost of the surgery?
b. Have you had anyone from
my insurance group
and if so, did they have
any trouble getting approval for the surgery?
c. How often does insurance
refuse to pay?
d. Will you help during the
appeal phase, if my insurance refuses the first request?
e. If my insurance won't pay
do you and the hospital have a flat cash rate (usually a lot less than the
"with insurance" price)?
f. My insurance will pay this
much so that means I will have to pay that much. I can't afford to pay this
much as a lump sum.
Will you assign the benefits? (Accept the insurance amount as
payment in full) or will you (or the hospital) allow me to make payments?
g. Does the hospital/surgeon
except a sliding scale payment?
(income based, applicable to
teaching hospitals mostly)
h. Do you or the hospital
require a deposit? How much?
A
PRE-OPS GET-READY LIST
(I suggest you review this list
with your doctor and buy very small amounts)
Groceries
a. Sugar free Carnation Instant
Breakfast (personally not something that I would use
however)
b. Sustical, Ensure, Boost,
etc. (ask your doctor about this, not all want you on these as they are
loaded with sugar. Also not something I would use)
c. Water
d. Herb Tea (non-caffeinated)
e. fat free canned chicken or
beef broth
f. Soup (stay with the simple
ingredient ones)
g. creamed soups (be careful
with tomato soup. lots of sugar)
h. bouillon
(you'll want to water this down as the salt will knock your socks off!)
i. rice or soy milk (nonfat)
(only if lactose intolerant)
j. sugar free Jell-O
k. Mashed potatoes
(you can thin this with chicken broth)
l. Smooth, no sugar added
yogurts (read the label!! Non fat is NOT sugar
free!!))
m. Gatorade (again, may have
too much sugar)
n. Sugar free Kool-aid,
Crystal lite, Diet Snapple, Diet Iced Botanicals
o. Fruit juices cut half with
water -- non-pulp grape, apple, Cranberry, etc.
p. applesauce (check the label
for sugar content!)
q. sugar free popsicles
r. Hot cereal (oatmeal, rice,
grits, cream of wheat etc.)
s. Baking potatoes (this will
probably be ok around 3 weeks post op)
u.
Fresh fruit (can be pureed)
Health
Store or Drug store
(again I stress this point,
REVIEW THIS WITH YOUR DOCTOR!)
a.
Protein supplements (eg: Designer Whey or Carb Solutions Check the label
for sugar!)
b. Citrate of Magnesia (your
doctor may require this to "clean you out' before surgery)
c. Liquid pain reliever
(children's liquid tylenol)
d. Liquid, Chewable, Spray or
Powder Multivitamin (Flintstones, Bugs Bunny,
Centrum Chewable)
e. Vitamin E Oil (if you put it
on your scar, it will heal faster and not look as bad)
f. Zinc to
prevent hair loss (common side effect but in my opinion, nothing helps with
the hair loss. HAIR LOSS HAPPENS )
g. Calcium citrate
h. Chewable or liquid Iron
i. Chewable or spray Ginseng to
improve the smell of passing gas
j. Chewable, sublingual or
liquid B-12
Department Store
a. antibacterial soap
b. ice cube trays for freezing
right size portions of the puree stuff
c. Blender - I think one of those
hand held ones are wonderful
d. zip lock bags (to store
frozen ice cubes)
e. shot glass for measuring or
those little cups you get salad dressing in
f. Play tea set (helps portion
control)
g. camera (gotta have those
before and after images. Be sure to take your measurements too!)
h. seafood fork and baby spoons
(helps you take smaller bites) chopsticks too! anything to
slow down your eating
i. a journal to keep your
pictures in, and to chart your weight loss.
Stuff
for Hospital
a. Clip on fan for bedside
b. toothbrush/toothpaste
(should be supplied by the hospital)
c. deodorant (should be
supplied by the hospital)
d. Lotion (should be supplied
by the hospital)
e. Moisturizing lip gloss (be careful with these as they
are petroleum based and flammable, if you are on oxygen this may not be a good
idea, check first!)
f. powder (should be supplied
by the hospital)
g. shampoo (should be supplied
by the hospital)
h. brush
i. hair clips, rubber bands,
bandana or hat (you won't be able to wash your
hair so whatever it takes to get it out of the way)
j. nightgowns (could be difficult to use with
the IV's you will have so you may just decide to use the hospital designer
gowns
k. robe
l. slippers
m. comfy pillows
(don't be afraid to bring your own!)
n. watch or travel clock
o walkman
or cd player (drowns out hospital noises)
p. stuffed animal
to brace against your tummy (hey, it
works for some people)
q. make up
r. writing paper
(pre-address the envelopes!)
s. Books, magazines,
cross-stitch, puzzles, etc. (but you'll probably never even
pick them up)
t. Stomach Binder (if they
don't provide it, check with your surgeon.)
u. Comfortable clothes to go
home in. (or just go home in your robe on nightie...why
not?
v. list of phone numbers (you
may be bored to tears and want to talk!)
w. chances are, if you are of
menstruating age, that you will get your period in the hospital. So be
prepared! Take panties, pads, tampax etc. They will have pads, but nothing
for you to put them in, no pins, belts etc.
x. Fabreeze or some air freshener, a scented candle
After Hospital
a. Shower Chair (if you think
you will need it)
b. A recliner (very few can
sleep in a bed at first ) Rent or borrow if you don't have
one...it won't be forever, just for a week or two.
c. lots and lots of support!
d. Someone to walk the dog
e. back scratcher
|
|
|
