I think a lot of people would be surprised at how time consuming the pre-operative process for gastric bypass is. I know that I myself never expected to be spending so much time at doctor’s offices! Thankfully, I know that at the end of the day it will be the best thing I have ever done.
First, I have my monthly visits with my primary care doctor. My PCP keeps a log of my goals, progress and set backs along with medical statistics like weight and BMI. I have to see her every calendar month for six months. I am on month four, so I still have two visits to go. These appointments are short, but with waiting time usually take around an hour.
At month three, you meet your surgeon for the first time. I was surprised at how long this day lasted, I was at the hospital for three and a half hours. First, a nurse takes you into a room to collect your height, weight, blood pressure and pulse rate. They then escort you into a room where you watch a short video on your surgery of choice. When it’s finished you meet your surgeon’s assistant and they ask you tons of questions. They will need to know a lot about your medical history, your weight loss history and your expectations. They can then answer any questions you have. I had already done my research, but I did want to ask about the success rate at the hospital, how many fatalities they have had, how the surgery differs with age and so on. I was pleased with all of the answers.
The surgeon’s assistant will examine you quickly and then you finally get to meet the surgeon. They ask you a few more questions, mostly about your expectations and then it’s your turn to ask them. I asked how many of these surgeries she has performed, how many she does a month, etc. She then hands me a huge stack of papers. I had a lot of reading to do! She also explained all of my pre-op testing and gave me the referrals I would need.
First up on my pre-op testing list was a Holter monitor. This isn’t a test they usually prescribe, but I had been feeling some palpations recently and they wanted to check it out. The monitor continuously monitors the electrical activity of the heart for 24 hours. My results came in a little unusual, but otherwise healthy.
When I brought the monitor back in I thought it would be a good time to do some of the other pre-op tests. I made sure to fast so that I could get my blood work done. I am pretty scared of needles but I did okay considering it was 27 tubes of blood! It seemed like it took forever. After a short bout of hyperventilation, I was done. The results are back and I need to bring my Vitamin D and Vitamin B12 levels up. I have always struggled with Vitamin D, living in the Northeast sure doesn’t help. My level had previously been at 3 and I brought it up to a 15. I still have to make it to 40 before my surgery so I have been put on a prescription strength dose. Other than that I just had to buy a B12 supplement. While I was at the hospital I also had a chest x-ray done and an EKG. All was good!
Thursday I am going for an upper and lower scope, otherwise known as a throat scope and a colonoscopy. This is actually an outpatient surgery that takes some preparation. Six days before the procedure I had to stop eating all seeds and nuts, and limit my intake of fiber and dairy. The day before I cannot eat after six and then I have to start drinking the prep solution. My appointment is on Thursday morning and luckily it only takes about 30 minutes. You are under local anesthesia though, so you must have a ride to and from the procedure. I will say, I am not looking forward to this!
Females must also visit their gynaecologist as a part of their gastric bypass pre-op testing for a pap smear. I haven’t made my appointment yet but I’m going to aim for July. Also in July, I will be going to my nutrition counselling and psychiatric evaluation. This is done at the hospital where I am having my gastric bypass, considering it is the most important tests before the surgery. I have received a book to read before my appointment on pre and post-operative nutrition. I have skimmed through it and so far I am disappointed. It seems that a lot of the suggested meals are a cop-out for health. They actually recommend things like sugar substitutes! I guess some people need that, but I am trying to be healthy, really and truly healthy. To me, health doesn’t include Splenda.
I am interested to see what my nutrition counsellor has to say about my views on health and their suggested meals. I won’t lie, I’m a little nervous about the appointment. Yes, the counsellor is probably a well-educated professional but how can you recommend things with aspartame to your bariatric patients? I don’t want to come off as a know-it-all, but I do want to express my concerns and utilize the counsellor to help me come up with a plan that I like and that works for my own lifestyle. I think it’s going to be very educational and although I’m nervous about it, I’m also excited!
I can’t say that I’m looking forward to the psychiatric evaluation and that’s probably because it’s sort of an unknown. I’ve tried to read about what kind of questions they ask you but haven’t found anything. I haven’t gotten along with psychiatrists in the past. The minute you have an unhappy thought they try to diagnose you with Bipolar Disorder and if you are particular, well you must have OCD. I don’t know if this has just been my experience, but doctors these days are too quick to prescribe medicines to “make you happy.” I have fought that because I wanted to find my own happiness and I did! I will talk about that in a later post. I waited to have gastric bypass until I was in a happy place and I am. So I can’t imagine I will have many issues with the psychiatric evaluation. I’m sure we will talk about my infatuation with food, which I just started to truly understand. I’m ready for that.
In conclusion, preparing for a bariatric surgery is a lot of work. Heck, the work doesn’t even stop after the surgery! It’s an ongoing process; a lifestyle change. You have to be ready for that. You have to be ready to spend hours in hospitals and at doctor’s offices. It just comes with the territory. Thankfully it will all be worth it!
Disclaimer: This is just my experience with the Minimally Invasive Bariatric and General Surgery Program at Magee-Womens Hospital of UPMC. Bariatric programs vary by hospital and I’m just sharing my personal experience.