Preparing for Your Bariatric Sugery

Pre-Operative Course at Providence Ensures Safe Procedures

The doctor will order pre-operative tests based on your physical exam and past medical history. The tests may include heart tests such as an echocardiogram, EKG and maybe a stress test. Another test may be an EGD. This is a test to look into the stomach and make sure the lining of the stomach is healthy. Some tissue may be sent to the lab for evaluation and to determine the presence of h.pylori. H.pylori is an organism found in the stomach that will need to be treated prior to gastric sleeve and roux-en-y bariatric procedures. Many patients are prescribed a sleep study to test for sleep apnea. Some additional labs test and other diagnostic test may be prescribed to ensure your safety during and after surgery.

All patients are expected to attend our nutrition class. The class is offered weekly and last one-hour. There is a fee for this class and you can schedule it in our office. All patients are expected to attend one pre-operative class and one post-operative class. 

Our program dietitian educates our patients regarding the pre-surgical and post surgical diet. We de require strict adherence to our program diet. It is necessary for patients to bring their protein with them to the post-operative class. Please call our office if you have any questions about the diet. Relatives and supportive persons are encouraged to come to the class with you. 

Please be aware, there are certain medications that must be stopped prior to surgery. These medications include but are not limited to aspirin, Motrin, Naprosyn, Aleve, Advil, blood thinners and any related medications. All herbal medications should be stopped 10 days before surgery and patients should avoid high doses of Vitamin E. Patients who are taking steroid medications e.g. prednisone will be asked to see the prescribing physician to discuss the impact of stopping the dose and in some cases just reducing the dose to at least 5mg daily prior to surgery. Please consult your primary care physician or your surgeon for specific questions. 

Your bariatric surgery experience begins the day you first walk in our office

• First you call the call-center and attend our informational session

• Second, you are scheduled an appointment in our office

• Third, during your first visit, you receive a list of consultations and test to complete and you are instructed that you need to lose weight prior to surgery

• Fourth, you arrange to come for supervised weight loss meetings monthly with our dietician

• Fifth, you schedule your appointment for nutrition class

• Sixth, you begin reducing your calories and walking daily

• Seventh, you schedule an appointment with your PCP to get any needed referrals for your consultations

• Eighth, you call schedule your appointments with the consulting providers and keep your appointments making sure you have informed to send a copy of the results and clearance to our office at 202-448-4080, Fax number: 202-448-4082

• Ninth, you confirm with the Medical Office Specialists in our office that all you consultation reports have been received and you have lost the weight required pre-operatively

• Tenth, our office informs you that the insurance company has approved you for surgery and you have received clinical approval from the surgeon. You and the Medical Office Specialist agree to a surgical date

Advanced Procedures Require Shorter Hospital Stays

Most patients stay in the hospital approximately five to eight days after an open procedure and one to two days after a laparoscopic procedure. You will be discharged when you:

• Are able to take enough liquids and nutrients by mouth to prevent dehydration
• Have no fever
• Have adequate pain control with medication

Depending on which procedure is performed, one or two small tubes may be placed around the stomach pouch and the bypassed stomach to drain body fluids after the surgery. These are usually removed in three to 10 days. To help prevent blood clots, anti-embolism stockings or other compression devices will be placed on your legs, and your surgeon will require you to attempt to stand up and move around as soon as possible, usually within the first 24 hours. Patients who use continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) for sleep apnea may be asked to bring their machines with them for use immediately after the operation.