Frequently Asked Questions
Getting Started
What should I expect during the initial evaluation?
You will meet with the surgeon and nurse. You
will undergo a complete history and physical exam,
nutrition screening, and discussion regarding
surgery. The initial evaluation takes about one
to two hours (including wait time).
What do I do after the initial screening prior
to surgery?
You will have a psychology evaluation. You will
need to go to your primary doctor, a cardiologist,
and possibly a pulmonologist to get medical clearance
for surgery. You will also need to obtain a few
medical studies. These will be tailored to your
individual health problems and will be explained
when you meet with the surgeon.
How long is the usual delay between the initial
visit and surgery?
The delay between the initial visit and surgery
on average is six to eight weeks depending on
your insurance company and how quickly you can
obtain your medical clearances.
Can I take anti inflammatory pain medicine
after surgery (NSAID's such as Advil©, Motrin©)?
Unfortunately these medications can irritate the
stomach and cause ulcers. If you require anti-inflammatory
medications after surgery it is safe to take Celebrex
or Tylenol.
Who do I contact with questions before surgery?
You can call the Bariatric Surgery Program
Coordinator 215-829-6795. Or you may call your
surgeon’s office.
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Pre-Op
Will I only be able to eat tiny amounts for
the rest of my life? Will I be able to eat regular
food?
At the beginning you will likely only eat approximately
two to four tablespoons of food. You will gradually
advance your diet and by six to eight weeks you
should be eating "regular" food. Your
capacity will increase over the first six to nine
months of surgery. The stomach pouch and small
intestine learn how to work together over a period
of months. Many patients notice a dramatic increase
in the amount of food they can handle comfortably.
This is normal in most cases. This is the time
when the good habits developed in the first few
months will support further weight loss.
How do I get my protein in when I can eat
such little amounts?
Following your surgery, it is important for healing,
as well as to aid in weight loss that you consume
an adequate amount of protein. Since you are limited
in your food intake, it is recommended that you
consume a low-fat, low-sugar, high protein drink
(we will give you several options). You can also
purchase protein powder and add it to liquids
or mix it into certain foods. As you are able
to tolerate more and increase the variety in your
diet, you should rely on high protein foods to
help meet the protein goal. The nutrition team
works individually with each patient to reach
their protein goal and to provide the best outcome
following surgery.
Do I have to take vitamin and mineral supplements
for the rest of my life?
Vitamin and mineral supplements are required to
help prevent nutritional deficiencies. Because
of your limited intake and some malabsorption
from the gastric bypass, certain vitamins and
minerals will not be absorbed as well. Most people
will require a multivitamin, calcium, and vitamin
B12 supplement. Other vitamin and mineral supplements
needed will be determined on an individual basis.
Does everyone experience dumping syndrome?
Most people are extremely sensitive to sugar after
their surgery, especially sugar that is added
to foods. After a gastric bypass, foods high in
sugar rapidly enter the small intestine ("dump").
This can lead to feelings of nausea, dizziness,
sweatiness, heart palpitations, stomach cramps,
and/or diarrhea. This problem can be prevented
by limiting or avoiding foods with added sugar
and eating/drinking at the same time. "Dumping"
tends to decrease over several months as the pouch
and small intestine learn to work better together.
Although dumping is uncomfortable, it is not dangerous.
Will I lose all my hair? How do I keep it
from falling out?
Hair loss after bariatric surgery is, unfortunately,
common. There are a number of reasons why you
may lose hair but it is generally reflective of
poor protein intake. Until the shortened intestine
learns to work effectively, you will be malabsorbing
some nutrients--including protein. Hair loss tends
to present itself around three to five months
after surgery, but will stop if enough protein
is consumed. Each meal should focus on protein
intake, especially immediately following surgery.
The nutrition team will help you with a protein-rich
diet.
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About Surgery
How much will the procedure cost?
Procedure costs differ depending on the patient.
Each patient's surgery is unique, and may encounter
different difficulties post-operatively. However,
many insurance companies will cover the cost of
the surgery, as morbid obesity can become a life
threatening condition. Each patient should confirm
with his or her own insurance company that the
procedure and its related expenses would be covered
prior to undergoing the procedure.
How long will I be in the hospital?
This varies from patient to patient. Any post-operative
complications will cause a patient to have an
extended hospital stay. On average, a surgery
with no complications can warrant a stay between
three to seven days. Patients can usually return
to work four to six weeks after surgery (sometimes
sooner), but should not do any heavy lifting or
heavy manual labor for an extended period of time.
How much weight can I expect to lose?
Again, each person’s weight loss progress
is different. On average, a weight loss of approximately
30 percent of starting weight is expected. The
most weight loss is usually seen in the first
few months after surgery. Weight loss usually
continues for about 12 to 18 months after surgery.
Healthy eating habits and exercise are critical
for continued success.
Are there any side effects?
Side effects vary and are difficult to predict
prior to surgery. Some people report problems
such as diarrhea, excessive gas, and vomiting.
Most side effects can be minimized with changes
in the diet. Malnutrition is rare with the current
procedures although vitamin/mineral supplementation
is essential. All patients are required to take
specific supplements for life because the procedure
creates changes in nutrient absorption and restricts
volume intake.
Can I get pregnant after weight loss surgery?
It is very important that you do not get pregnant
for at least 12 to 18 months after any type of
weight loss procedure. You must use a reliable
method of birth control throughout this time period.
Once your weight has stabilized and the appropriate
months have passed, you can become pregnant. It
is important, however, to be monitored closely
by an obstetrician and nutrition expert familiar
with your weight loss surgery. One study at Alvarado
Hospital and Medical Center in San Diego, California
actually found fewer pregnancy related complications
in a post-surgical group when compared to a control
group of pregnant morbidly obese women.
Are there any medications that I must avoid?
Some medications are not to be used because they
may cause ulcers in your pouch. You should permanently
avoid using any type of non-steroidal anti-inflammatory
drugs also known as “NSAID’s”.
Some specific medications to avoid include Advil,
aspirin, Excedrin, Motrin, Aleve, ibuprofen. If
you are unsure about your individualized medications
or any other medication, contact the physician
that prescribed the medication and/or your surgeon.
Is it true that some people regain some of
the weight that they lose following the surgery?
Regaining weight or even minimal weight loss does
and can occur. This is usually directly related
to consuming high fat and high sugar foods. Weight
loss surgery will only help you lose weight. It
is important to follow the nutritional guidelines
as a part of your new lifestyle. It is best to
avoid the following foods:
- Milk shakes and malt drinks
- Cakes and other pastries
- Fried foods
- Pudding
- Chips and other high fat snack foods
- Soft drinks
- Ice cream
- Candy
How will I know if I have experienced "dumping
syndrome"? What is the best way to avoid
it?
Dumping syndrome is characterized by nausea,
dizziness, stomach cramps and severe diarrhea.
It is primarily caused by eating and/or drinking
foods high in sugar and/or eating and drinking
at the same time. It is essential, most especially
after gastric bypass surgery, to avoid high sugar
foods and not to drink and eat at the same time.
Even small amounts of concentrated sugar can cause
dumping syndrome. Avoid foods that have sugar
as one of the first three ingredients. Some other
names for sugar are as follows:
- Sucrose Glucose
- Corn syrup Maltose
- Fructose
- Lactose Fruit sugar
- Dextrose Honey
- Mannitol
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