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FREQUENTLY ASKED QUESTIONS ABOUT BARIATRIC SURGERY

Please note this information is provided for general purposes only. All of your questions about surgery should be directed to your doctor, who is familiar with your specific case.

PRE-SURGERY

 

1. Can I skip the lecture? If I’ve already researched the gastric bypass surgery, why do I need to go? 

You are required to attend a lecture no matter how educated you are about the surgery. Lectures are a starting point for a programmatic approach to your care. In addition, the information presented at the lecture will assist you in completing the written exam. The lecture is given in three parts. The first session is usually presented by a patient/patients or one of our staff who have had the surgery. The second session is medical information presented by one of the surgeons. General insurance questions may also be covered. All three sections give the audience an opportunity to ask questions about the topics covered. Of course, questions from other individuals may help make you more informed. We want our potential patients to be as educated as possible so they can be certain gastric bypass surgery is right for them.
 

2. I went to the lecture, what do I do now? 

Read all the paperwork given to you at the lecture. It has been developed to make sure clients understand each step. These steps are: (A) After attending the lecture, and after reading the protocol, take the written exam. (B) Fill out the history and physical form in detail. (C) Take your lab request form and (D) your ultrasound (gallbladder) request form to your primary care physician or to a lab that your insurance group is contracted with, to have the labs complete them and send the results to Pacific Bariatric.
 

3. Can I have the laparoscopic procedure? What are the criteria? 

Each patient is different. Our physicians will need to meet with you and examine your health history before recommending which surgery is right for you. 
 

4. Do I have to stay in San Diego a full week? 

Bariatric surgery is a major surgery and should be treated as such. The average length of stay after discharge is three days to one week. However the length of your stay in San Diego will be at your surgeon's discretion. Your safety is our utmost concern. If a problem should occur, it would most likely happen within the first few weeks and it would be best for you to receive treatment directly from the doctors who are already familiar with you and your surgery. We have negotiated special room rates for our patients to help ease the financial burden for those who may live outside San Diego.
 

5. I have my own internist, psychiatrist, etc. Why do I have to see your doctors? 

Our program is designed to provide the best possible care for each of our patients under any circumstance during the bariatric process. The physicians with whom we coordinate your care have privileges at Scripps Mercy Hospital and are familiar with our program. While you are a patient in the hospital, this allows our surgeons to immediately connect with caregivers who have knowledge about your specific case – which is an advantage for you as a patient. 
 

6. How much does this surgery cost if I am a cash patient? 

We would be happy to discuss cash payment or address insurance questions with you. For pre-op questions, please call us at (800) 267-7212.
 

7. What insurance do you take? 

We take many insurance plans and have years of experience working with all types. Please call your insurance company and verify with them whether or not they cover the bariatric procedure. You may call our office with questions following your inquiry to your insurance company and before you begin your paperwork.
 

8. How long does the surgery take? 

The surgery can take between one and four hours depending on the procedure and the patient. Sometimes it takes longer with larger patients. It takes an additional 30 minutes if you are having your gallbladder removed, or having the surgery laparoscopically.
 

9. How many days am I in the hospital?

Most gastric bypass patients are in the hospital from three to four days. However, each patient is different and your discharge is contingent upon your individual medical condition.
 

10. When can I return to work? 

Usually gastric bypass patients return to work within two weeks. However, each case is different and you should discuss your specific situation with your surgeon.. In addition, there is a lifting restriction of 15 lbs. or more for 4 to 6 weeks
 

11. How many of the Roux-en-Y procedures have Pacific Bariatric performed? 

Conservatively speaking, more than 17,000 gastric bypass procedures have been performed by Pacific Bariatric. More than 2,000 of these cases have been done laparoscopically.
 

12. Is it safe to get pregnant after this surgery? 

After the gastric bypass procedure we request that you wait at least one year following your surgery before attempting pregnancy. Our main concern is for the nutritional well-being of the fetus. You must take extra precautions throughout the first year.
 

13. What causes hair loss with this program, and what could help minimize hair loss? 

As one of the more common gastric bypass side effects, about 80 percent of our patients will experience temporary hair loss. The trauma and anesthesia from any surgery, a lack of protein, toxins in the body from the rapid weight loss, and stress are all contributing factors in causing temporary hair loss. Coloring or perming the hair in addition can cause more damage to your hair’s already fragile condition. The temporary hair loss usually starts about 3 to 4 months after surgery and continues for 3 to 6 months. Please dicuss your concerns with your surgeon, who will be able to help you minimize side effects.
 

14. How can I prepare myself for surgery? 

The best way to prepare is to read your protocol, review your paperwork, begin your protein supplement, take your vitamins, and start your exercise program. We also encourage you to attend our support groups, as you can learn from our post-op patients. Be sure to share your preparatory work with your surgeon as well.
 

 

POST-SURGERY

1. What can I eat?

From the first five days to a week after gastric bypass, only clear liquids and protein drinks are allowed. After the first visit your diet will be modified at the discretion of your surgeon.
 

2. Can I advance my diet before seeing the doctor?

No. Usually the bariatric surgeon will see the patient within five to seven days after the surgery and at that time, if everything is going well and the doctor’s examination is satisfactory, the patient will then progress to a Level 4 diet.
 

3. What can I take for gas?

A variety of simethicone-related products are available for gas such as Gas-X, Mylicon-80, etc. Gas and gas pains are most often related to swallowed air that is taken in by mouth accumulating in the colon or the bowel forming gas bubbles. At times this needs to be relieved with an enema, hot tub baths, or other means. Should the gas pain not respond to such measures, the patient should see a physician or contact your bariatric surgeon.
 

4. Why am I burping so much?

Again, burping represents the expulsion of gas that is swallowed by the mouth. In the early period after surgery, the anastomosis of the small upper stomach to the intestine is quite small and will remain so.
 

5. When can I swim?

Ordinarily, the incisions heal quite satisfactorily within a period of seven days and swimming can be allowed thereafter. It is advisable that for the first several days to a week after the patient gets back in the pool that water aerobics be undertaken in the shallow end of the pool rather than swimming in the deep end, due to the possibility of cramps.
 

6. What can I take for nausea?

Some nausea in the early aftermath of weight loss surgery, for the first two to three weeks, is very common. The use of peppermint extract is helpful. On occasion, one-half teaspoon of soda bicarbonate in a half glass of lukewarm water will relieve the nausea; sometimes antacids of Mylanta II are helpful. The use of ginger (made into a tea) is very helpful when a patient is nauseated. If nausea is excessive or persistent for a significant amount of time after weight loss surgery, please contact your physician.
 

7. How do I use peppermint extract?

Place two or three drops of peppermint extract on crushed ice along with two or three ounces of water and sipped very slowly. This is very tolerable.
 

8. How long do I take Prevacid ® / Prilosec /Aciphex / Nexium / Protonix?

As a rule, Prevacid ®, as well as similar products should be taken after the surgery for a period of thirty to forty-five days.
 

9. Can I have crackers?

The critical thing here is that crackers, cookies or such snacks must not be taken between meals (i.e., as a snack or fourth meal) at any time after gastric bypass surgery. They are, especially crackers, one of the causes of failure of the gastric bypass to maintain weight reduction.
 

10. When can I drive?

Ordinarily, the incision is very well healed and the patient is well on the way to recovery within two weeks after gastric bypass surgery and at that time driving is permitted. The patient must use reasonable caution and good judgment and should not drive after taking medications, when in a state of pain or reduced alertness, or when other problems occur. Always check with your surgeon after gastric bypass surgery for confirmation.
 

11. What can I take for a cold?

After Roux-en-Y gastric bypass, any of the usual cold medications may be taken, with the exception of those that contain nonsteroidal anti-inflammatory drugs (e.g., Advil Cold and Sinus ™, Motrin Cold and Sinus ®, etc.), alcohol, or aspirin. More specifically, the following drugs cannot be taken after gastric bypass:
  • Aspirin
  • Any form of nonsteroidal anti-inflammatory drugs with the exceptions mentioned above in Answer 3 (gas products).
  • Alcohol

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12. How long will I feel weak and tired?

After gastric bypass surgery, and for the first three to six months following the surgery, there is very rapid breakdown of the toxic metabolic products of fat in the body. These materials reach the body’s circulation in the form of uric acid, urea and various ketones and acetones. While this rapid phase of weight loss is occurring and these materials are circulating in the blood, before the kidneys can excrete them, there is an associated group of common observations that patients have:
  • A feeling of fatigue and weakness
  • Temporary hair loss
  • A metallic odor of the breath
  • Change in the odor or feel of the skin
These changes are temporary and will begin to fade after the most rapid phase (the first six months) of weight loss is over.
 

13. Why am I losing so much hair?

This is one of the most common gastric bypass side effects. The best explanation is mentioned above. The hair follicles throughout the body are sensitive to circulating levels of acidic components such as uric acid, ketones and acetones, and urea nitrogen. Consuming large amounts of water advised in the protocol, vitamins, and the combination of intensive exercise can reduce many gastric bypass complications, especially this one. If symptoms persist, increase the protein shake to twice a day and contact your doctor.
 

14. Why have I stopped losing weight?

In the first six months after the surgery, approximately two thirds of all the excess weight will be lost provided that the patient observes the following:
  • No snacking between meals
  • Exercise at least one hour four days a week
  • Take protein supplements, at least 30 grams daily
  • Take vitamins + B12
Even during the three to six month period, and particularly after the first six month period, the patient will observe periods of two to four weeks or more where there is "a plateau effect.” This is common, to be expected, and as long as the above four principles of dietary and lifestyle change are observed, should not be worrisome.