Gastric
Surgery - Frequently Asked Questions
Do I need a referral from
my doctor?
No, a doctors referral is not necessary, however, it is very helpful
to have their support. We prefer where possible, prefer to work
with your doctor or GP. This can only benefit the patient in the
long run. Should your GP or doctor wish to know more about our organisation,
we would welcome a contact from them.
How do I know if I am suitable
for obesity surgery?
Check your BMI below. This will normally indicate
whether you are suitable for obesity surgery.
BMI Categories:
- Normal weight = 18-25
- Overweight likely to have mediacl problems=
25 – 30
- Obese = BMI of 30 or greater
- Morbidly Obese
= BMI of 40 or greater
I have a BMI of over 40.
Does this mean I cannot have Adjustable Laparoscopic Banding?
It is important to us that you receive the treatment you are most
comfortable with. Each type of obesity surgery has it own pros and
cons. Many people express a preference for one type of surgery.
Having a high BMI doesn’t prevent us from carrying out your
preferred surgery - it is merely an indicator for the most suitable
and effective surgery statistically for your BMI.
Can I expect to have any
health problems as a result of weight loss surgery?
It is possible to suffer from gallstones after weight loss surgery.
If you have concerns about this or have experienced gall bladder
problems in the past, it is possible to remove the gallbladder during
your surgery.
Can I have my consultation
in the UK?
All consultations take place in Belgium only. In many cases its
easier and faster to travel to Belgium than it is to travel within
the UK.
Will smoking affect my surgery?
You are encouraged to stop smoking at least one month before surgery.
Will I have the opportunity to ask questions?
Yes of course. You will meet with your surgeon and a nutritionist
the day before surgery for a pre-surgery consultation. You will
find that the surgeon is quite open to answering all of your questions.
Can my partner attend the consultation?
Yes, they are welcome to attend.
Can I have my surgery even though I’m
on medication?
Please ensure that we are informed of any medical conditions
associated with excess weight, such as Diabetes II or heart problems.
You will need to stop taking any medication for thinning the blood
such as Coumadin, Aspirin or Warfarin, 10 days before travelling.
If you take any of these medications are unsure or unclear about
this, please contact us.
How will it affect contraception?
Following weight loss surgery the body may absorb fewer hormones
thus making the contraceptive less effective. Weight loss surgery
will make you both more attractive and fertile.
Will I be able to have IVF treatment afterwards?
Yes there is no reason why not but keep in contact with the
aftercare program. Please be aware that after treatment you will
become more fertile in any case and pregnancy may well follow without
the need for IVF.
Should I inform the surgeon if there is
anything unusual in my medical history?
Yes - also ensure you have completed the pre-surgery questionnaire,
which you can download at : www.direct-healthcare.com/download.htm
I am thinking of having Adjustable Laparoscopic
Banding, what kind of band is placed?
The inamed LAP-BAND®
System. FDA approved over 300,000 have been fitted since 1990.
What sort of fluid is inserted into an Adjustable
Laparoscopic Band?
The band is filled with surgical saline solution. Normally
your weight should start to reduce immediately, you will need to
have the band adjusted. Please see our postoperative aftercare program.
What type of anaesthesia is used?
General anaesthesia. When you are undergoing general anaesthesia,
you will be put asleep by IV-medication. The anaesthetist will discuss
the type of anaesthesia to be used prior to surgery.
Can I fly after having my surgery?
You can fly home after your surgery. Low weight heparin 'B'
may be administered to reduce the possibility of thrombosis. Ask
the surgeon about this.
What is the risk of infection?
Our partner hospital has successfully treated hundreds of
our patients with no cases of cross infection. Should a patient
be found to have an infection on arrival, they are isolated and
treated accordingly. If a secondary infection did occur, it would
manifest itself during the stay in hospital. Belgium has one of
the lowest secondary infection rate is in Europe. Rates in the UK
and Eire continue to remain at alarming levels. In the USA occurrences
are on the increase. As recently as 2006 reports from within the
UK and Eire health services, the news media, and senior consultants
indicate that the problem remains acute in most hospitals. So far,
all our clients have remained free of secondary infections.
Could you tell me a little more about the
intensive care facilities?
The hospital has a fully functioning 24 - hour accident &
emergency department, paramedics, and fully equipped intensive care
unit. Response time for a doctor to be at bedside - day or night
- is under 2 minutes.
Which tests will be taken before the surgery?
If you are older than 45, there will be a chest X-ray, ECG
and a laboratory investigation. If you are younger than 45 there
will only be a laboratory investigation. The surgeon will judge
whether other tests are necessary.
Will my stay in hospital be extended?
If you have any preoperational risk factors your stay may
be extended.
What are preoperational risk factors?
Preoperational risk factors are any risk factors in determining
a patient's eligibility for obesity surgery.
Serious preoperational risk factors include:
- Type II diabetes mellitus
- Obstructive sleep apnea
- Pseudotumor cerebri
- Heart conditions
- Excessive BMI - over 50
- Less serious preoperational risk factors include:
- Hypertension
- Dyslipidemias
- Non-alcoholic steatohepatitis
- Venous stasis disease
- Significant impairment in activities of daily
living
- Intertriginous soft tissue infections
- Stress urinary incontinence
- Gastroesophageal reflux disease
- Weight-related arthropathies which impair physical
activity
- Obesity-related psychosocial stress
Having risk factors such as these does not mean that you are not
eligible for surgery, but we do need to be informed if you have
any health problems.
What should I bring with me?
- Slippers, trainers or walking shoes; loose
comfortable clothing; dressing gown or bath robe; personal toiletries;
eye glasses; dentures; reading materials or anything to help you
relax such as a personal walkman and music.
- Phone numbers of people you may want to call.
- Money for telephone calls and items such as
a magazine.
- Passport.
- Form E111 (obtainable from your local post
office - UK only).
- Because you will be on a soft food diet for
a while its useful to bring protein shake mix, broth, soups, and
tea. These can all be found in dry forms and mixed with hot water.
- Bring any medication and a list of any medicines
that you have been taking.
If you have a heart condition bring along any medical reports
that may be relevant.
- It is not necessary to have a medical referral
and if you are unable to get hold of your medical records we can
manage without them.
- one week before travelling, using an antiseptic
cleansing shower gel such as "Hibiscrub" may reduce
germs that may be present on your skin. This is obtainable from
a pharmacy.
Can I eat whatever I wish after obesity
surgery?
You will need to change your eating habits. You must not take fluid
with your meals. You will need to emulsify solid food for a while
and eat 4-5 small meals a day. It is important for you to get a
good intake of proteins and so a good healthy balanced diet is recommended.
For the rest of your life, you will need to take multivitamins with
B12 and Iron. You may not take gassy drinks such as colas or lemonade.
Can I relax my eating regime for a few days
before having surgery?
This is a bad idea! The surgeon finds that those that relax their
eating habits for a few days or weeks before surgery often find
that their BMI has increased and that the surgery has less chances
of long term success. It is far better to start right away in reducing
your food intact and see if you can loose a little weight before
surgery. This will make the surgeons job and your progress much
easier.
What is “dumping syndrome”?
This term refers to the emptying of concentrated food directly into
the small intestine. Gastric bypass surgery empties food from the
small stomach pouch directly into the small intestine without first
being diluted with fluids in the rest of the stomach. Therefore,
whatever you eat empties directly into the small intestine. Sweets
and fatty foods irritate the small intestine and causes discomfort.
Eating and drinking fluids simultaneously will also cause this dumping
syndrome. This is why we recommend waiting half an hour between
eating and drinking.
When can I return to normal daily activity?
This depends on what your normal activity involved. Providing your
vocation is not too physical, you may return to work shortly after
returning home. Any pain related to the surgery should go away after
10 days or so. General fatigue can last from 3 to 4 weeks after
surgery. 4 to 6 weeks after your operation, you should be completely
back to normal.
How soon can I drive?
For your own safety, you should not drive until you have stopped
taking medications and can move quickly and alertly to stop your
car, especially in an emergency. After major surgery you should
wait 8 weeks before driving unless you have seen your physician.
Should I exercise after obesity surgery?
You are recommended to exercise daily. Whether you have surgery
or not, exercise is important to overall health. The more you exercise,
the healthier you will be and the more weight you will lose. Walking
greatly accelerates weight loss, specifically fat loss. It is suggested
that you walk a little every day - gradually increasing the length
of your walks.
How much should I exercise after surgery?
Following weight loss surgery, your weight reduces because you eat
less food energy (calories) than your body uses. The body makes
up the difference by burning reserves of fat. Your body will want
to burn unused muscle first before it burns fat. Daily aerobic exercise
for 20 minutes will tell your body to burn the fat instead of your
muscles.
When do I have my stitches removed?
After surgery, the incisions on your abdomen are closed with internal
stitches, which dissolve in 4 to 6 weeks.
How many times do I have to get my Lap band
refilled?
Lap band refills vary from person to person. The band will need
adjusting 3 - 4 times in the first year and normally yearly thereafter.
Can I get this done in the UK?
For refills in the UK, please see our website for details.
Can I get this done in the USA, Canada or
Europe?
For refills in the USA, Canada or Europe, please contact our office
for details.
What if something goes wrong after I return
home?
There are a number of aftercare and emergency systems in place should
they be needed. Please remember that these should only be used in
the event of urgent need. Patient seeking urgent assistance should
follow the steps laid out below. If the patient ‘s condition
appears serious your local Physician, GP, or Accident and Emergency
Centre should be contacted in the first instance otherwise:
- Call DHI (preferably during office hours) if
necessary use the 24hr response emergency phone number.
- The treating surgeon will be contacted and
asked take direct contact with the patient or their physician.
- The patient may be asked to see their physician
or GP if this is more practicable or attend their local hospital.
- A doctor can be called to attend at the patients
home (UK only) in the event of any significant problems. The doctor
can take a wound swab which will be tested in our labs, report
and if necessary medicate.
- If the problem appears significant but not
an emergency the patient may need to return to the operating facility
for further examination and treatment.
- DHI also employs consultant surgeons and labs
(within the UK) that will assist in the event that it is needed.
Please remember that DHI have successfully sent thousands of people
for treatment. No significant or urgent medical problems have occurred.
No patient has ever had a cross infection of any kind in one of
our partner hospitals.
How many operations has the Surgeon done?
The surgeon has performed approximately 8,000 successful obesity
surgeries.
Can I talk to someone who has already had
the surgery?
Yes, we have many previous clients who are willing to talk to you
and answer any questions you may have. Please contact us for details.
Can the surgeon refuse surgery?
The surgeon would only refuse to operate where medical conditions
prevent surgery. Please contact us if you feel that you may have
any medical conditions that may prevent surgery.
How big are the hospital rooms? Are they
en-suite and do they have TV?
Each hospital room normally contains 2 beds. If a 2-bed room is
not available, you may be placed in a 4-bed room. Rooms have a TV,
telephone and en-suite toilet. Telephones function with a call card
system that requires a 10 Euro returnable deposit. The deposit together
with any remaining credit is refunded when you leave the hospital.
Why do I have to stay extra days in Belgium
after I am released from the hospital?
Patients are asked to stay a few days extra after surgery is for
their safety. If any postoperative complications should occur, this
will happen within 2-3 days of surgery. We therefore like the patient
to be near the surgeon during this period so that he may monitor
the recovery progress. There is a final examination before departure
as well as a postoperative visit by our nurse at your hotel.
Is there any additional cost associated with
obesity surgery?
The DHI fully inclusive package includes DHI overrun Medical Cover,
however this doesn’t cover the first two additional nights
in intensive care. (Please see our DHI overrun insurance for details.)
Normally, our surgery allows for patients occasionally staying an
extra day in hospital and in such cases no additional fee is charged.
However, if the duration of stay becomes longer, there may be some
extra charges involved.
Can DHI Organise My Accommodation?
Yes, the DHI fully inclusive package takes care of your travel,
flights, accommodation and all transfers. If you have booked the
Basic Package, we can direct you to a website featuring hotels in
Bruges.
Can I bring friends or family with me?
Yes you can bring one friend or family. We would prefer it if one
person accompanies you for moral support.
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