Questions

Choosing to go forward with WLS is a huge deal.  Going further and choosing the DS as the best procedure for yourself – a bigger deal still.  That means you’ve done more than a cursory level of investigation – good for you!  What some of us learn – unfortunately – is that our insurance won’t cover the cost of WLS and/or anything related to weight and then we find ourselves as self-pay patients.  Another big deal – there isn’t a good, qualified, proven DS surgeon on every corner.  They’re hard to find, and sometimes you have to travel quite a way to get to the surgeon you choose for your surgery.  A lot of things to factor in!  On top of it all, it’s an emotional rollercoaster ride, at best.  There’s joy at the thought of finding something that might actually work.  Fear that something bad will happen.  Dread at spending all of that money on yourself.  Worry about quality of life after surgery.  Thoughts that you’ll be the only one the surgery won’t work for…

So sometimes it’s really difficult to formulate a list of questions that will help you make some good informed decisions and solidify your course of action.

I’ve got a list of questions here that I relied on pretty heavily when I was researching my DS all of those years ago.  Maybe they’ll help you out.

About Credentials

Ask your surgeon who he/she was trained by, if he’s willing to send you a copy of his CV.

Ask what his/her numbers are on mortality, complications (both early and late), and infections.  I’d also want to know what the causes of death were on any of the deaths reported with mortality.

Check up on your surgeon’s stated credentials.  Are they a member of the ASMBS, IFSO, ACS?

Ask how many of the DS he/she has done:

  • How many open?
  • How many lap?
  • How many are local patients from his/her area?
  • How many patients travel from out of country.

I’d ask what papers he has published, and if he can supply you copies of them.  If he can’t, then ask where they are published.

Financial Considerations

Does the $$ amount you’re quoted include:

  • Surgeon’s fees
  • Hospitalization
  • Anesthesiologist’s fees
  • Labs, x-rays, medications
  • An estimate for funds necessary in case of post-operative complications?
  • A program fee for follow-up care?  (And if not, what will you be charged each time your surgeon is copied on labs, or is consulted by your PCP on various issues, etc.)

Be sure to also ask if there is a resource available to patients who travel for surgery for lodging suggestions (and costs associated with lodging).

Ask if there is someone your surgeon can direct you to who can help give an idea as to non-surgery related costs – air and ground transportation, food costs, tipping, etc.

Support

Does your surgeon have an active support group of any kind for pre- and post-op patients?

Will your surgeon give you a list of prior patients to contact so that you may inquire as to their experiences as his/her patient?  If not, why?

Will you need a support person to accompany you for surgery – i.e., if you are traveling?

Surgery

Is a pre-op diet required?

What type of surgical prep is required?  NPO for a certain number of hours?  Bowel prep?

When do you check into the hospital?  (Day of surgery, day before?)

What time of day will your surgery be?

Are you expected to have a support person?

  • Does the support person stay with you in your room in the hospital?
  • Or will you need to arrange for alternative lodging for them while you are hospitalized?
  • If your support person stays in the hospital with you, will they have meals provided to them, or will they need to go out to find food?

Do they use Foley catheters?  Or can you get up and walk to the toilet early after surgery?

How long does the surgeon speculate your surgery will take  I.e., how many hours on the table?

Does he use a horizontal or vertical incision for an open surgery?  What percentage of his/her patients have post-surgical hernia repair?  (Not all surgeons will keep in contact with their post-ops after a six to 12 months following surgery, so they may not know the answer to this.)

How many ports/trocar sites are used for a lap procedure?  What percentage of his/her post-ops have experienced hernia at trocar site?

How long will you be in recovery?

How long before you’re returned to your hospital room?

How long after surgery until you can get up and walk?

If required to stay in bed for the first night after surgery, do they use the compression boots to help prevent thrombosis?  What percentage of his/her post-ops have experienced pulmonary embolism and/or deep vein thrombosis?

How long are you expected to be in the hospital?

How long will you be NPO after surgery?

After Discharge

What is the post-op diet?

  • How long on liquids (define liquids)?
  • How long on soft foods (define)?
  • How long until release to normal diet?)

Where does he prefer his out of country patients stay after discharge from the hospital?

How long until you are released to go home?  (I.e., how many days does he want you in the area/or until you can fly?)

How closely does he expect your PCP to work with him?

How often does he want labs done post-op?  Does he want to be copied on them?

How often does he want you to report back to him on your labs and progress?  For how long does he want to remain in contact with you?  (Months?  A year?  Several years?  For life?)

 

The point is this is about THE REST OF YOUR LIFE.  Every single decision plays into the outcomes – every single one.

Please – do not take ANY of them lightly.  Understand the repercussions of them all.

I hope these help some.

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