Is there an age limit for surgery?

Not really. Oregon Weight Loss Surgery evaluates each application on an individual basis. If you think bariatric surgery may benefit you, you are encouraged to fill out an application which will then be evaluated. After this evaluation, if Dr. Patterson feels the patient is an acceptable operative risk, the patient will be accepted, regardless of age. The FDA is currently looking into approving the gastric banding surgery for adolescents; this should be decided by the end of 2010 or early 2011.

How fast is the process from the information session to surgery?

This can vary greatly depending on a person’s individual insurance requirements. It can take anywhere from 2-6 months to complete the required work up, meet with the surgeon and obtain the insurance authorization. Surgery cannot be scheduled until insurance has approved the surgery of choice, unless you are a self-pay patient. The total process could require between 3 and 8 trips to the Portland area.

Can I eat around the surgery and fail?

Yes. It is important to remember that there are no guarantees in any kind of medicine or surgery. Weight loss surgery will only succeed if you make a lifelong commitment to better health. Surgery is only a tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise and lifestyle changes.

Will having weight loss surgery mean I can eat anything and not exercise?

No. Surgery should be the beginning of a new, healthy lifestyle that includes eating small portions of healthy foods and exercising. Surgery provides a tool for weight loss with a lifetime commitment to change. You will receive specific dietary and exercise recommendations during your follow up visits.

Can I get pregnant after surgery?

The recommendation is to wait one year. This allows your body to “normalize” with your new surgery and does not sabotage your weight loss efforts.

Are vitamins required before surgery in the same way as required after surgery?

Yes. The number of required vitamins varies depending on the surgical procedure chosen: Gastric Banding = (3) multi-vitamin, calcium and vitamin D; Sleeve Gastrectomy = (4) multi-vitamin, calcium, vitamin D, and vitamin B; Gastric Bypass (RNY) = (5) multi-vitamin, calcium, vitamin D, vitamin B, and iron.

Does weight loss cause saggy skin?

Sometimes. It depends on the individual person, age and gender. If you experience sores due to extra folds that require medical intervention and this is documented by your physician, sometimes your insurance company will cover the plastic surgery needed. Otherwise, plastic surgery is considered cosmetic and is not covered by insurance. Performing the recommended resistance exercises after surgery can reduce loose skin.

Why do I need so much protein?

Having restrictive surgery does not allow you to eat very much food. This means that nutritional “economy” (or balance in smaller quantities) becomes very important for you. Every day you need to eat about 30 grams of protein for every 100 lbs of body weight to maintain your healthy muscle tissue which is important for weight loss.

Does acid reflux get better?

Yes, GERD (gastroesophogeal reflux disease) is improved in most patients following bariatric surgery. The sleeve gastrectomy procedure, however, may increase reflux in patients with severe GERD.

Is the psychological evaluation required to be done through our provider?

All patients need a psychology evaluation. We prefer this be done by one of our psychologists, as they are specialized in bariatrics. If you have recently been evaluated by a psychologist we will review their evaluation. However, we may still need you to be evaluated by our psychologist.

Why is laparoscopic adjustable banding weight loss slower than gastric bypass?

It typically takes 2-6 months to get the band optimally adjusted so that you feel “restricted” when eating a small amount of food.

How does the surgery affect how quickly I get off insulin?

Blood sugars can normalize quickly and insulin requirements can decrease rapidly, even in the first two weeks after surgery.

What if the surgery does not work?

Lack of weight loss after bariatric surgery can be multifactorial. If you have concerns about the progress of your weight loss you should make an appointment with your bariatric surgeon to discuss your concerns. Depending on your circumstance, the surgeons may order additional tests for metabolism or other diagnostic studies.

You may also be encouraged to keep an exercise and food log and have them reviewed by your surgeon or other clinicians to ensure proper lifestyle changes.

Are there exercise restrictions after surgery?

During the first four weeks after surgery we want you walking at least 5-10 minutes every 2 hours while awake or more if tolerated. You will also be limited to lifting less than 15 pounds for the first four weeks. Generally after four weeks there are no restrictions but your activity level should be discussed with your surgeon at your follow up visit.

What surgical option is best for me?

Because there are several operations for treating obesity, our goal is to help patients find the procedure they are most comfortable with. Oregon Weight Loss Surgery, LLC strives to educate patients about every option and typically allows the patients to choose. Although this is generally the case, one surgery may be recommended over another depending on individual circumstances.

To which health conditions does morbid obesity contribute?

Morbid obesity increases the risk of developing heart disease, high blood pressure (also known as hypertension), high cholesterol, sleep apnea, respiratory insufficiency, obesity hypoventilation syndrome, asthma & bronchitis, degenerative disease of the Lumbo-Sacral spine, degenerative arthritis of weight-bearing joints, heartburn or reflux disease, diabetes mellitus, gallbladder disease, stress urinary incontinence, venous stasis disease, depression and some cancers.

Will I be required to lose weight before surgery?

Sometimes. Depending on your BMI, the surgeon may require some weight loss before surgery to make surgery safer for you. Your insurance may also require a specific amount of weight loss prior to surgery.

Could I be too sick for surgery?

Your surgeon will determine your risk for surgery during your consult. You may be required to lose weight or see other specialists (such as cardiologist, pulmonologist, endocrinologist) to optimize your health to make surgery as safe as possible.

Are vitamins required after surgery?

Yes. The number of required vitamins varies depending on the surgical procedure chosen: Gastric Banding = (3) multi-vitamin, calcium and vitamin D; Sleeve Gastrectomy = (4) multi-vitamin, calcium, vitamin D, and vitamin B 12; Gastric Bypass (RNY) = (5) multi-vitamin, calcium, vitamin D, vitamin B 12, and iron. You may be recommended to take vitamins before surgery based upon your pre-surgical lab values.

Is there a special diet before and after surgery?

Typically your surgeon will place you on a high protein, low calorie diet before surgery to allow for preoperative weight loss. You will be required to do a liquid diet 1-3 days before your surgery. After surgery your diet will consist of two weeks of liquids followed by two weeks of pureed food from high protein sources. You will see a dietician both before and after surgery to discuss your specific nutritional requirements.

Will my spouse/partner/family member or friend be allowed to be with me before and after surgery?

Yes. You are allowed to have 1-2 visitors with you in the preoperative area before surgery. Once you are taken to the operating room your visitors will need to go to the visitor waiting area. If you wish, after surgery, your surgeon will discuss your surgery with your visitor(s) either in the waiting area or by phone. You will not see your visitors again until you are taken to your hospital room after surgery.

Are there certain medications that I cannot take after surgery?

Anti-inflammatories (such as ibuprofen, naproxen) and aspirin are contraindications to the Gastric Bypass due to the increase risk of life threatening ulcers. Smoking is also contraindicated after a Gastric Bypass due to the same risk of stomach ulcers. If you have specific conditions that require you to take these medications then an alternative surgery may be recommended by your surgeon. If you are unsure if a specific medication is safe for you to take after surgery, always consult with your bariatric surgeon before taking it.

Will I need to follow up after surgery?

Specific surgeries require different recommended follow up intervals. The Lap Band has the most frequent follow up schedule. You may be recommended to follow up monthly for at least the first year with the Lap Band to ensure the best results. After the first year of having your lap band, it is typically recommended that you follow up every 3-6 months.

The Gastric Bypass and Sleeve Gastrectomy have less recommended follow up than the Lap Band. These require a one month post op visit then every 3-4 months for the first year. After the first year it is recommended you follow up annually to ensure you are having a healthy weight loss. You may be recommended to follow up more frequently depending on your specific health needs.