What do you say Doc? (and a Pre-op and Post-op Get-ready List)
Hey...we have to start somewhere...so why not read over this handy list questions to ask the doctor? This is the beginning of a long trip back to good health! We "need" our doctor's good advice.
SUGGESTED PRE-OP LIST OF QUESTIONS
(there are so many more!)
1. Pre Surgery
a. What pre-testing do you require? (Blood test, EKG, gall stone ultrasound, upper GI, lung testing, chest x-rays, etc.)
b. What should I do to prepare for the surgery? (in general) I have heard deep breathing helps, what does he suggest?
c. Do I have to do anything special the day(s) before surgery? For example, have a clear liquid diet or wash with special soap?
d. Do you require psychological testing? Do I do it through your office or on my own?
e. If I smoke, how will that effect the pre and post surgery?
f. If I have asthma and/or sleep apnea, how will this effect the pre, during and post surgery?
g. I am allergic to ......., how will this effect my surgery?
2. Surgery
a. Can you describe the surgery you perform?
b. How is the surgery performed? Will you do it laproscopily or full cut.
c. How do you do the stomach? Stapling, sewing, staple and cut off the excess, bands?
d. Is the anesthesiologist experienced with big people?
e. How much of the intestines are by-passed? Is it proximal or distal? This has a lot to do with the side effects that can occur.
f. Do you cut the acid producing nerve to prevent ulcers? Will you prescribe an acid reducer after the surgery?
g. What do you do about the gall bladder? Will you go ahead and remove it (best choice)?
h. Will you do a liver biopsy? I've heard that this is a common practice to show any irregularities.
i. Will I be in ICU?
j How long will I be in recovery?
k. Will I get a morphine pump? When will it come out?
l. Where wills the IV be (neck or arm)? When will it come out?
m. Will you have a nasal tube or intubation tube? When will it come out?
n. Will I have a catheter? When will it come out?
o. Will I have an epidermal? When will it come out?
p. Will I have a drainage tube in my incision? When will it come out?
q. Will I have a drainage tube in my stomach? When will it come out?
r. Does doctor prescribe a stomach binder? This will help a lot with the pain.
s. How soon do I drink water, juice, broth, etc. after the surgery?
t. Will your doctor perform the operation or a resident?
u. Will you visit with my family in the waiting room after the surgery to let them know how the surgery went?
v. I am concerned about telling my family. If I ask you to, will you assure them that I am doing OK but not tell them specifics about the surgery?
3. Hospital Stay
a. Which hospital will you be using? What is the reputation of the hospital?
b. 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?
c. Can I pre-register at the hospital to save time?
d. How long is the hospital stay?
e. Are the gowns in the hospital for large people?
f. I have a lot of nasal congestion and use Afrin regularly. Can I still use it in the hospital?
g. Will I have to stay in the hospital until I have a bowel movement?
h. Will I have a private room or will I share?
h. Can my husband/wife/parent/friend stay with me at the hospital?
j. How often should I be walking?
k. Will I have lung therapy?
l. I have bracelets/rings that won't come off. Will I need to have these cut off or can the hospital work around them?
m What is the nurse/patient ratio? For ICU and the regular floor I will be on.
4. Complications
a. Have you ever had a case where the surgery had started and you couldn't complete it? What were the circumstances?
b. What type of complications have you seen during surgery and post-op?
c. Have you had any patients die either in surgery, within a few days of surgery or later on because the surgery.
d. 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?
e. Will my hair fall out? Does chewable zinc help? When will it start falling out? How much? When will it grow back?
f. 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?
g. Will I vomit a lot? How will I know when to stop eating?
i. I am really concerned with my eating. Can I "out eat" this surgery?
j. 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?
k. I have heard of surgeries canceled due to the H.Pylori bacteria being present in your stomach. What is this and can I do anything to prevent it?
5. Miscellaneous
a. How long will the staples stay in? (the outside staples, the ones inside are permanent.)
b. I have to travel X miles by car/train/plane, should I take any precautions?
c. How long will I have to be off work/school?
d. How long do I need someone to stay with me? When can I resume my normal household duties?
e. Do I have a limit on how much I can carry/lift? For how long?
f. What will the scar look like?
g. How much should I lose and how fast?
h. What will be my absorption rate after surgery?
i. How small will my stomach be?
j. Will it stretch back out? After how long?
k. Will I have "dumping" after eating a lot of sugar? How painful is it? How much sugar is a lot?
l. How much calories, nutrients, minerals, etc. percentage wise will my body absorb? 50%? 60-80%?
6. After Surgery Care
a. What is you�re 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?
b. Are there any foods I need to stay away from? (Nuts peels, etc.) Can I never have these or is it just at first?
c. Does he have a live support group? And when do they meet?
d. What are his follow-up requirements?
e. Do you require vitamin and protein supplements?
f. Will I need to get monthly B-12 shots?
g. Will I need to take the vitamins, supplements; B-12 shots for the rest of my life? h. How much water should I try to drink?
h. How often should I weigh? Will I be subject to plateaus?
i. What kind of exercise do you recommend after surgery and how soon can I start?
j. After the weight loss, are tummy tucks common? Do you perform those? Can you refer me to someone who does?
7. Medical Conditions After Surgery
a. 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?
b. 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?
c. 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?
d. I have heard that this surgery will really help my blood pressure/diabetes/joint pain/etc. How soon can I stop taking my medicine or these?
e. 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
a. How many operations have you performed?
b. Have you performed the surgery on anyone my size? Were they successful?
c. Can I have some patient referrals? If he/she says no out right, go to another surgeon.
d. d. Do you have any malpractice suits?
9. Insurance/Payment
a. How much will be the total cost of the surgery?
c. Have you had anyone from my insurance group and if so, did they have any trouble getting approval for the surgery?
c. How often does insurance refuse to pay?
d. Will you help during the appeal phase, if my insurance refuses the first request?
e. 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)?
f. 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?
g. Does the hospital/surgeon except a sliding scale payment? (income based, applicable to teaching hospitals mostly)
h. Do you or the hospital require a deposit? How much?
A PRE-OPS GET-READY SUGGESTION LIST
You MAY or MAY not need these things....consult your DOCTOR!
Groceries:
Sugar free Carnation Instant Breakfast
Sustical, Ensure, Boost, etc.
Water
Herb Tea (decaffeinated)
fat free canned chicken or beef broth
Soup (stay with the simple ingredient ones)
creamed soups
bullion
rice or soy milk (nonfat) (only if lactose intolerant)
sugar free Jell-O
Mashed potatoes
Smooth, no sugar added yogurts
Gatorade
sugar free Kool-aid
fruit juices cut half with water -- non-pulp grape, apple, Cranberry, etc.
applesauce
sugar free popsicles
Baby food
Hot cereal (oatmeal, rice, grits, etc.)
Baking potatoes
2. Health Store
Designer Protein (similar to slim fast)
Citrate of Magnesia (often you drink this the day before surgery to "clean you out")
Liquid pain reliever
Liquid, Chewable, Spray or Powder Multi-Vitamin
Vitamin E Oil (if you put it on your scar, it will heal faster and not look as bad)
Zinc to prevent hair loss (common side effect)
Chewable Calcium (Tums)
Chewable or liquid Iron
Chewable or spray Ginseng to improve the smell of passing gas (common side effect)
Chewable, sublingual or liquid B-12
3. Department Store
Dial (anti-bacterial soap)
ice cube trays for freezing right size portions of the puree stuff
Blender I think one of those hand held ones are wonderful
zip lock bags (to store frozen ice cubes)
shot glass for measuring
Play tea set (helps portion control)
camera (gotta have those before and after images)
4. Beauty Stuff
For Minz Bath Oil Equal parts of these
Sesame (not roasted but cold pressed)
Olive (light)
Avocado
Almond
Vitamin E Oil
Vitamin A Oil (optional)
Fragrance (optional)
5. Stuff for Hospital
toothbrush
toothpaste
deodorant
Lotion
Moisturizing lip gloss
powder
shampoo
brush
hair clips
gowns
robe
slippers
my comfy pillow
watch or travel clock
walkman
stuffed animal (hey it works for some people)
make up
writing paper
book(s), magazine(s), cross stitch, puzzles, etc.
Stomach Binder (if they don't provide it, check with your surgeon.)
Comfortable clothes to go home in.
6. After Hospital
Shower Chair (if you think you will need it)
A recliner (very few can sleep in a bed at first)
DON'T FORGET TO DRINK YOUR WATER!
IT WILL BE GOOD TO BE HOME!
