New here and have a few questions please

goodlife · March 16, 2010

Hi everbody.

Since making the decision to have WLS I've been reading and researching and just absorbing as much information as possible. I'm so glad I found this site! After reading about the band, the bypass, and the sleeve...the decision was an easy one for me. The sleeve it is!

I'm a 39 yr old mother of two and wife of one.

I work full time at a job I absolutely love.

I've struggled with my weight most of my adult life. I have some pretty bad lower back problems and also have very high cholesterol although I've never been put on anything for it. (Probably because I don't have a regular family doctor that I see) I also suspect that I have a mild to moderate case of sleep apnea that's developed over the last couple of years. When my back problems started to get worse I really packed on the pounds. I probably have about 150 lbs to lose at this point...and doesn't that just sound YUCK! It's really affected my physical ability and that is SO not working for me anymore! LOL I'm hoping that getting rid of some of this extra weight will help with these issues.

I want to be healthy. I want to be active again. I want to live a long life and see my kids grow up and give me grandkids one day...not too soon mind you!

I attended a seminar last week and I have an appointment scheduled with the surgeon on March 31st. I'm self pay so they said it would go pretty quick so I'm trying to gather as much information as possible so I can be as best prepared as possible. I also went ahead and made an appointment with a regular GP/Internist for a checkup next week just because I don't have a doctor that I see on a regular basis and haven't had a full checkup in probably oh....ever? But at least I'll have that behind me when I go for my consultation with the surgeon.

I tell you...you guys are just an invaluable source of information...and I wanted you all to know how much I appreciate you all sharing your insight, your stories, and your knowledge on these forums.

Now for my questions.

1. I'm a smoker. I know they ask you to quit at least two weeks before you surgery but realistically speaking I don't think that's going to happen. I was curious if there are any other smokers out there and what your docs had to say about that. I did order some e-cigs and am hoping to substitute with that and at least cut down significantly. I'm also hoping that after I lose some of this weight and feel better physically and can become more active that I will have a desire to quit. Any other smokers out there?

2. What tests did your surgeon do or order before surgery? I know that I will probably have a sleep study done and some bloodwork, but I'm not sure about what else. They will do the psych eval on the 31st during my consultation.

3. Can anyone expand on this drain tube I keep reading about? What is it draining and what is it attached to on the inside? I will have a one night hospital stay (assuming all goes well and according to plan) so will that be removed by I leave the hospital? That really seems like the grosset part of the whole thing! lol

4. Do they catheterize you during surgery?

5. Hair loss. I keep reading about this. What causes this to happen and does it happen to everyone? I have super thin hair already...I'll be bald if I start losing hair! Is there anything you can do to prevent it?

I had other questions but now I can't think of them! lol

Any words of advice or any specific questions I should ask my doctor about? I'm seeing Dr. Matthew French with the Surgical Specialists of Louisiana.

Thanks!

kbl · March 16, 2010

i can only answer about the drain... i have not had the surgery but i have been an rn for the past 21 years. not all doctors will use the drain so it may not apply to you. it is called a JP drain. it is a small tube that they will place in in abdomen to drain any of the Fluid they use for irrigation and also so that if you have any post op bleeding it will drain. the staff will monitor the drainage for color and volume. the drain is very small and is attached to a bulb to serve as a collection system. when empty to bulb is squeezed. this give the bulb some suction so the the fluid will drain. as the bulb fills there is less suction. the drain is attached to the out side with a suture and when it is time to pull out the sutures are removed and the drain is pulled. usually an RN will remove but some of the surgeons remove as well. the removal is not really painful but maybe a little uncomfortable but happens very quickly. usually the drain is removed a couple of days post op. hope this helps, good luck. kelly

Tiffykins · March 16, 2010

Hi and congrats on taking the steps to a healthier and better you.

The sleeve is a wonderful and I absolutely love life post-op.

As for your questions, I'll answer honestly and openly as I can.

1) I am a smoker. Smoking inhibits healing, and can cause ulcers. Not only that, it increases your risk of a leak due to hindering healing of the staple line. My surgeon knew my smoking status, but I didn't quit pre-op. Could it have contributed to the fact that I did have a leak, yes, but the biggest issue in my recovery and leak issues was because I had a band first that destroyed my stomach tissue. Smoking also complicates anesthesia recovery. Your abdomen is sore, causes more coughing and I had to use a spirometer to help prevent pneumonia. That really sucked because coughing caused major discomfort. I have quit twice since surgery, and am now trying to quit again. I actually went on Wellbutrin to help with the withdraws of nicotine as the patch, gum and cold turkey make life with me pure hell.

2) I had a huge panel of labs, a chest xray, psych eval, and consult with a nutritionist. Some surgeons require an upper gi and sleep study.

3) I didn't have a drain initially. A lot of surgeons use drains to make sure there is no leak, and some pull it before discharge, some require it stay in for about a week. I only had drains due to the leak repair surgery, and they stayed in for over 2 weeks.

4) I was not catheterized for my revision. I urinated before surgery, and was dry when I came out.

5) hair loss can happen to anyone that goes through surgery. It's a pretty normal occurrence. There is absolutely nothing you can do to stop it. It's a combination of anesthesia, surgical stress, and rapid weight loss. I lost hair for about 3 months, and I lost half of my hair. Luckily, I had super thick, coarse hair and no one that didn't know me before never guessed that I had lost all of my hair. The only thing you can do pre-op and during your recovery is to take hair/nail/skin supplements to help with regrowth. Biotin is usually the one most people choose. I didn't do anything to help with regrowth until I started losing. I used Folicure extra care Shampoo. I started having new growth pop in while I was still losing. Currently, I look like a chia pet, and have chopped my hair off, layered it and bleached the top to help hide some of the new growth. I kept the back and underneath dark to help give the illusion of depth and volume. Unfortunately, Hair loss seems pretty inevitable. There's several patients on this board that got in there Protein and extra Protein, and they lost more hair and lost it for a longer period of time than I did, and I didn't get in my protein until I was on soft solids when I could eat chicken and other meat.

My main advice is make sure you can handle the mental and emotional aspect of this surgery. It's a huge change, and no matter how much you read or talk to people will you really grasp it all until you go through it. I truly believe going in positive, and upbeat helps. Find strength within yourself, and know that you are doing something absolutely fabulous for yourself and your family. Know that recovery can be difficult, you'll be tested, you'll be exhausted, you might be mad at yourself especially during the post-op diet, but all of that is just temporary.

Questions to ask your surgeon:

What size bougie do you use to make the sleeve?

What are your leak/complication stats?

What are your expectations of my weight loss?

Do you provide follow up care, labs, access to a nutritionist and psych if needed post-op (especially since you'll be self-pay find out what all is included in that cost)?

Do you prescribe an acid reducer such as Prilosec, Prevacid, Nexium to protect the sleeve, how long should I be on it?

Post-op diet instructions?

Pre-op diet instructions?

How many sleeves have you performed?

How many bariatric procedures have you performed?

How long is the hospital stay?

Leak tests, how many and when are they performed?

That's all I can think of right now.

Best wishes on your consult, and if you need anything ask away. We'll all be here for you through this journey.

cwalck · March 17, 2010

This IS the most valuable information you will ever get, here on this site. I could not have done it without this forum. Everyone will probably tell you the same thing. I had to do an upper GI, swallow that awful stuff, a sleep study, bloodwork, an EKG and a stress test which caused a delay fro me. Many heavy people get false poitives on stress tests because of the extra fat and breast tissue. THAT part was hell for me. I also was concerned about the Hair loss, and everyone told me it is the Protein. When they say 60 gm. of protein a day, they mean it. I am 60 and can't afford any more hair loss. Get that protein in. The smoking is a HUGE issue. I don't smoke but your surgeon will absolutley deny you surgery if you smoke. It is very dangerous for so many reasons, anesthesia being a major reason, and infection and healing, ,etc. You need to quit the smoking at least until after you are well on your way. It could seriously affect the healing process. I even had to get clearance from my Infectious disease doctor because of back surgery 2 years ago and almost dying from a staff infection. The hoops are stresful but now that I am done I get it. Have my psych next week and then probably I am a couple weeks out, finally.

Kimmysil · July 19, 2010

HI Everyone, OMG....all of these doctor's appts and testings are really running me crazy. So far I have see all the Dr's now I"m doing the testing that they are requiring. Need to do a chest xray and blood work for the Pulmonary, the GI Dr has to do an Endoscopy on Aug 31st. Still have 2 more visits with the nutritionist. I figure by the time all of the results go through I'm looking into an Oct/ Nov surgery. Just found on friday that I have gallstones from the GI. OH and I forgot I have to get a new psych eval because the one I went said she wouldn't recommend me until my panic attacks are under control so I have to do that too......My own Physc wanted to charge me 350.00 for the eval. Isn't that crazy.

lamsunshine · July 19, 2010

Oh, I do know how you feel. I went for my consultation last October, already been approved, by the VA and thought I would have my surgery by December, boy was I wrong. The surgeon would not take my evaluation from my VA psych doc who actually knows me because I go see him every three months, I had to go to their Psych doctor. Went for my sleep study, my Sleep Doctor said I was ok to have the surgery without being on the cpap machine sent documentation to my surgeon, and the surgeon insisted that I had to be on the cpap for 4 weeks. With the VA it takes forever sometimes to get things done, and finally in April I received my CPAP machine. THen I told my nutritionist I get up and eat at night, so then my surgeon said I had to be evaluated, and treated for nite eating syndrome, which of course I don't have it is just habit. So I totally understand how you feel. But stay strong, and don't give up it will be worth it.

Number50 · July 20, 2010

I do not smoke and I use a CPAP, so that may affect the tests my doctor required. I first did an upper GI x-ray, and because of a small issue, they did an upper GI endoscopy, too. I did a resting EKG and lab work: CBC, CMP,URINALYSIS,FASTING LIPIDS,VITAMIN B12, Iron LEVELS, FOLIC ACID,TSH, PT/PTT, HGBA1C. Finally, I did a psych evaluation. I am having my surgery day after tomorrow in Dalton, GA at Hamilton Medical Center. Hamilton Weight Management is a Bariatric Surgery Center of Excellence.

breezy · July 20, 2010

1. I'm a smoker, have been for 30 years. I wasn't asked to quit by my doctor, though of course, he said it would be better for my health if I did. I didn't have any surgery complications because of my smoking. I am a quick healer, despite the smoking, and my incisions healed fast. Like Tiffy, I want to quit and plan to try again after I get a handle on the lifestyle change the sleeve has initiated.

2. I already knew I had sleep apnea and use a cpap machine. My doctor only did a blood test on me. I am pretty healthy, despite the smoking, and a self-pay, so I didn't have to do anything else.

3. I only had a drain tube for a couple of days. It didn't hurt when they pulled it out, just wierd feeling. It didn't bother me much.

4. Do they catheterize you during surgery? No.

5. hair Loss. I'm at a little over 3 mos out and I haven't loss any hair that I've noticed. My hair was thin to begin with so I think I would have noticed. Knock on wood.

Tiffy's list of questions to ask is a good one.

I had back problems, too, but managed them pre-op with stretches. Now, after losing over 40 lbs, my back feels much better. As I exercise, I am getting stronger and stronger. I can play with my grandchildren much better now. I know it will only get better.