What should a WLS patient expect before surgery?
Tuesday, January 12, 2016
Last week I wrote a little about the pros and cons, and the differences between the procedures. Today I'd like to write a bit about the expectations I've read about, and heard about, in general, before and after the surgery.
Making it official
Well, once you've found the perfect hospital and the perfect surgical and support teams, you need the OK from your insurance. Some insurance companies are quicker to grant coverage than others, so start early.
Some people can pay for this on their own, but it's $20,000 to $50,000! Some people have gone to Mexico for more affordable self-pay options. There is Kindle book out on that subject, but I have not read it.
It seems that most plans that cover WLS will cover a patient whose BMI is 40 or over, or 35 with co-morbidities. Your PCP probably have to write a letter or medical necessity.
Some insurance providers require a number of pre-op medical and nutritional appointments; some for as long as six months. They say the WLS patient must learn what to expect and how to make life long changes in order to avoid regain or other issues.
Pre-op Diets and tests
Many surgeons will require patients to lose some weight before agreeing to the surgery, possibly to prove they are serious about making lifestyle changes. Of course there's the questions that if they can do that, why bother with an operation? Perhaps knowing a diet is short term post-op makes it more doable?
There Is also a pre-op diet that most surgeons require. This is a strict diet that lasts from one day to a month, depending on the program. This is designed to shrink the liver and make room the abdomen for the surgeon to work. The liver is in front of the stomach and must be moved out of the way as it is easily damaged. Apparently the diet is highly effective. I've heard that there are surgeons who will see that the liver has not changed, since the diet was not followed, and will just close up the patient without proceeding.
There are also many pre-op lab tests that are required, such as an upper GI, lots of blood work. Many patients are required to quit smoking and drinking alcohol, and are tested for use of both.
It's also a good idea to give up caffeine, slowly, before surgery to avoid any unpleasant withdrawal symptoms after surgery.
The big day
So assuming all goes well before, and you get to the hospital for your big day. They put in an IV and you take a little nap for an hour or two.
Most patients spend two nights, just to be sure they can swallow liquids, and get part of a protein shake down, and urinate. They say most complications, though rare, are seen while still in the hospital.
Before discharge, they send a nutritionist to go over the "food" plan and wound care.
(More coming soon)