Questions

Answers

I am tired of losing weight and gaining it back. I am
concerned about what may happen to me if I don’t lose weight and keep it off.
However, I wonder whether Bariatric surgery will be the answer.

Bariatric surgery is a great tool to help you reach your goal. However, you still need to make significant lifestyle changes in order to be successful in your efforts to lose weight and keep it off. Our team will help you work toward those sustainable changes prior to the surgery and will follow you up to 2 years after surgery to address any nutritional deficiencies and to support you through your journey.

Are there any risks associated with Bariatric surgery?

All medical procedures have risks, which may very from one patient to another. Your Bariatric surgeon will be explaining all potential risks in your consultation.

I just attended orientation.
What are the next steps and how long after the orientation I will have surgery?

You will receive appointment for your initial
appointment with one of our dietitians and social worker sometime after the orientation day, once you have opt-in. You will also be given requisition for blood work and an abdominal ultrasound. Also, your appointments for bone density and sleep testing will be made. Your surgery date will depend on many factors such as your compliance with the team’s recommendations, the need to see our psychiatrist or endocrinologist or other specialists or take Changeways class or the need for further tests; everyone is different.

I came to the orientation with several other patients and
most of them already have had surgery; why am I not being sent for surgery?

Each individual’s journey is different and patients
shouldn’t compare themselves with others. We do best to ensure that you are ready for surgery and that surgery is safe for you.

My referral was sent to the Bariatric clinic more than a
year ago. How do I ensure that my consult has been sent received?

Please note that our staff are quite busy so calling the clinic will disrupt their work. The best way to get the answer is to contact the physician who sent the referral and then wait for our phone call. Please note that the bariatric surgeons office stamp the referral when received and send it back to where it came from as receipt it was received.

My doctor has referred me to the Bariatric clinic. How
can I prepare myself to become surgical candidate as soon as possible?

You may start by watching videos in our website and do research about those topics online.

Someone told me that I can eat what ever I want after the
surgery and I will still keep losing weight! Is this correct?

No. You still need to keep following a healthy lifestyle and continue journaling in order to lose weight and finally maintain the weight loss once you have reached your goal weight.

Why is it important to have a family doctor?

Your family doctor can follow up with your blood test results, which becomes necessary after you have been discharged from our program (5 years post surgery) and also adjust your medications while you are losing weight.

Why should I stop taking vitamin or multivitamin and
mineral supplements 10 days before the surgery?

Since they might have adverse effects on the surgery outcome such as blood thinning properties.

What should I take with me to the hospital?

A complete list of items will be provided by the
pre-operative nurse, which may include Care Card (Medical Services Plan card), …

Are there any resources, beside manual, to help me learn about
healthy eating and diet after surgery?

Yes you may refer to the resources which were sent to you after orientation including books and online sources. We also have produced many videos you may watch in this website.

Why is it important to follow a pre-op diet 2-3 weeks
prior to the surgery?

The purpose of pre-op diet is to shrink your liver in preparation for the surgery. If the liver has not shrunk, the surgery risks are increased and if
it remains large, the surgery will be cancelled.

What should I do if I can’t come to my appointment?

We require a minimum of 24 hrs notice if you are unable to attend a scheduled appointment, unless an emergency occurs. You will be discharged from the program if you have more than 2 no-shows or cancelled appointments, which were not due to an emergency.

What do I bring to hospital?

Care card, one piece of picture ID, toiletries, and
slippers.

What are the hospital’s visiting hours?

10 am to 8 pm

Is there somewhere for my family member to stay while I am
having surgery?

Yes, there are a few different waiting areas located by Family Resource Centre and near Starbucks.

What is the Pre-Admission Clinic appointment all about?

This is when you meet with a nurse and your Anesthetist and learn about what to expect during your hospital stay and recovery.  You will also be sent for a blood test, ECG, and chest X-Ray.

How long will I be staying in the hospital after the
surgery?

Usual stay is 1-2 days. But your surgeon will decide how long you need to stay in the hospital.

Which doctor will be reviewing my medications after surgery?

Please see your family doctor, or your endocrinologist,
soon after the surgery so that he/she can review your medications.

Whom should I contact if I have a problem or question after the surgery?

First refer to the resources provided for you. A nurse will also approach you in the hospital and will provide you with a phone number to reach her if you have any questions or concerns.

Can I swallow my medications after surgery or should I crush them?

Yes you may swallow you medications without need to crush them. However, your supplements must be in chewable or liquid form.

How soon after the surgery can I drive?

Wait at least 2 weeks before starting to drive again.

Can I wear my seatbelt in the car?

Yes you may.

Can I take medications such as Advil or Aleve after the surgery?

Your should not be taking those medications which are considered NSAIDS. Check with your doctor if those are the only medications that relieve your pain.

Can I fly after the surgery?

You can fly short distances as soon as you feel strong
enough to make the trip. However, you may want to check with your surgeon since your circumstances might be different from other patients.

How soon after the surgery I can go back to work?

If your work is not labour intensive, you may go back to work after 2 weeks. However, you may find it difficult to work for full day since you get tired easily and are not able to have adequate amount of fluids and foods. Therefore, we recommend being off work for 4 weeks. If your work involves a lot physical activity, it is better to go back to work after 6 weeks. 

How soon after surgery I can start exercising?

You will be encouraged to take short walks right in the
hospital and you may continue walking without exerting yourself. Please check with Bariatric QEP staff (Health Link BC 811) to help you get started with other activities.

How soon after surgery I can start swimming?

Please get permission from your surgeon or your GP before starting swimming so that he/she can determine whether your wound has properly healed and if it safe to do so.

What tests should I do right after the orientation to get the process started?

The tests include blood test, abdominal ultrasound, bone density scan, and sleep studies.

How much weight will I lose after Bariatric surgery; is the weight loss the same in both RYGB and VGS?

For VSG, the expected weight loss is 50-60% of excess body weight; for RYGB, the expected weight loss is 60-70%. Some patients may even lose more weight and reach their ideal body weight in 18 months.

Why should I avoid caffeinated beverages before and after the surgery?

Caffeinated beverages are diuretic and are not recommended until you can consume adequate amount of fluids. Also, caffeine may aggravate heart burn (acid reflux) and you are given medication to prevent that.

Why should I avoid carbonated beverages after the surgery?

You will feel extreme pain if you drink carbonated
beverages after the surgery, at least for a few months.

I love drinking wine/beer when socializing in summer. Will
I be allowed to have alcoholic beverages after surgery?

We do not recommend consuming alcoholic beverages after the surgery at least for a year. If you would like to re-start its consumption note that smaller amount of alcohol may intoxicate you. Remember that you don’t want to drink your calories.

I had my surgery a few days ago and feel constipated; what
should I do? Can I take over the counter stool softeners?

Please make sure you are consuming adequate amount of fluids and gradually increase your fibre intake. Yes you may take over the counter stool softeners. If the problem is not resolved you may contact your dietitian/RN and/or your GP.

I would like to get pregnant after my Bariatric surgery.
How long should I wait?

Weight loss should be stable before attempting gestation.
In most people this will occur by 12 months, however waiting until 18 months is safest, as >95% of weight loss has stabilized by that point.

I am able to eat variety of foods now. Why should I still take supplements?

Bariatric surgery renders all patients malabsorptive,
or with decreased ability of the digestive tract to absorb nutrients. This is one of the reasons weight loss occurs after surgery. As a consequence, patients have to take extra vitamins, and nutrients for the remainder of your life, as this occurs in over 50% of bariatric patients.  The food you are eating now, while healthy, will not offer complete absorption of all nutrients, due to abnormal digestion, and therefore extra supplements are required in many people. You will be doing blood tests at 3, 6, and 12 months and annually after that (with us until  years after surgery) to make any necessary adjustments in your supplements.

Why should I keep doing blood work for my appointments? I eat well and take my supplements regularly.

Since the bariatric procedure may put you at risk of
nutritional deficiencies and only blood work can determine if you have any deficiencies before permanent damage is visible.

Why should I continue journaling after the surgery?

Journaling makes you accountable and you can find patterns if you are not tolerating certain foods. Also, you dietitian can determine whether you are consuming adequate amount of nutrients by looking at your
journal.

I am feeling overwhelmed after the surgery since I used to eat food for comfort but I can’t do that now. What should I do?

Please call our clinic to schedule appointments to
talk to our dietitian and social worker.

What should I do with my excess skin now?

You may talk to your surgeon to refer you to our plastic
surgeon.

When should I seek immediate medical attention after the
surgery?

• Any bleeding or signs of infection (fever over 38°C,
  unusual pain, swelling, foul smelling drainage, oozing) from incisions
• Persistent abdominal pain
• Severe bloating
• Persistent nausea, vomiting, diarrhea
• Inability to tolerate fluids
• Dark and foul smelling stools
• Cramping leg pain
• Pain that is not relieved by pain medications

Please call 911 if you symptoms such as difficulty
breathing, chest pain, or urine output less than 4 times in 24hrs

Why there is so much emphasis on consuming adequate amount
of protein after surgery?

Adequate amount of protein is required for maintenance as well as helping your wounds to heal. You may ask your dietitian to inform you about the amount of protein you should have after the surgery.

How much fluids should I consumer after surgery?

Your aim is to have 8-10 cups of fluids including water.

I can’t tolerate taste of water, what else can I drink?

You may try low sodium and fat free broth, water with
crystal light or other sweeteners, decaf coffee/tea, herbal teas, milk, diet Jello, etc.

Is it possible to gain weight again after the surgery?

Yes it is possible to gain back the weight you have lost
and even more if you fail to follow the life style guidelines you were given throughout the program, e.g., by:

• Not journaling
• Not doing your blood work and not attending your post-op appointments
• Choosing high fat/sugar foods
• Not exercising and being sedentary
• Drinking high calories fluids
• Eating beyond feeling full and gradually stretching your stomach
• Not eating mindfully

Will I ever feel normal again?

Of course you will; just be patient and listen to your
body queues and therefore you will heal faster and you can enjoy eating again. For most patients, this occurs around 6 months post surgery.

I seem to be healing well and can tolerate all the foods in full fluid stage with no problem. Can I move to pureed stage when I am only 10 days post-op?

Please follow all the guidelines which were written in
your manual and only proceed to next diet stage after completion of full days of current stage; i.e., following pre-op diet for 3 weeks before moving to pureed stage. If you push boundaries, you may not only feel discomfort, but also potentially stretch your stomach and delay the healing process.

I’ve noticed I am losing lots of hair, is this going to stop soon?

Most patients will notice that their hair thins out.
However, this is just temporary and your hair will grow back; make sure you consume adequate amounts of protein and take your supplements regularly to help the re-growth. Please note, it may take up to 3-6 months to notice reduction (improvement) in hair loss.

Should I be concerned that I am experiencing a lot of gas and bloating?

There are several possible reasons for gas and bloating:

1. Lactose intolerance: try to eliminate milk or have lactose free milk to see whether it helps.
2. Constipation accompanied with inadequate fluids and fibre intake: please see the section on constipation above.

Presence of sugar alcohols in various foods, e.g., protein shakes, e.g., sorbitol, xylitol, etc.; eliminate these items and observe whether you are having less symptoms or not.

After my surgery I noticed I have a divot/dent in my
abdomen.  Is this normal?

Yes this is normal.  With time and as you lose weight the divot/dent/dimple will start to disappear.