FAQ’s

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Bariatric Surgery Support Information Booklet FAQ 2014

 

1. How can I contact the Surgeons?

You may contact either Dr Swanepoel or Dr Potgieter via their contact details on our website or you can send a mail to info@bariatricsurgerysupport.co.za and one of our Bariatric Support Councilors will contact you.

2. Am I a good candidate?

Your doctor will assess this during your consultation.

To be considered as a surgical candidate, individuals must meet the following criteria (subject to slight variation per surgical program):

Be between 18 and 70 years of age

Have a Body Mass Index of 40 or above OR

Have a Body Mass Index of 35-40 with significant associated health problems

Made serious past attempts to lose weight

Are dedicated to drastic lifestyle changes and follow-up appointments

Not suffering from any disease that may be causing excess weight

Absence of drug, alcohol or emotional problems

Understand the surgery and associated risks.

3. What are the different types of Bariatric Surgery?

LAP-BAND

Vertical Banded Gastroplasty (VBG)

Roux-en-Y Gastric Bypass

Sleeve Gastrectomy

Once again your doctor will assess the best procedure for your individual needs.

 

4. How much will the surgery cost?

This type of surgery can vary widely between doctors.  a Gastric bypass can cost from R60 000 to 140 000 upwards depending on the procedure.

5. What kind of changes do I need in my diet?

July Kotze   is our resident dietician and is part of the team that will assess you

She will consult with you before and after the surgery to ensure that the necessary dietary changes are made to accommodate your lifestyle change.

6. What kind of psychological assessment do I need?

Psychological assessments are done as a routine part of your consultation.

7. Will I need plastic Surgery?

Because weight loss is so fast after surgery, and the skin is often not elastic enough to rebound, it is common for bariatric patients to have excess skin removed later on by plastic surgery.

Discuss this with your surgeon.

8. What changes will I need to make to my lifestyle after surgery?

This surgery is life changing. At Bariatric Surgery Support we are committed to offering you a helpline to guide you through this life changing experience. We together with the Surgeons, Dietician, Psychologist, Physician and the rest of our Team are committed to supporting you on this journey every step of the way.

What Happens…?

9.What happens before surgery?

Your surgeon will give you specific instructions on how to prepare for the procedure. Your stomach must be completely empty to reduce the changes of vomiting during the procedure. It is important that you abstain from food and liquid after midnight the evening before your surgery.

10.What happens on the day of surgery?

You will report to a pre-operative nursing unit, where you will change into a hospital gown. A nurse will review your chart and confirm that all paperwork is in order. You will be taken to a pre-operative nursing unit where an anesthesiologist will start an IV. Before any medications are administered, your surgeon will verify your name and the type of procedure you are having. You will then be taken to the operating room. After the appropriate form of anesthesia is administered, surgery will be performed.

11.What type of anesthesia will be used?

You will have a pre-operative interview with an anesthesiologist who will ask you questions regarding your medical history. Gastric bypass surgery is performed under general anesthesia, which will keep you asleep during your surgery.

12.What happens during the surgery, and how is it performed?

Your surgeon will make five to seven small incisions, and insert tube-like instruments through them. The abdomen will be filled with gas to help the surgeon view the abdominal cavity. A camera will be inserted through one of the tubes that will display images on a monitor in the operating room. In this manner, your surgeon will be able to work inside your abdomen without making a larger incision.

During the Roux-en-Y procedure, the stomach is divided and separated. A small pouch is created at the top of the stomach and the rest is permanently separated. The small intestine is then attached to the new pouch creating a new digestive tract.

13.What happens after the surgery?

Once the surgery is completed, you will be taken to a post-operative or recovery unit where a nurse will monitor your progress. It is important that your bandages be kept clean and dry. You will be asked to walk the night of surgery. You will undergo a swallow study on the first postoperative day to make sure there are no problems. If there are no problems, you will be discharged on postoperative day two. You will be scheduled for a follow-up appointment within two weeks after you are discharged from the hospital.

14. How long will I be in the hospital?

Usually, patients are in the hospital for two to five days.

15.What are the risks associated with a Roux-en-Y procedure?

As with any surgery, there are risks such as bleeding, infection, or an adverse reaction to anesthesia. Other risks include anastigmatic leakage, deep venous thrombosis, pulmonary embolism, follow-up operations to correct complications, increased risk for gallstones and nutritional deficiencies such as anemia. Your surgeon will inform you of the risks prior to surgery.

16.What should I watch out for?

Be sure to call your doctor if any of the following symptoms appear:
• Fever
• Worsening pain
• Redness or swelling around the incision
• The incision is warm to the touch
• Drainage from the incision

17.Will there be scar(s)?

The incisions should heal well, leaving small discrete scars.

18.When can I expect to return to work and/or resume normal activities?

Light activity at home is encouraged after surgery. You can expect to return to normal daily activities, such as showering, and walking up stairs within a few days. If you are taking narcotic medications for pain, you should not drive.

19. What is the Bariatric Surgery recovery process?

Most people typically stay in the hospital for a few days or less after gastric bypass surgery. Some may need to stay four to five days. Your doctor will approve your discharge home once the following is true for you:

  • You can move without too much discomfort.
  • You can eat liquid and/or pureed food without vomiting.
  • You no longer require pain medication given by injection.
You will remain on liquid or pureed food for several weeks after the surgery. Even after that time, you will feel full very quickly, sometimes only being able to take a few bites of solid food. This is because the new stomach pouch initially only holds a tablespoonful of food. The pouch eventually expands. However, it will hold no more than about one cup of thoroughly chewed food (a normal stomach can hold up to one quart).
Upon follow up, your doctor will determine if you need replacement of iron, calcium, vitamin B12, or other nutrients. Supplements, such as a multivitamin with minerals, will be prescribed to provide any nutrients that you may not be getting from your diet. A lack of nutrients can occur because you are eating less and because the food moves through your digestive system more quickly.

Other recommendations you should follow:

  • Once you are eating solid food, remember to chew each bite very slowly and thoroughly.
  • Eat small meals frequently throughout the day, rather than large meals that your stomach cannot accommodate. Your new stomach probably won’t be able to handle both solid food and fluids at the same time. So, you should separate fluid and food intake by at least 30 minutes and only sip what you are drinking.
  • Avoid high fat, high sugar foods and alcohol.
  • Resume physical activity six weeks after the operation. Once you are fully recovered, you should strive for daily physical activity in order to maintain weight loss after the surgery.
  • Seek social support from others who have undergone weight loss surgery.
The weight loss results of gastric bypass surgery are generally good. Most patients lose an average of 4-5 kg per month and reach a stable weight between 18 and 24 months after surgery. Often, the greatest rate of weight loss occurs in the very beginning (that is, just following the surgery when you are still on a liquid diet).

15 Comments

  1. Hi there,

    My Medical Aid has approved my op but Dr Swanepoel has not given me a date yet. I don’t want to keep asking him so many questions, so I thought I would ask you guys.

    What happens now? Dr Swanepoel gives me a date… do I need to see anyone else before the op?

    Im very nervous and would like to know what the next steps are?

    Many thanks
    Wendy

    • Hi Wendy,

      Thanks so much for getting in touch with us,please complete the form on our contact page and give us your details…someone from the support group will contact you and put your mind at ease. you are welcome to join our support group meeting on 22 February 2011.

      regards
      Barry

    • Hi There

      I recently had my op and it went very well so dont be nervous. I went to see a dietician before my op so that I would know exactly what I would be allowed to eat afterwards so that I was prepared for my new life changing experience

    • Hi there

      Please can you assist me with the name of the medical aids that pay for bariatric or lapband surgery in south africa

    • Hi Wendy! Congrats on getting approval for the procedure! Hope you don’t mind me asking what medical aid you are using, as well as what is the “plan” that you are on? I am struggling to find out which of the medical aids is paying for this procedure 🙂
      Hope all is well and that you are on the road to a new, better, healthier you!
      Kindest Regards,
      Bernadine

      • Hi Bernadine, you may already have had a response to this query, as I see it is rather date. However, as far as my layman’s knowledge is concerned, and speaking purely from personal experience, Discovery Health Classic Comprehensive plan pays 80% of the procedure only if you meet the set criteria, some of which are mentioned on this page under “Am I a good candidate?”. It is quite a time-consuming and expensive process before-hand, most of which should be covered by our medical aid, but don’t go through the process if you are not 100% sure your plan covers the procedure, as I know quite a lot of people apply even though they know it is not covered. Your Endocrinologist should be able to advise you (your first step being to get referred to an Endocrinologist). Where are you from?

    • Hi Wendy, have you had the op yet? I am waiting to have mine done. I would love to chat. If you keen please email me on kimk678@gmail.com.

    • Hi,
      Please let me know what medicial aid you are on and the plan.

  2. Hi All,

    I am in the process of being assessed for the surgery. I was wondering if two weeks off work would be enough recovery time? I need to be mentally sharp (not tired) for my job and was wondering how long one is tired for. Also does anyone have any tips on how to get approval from medical aid?
    Thanks

    • Hi Kim Thanks for your question – pleae fill in the form on the contact page and supply us with your contact details – a support group consultant will contact you as soon as we receive your details.

  3. Hi Everybody.
    I am now 2 and half months post op. I have lost 17Kg. I feel great and I am down on 2 pants sizes. The only thing is I am failing back in to some of my old habits.E.G late night snacking and gravings. Any suggestions??

    • Hi Hamid,

      Thanks for your comment. Our Resident dietitian, Judy Kotze has many successful tips and advice to help you stop your late-night snack-attacks. You are most welcome to contact her [mailto:gert.k@absamail.co.za]

  4. Hi Almal,hoop nie julle gee om as ek in afrikaans kommunikeer nie. Het gastric bypass operasie 7 maande gelede gehad vir gesondheids redes. As daar dalk enige iemand met my per email wil kontak maak om net bietjie te wil gesels. Sal graag jul opinie wil hoor hoe voel julle na die operasie en of julle dalk enige positiewe of negatiewe gevoel het na die operasie. Hoor graag van julle

  5. Hi there all. I would like to know how long does it take and what is all the procedures to go throught from the first day I go to see the dr till the day they do the operation. I would I know if I am a candidate and or if my medical will cover some of the costs. I urgently need help, for I am starting to have serious health prolems

    • Hi Lolla, Are you refering to the surgery it depends on your individual case and takes about 2-3 hours – watch the you tube videos on the home page for the procedure

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