Frequently Asked QUESTIONS
What do I need to do first?
Attend one of our informational workshops. We offer bi-monthly, no-charge online seminars. Click here to register for a seminar.
How much do I have to weigh to have surgery?
If your BMI>35 and you have medical problems related to your weight or if yourBMI>40, then you qualify for surgery. Please see the patient qualifications section for more information.
What is the youngest patient you can operate upon?
We have operated on patients as young as 17 years of age but consider 16 to be the cutoff age.
What is the oldest patient you can operate upon?
The benefits of bariatric surgery have been seen in patients of all ages. However, as we age, surgery becomes riskier and the recovery more difficult. A thorough consultation with your surgeon will allow a full risk assessment to determine if you are a candidate for bariatric surgery.
What if I have medical problems?
The answer depends on the problems. Many medical problems such as heartburn, hypertension, diabetes, sleep apnea, arthritis, and numerous others are “co-morbidities”. These problems are caused by the obese condition. They improve with weight loss and are actually an argument for the benefits of surgery.
What are the routine tests before surgery?
As a policy we always do some basic tests including a complete blood count, (CBC) chemistry panel and comprehensive metabolic function testing. Most persons, except for the young, will get a chest x-ray and an electrocardiogram (EKG). Other tests may include pulmonary function testing, echocardiogram, sleep studies, endoscopy, or cardiology evaluation.
Why do I have to have a psychological evaluation?
We do not believe that people with weight problems necessarily need psychological help. We do believe that choosing to undergo surgery for obesity is challenging and life after surgery is potentially stressful. We believe a psychologist can help our patients make good, well-informed decisions and help deal constructively with the life changes obesity surgery brings.
Why a team approach?
Obesity is a multifactorial disease. A team approach allows for the best patient care, as well as the best chance for our patients’ success.
How long does it take between the time of consult and surgery?
You will need to be seen by the mental health specialist, exercise specialist, dietitian, and attend two support groups. This usually takes about six to eight weeks.
Have these surgeons done these operations before?
Dr. Pennings and Richardson have performed well over 2000 Advanced laparoscopic gastrointenstinal procedures, including laparoscopic and open Roux-En-Y gastric bypass, laparoscopic sleeve gastrectomy and gastric banding procedures. They are also experienced with revisional surgeries. They prefer the laparoscopic approach for the benefit of the patient and have completed formal fellowship training in Advanced laparoscopic and bariatric surgical techniques. Training and experience are very important when considering which surgeon should perform your procedure.
Does laparoscopic surgery reduce the general risks of surgery?
Yes. Laparoscopy reduces the risk of bleeding, infection, post-op pulmonary problems, and hernias. This method also leads to shorter hospital stays, less pain and scarring, and earlier return to work.
How long does the operation take?
The gastric bypass operation typically takes about 60-90 minutes. The gastric banding procedure takes about 45-60 minutes. If you have friends or family waiting, they should understand that the operation may not begin immediately, so they should not worry if it seems to take longer than anticipated. The surgeon will be out to give an update as soon as the operation is complete.
Will I have a lot of pain?
We take pain very seriously and work very hard to control pain before, during, and after surgery. In the operating room, numbing medicine, like Novocain, is injected into all incisions. We use a machine called a PCA (Patient Controlled Analgesia) to administer pain medication as the patient pushes a button. We like to make it easy for patients to walk the same day of surgery and pain control helps all of us.
How long will I be in the hospital?
The typical stay after a laparoscopic Roux-en-Y gastric bypass is one night. The typical stay after an open Roux-en-Y gastric bypass is three to five nights.
Do you take out the gallbladder?
The gallbladder is only removed in patients with known stones, in patients with known gallbladder disease, and in patients with abnormal appearing gallbladders.
Do you use a drain?
Sometimes a drain is placed in the patient undergoing laparoscopic gastrointestinal procedures. This is done to test for leaks on the first day after surgery. The drain will be removed after it has served its purpose.
What can I do to prepare for my consult?r
First, our patients are required to attend one of our informational workshops. Then, help us to gather all of your medical information together (diet records, medical records, medical tests, etc.) Letters from your personal physician and specialists can also help to document medical necessity. When one or several physicians agree that surgery would help the patient, it is harder for insurance carriers to refuse.
How soon will I be able to walk?
We encourage walking on the day of surgery. It is the best exercise for the lungs and the best way to prevent blood clots. It also helps with occasional gas pains.
How soon can I drive?
Driving or operating heavy machinery should be avoided while taking narcotic medications. This usually takes three to seven days after surgery.
When can I leave the area?
Patients who come from outside the Post Falls area for surgery are asked to remain in the area for the first day or two after surgery. There are important educational sessions and post-operative visits during this time. Most patients stay at a nearby hotel (the office has a list) or with friends and relatives in the area.
When can I go back to work?
Some people go back to desk jobs within a week of surgery, but we usually recommend two weeks off after surgery. A big part of that is learning how to eat with the new pouch and how to use it successfully.
When do I see the doctor again?
Your first follow-up appointment will be scheduled at about three weeks out from surgery. Additional appointments will be scheduled at six weeks, three months, six months, nine months and a year after surgery and every year thereafter.
Is this operation the easy way to lose weight?
Bariatric surgery is by no means the easy way out. There are risks to any operation, and the lifestyle changes that must be made are major and require a long-term commitment. That being said, surgery offers the highest success rate to losing significant weight and keeping it off. The risks of remaining morbidly obese outweigh the risks of undergoing surgery.
Can the surgery be reversed?
These operations are meant to last a lifetime. If a patient does not wish to commit to a lifelong change, then they should not consider surgery.
How much can I eat after surgery?
The size of the pouch immediately after surgery is about one ounce. If you eat more than that, you will be physically ill. After about a year, the pouch expands to a few ounces.
What is dumping syndrome?
Dumping syndrome is caused by eating sugars or other foods with a lot of carbohydrates, which your body cannot handle as easily after surgery. These substances force your body to try to dilute them by secreting fluid. This also causes the release of hormones and makes people feel like their blood sugar is very low. They tend to feel cold, sweaty, and weak.
Does my insurance cover weight loss surgery?
Everyone's insurance policy has different criteria for weight loss surgery. You will need to call your insurance company directly to discuss your particular policy.