I'm meeting with my surgeon today..... - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

kristyann · 05-16-2005, 07:23 AM

Well today is the day that I meet with my surgeon and he reviews all of the test results. If he does not find any problems he will be submitting my insurance information also. I was also told my his office that they should be able to give me a tentative date today, of course this date will be tentative on the insurance approval, which they feel will be no problem. I am so nervous. I have so many questions for him and I am sure there are so many more that I should ask that I have not thought of yet. I am starting a list, can anyone help me. Any suggestions of some important questions that you guys found helpful to ask the surgeon at this point in the process.

I'm so excited I just can't wait to get that approval and the date.

Anne · 05-16-2005, 05:29 PM

Kristyann,

Congratulations to getting that much closer. You know, I can't even remember what I asked him. The best advise I got was to write all your questions down. I was so nervous & excited, I basically just listened to them. I quess my biggest question was open or lap? I opted for open after I talked to the doctor.

Good luck and just keep a list of all the questions that will pop up!

Laura@BellaBabies · 05-16-2005, 05:56 PM

YAY one day closer to being a loser!!!!

My most important questions for me was what he wanted me to do as far as the post op diet, pain management in the hospital, I am lucky my hospital does the epidural so I won't be groggy and dopey when I wake up, but I will be able to get up and walk around. I had this for all of my sections and it worked awesome!

LizardQueen · 05-16-2005, 06:20 PM

It is great to make a list so you won't forget anything. My big question was How long will I be in the hospital? what should I do or not do at home? How long will I be off work? those are just a few that I can remember off hand. I wish I had kept my list! Good luck and I hope things go well!

Amber

kristyann · 05-17-2005, 06:47 AM

Well I am on my way. I am now in the dictation stage. I'm a little disappointed though, my surgeons office had original told me they would let me schedule a date when I spoke to the surgeon however they do not do that anymore. They were having difficulties with people scheduling and then not getting approved. My doc did say that I would definitely get in for surgery this summer. My insurance company is only taking about 2 or 3 weeks to respond to the letter so hopefully I will get a call from my surgeons office before my next appointment which is on June 20th. Eventhough I was kinda disappointed about the scheduling he did make feel better by telling me that he feels very strongly that I have enough documentation that the insurance will approve me. I AM SO EXCITED!!!!!!!! He answered all my questions and then some, I'm going for open, because of my previous c-section, he feels it would be safer for me. Well anyways thanks for the support.

watergirl · 05-17-2005, 08:14 AM

I copied these from another post I did regarding questions to potentially ask your doctor. Hope you find it useful.

Here are some of the questions I asked. You can pick what works for you.

1. Pre Surgery
o What pre-testing do you require? (Blood test, EKG, gall stone ultrasound, upper GI, lung testing, chest x-rays, etc.)
o What should I do to prepare for the surgery? (in general) I have heard deep breathing helps, what does he suggest?
o Do I have to do anything special the day(s) before surgery? For example, have a clear liquid diet or wash with special soap?
o Do you require psychological testing? Do I do it through your office or on my own?
o If I smoke, how will that effect the pre and post surgery?
o If I have asthma and/or sleep apnea, how will this effect the pre, during and post surgery?
o I am allergic to ......., how will this effect my surgery?
2. Surgery
o Can you describe the surgery you perform?
o How is the surgery performed? Will you do it laproscopily or full cut.
o How do you do the stomach? I've heard of stapling, sewing, some staple and cut off the excess, some put bands, and others do combinations.
o Is the anesthesiologist experienced with big people? We have special requirements due to the fact that fat cells retain the sedative, and since we have more fat cells...
o How much of the intestines is by-passed? Is it proximal or distal? This has a lot to do with the side effects that can occur.
o Do you cut the acid producing nerve to prevent ulcers? Along those lines, will you prescribe an acid reducer after the surgery? How long will I need to take it?
o What do you do about the gall bladder? (gall stones are a common side effect - 30% of patients). Will you go ahead and remove it (best choice) or will he prescribe bile salts to prevent them? How long will I need to take them?
o Will you do a liver biopsy? I've heard that this is a common practice to show any irregularities.
o Will I be in ICU? j. How long will I be in recovery?
o Will I get a morphine pump? When will it come out?
o Where will the IV be (neck or arm)? When will it come out?
o Will you have a nasal tube or intubation tube? When will it come out?
o Will I have a catheter? When will it come out?
o Will I have an epidural? When will it come out?
o Will I have a drainage tube in my incision? When will it come out?
o Will I have a drainage tube in my stomach? When will it come out?
o Does he prescribe a stomach binder? This will help a lot with the pain.
o How soon does he allow water, juice, broth, etc. after the surgery?
o Will he perform the operation or a resident?
o Will you visit with my family in the waiting room after the surgery to let them know how the surgery went?
o I am concerned about telling my family. This is a private choice for me, but I know they will want to be at the hospital. If I ask you to, will you assure them that I am doing OK but not tell them specifics about the surgery? I do not want them to know that I have had obesity surgery. When I lose weight, I will tell them I am on a diet.
3. Hospital Stay
o Which hospital will you be using? What is the reputation of the hospital?
o Will I go into the hospital the day before or day of the surgery. If day of, do they have any "deals" with local hotels?
o Can I pre-register at the hospital to save time?
o How long is the hospital stay?
o Are the gowns in the hospital for large people?
o I have a lot of nasal congestions and use Afrin regularly. Can I still use it in the hospital?
o I have heard of some people not having a bowel movement for several days after surgery. Will I have to stay in the hospital until I do? I have heard some people say that they had to stay and others who didn't. What is your policy?
o Will I have a private room or will I share?
o Can my husband/significant other/parent/friend stay with me at the hospital?
o How often should I be walking?
o Will I have lung therapy?
o I have bracelets/rings that won't come off. Will I need to have these cut off or can the hospital work around them?
o What is the nurse/patient ratio? For ICU and the regular floor I will be on.
4. Complications
o I have heard on one case where the surgeon went in and due to the size of the liver and blood analysis the surgery could not be performed. Have you ever had a case where the surgery had started and you couldn't complete it? What were the circumstances?
o What type of complications have you seen during surgery and post-op? (Ulcers, hernias, vitamin/mineral nutritional deficiencies, iron deficiency, hair loss, gall stones, leaky staples, incision infection, blockage of the connection between the stomach and the intestines, etc.)
o Have you had any patients die either in surgery, within a few days of surgery or later on because the surgery.
o I have heard that it is harder to detect stomach cancer and ulcers after this surgery, especially in the "unused" portion of the stomach. Does you agree? How concerned should I be about this risk.
o Will my hair fall out? Does chewable zinc help? When will it start falling out? How much? When will it grow back?
o I have heard that there is a lot of diarrhea and real stinky gas after the surgery. How can I minimize these? I have heard Ginseng helps. Are the diarrhea and gas permanent or will it go away eventually?
o Will I vomit a lot? How will I know when to stop eating?.
o I am really concerned with my eating. Can I "out eat" this surgery?
o I understand that Wernicke-Korsakoff's syndrome is caused by a deficiency of vitamin B1. How common is this and how can I prevent it?
o I have heard of surgieries cancelled due to the H.Pylori bacteria being present in your stomach. What is this and can I do anything to prevent it?
5. Miscellaneous
o How long will the staples stay in? (the outside staples, the ones inside are permanent.)
o I have to travel X miles by car/train/plane, should I take any precautions?
o How long will I have to be off work/school?
o How long do I need someone to stay with me? When can I resume my normal household duties?
o Do I have a limit on how much I can carry/lift? For how long? f. What will the scar look like?
o How much should I lose and how fast?
o What will be my absorption rate after surgery?
o How small will my stomach be?
o Will it stretch back out? After how long?
o Will I have "dumping" after eating a lot of sugar? How painful is it? How much sugar is a lot?
o How much calories, nutrients, minerals, etc. percentage wise will my body absorb? 50%? 60-80%?
6. After Surgery Care
o What is your after surgery diet? I've heard different diets. Some only clear liquids for 4 weeks, some liquids 1 week, pureed for 4, then regular food adding one item per day. What is your policy?
o Are there any foods I need to stay away from? (Nuts peels, etc.) Can I never have these or is it just at first?
o Does he have a live support group? And when do they meet? d. What are his follow-up requirements?
o Do you require vitamin and protein supplements?
o Will I need to get monthly B-12 shots?
o Will I need to take the vitamins, supplements, B-12 shots for the rest of my life?
o How much water should I try to drink?
o How often should I weigh? Will I be subject to plateaus?
o What kind of exercise do you recommend after surgery and how soon can I start? What does you think about water aerobics (this seems to be the exercise of choice for most of the people on my support e-mail group)
o After the weight loss, are tummy tucks common? Do you perform those? I have heard of surgeons at burn centers will perform the procedure free of charge except for the hospital stay to get the skin. Have you ever heard of this?
7. Medical Conditions After Surgery
o What about medications after surgery? I take such and such and such. Should I be OK with these? Since my absorption rate will be #%, how will that effect my dosages? Should I contact the prescribing doctor?
o I have heard I will never be able to take aspirin or anti-inflammatory drugs ever again. What should I take instead? Do you have a list of what I can and can not take?
o What about pregnancy after the surgery? When can I have children without risk to my unborn child or myself? Is it considered a high-risk pregnancy?
o I have heard that this surgery will really help my blood pressure/diabetes/joint pain/etc. How soon can I stop taking my medicine for these?
o I have heard of cases where when the person went to the ER and the doctors there put in a "tube" and punctured the stomach. Should I get a medic-alert bracelet?
o If worse comes to worse and I have severe nutritional problems or if I am in accident with abdominal injuries, is this surgery reversible?
o I have a lot of sinus drainage. I have heard that this will sometimes collect in the stomach and not "go down". What do you suggest to minimize this problem.
8. About the Doctor
o How many operations have you performed?
o Have you performed the surgery on anyone my size? Were they successful?
o Can I have some patient referrals? If he/she says no out right, go to another surgeon.
o Do you have any malpractice suits? I have checked my state medical board or consumer protection group and it says.....I found this law suit, can you tell me about it?
o (Give the guy the benefit of the doubt if you find anything, doctors are getting sued over everything)
9. Insurance/Payment
o How much will be the total cost of the surgery?
o Have you had anyone from my insurance group and if so, did they have any trouble getting approval for the surgery?
o How often does insurance refuse to pay?
o Will you help during the appeal phase, if my insurance refuses the first request?
o If my insurance won't pay do you and the hospital have a flat cash rate (usually a lot less than the "with insurance" price)?
o My insurance will pay this much so that means I will have to pay this much. I can't afford to pay this much as a lump sum. Will you assign the benefits? (accept the insurance amount as payment in full) or will you (or the hospital) allow me to make payments?
o Does the hospital/surgeon except a sliding scale payment? (income based, applicable to teaching hospitals mostly)
o Do you or the hospital require a deposit? How much?

Realtor Linda · 08-01-2005, 02:51 PM

WOW! Thanks Kim. Now that is some information !
Linda

Grumpy_Old_Man · 04-06-2009, 02:03 PM

I go see the surgeon to have the Yes or No, and if Yes then the date set appointment tomorrow. I am 99% sure it is a yes, as the assessment team all spoke of when I come in for the surgery, and even spoke of early this summer as the time frame.... So I am so hopeful. I even have the pre-surgery class booked for 2 weeks from tomorrow that was done by the assessment team and I was told to tell the surgeon it was booked already and to tell him the date.

I am just twitching, a bundle of raw nerves waiting to get into that office and finally get the word!

j.marie · 04-13-2009, 11:03 PM

This was super helpful, I had no idea what to ask my doctor for my initial consult- im ready for my next appt now LOL

Quote:

Originally Posted by watergirl

I copied these from another post I did regarding questions to potentially ask your doctor. Hope you find it useful.

Here are some of the questions I asked. You can pick what works for you.

1. Pre Surgery
o What pre-testing do you require? (Blood test, EKG, gall stone ultrasound, upper GI, lung testing, chest x-rays, etc.)
o What should I do to prepare for the surgery? (in general) I have heard deep breathing helps, what does he suggest?
o Do I have to do anything special the day(s) before surgery? For example, have a clear liquid diet or wash with special soap?
o Do you require psychological testing? Do I do it through your office or on my own?
o If I smoke, how will that effect the pre and post surgery?
o If I have asthma and/or sleep apnea, how will this effect the pre, during and post surgery?
o I am allergic to ......., how will this effect my surgery?
2. Surgery
o Can you describe the surgery you perform?
o How is the surgery performed? Will you do it laproscopily or full cut.
o How do you do the stomach? I've heard of stapling, sewing, some staple and cut off the excess, some put bands, and others do combinations.
o Is the anesthesiologist experienced with big people? We have special requirements due to the fact that fat cells retain the sedative, and since we have more fat cells...
o How much of the intestines is by-passed? Is it proximal or distal? This has a lot to do with the side effects that can occur.
o Do you cut the acid producing nerve to prevent ulcers? Along those lines, will you prescribe an acid reducer after the surgery? How long will I need to take it?
o What do you do about the gall bladder? (gall stones are a common side effect - 30% of patients). Will you go ahead and remove it (best choice) or will he prescribe bile salts to prevent them? How long will I need to take them?
o Will you do a liver biopsy? I've heard that this is a common practice to show any irregularities.
o Will I be in ICU? j. How long will I be in recovery?
o Will I get a morphine pump? When will it come out?
o Where will the IV be (neck or arm)? When will it come out?
o Will you have a nasal tube or intubation tube? When will it come out?
o Will I have a catheter? When will it come out?
o Will I have an epidural? When will it come out?
o Will I have a drainage tube in my incision? When will it come out?
o Will I have a drainage tube in my stomach? When will it come out?
o Does he prescribe a stomach binder? This will help a lot with the pain.
o How soon does he allow water, juice, broth, etc. after the surgery?
o Will he perform the operation or a resident?
o Will you visit with my family in the waiting room after the surgery to let them know how the surgery went?
o I am concerned about telling my family. This is a private choice for me, but I know they will want to be at the hospital. If I ask you to, will you assure them that I am doing OK but not tell them specifics about the surgery? I do not want them to know that I have had obesity surgery. When I lose weight, I will tell them I am on a diet.
3. Hospital Stay
o Which hospital will you be using? What is the reputation of the hospital?
o Will I go into the hospital the day before or day of the surgery. If day of, do they have any "deals" with local hotels?
o Can I pre-register at the hospital to save time?
o How long is the hospital stay?
o Are the gowns in the hospital for large people?
o I have a lot of nasal congestions and use Afrin regularly. Can I still use it in the hospital?
o I have heard of some people not having a bowel movement for several days after surgery. Will I have to stay in the hospital until I do? I have heard some people say that they had to stay and others who didn't. What is your policy?
o Will I have a private room or will I share?
o Can my husband/significant other/parent/friend stay with me at the hospital?
o How often should I be walking?
o Will I have lung therapy?
o I have bracelets/rings that won't come off. Will I need to have these cut off or can the hospital work around them?
o What is the nurse/patient ratio? For ICU and the regular floor I will be on.
4. Complications
o I have heard on one case where the surgeon went in and due to the size of the liver and blood analysis the surgery could not be performed. Have you ever had a case where the surgery had started and you couldn't complete it? What were the circumstances?
o What type of complications have you seen during surgery and post-op? (Ulcers, hernias, vitamin/mineral nutritional deficiencies, iron deficiency, hair loss, gall stones, leaky staples, incision infection, blockage of the connection between the stomach and the intestines, etc.)
o Have you had any patients die either in surgery, within a few days of surgery or later on because the surgery.
o I have heard that it is harder to detect stomach cancer and ulcers after this surgery, especially in the "unused" portion of the stomach. Does you agree? How concerned should I be about this risk.
o Will my hair fall out? Does chewable zinc help? When will it start falling out? How much? When will it grow back?
o I have heard that there is a lot of diarrhea and real stinky gas after the surgery. How can I minimize these? I have heard Ginseng helps. Are the diarrhea and gas permanent or will it go away eventually?
o Will I vomit a lot? How will I know when to stop eating?.
o I am really concerned with my eating. Can I "out eat" this surgery?
o I understand that Wernicke-Korsakoff's syndrome is caused by a deficiency of vitamin B1. How common is this and how can I prevent it?
o I have heard of surgieries cancelled due to the H.Pylori bacteria being present in your stomach. What is this and can I do anything to prevent it?
5. Miscellaneous
o How long will the staples stay in? (the outside staples, the ones inside are permanent.)
o I have to travel X miles by car/train/plane, should I take any precautions?
o How long will I have to be off work/school?
o How long do I need someone to stay with me? When can I resume my normal household duties?
o Do I have a limit on how much I can carry/lift? For how long? f. What will the scar look like?
o How much should I lose and how fast?
o What will be my absorption rate after surgery?
o How small will my stomach be?
o Will it stretch back out? After how long?
o Will I have "dumping" after eating a lot of sugar? How painful is it? How much sugar is a lot?
o How much calories, nutrients, minerals, etc. percentage wise will my body absorb? 50%? 60-80%?
6. After Surgery Care
o What is your after surgery diet? I've heard different diets. Some only clear liquids for 4 weeks, some liquids 1 week, pureed for 4, then regular food adding one item per day. What is your policy?
o Are there any foods I need to stay away from? (Nuts peels, etc.) Can I never have these or is it just at first?
o Does he have a live support group? And when do they meet? d. What are his follow-up requirements?
o Do you require vitamin and protein supplements?
o Will I need to get monthly B-12 shots?
o Will I need to take the vitamins, supplements, B-12 shots for the rest of my life?
o How much water should I try to drink?
o How often should I weigh? Will I be subject to plateaus?
o What kind of exercise do you recommend after surgery and how soon can I start? What does you think about water aerobics (this seems to be the exercise of choice for most of the people on my support e-mail group)
o After the weight loss, are tummy tucks common? Do you perform those? I have heard of surgeons at burn centers will perform the procedure free of charge except for the hospital stay to get the skin. Have you ever heard of this?
7. Medical Conditions After Surgery
o What about medications after surgery? I take such and such and such. Should I be OK with these? Since my absorption rate will be #%, how will that effect my dosages? Should I contact the prescribing doctor?
o I have heard I will never be able to take aspirin or anti-inflammatory drugs ever again. What should I take instead? Do you have a list of what I can and can not take?
o What about pregnancy after the surgery? When can I have children without risk to my unborn child or myself? Is it considered a high-risk pregnancy?
o I have heard that this surgery will really help my blood pressure/diabetes/joint pain/etc. How soon can I stop taking my medicine for these?
o I have heard of cases where when the person went to the ER and the doctors there put in a "tube" and punctured the stomach. Should I get a medic-alert bracelet?
o If worse comes to worse and I have severe nutritional problems or if I am in accident with abdominal injuries, is this surgery reversible?
o I have a lot of sinus drainage. I have heard that this will sometimes collect in the stomach and not "go down". What do you suggest to minimize this problem.
8. About the Doctor
o How many operations have you performed?
o Have you performed the surgery on anyone my size? Were they successful?
o Can I have some patient referrals? If he/she says no out right, go to another surgeon.
o Do you have any malpractice suits? I have checked my state medical board or consumer protection group and it says.....I found this law suit, can you tell me about it?
o (Give the guy the benefit of the doubt if you find anything, doctors are getting sued over everything)
9. Insurance/Payment
o How much will be the total cost of the surgery?
o Have you had anyone from my insurance group and if so, did they have any trouble getting approval for the surgery?
o How often does insurance refuse to pay?
o Will you help during the appeal phase, if my insurance refuses the first request?
o If my insurance won't pay do you and the hospital have a flat cash rate (usually a lot less than the "with insurance" price)?
o My insurance will pay this much so that means I will have to pay this much. I can't afford to pay this much as a lump sum. Will you assign the benefits? (accept the insurance amount as payment in full) or will you (or the hospital) allow me to make payments?
o Does the hospital/surgeon except a sliding scale payment? (income based, applicable to teaching hospitals mostly)
o Do you or the hospital require a deposit? How much?