Q: I am interested in having the gastric bypass operation. Where do I go from here?

A: If you have decided that you are interested in having the gastric bypass operation, the first step would be to contact the Bariatric Institute of Kentucky, by e-mail, or you may call, and we will set up an appointment for you.

Q: From the time I am seen in the office, how long before I will have the gastric bypass surgery?

A: In general, after the initial consultation in the office, it can take anywhere from 3-8 weeks to have the gastric bypass surgery. Once we have gathered the information that we need, we send a letter to your insurance company for pre-approval for the procedure. Once obtained, you would then undergo an in-depth history and physical examination as well as some laboratory tests and x-rays. Once those are done, provided there are no additional or unexpected medical problems that would require treatment first, we would schedule your gastric bypass operation.

Q: What can I do to speed up the process of having my gastric bypass surgery?

A: The most helpful thing you can do is to arrange for copies of your previous medical records to be mailed, faxed, or brought to the The Bariatric of Institute of Kentucky prior to the initial consultation. Your records will show documentation of your weight and medical problems. We must include this information in the prior approval letter to your insurance company, the sooner you gather this information, the sooner we can contact your insurance company.

Q: Does my insurance company cover a gastric bypass surgery?

A: Most insurance companies do cover gastric bypass surgery for morbid obesity as long as the surgery is medically necessary. It is not uncommon to be denied on the initial application for pre-approval. If you were denied initially, we would appeal this a first and even second time. Usually if a patient medically qualifies for gastric bypass surgery, we can get an approval although it does sometimes require some patience as well as persistence.

Q: How should I select a gastric bypass surgeon?

A: I certainly would recommend you seek a gastric bypass surgeon who is experienced in bariatric surgery and performs this surgery on a regular basis. The American Society for Bariatric Surgery website is a great source to locate a gastric bypass physician in your area.

Q: How do I select a hospital for my gastric bypass surgery?

A: I would recommend you select a hospital that is a full service facility. The term full service I use to mean the availability of an intensive care unit, experienced operating room staff, board certified internal medicine specialists, custom made operating instruments, a dietician, a compassionate and knowledgeable nursing department, and also very important an administration who is supportive of the needs of Bariatric patients.

Q: Can I have the gastric bypass operation with the tiny incision (laparoscopically) or do I need this done as an open (the larger size incision) procedure?

A: The short answer is it depends. The decision to have this done laparoscopically vs. open can generally be made at the time of the initial consultation. Your surgeon will discuss with you the pros and cons each method. We do about 70% of the gastric bypass operations laparoscopically. The remaining 30% are done open (single larger incision). I you have had a lot of previous surgery or are very barrel chested, we generally recommend an open procedure. Under those circustances, the open technique is much more safe. I f you haven't had much surgery before and aren't barrel chested then the risks for open or laparoscopic surgery are the same and we would offer a choice for you.

Q: How long is the hospital stay for a gastric bypass operation?

A: On average, the hospital stay for gastric bypass surgery is four days, though certainly there are patients who may require an extra day or two. On rare occasions, there have been patients who have gone home on the third day.

Q: How long would I be off work after bariatric surgery?

A: In general, I tell my patients to plan on being off about four weeks after bariatric surgery. I've had some patients return to work within seven to ten days after surgery, and I've had a few patients who have strenuous jobs that have been off for as long as five weeks. It is important to remember that everyone's occupation and level of activity is different, and therefore, recovery time from the gastric bypass operation will be different as well.

Q: What do the follow up procedures from gastric bypass surgery consist of?

A: I see my patients about 10 days after discharge from the hospital at which time the skin staples are removed. Also at that time, a soft diet is begun and the patient can usually resume driving. They are seen back in the office, approximately two weeks after the first post-op appointment when, as long as the patient is doing well, we begin a regular diet. The next office visit would be about three months later. For the first year, we see our patients every three months and the second year, every six months. If possible, we like to see our patients once a year thereafter.

Q: How much weight can I expect to lose with gastric bypass surgery?

A: Most patients will lose 50-70% of their excess body weight; some patients can lose more. The gastric bypass operation will limit the amount of food you take in, decrease the amount of calories consumed and make it so that you eat less but still feel satisfied. However, the gastric bypass operation will not do two very important things. It cannot make you exercise nor will it make you choose healthy foods to consume. If you exercise and eat healthy foods, your weight loss bariatric surgery can be significantly greater. Though the gastric bypass operation rarely gets people to their ideal body weight, most patients get within 30-40 pounds.

Q: Do I need a special diet or supplements after the gastric bypass operation?

A: I recommend a good one-a-day vitamin, especially one with iron after the operation. However there is no special diet other than choosing well-balanced meals. Patients should eat not only three meals a day, but in fact, it is reasonable to snack in between meals also. Most patients require no additional supplementation however on occasion iron deficiency anemia can develop. This is most common in women who are experience a heavy flow during menstrual cycle. Though this is rare, some of those patients will need some iron pills.

Q: Where is the Bariatric Institute of Kentucky located?

A: We are currently located in Lexington, Kentucky. The second largest metropolitan area in Kentucky, we are centrally located 2 blocks from both the University of Kentucky campus and downtown Lexington.