Weight Loss Surgery: How to Get Started?

Thank you so much for coming. Thank you for your interest in weight loss surgery and also for attending our program today. I would like to tell you a little bit more if you decide that you like to be considered for bariatric or weight loss surgery. I would like to tell you a little bit more about the evaluation process. Everybody always wants to know how we get start with this.

What you do is you turn in your application and you get your first new patient appointment with us and that begins a very extensive evaluation process so that we can help you decide and you can help us decide if weight loss surgery is going to be a safe and good thing for you to undergo. You will get your new patient appointment and you will come in and I am the nurse practitioner in our program.

I am going to begin the process with you with getting your medical history. During that process I want to get as much information as I can from you about past medical problems that you might not have had that are since been cured or not an issue for you anymore as well as current medical problems and that might include medications that you are on or treatments that you are undergoing.

You may be seeing specialists for other reasons that are associated with your health conditions and I want to do a physical exam with you and gather information that way. We are going to start that evaluation process that firs day. You are also going to see Patrick Mahany who is our dietician and he is going to go over your nutritional history and how you are currently eating and tell you more about how you are going to eat after surgery.

You are also going to see one of our two psychologists and go through a psychological evaluation. In addition to that I would like to show you a little bit about some other studies that we are going to need to help make a decision for you as I said about the safety of having bariatric surgery. Now you do not need to worry about writing these down because we will give you these in writing. There are a couple of different options about getting some of this medical testing completed that you can make a decision for yourself as to what the best way is to get it done.

Either I can order it for you when you come to your first initial patient appointment. We can have it done here at Durham Regional Hospital. You will not have it done the same day as your appointment so you do not have to come fasting that day. I can order it to be done on a different day over at Durham Regional Hospital or if you live a distance away or it is more convenient for you, you can have that testing that through your doctor. We will give you the information that you need to take to your doctor to get that accomplished.

The first piece that we are going to need to do is pre-extensive blood work. We need to get an idea of problems that you may already know about. You may say I already know that I am diabetic or you might not know that you have got some blood sugar problems or some problems with your cholesterol or problems with your thyroid. We are going to get extensive blood work. We are also going to get some other testing and you may have had some of these done in the past. We are going to get a barium swallow.

Nobody really likes having a barium swallow but it helps gives us a lot of information about how your esophagus works and your swallowing mechanism. We are also going to get an electrocardiogram or an EKG and that tells us about the rhythms of your heart and we are going to get some breathing test, some pulmonary test called pulmonary function test and arterial blood gases and that lets us know about your breathing mechanisms and the oxygenation of your blood.

If have specific medical problems that you know about or that we discover with these tests we may have to have some other testing done but this is the testing that we know we need to have for everybody to begin your evaluation process. We will individualize it to your particular care based on your medical conditions. The other reports that we need to have done if you have had any of these conditions or have had any of this test is done is a sleep study. If you have had a sleep study done in the past we may not have to repeat that. We need to get a copy of it and take a look at it and make an evaluation with you.

If you have had any testing done on your heart in the past, if you have had an echocardiogram done or a stress test done or a cardiac catheterization done, I would like to have you get a copy of that report which may be available from your cardiologist or from your primary care doctor. If you have had surgery in any part of your abdomen, if you have had any kind of bowel surgery, any kind of hernia repair, any kind of surgery on your heart or any kind of cancer surgery I would like for you to get the operative note from your doctor or from the hospital that it was done.

I will certainly be glad to work with you if you need help in doing that. In addition to that you will see as I said nutrition and psychology and then we will kind of gather an entire picture and go from that point. Before I leave to day though, I want to tell you a little bit about our support group. It is the kind of interjection and I would love to have anyone of you who are interested in it to join us. Our support group is for both preoperative and postoperative patient’s who are going through our program.

We hope the support group on the fourth Tuesday of every month in the Durham Regional classroom right here where we are today and that is from 6:30 until 8:00 in the evening. We always have an educational session that is followed by questions and answers and then we also have a lot of sharing time so that if you have questions of other patients who are a little ahead of you in the program or behind you in the program you can offer your support and your suggestions as well as ask questions of those who may have been where you are now or where you are considering going.

I would invite any of you to come. You are welcome to come with your support people whoever that might be and we would welcome you to come on the fourth Tuesday.