Alabama Weight Loss Surgery
Frequently Asked Questions

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Frequently Asked Questions

How do I get started?

That is easy. Get started today, here on this website. The first thing to do is to watch the online seminar. There is a link on the right side of this page. Before you watch it, you will be asked for your name and other information so we can contact you. After you watch the seminar, we will call you in 1 to 2 business days to answer any questions and to set up your consultation with one of our surgeons. You may also want to call the number on the back of your insurance card and ask them if you have coverage for weight-loss surgery and to ask about any special requirements they have. If you do not have insurance coverage, there is the self-pay option. Read about it here.

How long will I be off work?

Recovery after these operations is typically quick and easy. Most patients go back to work after a week, sometimes earlier if they are particularly motivated. You will be up and walking around on the day of surgery. You should feel pretty much back to normal in one week. When you go back to work you can drive and walk as much as you like. You should not pull, strain or lift more than about 15 to 30 pounds, depending on your size, for 3 to 4 weeks. After six weeks you should be able to do anything you desire.

Does insurance cover bariatric surgery?

Most insurance companies recognize the great benefits of weight loss surgery and do cover the procedures if you meet their criteria. Medicare also covers weight loss surgery. We recommend that you call your insurance company (the number is on the back of your card) and ask if "bariatric surgery is covered if it is medically necessary".

How long do I have to stay in the hospital?

This varies by procedure. The laparoscopic adjustable gastric band is done on an outpatient basis with a possible overnight stay, while sleeve gastrectomy is usually an over-night stay. Two days is usual for a laparoscopic gastric bypass.

Will I experience pain after the surgery?

Every attempt is made to control pain after surgery to make it possible for you to move about quickly and become active. This helps avoid problems and speeds recovery. Often several drugs are used together to help manage your post-surgery pain. Various methods of pain control, depending on your type of surgical procedure, are available. Most patients report that they are pleasantly surprised how little pain and discomfort they experience from the surgery.

Will the doctor leave a drain in after surgery?

Most patients will have a small tube to allow drainage of any accumulated fluids from the abdomen. This is a safety measure, and it is usually removed prior to discharge from the hospital. Generally, it produces no more than minor discomfort.

How soon can I drive?

For your own safety, you should not drive until you have stopped taking narcotic medications and can move quickly and alertly to stop your car, especially in an emergency. Patients usually drive a week after surgery.

What is obstruction sleep apnea (OSA)?

It is the interruption of the normal sleep pattern because of obstruction in the upper airway that occurs during sleep. It is associated with repeated drops in the blood's oxygen content and is a risk factor for sudden death. In most patients, there is a complete resolution of symptoms by six months following surgery.

Do I have to have a sleep study?

In most cases, the answer is "yes". The sleep study detects a tendency for abnormal stopping of breathing, usually associated with airway blockage when the muscles relax during sleep. This condition is associated with a high mortality rate. After surgery, you will be sedated and will receive narcotics for pain, which further depress normal breathing and reflexes. Airway blockage becomes more dangerous at this time. It is important to have a clear picture of what to expect and how to handle it.

Can I get pregnant after weight loss surgery?

It is strongly recommended that women wait at least one year after the surgery before a pregnancy so their weight and nutrition levels will be stable. It is important to note, that there is NO increased risk to your baby after bariatric surgery and in fact, there are studies that show babies are healthier when born to mothers after weight loss surgery than when born to morbidly obese mothers. You should consult your surgeon as you plan for pregnancy.

What happens to the lower part of the stomach that is bypassed in Roux en Y gastric bypass surgery?

In this surgical procedure, the stomach is left in place with intact blood supply. In some cases it may shrink a bit and its lining (the mucosa) may atrophy, but for the most part it remains unchanged. The lower stomach still contributes to the function of the intestines even though it does not receive or process food. It makes intrinsic factor, necessary to absorb Vitamin B12 and contributes to hormone balance and motility of the intestines in ways that are not entirely known. In the sleeve gastrectomy and duodenal switch procedure, some portion of the stomach is completely removed.

What will the staples do inside my abdomen? Is it okay 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 staples you use in the office. Each staple is a tiny piece of stainless steel or titanium so small it is hard to see other than as a tiny bright spot. Because the metals used (titanium or stainless steel) are inert in the body, most people are not allergic to staples and they usually 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 MRI. The staples will not set off airport metal detectors.

What if I'm not hungry after surgery?

It's normal not to have much of an appetite for the first month or two after weight loss surgery…enjoy this period of rapid weight loss without hunger! You do not have to force yourself to eat, but when you do eat, it is important to eat your protein first. You do have to drink plenty of water though, to process the energy you have stored over the years and are now burning off.

Is there any difficulty in taking medications?

Initially, we suggest that medications be taken in liquid form or crushed. After a month, you should have no trouble taking pills whole.

Is sexual activity restricted?

Patients can return to normal sexual intimacy when wound healing and discomfort permit.

Will I be asked to stop smoking?

You must stop smoking at least three months before surgery. Smoking increases the risk of lung problems after surgery, can reduce the rate of healing, increases the rates of infection, and interferes with blood supply to the healing tissues. Smoking greatly increases the chance that you will get an ulcer as well as a blood clot.

How can I know that I won't just keep losing weight until I waste away to nothing?

Patients may begin to wonder about this early after the surgery when they are losing 20 to 40 pounds per month, or maybe when they've lost more than 100 pounds and they're still losing weight. Two things happen to allow weight to stabilize. First, a patient's ongoing metabolic needs (calories burned) decrease as the body sheds excess pounds. Second, there is a natural progressive increase in calorie and nutrient intake over the months following weight loss surgery. The stomach (in sleeve gastrectomy) or stomach pouch and attached small intestine (in gastric bypass) learn to work together better, and there is some expansion in size over a period of months. The bottom line is that, in the absence of a surgical complication, patients are very unlikely to lose weight to the point of malnutrition.

What can I do to prevent lots of excess loose skin?

Many people heavy enough to meet the surgical criteria for weight loss surgery have stretched their skin beyond the point from which it can "snap back." Some patients will choose to have plastic surgery to remove loose or excess skin after they have lost their excess weight. Insurance generally does not pay for this type of surgery (often seen as elective surgery). However, some do pay for certain types of surgery to remove excess skin when complications arise from these excess skin folds. Ask your surgeon about your need for a skin removal procedure.

Will exercise help with excess hanging skin?

Exercise is good in so many other ways that a regular exercise program is recommended. Unfortunately, some patients will still be left with loose skin.

Will I lose hair after surgery? How can I prevent it?

Many patients experience some hair loss or thinning after surgery. This usually occurs between the fourth and the eighth month after surgery. Consistent intake of protein is the most important prevention method. In addition to a multivitamin and protein supplement, biotin and zinc may also help. Most patients experience natural hair regrowth after the initial period of loss.

How long will I be off of solid foods after surgery?

Generally there are no solid foods until four weeks after surgery. A liquid diet, followed by semi-solid foods or pureed foods, is followed for a period of time until adequate healing has occurred. We will provide you with specific dietary guidelines for the best post-surgical outcome during the pre-operative nutrition class.

Why drink so much water?

When you are losing weight, there are many waste products to eliminate, mostly in the urine. Some of these substances tend to form crystals, which can cause kidney stones. A high water intake protects you and helps your body to rid itself of waste products efficiently, promoting better weight loss. Water also fills your gut and helps to prolong and intensify your sense of satisfaction with food. If you feel a desire to eat between meals, it may be because you did not drink enough water in the hour before.

Why can't I snack between meals?

Snacking, nibbling or grazing on foods, usually high-calorie and high-fat foods, can add hundreds of calories a day to your intake, defeating the restrictive effect of your operation. Snacking will slow down your weight loss and can lead to regain of weight.

Why can't I eat red meat after surgery?

You can, but you will need to be very careful, and we recommend that you avoid it for the first several months. Red meats contain a high level of meat fibers (gristle) which hold the piece of meat together, preventing you from separating it into small parts when you chew. If you do not chew well enough, you could experience some discomfort as large bites try to pass through the small stomach.

Will I be allowed to drink alcohol?

Alcoholic drinks are high in calories. They are "empty" calories that your body cannot use for building or maintaining your body, but can only be used for energy or storage (fat). Alcohol is not part of any sensible diet plan.

What vitamins will I need to take after surgery?

A daily multivitamin is recommended for the rest of your life. Depending on the type of surgery you have, B12, calcium with vitamin D, iron, and other trace elements may also be needed. A protein supplement is also recommended during the first 6-12 months after surgery.

Do I meet with a nutritionist before and after surgery?

Yes. Nutrition counseling is very important prior to bariatric surgery. You will attend a nutrition class led by a dietician prior to surgery and you can meet with the dietician individually after your surgery.

What is the youngest age for which weight loss surgery is recommended?

Physically mature morbidly obese adolescents can benefit from bariatric surgery. We have helped patients as young as 15 years old. Insurance will not pay for surgery on patients younger than 18.

What is the oldest patient for whom weight loss surgery is recommended?

There is no upper age limit. Gastric bypass, sleeve gastrectomy, and gastric banding, when done by experts like Dr. Miles and Dr. Schmitt have a lower mortality rate than gallbladder surgery. So, if you are healthy enough to have your gallbladder removed, then you are healthy enough for any of these surgeries. We have operated on hundreds of patients over age 65 and several in their 80s. Medicare pays for these procedures.

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