What To Expect

An overview of the weight loss surgery process 

Initial Patient Education and Interview

At your first Office appointment, you will fill out forms about your medical history and health insurance information. You will also view a video which explains the disease of morbid obesity, the operations available to address this disease, as well as the expected outcomes and potential risks of surgery. You will meet your potential surgeon, who, after an initial medical interview, will allow you to ask further questions about bariatric (weight reduction) surgery. If you chose to participate in the Healthy STEPs Weight Loss Program, you will then be asked to sign our contract which details the responsibilities the patient and the surgeon have in the Program.

Preoperative Evaluation 

You will be asked to obtain necessary preoperative evaluation and clearance from various specialists. Most insurance carriers require psychological evaluation, and this will be arranged for you. An obligatory nutritional evaluation and counseling session will also be arranged. Depending on your medical condition, evaluation by specialists in pulmonary medicine, cardiology, or endocrinology may be necessary. During this time period, our office's administration specialists will work on obtaining approval from your insurance carrier to proceed with surgery.

First Support Group Meeting

Healthy STEPs Weight Loss Center participates with a local Bariatric Support Group, which meets monthly, and is intended for all individuals a) interested in learning more about bariatric surgery, b) having gone through bariatric procedures, and/or c) in need of the help and support of like individuals with weight-related problems. Currently there is no charge for an individual to attend these Support Group meetings and you may attend as many as you like (times and location listed below). However, all bariatric candidates must at least attend ONE Support Group meeting before their surgery will be performed.

Preoperative Visit

Approximately two weeks before surgery is scheduled, patients will undergo a detailed physical examination in the Mendocino Avenue office, counseling will be completed, and a consent form signed. Preoperative anesthesia and hospital interviews are arranged, and any necessary fees collected.

Day of Surgery

Patients are admitted to the hospital approximately two hours before scheduled surgery, and undergo their planned procedure as detailed in the prior section (see button to left). Afterwards, they will proceed to the Recovery Room until awake from anesthesia, then proceed to the Surgical Ward. A few patients, due to complexity of medical condition, will require stays for a day or two in our ICU.

Hospital Stay

Each patient reacts differently to the surgery, and may have little or no pain or discomfort, or perhaps a great deal. Each patient is given a PCA (a "pain button") which directs intravenous dosing of pain-killers for this purpose. Other things you can expect in the first day or two include compression stockings on the lower legs (to prevent blood clots), a bladder catheter (to monitor urine output), and an intravenous line to administer fluids. You will be encouraged early on to take deep breaths (using a Spirometer) and to get out of bed & ambulate - these are the best measures you can do to speed your recovery. If your recovery is proceeding very well, you will be allowed a clear liquid diet 24 hours after surgery, and be allowed to go home after 48 hours.

First Two Weeks After Surgery

Recovery from laparoscopic surgery is usually rapid, but care must be taken to allow your "inner plumbing connections" to heal adequately. A clear liquid diet is continued for 2 weeks following surgery.  Some gastric band patients may be advanced more quickly, depending on their progress at the first follow up appointment.  After this, pureed and soft foods can be started, at the approval of your surgeon and dietician, whom you will visit two weeks after surgery. Daily walking is greatly encouraged during this phase, but nothing more strenuous until after your check-up with your surgeon.

Advance Diet and Activity

If you are doing well at your two-week check up, you will be approved and encouraged to engage in a physical training (exercise) program - this will help with your weight loss and toning your skin as well. Under your dietician's instruction, your diet will be advanced. Some guidelines important to remember about your diet:

• keep yourself hydrated, being sure to drink a minimum of 48 oz of water per day
• avoid snacking between meals! - Find interests/employment outside the home to get yourself away from the refrigerator and the temptation to "graze;" you should optimally eat 3 meals per day of a balanced 1/4 cup total volume with an additionally healthy snack (e.g. carrot sticks or turkey jerky) in the mid/late afternoon
• eat protein first and foremost at every meal - after all, your total intake is much less, so make the quality of it top-notch for what your body requires - 60g protein per day
• eat slowly and chew completely - enjoy your meal!

Vitamins

You will need to take vitamins every day for the rest of your life. One well-balanced multivitamin is probably sufficient, making sure that it contains 100% MDA for iron and B12 as a minimum. You should also ensure you take additional calcium - at least 1200mg per day.

Support Group 

After surgery, you are strongly encouraged to come share your experiences, as often as you would like, with others waiting for and having gone through this surgery. And, who knows, the support and education may help you in the process.

Plastic Surgery

Eighteen months or so down the road, after maximum weight loss, a certain percentage of patients (about 30%) notice that they have too much excess skin - usually in the abdominal wall and under the arms. If this applies to you, let your surgeon know at your follow-up appointment and arrangements will be made for evaluation with a plastic surgeon for potential removal.

Long Term Follow Up 

Both your surgeon and your dietician expect to see you for regular follow-up: at one month, three months, six months, and twelve months following your operation, then every six months for the rest of your life. This has been found to be the best way to ensure you "stick with the Program" and identify problems that may require attention (such as a vitamin deficiency). You should know that WHENEVER you have a serious problem that you even THINK is related to your gastric bypass surgery, your surgeon STRONGLY desires to know about this and stands ready to help you.