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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)
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Member Comments About This Blog Post
  • SEAGLASS1215
    As you know, my doctor suggested WLS as an option for me but I need to really work hard to lose the weight on my own with 100% effort before I go that route. Resolving the emotional reasons for eating need to be dealt with before any WLS because otherwise my reasons for binge eating and emotional eating will not go away (hunger is not my issue)...there is a part of me that is tempted to consider the WLS option because it almost seems like a quick fix in that it will leave me no choice but to rethink my eating patterns - however, the chance that I would fail and end up bursting stitches or stretching my new stomach and not losing or maintaining a loss - well, no thanks - not quite there yet. Really enjoy reading all your research though! I'm glad you are becoming well informed before making such a big decision!
    1164 days ago
    I researched WLS for about 5 years before I had the surgery.
    At one point I decided that I needed to try some other things first and I went a different route.

    After I turned 40 I ended up having some pretty significant GYN issues that were caused by my obesity, and contributed to my obesity. It was a vicious downward spiral from which I couldn't escape.

    My GYN urged me to research the surgery again and both my GYN and Bariatric surgeon did an incredible job of explaining why the surgery was necessary, how it would solve my problems, and why I couldn't just lose the weight on my own.

    I wish I had the surgery 5 years ago, when I first started researching it. I could have avoided multiple GYN surgeries, pain and suffering. But, we all are on our own unique journey and we make the best decisions we can with the information we have at the time.

    I learned that a lot of the information I had read online was often the "worst-case-scenario" situations.

    My surgery was much easier than I had anticipated. The things I expected to be very hard were easy (and some of the things I expected to be easy were hard).
    I did learn that despite all of my research there were some things that were unexpected, that I just didn't know, that I wished someone had told me.

    This is not an easy journey, but losing weight is never easy, whether it's 10lbs or 100+lbs. There is no easy way. This journey is just different than some other peoples' weight loss journey. It is working for me, but like any other weight loss plan, it is still a daily decision to follow the plan. In our case though, the consequences of not following the plan happen immediately.

    Good luck on your journey. Keep up the research!
    1164 days ago
  • DSJB9999
    thank you but NO THANKS x
    1165 days ago
    Did you decide on which surgery? How much do you weigh now? Your tracker says you've already lost over 50 pounds, did you do that with diet and exercise? Maybe you could do that for the rest and not even need the surgery after all? Save some money and not have a small stomache for the rest of your life? How long do you have to wait for your surgery and what things does your doctor to do first before the surgery from the list you mentioned? What if you lose weight before the surgery, will that give you the boost you need to keep going without the surgery? Also in one blog you mentioned emotional eating patterns, have you addressed those first and have them under control? Like on the biggest loser show where they get to the root of the contestants problems in order to move forward with their weight loss.

    Best wishes on your journey, thanks for sharing your path with others wondering about weight loss surgery!
    1165 days ago
    1165 days ago
    This sounds scary
    1165 days ago
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