What are the routine tests before surgery?
Certain basic tests are done prior to surgery: a Complete Blood Count (CBC), a Chemistry Panel, and other chemistry tests to make sure a patient doesn’t have a medically treatable cause for their obesity. All patients but the very young get a chest X-ray and an electrocardiogram. Other tests, such as an echocardiogram, sleep studies, GI evaluation, or cardiology evaluation may be requested when indicated.
What is the purpose of all these tests?
An accurate assessment of your health is needed before surgery. The best way to avoid complications is to never have them in the first place. It is important to know if your thyroid function is adequate since hypothyroidism can lead to obesity. If you are diabetic, special steps must be taken to control your blood sugar. Because surgery can increase cardiac stress, your heart will be thoroughly evaluated. These tests will determine if you have liver malfunction, breathing difficulties, excess fluid in the tissues, abnormalities of the salts or minerals in body fluids, or abnormal blood fat levels.
Why do I have to have a GI Evaluation?
Patients who have significant gastrointestinal symptoms such as upper abdominal pain, heartburn, belching sour fluid, etc., may have underlying problems such as a hiatal hernia, gastroesophageal reflux or peptic ulcer. For example, many patients have symptoms of reflux. Up to 15% of these patients may show early changes in the lining of the esophagus, which could predispose them to cancer of the esophagus. It is important to identify these changes so a suitable surveillance or treatment program can be planned.
Why do I have to have a Sleep Study?
The sleep study detects a tendency for abnormal stopping of breathing, usually associated with airway blockage when the muscles relax during sleep. This condition is associated with a high mortality rate. After surgery, you will be sedated and will receive narcotics for pain, which further depress normal breathing and reflexes. Airway blockage becomes more dangerous at this time. It is important to have a clear picture of what to expect and how to handle it.
Why do I have to have a Psychiatric Evaluation?
Prior to weight loss surgery, underlying psychiatric disorders must be ruled out. Most psychiatrists will also evaluate your understanding and knowledge of the risks and complications associated with weight loss surgery and your ability to follow the basic recovery plan.
What impact do my medical problems have on the decision for surgery, and how do the medical problems affect risk?
Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, if they are problems that are related to the patient's weight, they also increase the need for surgery. Severe medical problems may not dissuade the surgeon from recommending gastric bypass surgery if it is otherwise appropriate, but those conditions will make a patient's risk higher than average.
If I want to undergo a gastric bypass, how long do I have to wait?
New evaluation appointments are usually booked in a matter of days. Once a patient is seen, if the surgeon and patient agree it is appropriate, the patient is enrolled in our weight loss surgery program which is about 4 months.
What can I do before the appointment to speed up the process of getting ready for surgery?
Select a primary care physician if you don't already have one, and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing is current.
- Make a list of all the diets you have tried (a diet history) and bring it to your doctor.
- Bring any pertinent medical data to your appointment with the surgeon - this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.
- Bring a list of your medications with dose and schedule.
- Stop smoking for at least two months before surgery. Surgical patients who use tobacco products are not candidates. Please note that resuming smoking after surgery very dangerous and predisposes gastric bypass patients to ulcer formations that can be very difficult to treat.
How should I prepare myself mentally for surgery?
Weight loss surgery is like other major surgeries. The best preparation is to understand the risks and potential benefits and to closely follow your doctor’s instructions.
- Understand the surgical process and what to expect afterwards.
- Talk to people who have had weight loss surgery (click here for information on support groups).
- Write a letter to yourself and your surgeon explaining your reasons for having the surgery and outlining your plans to maintain your weight loss after surgery.
- Start a journal about your experience. Record how you feel now, the obstacles you encounter, and the things you hope to be able to do after surgery.
- Get a letter of support from your family. It helps to know that you have people behind you, waiting to help.
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