After you attend an information session, you can schedule a meeting with a surgeon. The surgeon will review your complete medical history, and give you a thorough physical medical exam. You will also need a number medical tests to ensure that your overall health is good enough to endure the surgery.
Next, you will meet with an NSMC cardiologist, and a NSMC Heart and Wellness Center fitness nurse and nutritionist for further evaluation. Finally, you will have a psychiatric evaluation to assess your mental status and competency, as well as your commitment to comply with the lifelong post-operative follow-up needed for post-surgical success.
NSMC is committed to helping patients who will not undergo surgery to attain their weight loss and health goals through weight management and exercise programs. These are offered through our Wellness and Integrative Medicine Center.
Because bariatric procedures are considered elective by many insurers, you must obtain insurance approval for the surgery prior to scheduling the procedure. There is no fee for the information session nor for the initial interview by the program coordinator. While many of the costs that will be incurred during the evaluation process will be covered by insurance, some charges may become the responsibility of the patient. If a you qualify medically for weight loss surgery, the surgeon's office will request pre-approval for coverage of the procedure from the your health insurer. This can take from a week to two months to obtain. When the insurance company gives its pre-authorization, you are notified by the surgeon's office. In most cases, a date for the operation will be scheduled during this notification. For patients not covered by insurance, there are self-pay options.
Once a date for the operation is scheduled, patients are often asked to come into the office about a week before the procedure. At this point you are given pre-operative instructions and a more detailed explanation of what to expect on the day of surgery and the days immediately following. You will have the opportunity to ask all your remaining questions before signing consent forms indicating that you understand the procedure and the risks associated with it. Surgeons need these signed forms so they can have assurance that you understand the serious nature of the procedure and that you also appreciate the nature of the life-long commitment.
Typically, patients whose weight loss surgery is performed laparoscopically stay in the hospital for one or two nights and then see their surgeon again seven to ten days after surgery. For an open gastric bypass procedure with a full incision, the hospital stay can be three to four days.
Weight loss surgery can successfully start your weight loss, but surgery alone will not ensure long-term success. NSMC is committed to supporting and educating our patients as their bodies, psyches and lifestyles transform. Surgical weight loss patients are required to attend a 12-week post-operative weight loss risk reduction program through NSMC's Heart and Wellness Center. This program includes individual counseling, group nutrition and lifestyle education, medically supervised exercise, stress management and instruction in cardiovascular risk reduction.
In addition, you are asked to commit to a year-long, follow-up program that includes medical and nutrition follow-up appointments with your surgeon and the Heart and Wellness staff, as well as monthly support groups, where patients share successes, challenges, tips and successes. This year-long commitment is a unique feature of NSMC's program and a key factor in the success of our patients.
After the first year, you will then have yearly appointments your surgeon and Heart and Wellness staff.
Weight Loss Following Surgery
Surgery alone will not remove the excess pounds and keep them off. It is only a tool, something to help patients do the hard work. To reach a healthy weight, you must adjust your eating habits and exercise patterns. Our nutritionist and other members of the NSMC support team can help.
The greatest weight loss usually occurs in the first year to 18 months following surgery. Five years after the procedure patients have usually lost 50 to 75 percent of their excess weight. After two years, NSMC patients have averaged a weight loss of 119 pounds. Some patients regain a small amount of this weight, but few ever regain it all.
Immediately following surgery, a patient's diet is limited to sugar-free clear liquids. It is slowly expanded to include soft foods, and then finally solid foods. Patients find that eating only a little bit of food will make them feel full. They are instructed to eat small amounts slowly several times a day. A consultation with a nutritionist following surgery helps them adjust to their altered digestive system.
Because gastric bypass changes the digestive process, lifelong nutritional supplements are essential to prevent malnutrition. Patients must take daily multivitamins in addition to B12, iron and calcium supplements. A complete detailed list will be furnished by the surgical weight management team. Gastric band and sleeve gastrectomy patients may also have to take vitamin supplements because it may not be possible to get all that are needed in three small meals a day.
Eighteen to 24 months after surgery, when their weight has stabilized, many patients find that they have excess skin and sagging that exercise and muscle toning cannot fix. NSMC's cosmetic and reconstructive plastic surgeons can offer patients a variety of total body lift procedures that help contour the body to its new shape.