This image describes the anatomical changes fairly well
The final part of my initial consultation for bariatric surgery was an hour long appointment with a bariatric surgeon. Normally, you meet with one of the nurse practitioners on the team, but I ended up meeting with a general surgeon who was doing a fellowship in bariatric surgery. This is not the surgeon who will be doing my surgery.
My medical group has three different surgeons who do these surgeries, and you do get a say as to which surgeon you prefer. However, you do not have any appointments with your actual surgeon until you lose about half of the weight that they ask you to lose (I’ll get to this in a minute). Basically, they want to make sure you are committed and take the steps to start the lifestyle changes before you see your surgeon.
Basically she asked about my medical history – no surgeries other than a tonsillectomy when I was three, no allergies, no major medical issues. Fortunately, I had visited my Primary Care Physician a couple weeks before, so she had access to my labs and prescribed Vitamin B12 and B1 supplements to go along with the Vitamin D supplement my PCP prescribed. She also recommended trying to find a chewable multivitamin, since I will need one post-surgery.
When you first arrive they give you some forms where they ask you to fill out questions about your sleep and whatnot, on one of the forms there are a ton of different diseases/injuries.. and you circle what applies to you. I circled PCOS, which has been diagnosed, Sleep Apnea – which I stated is a possibility since my gf says that as of a few months I have started snoring, and it is progressively getting worse, I also circled GERD (gastroesophageal Reflux Disease) and wrote suspected next to it.
I told her that I had a sleep test scheduled, so I would know more about that soon. She asked why I suspected GERD and I told her that on two separate occasions this past year I had an experience that left me on the bathroom floor crying in pain for about half an hour each time and that a doctor friend thought it might be GERD, but that I hadn’t had it checked out yet. Right away she just said, “Yeah, you don’t have GERD, or at least I would be VERY surprised if you did. What you are describing sounds A LOT like gallstones.” Apparently you can have gallstones with no symptoms whatsoever, but, for some people, every once-in-a-while one of those gallstones will come up and cause some kind of blockage which will cause the kind of pain I described, which will go away as soon as the blockage becomes dislodged. So, I have to get an ultrasound to check for gallstones.
Once we covered my history and made sure there was nothing that would absolutely make me a non-viable candidate for weight loss surgery she went into the two surgeries that would be recommended for me: Gastric Bypass (roux-en-y) and the Sleeve Gastrectomy (often called a Vertical Sleeve or VSG). She described both of the procedures, what recovery looks like for both, immediate risks and long-term risks for both, weight loss statistics for each, etc. She even brought out charts and pictures to show you exactly how your anatomy would change with each surgery.
I had been doing my research for a bit and was leaning very strongly towards the Vertical Sleeve for a couple reasons. Less chance of complications, less intrusive, less time in the OR – I just didn’t see why I would need to do the incredibly invasive Gastric Bypass. After explaining both procedures and that I had none of the issues for which they would highly recommend the Bypass she said that her recommendation for me would be the Vertical Sleeve. I told her that I completely agreed with her on that – so at least that was settled!
She followed that by doing a physical exam of my abdomen. Apparently I have a soft tummy – apparently this is a good thing! Yay! She did some math and told me that I need to lose 20-25 lbs pre-op – through diet changes and she would like for me to work my way up to 30-45 minutes workouts 5X a week. This way they have a bit more space to work in when they are doing the procedure laparoscopically. Once I have lost about 12 lbs, I get to schedule my appointment with my actual surgeon.
I will have to do a liquid diet for two weeks pre-op and for FOUR weeks (!!!) post-op, so any tips on this would be greatly appreciated.
I have my next appointment with both the doctor and dietician in mid-July and will have had my ultrasound to check for gallstones and a ton of labs a week before then. We’ll see how it goes!
If you guys have any questions, feel free to ask!