Frequently Asked Questions
Q: Which bariatric procedures are available at the Bariatric Care Center?
A: We offer the laparoscopic gastric sleeve, adjustable gastric band and roux-en-y gastric bypass procedures.
Q: I have been overweight my whole life but I do not have any health problems; will you still do my surgery?
A: The requirement for weightloss surgery is a body mass index (BMI) of at least 40 without other obesity related disease or 35 if the patient has obesity related co-morbidities including hypertension, diabetes mellitus, and obstructive sleep apnea. This BMI would coincide with 80 pounds over ideal body weight for a female and 100 pounds over ideal body weight for a male.
Q: Will insurance cover the cost of my operation?
A: It is advisable to confirm your insurance coverage before contemplating weight reduction surgery. Some insurance companies specifically exclude coverage for any aspect of weight loss in their policies. In this case, it will be impossible to convince the insurance company to cover the surgery. We will work with you to obtain coverage from your insurance company should they be reluctant. This is, after all, not cosmetic surgery, but surgery to improve your health and longevity. Some insurance companies look at each case individually, therefore, there may be patients you know who have their surgery and still others who may not qualify under the determination of the insurance company.
Q: Will there be a delay before I can have my surgery?
A: There often is a delay, and this is usually the time required to get "preauthorization" from the insurance company. There are some tests required by the insurance company. It is not uncommon to have a delay of a few months while we work on this. It is necessary to obtain sufficient medical information to reduce the potential for complications during or after surgery.
Q: What tests are required before bariatric surgery?
A: Each patients medical status is reviewed and tests are required based on each patient’s unique situation. In general most patients will be required to obtain:
A cardiology clearance that may include an EKG and Echocardiogram .
A psychiatric exam that will ensure the patient has the skills and social supports to adjust to the life change associated with weight loss after surgery.
A nutritional training class offered in my office that outlines the diet before and after surgery.
Still other tests and consultations may be required for optimal outcomes.
Q: I am afraid of anesthesia. Is this justified?
A: There is always some risk to having anesthesia. Providence Hospital has been doing bariatric surgery since 2001. All of our anesthesiologists are well-versed in the care of the morbidly obese patients. If you have concerns about the anesthesia we can put you in touch with the anesthesiologist at the time of the initial evaluation.
Q: Will I have pain after surgery?
A: Patients do experience some pain after this surgery. We do deliver pain medications in the post-operative period. We do encourage patients to walk around to reduce some of the pain associated with gas. We will monitor our patients and call once you are home to make sure the pain treatment methods are effective.
Q: What about a support group?
A: A support group for patients meets twice per month at two different locations, once at Providence Hospital’s Ross Auditorium and at St. Joseph’s Catholic Church in Largo, Maryland. The support group is professionally run, and is an extraordinary opportunity for patients to discuss and compare their experiences. The support group is currently for postoperative patients. There is no charge for attending the support group meetings.
Q: Does the Bariatric Care Center have an age range for the surgery?
A: Patients under the age of 18 cannot have their bariatric surgery at the Bariatric Care Center at Providence Hospital. In general, if a patient is in reasonably good health and does not pose an unacceptable surgical risk, then surgery will be offered. Generally, we provide weight loss surgery to patients 18 to 65 years old. Any older patients would be considered on a case-by-case basis.
Q: Why should I attend an informational session before my first visit in the office?
A: Many patients have found that they preferred a detailed informational session before their first visit in our office. During the informational session, we discuss all the bariatric procedures offered in our Bariatric Care Center. It’s an opportunity for prospective patients to talk to patients who have already had the procedure of interest and have some of their individual questions answered before they come into the office. Once all your general questions are answered you will be able to discuss more specific questions in the office one-on-one with your surgeon.
Q: I am thinking about getting pregnant. Will I be able to have children after weight loss surgery?
A: Many women have had successful pregnancies after weight loss surgery. There is nothing per se that would prevent pregnancy. We recommend, however, that you wait until your weight loss is complete before becoming pregnant. This may take a year or more. The effect of rapid and prolonged weight loss on the developing fetus is unknown but it could have dire consequences, and pregnancy is not recommended until a stable weight has been attained.
Q: Do I have to make any changes before surgery?
A: All patients are expected to quit smoking and all NSAIDS prior to surgery. NSAIDS e.g. motrin, ibuprofen, aleve, advil, 3etc.
Q: I have a friend who had weightloss surgery and has started gaining the weight back. Is this common?
A: All patients are expected to continue the behavioral changes they have been taught in my office for sustained weightloss and continued healthy living. All my patients are expected to continue an active exercise program in addition to healthy food choices. I require that my patients continue with some protein supplements and vitamins indefinitely after surgery for sustained overall health.
Q: What post-operative changes do I have to make?
A: All of my patients are given post-operative instructions to follow immediately after surgery. Be assured you will be given these during your pre-operative visits, your appointments with the dietician and at discharge from the hospital. From the first day you return home from the hospital, you are expected to exercise at least 30 minutes daily.
Long term, you will be expected to keep all appointments in my office which are at least every 6 months. You will continue on additional vitamins and at least 2 supplemental nutritional shakes daily. You are instructed to continue to avoid alcohol and cigarettes as long-term success depends on lifestyle changes not matter the surgery.
Q: How long will my surgery be?
A: The length of the surgical procedure varies with the type of surgery. In general, all procedures are completed within 2 hours. The lapband procedure tends to be the shorter procedure. Some patients take longer than others. My patient will then, go to recovery room for 4 – 6 hours.
Q: Will my gallbladder be removed at the same time as my surgery?
A: I do not remove the gallbladder at the same time. There are times when I will repair a hiatal hernia with this procedure.
Q: How long will I stay in the hospital?
A: We expect our patients to stay in the hospital over night. Patients come in the hospital the day of surgery and go home the following day. Some patients have health concerns that necessitate a longer stay but this is discussed prior to surgery and you would be aware of this in advance.
Q: How long will it be before I can get back to work?
A: After adjustable gastric banding, patients are able to return to work in 1 – 3 weeks; after gastric sleeve or gastric bypass, they return to work in 3 to 6 weeks. Patients who have physically demanding jobs may take longer to resume work.