[Skip to Content]
 

Chat with a Representative

Frequently Asked Questions

Local Support Groups

Below are some common questions related to metabolic and bariatric surgery. Please contact us for any question for which you have not found an answer or attend a seminar to learn more.

Pre-Operative Phase

Expand all

Is there anything I can do to prepare for surgery?

Yes.

  • STOP SMOKING: Smoking has a significant influence on your outcome, including the chance of dying around the time of surgery. Everyone knows that smoking creates lung problems, but the unavoidable reality is that a history of smoking also leads to a 5-10 fold increase in the following risks: infection, heart attack, and even deep vein thrombosis (DVT) or pulmonary embolism (PE).
  • Lose weight before surgery: It appears that the heart and lungs, as well as other organs in the body, suffer the most from obesity. Great benefit comes from the loss of 5 to 10 percent of your excess weight, with more loss being even better. We also find that excess weight tends to come out of the abdomen first (likely the liver), so just a few pounds can make it much easier for your surgeon to perform the procedure. WE WILL HELP YOU WITH THIS WEIGHT LOSS!
  • Exercise: Get your heart and lungs in the best possible shape by doing whatever physical activity you can tolerate.
  • Prepare Mentally: Try to approach the surgery as the beginning of a whole new life style. If you approach surgery with education and determination to make the best of the opportunity, the chances of success are very high. Be ready for a change.
  • Attend a monthly support group - much can be learned from other patients who have been through the surgery.

What can I do before the appointment to speed up the process of getting ready for surgery?

  1. Contact your health insurance company to learn about their criteria to cover bariatric surgery.
  2. Establish a relationship with a primary care physician, if you don't already have one. Work with that physician to get "caught up" on your routine health maintenance testing.
  3. Discuss the symptoms of obstructive sleep apnea with your primary care doctor and work to get this evaluated and treated.
  4. Bring any pertinent medical data with you to your appointment to see your bariatric surgeon; this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.
  5. Bring a list of your medications with dose and schedule.
  6. STOP SMOKING.

What if I have had a previous bariatric surgical procedure and I'm having problems?

The first option is to contact your original surgeon. It is highly preferable for the original surgeon to take care of any problems because he/she is most likely to know the correct solution based on prior knowledge of your surgery. If you have relocated too far away from your original surgeon, or there is some other reason that it's not reasonable, then we may be able to help. We will need to have an operative report from your first operation and it will be up to you to obtain that from your original surgeon's office. We may also first want an upper gastrointestinal (GI) X-ray or scope performed to see if it’s a correctable surgical problem.

What about insurance coverage?

Insurance companies and employers coverage for morbid obesity is constantly changing. We have developed a dedicated staff who will be happy to assist you during the insurance approval process.

Surgical and Recovery Phase

Expand all

What is done to minimize the risk of deep vein thrombosis (DVT)?

Because a DVT often originates on the operating table, we begin therapy before you go to the operating room. We treat patients with sequential leg compression stockings and Heparin (a blood thinner). Both of these therapies continue throughout your hospitalization. The third major preventive measure involves getting the patient out of bed as soon as possible after the operation in order to restore normal blood flow in the legs. The nursing staff will ask you to get out of bed and walk in the hall the same day as your surgery.

What happens to the lower part of the stomach that is bypassed?

This is left in place with an intact blood supply so that it remains healthy and unchanged. The lower stomach still contributes to the function of the intestines. Even though it does not receive or process food, it does make Intrinsic factor (necessary to absorb Vitamin B12) and contributes to hormone balance and motility of the gut.

How do I eat after bariatric surgery?

During bariatric surgery the size of the stomach is drastically reduced. The modifications made to your gastrointestinal tract will require permanent changes in your eating habits. You may hear of other patients being given different guidelines following their weight loss surgery. It is important to remember that every surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each type of procedure. What is most important is that you strictly adhere to your surgeon's recommended guidelines.

The following are some of the generally accepted dietary guidelines a weight loss surgery patient may encounter:

  • When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.
  • Don't drink fluids while eating. They will make you feel full before you have consumed enough food.
  • Omit desserts and other items with sugar listed as one of the first three ingredients.
  • Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.
  • Avoid alcohol.
  • Limit snacking between meals.

What important digestive functions do people lose when the lower stomach is bypassed?

The bypassed stomach and small intestine do play important roles in the absorption of Iron, Calcium, and Vitamin B12, thus we require the patients to take supplements and we follow blood levels of these and other nutrients for life.

What is dumping syndrome?

A key feature that helps control calorie intake after gastric bypass is that food leaves the tiny pouch into a section of the small intestine called the jejunum. The jejunum is simply not made to handle concentrated calories, especially refined sugar. The effect of a person consuming concentrated sugar after a gastric bypass (such as ice cream, chocolate candy, or a soda) is a reaction called dumping syndrome that affects the whole body.

During an episode of dumping you may feel palpitations (i.e. heart racing), a sweaty and clammy feeling, cramping abdominal pain, diarrhea, and then a feeling of weakness during which the person simply must lay down for an hour or so until it passes. Dumping syndrome is not dangerous but it feels awful. It is not exactly a side effect, in the sense that it works in a beneficial way by steering patients away from that type of food.

Patients with gastric sleeve do not usually have dumping syndrome.

What about the staples inside my abdomen? Is it OK in the future to have an MRI test? Will I set off metal detectors in airports?

The staples used on the stomach and the intestines are very tiny in comparison to the staples you will have in your skin, or even staples used in an office. Each staple is a tiny piece of stainless steel or titanium. Because these metals (titanium or stainless steel) are totally inert in the body, people are not sensitive to the staples and the staples do not cause any problems in the long run. The staple materials are also non-magnetic, which means that they will not be affected by an MRI nor set off airport metal detectors.

Can I get pregnant after metabolic and bariatric surgery?

Yes, but we strongly recommend you wait at least two years after the surgery. Please consider reliable birth control for the first year after surgery to avoid the possibility of pregnancy.  At approximately one year, your body will be fairly stable from a weight and nutrition standpoint. You should be able to carry a baby with no nutritional issues. You should be in contact with your surgeon as you plan for pregnancy.

Long Term Outcomes

Expand all

Will I be miserably hungry after bariatric surgery since I'm not eating much? What if I am really hungry?

No. Your appetite will decrease due to decreased levels of ghrelin, or the hunger hormone.

Will I have to change my medications?

Many medications such as those used to control blood pressure, diabetes, etc., can be stopped at some point after surgery. Please ask your provider during your follow up appointments.

What can I do to prevent lots of excess hanging skin? Will exercise help?

Exercise is good in so many other ways that we definitely recommend it. Unfortunately, patients who are left with large flaps of loose skin will not be able to change that by exercise. In our program we can refer you to plastic surgeons available for consultation. These surgeons can help you explore ways for dealing with excess skin resulting from weight loss.

When do I follow up with Upstate's bariatric clinic?

Follow up appointments after bariatric surgery are critical. When you are losing weight, you will be asked to follow up frequently. We ask patients to come back to clinic at 2 weeks, 6 weeks, 3/6/9/12/18 months and then  you will need periodic checks for anemia (low red blood cell count) and Vitamin B12, folate and iron levels yearly for life.

Learn more here.

Where do I find additional support?

Our program has support groups in place to assist you with short-term and long-term questions and needs. The use of support groups has provided weight loss surgery patients an excellent opportunity to discuss their various personal and professional issues. Many also find support for emotional issues that years of obesity can cause. Most bariatric surgeons will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.

For a list of local support groups, when and where each meets, see our resources here.

Top