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When you decide it is time for your new beginning, it's helpful to know the steps you'll need to take in your journey. Martha Jefferson's surgeons and staff are here to help you through each step of the way.
In truth, if you are reading this, you've already completed the first step: beginning to educate yourself about the surgery and the process.
In addition, you will need to attend one of our About Bariatric Surgery seminars, where you will meet one of our surgeons and learn about your options.
After the seminar, you'll schedule time to meet with a surgeon and our staff. You will probably also want to inquire with your insurance company to learn what their requirements are before they will cover the surgery.
The National Institutes of Health (NIH) has also identified other factors that indicate bariatric surgery may be the best course of treatment. These factors include:
To ensure that bariatric surgery truly will be effective, each of our patients goes through a mental health evaluation and a nutritional assessment/education session. During these sessions, patients are evaluated so that they can be educated and prepared for such a life-changing event. These sessions are not intended to "weed people out," rather than to help ensure their success.
Depending on a patient's insurance requirements, he or she may also need to complete a medically supervised weight-loss program of diet and exercise.
Additionally, patients will have pre-surgical blood-work done and will need to receive a clearance letter from their primary care physician.
Finally, after receiving authorization from the PCP and a patient's insurance company, the surgery is scheduled and the patient comes in for a pre-op visit with the surgeon and a second visit with the dietician.
Financing your surgeryAfter all the preparation required for surgery, coming into the hospital for the surgery is almost easy. Patients come to the hospital on the morning of their surgery, are taken to the operating room and anesthesia is induced. The surgeons then go to work.
Following surgery, the patient goes to the recovery room for a period of observation first, then to a private room. Many patients are surprised that they are expected to get up off the stretcher and walk to the bed with assistance, but they typically can do so without too much difficulty.
That afternoon and evening, they will rest, but they will also be required to get up and walk around every two hours. Gastric band patients will be able to consume clear liquids (which includes broth, plain water or sugar-free flavored water, and jello), while gastric bypass patients will not have anything until the following day.
Patients may have visitors while in the hospital, and one adult may stay overnight with them if they wish (there is an extra bed or a fold-out chair in each room).
First thing in the morning the next day, they will go in a wheelchair to Radiology to have a barium study. During the study, an x-ray that is taken while they drink barium in order to verify that the opening to the stomach is big enough to allow the liquid to pass easily into the stomach.
Gastric band patients are discharged after one night in the hospital with a prescription for liquid pain medicine. Gastric bypass patients will then be allowed to begin sipping clear liquids after the first night if everything looked good on the x-ray. These patients will go home after a two-night stay, provided there are no complications.
For gastric bypass patients, the scheduled follow-up visits take place after one week, two weeks, four weeks, three months, six months and one year post-op and yearly thereafter. At each annual checkup, the patient has lab work done to check their nutritional status.
In addition, these patients have scheduled follow-up visits with one of our dieticians at two weeks, six weeks, three months, six months and one year post-op and yearly thereafter. The surgeons and dieticians are also available for visits at other times as needed.
For gastric band patients, the follow-up schedule is much more driven by the patient and may vary based on how well the patient is doing with their weight loss and how restricted they are. All patients are seen at two weeks post-op, and then every four to six weeks until approximately six months. Then they are seen every two to three months, at one year post-op, and at least yearly thereafter.
This is variable, of course, as some patients need band adjustments much more often than others. Band patients also have labs drawn at one year and yearly thereafter, and they follow up with the dietician on an as-needed basis.
It is important for patients to understand that their weight loss is dependent on maintaining adequate restriction by coming to the office to get some fluid injected into the band (an "adjustment" or "band fill") when needed — whether that's at a regularly-scheduled visit or whether they need to come in between their regularly-scheduled follow-up visits.
Band adjustments are done either by the patient's surgeon or the nurse practitioner.
