Frequently Asked Questions
Pre-op General Questions
Q: When do I stop my Aspirin, or any other medicines, prior to my
operation?
A: As a rule we do not stop aspirin. STOP taking all herbal
remedies 2 weeks prior to surgery. If you are taking
Warfarin/Plavix, we will need to discuss this with the Surgeon.
Q: I have got a cold/sore throat and my surgery is coming up?
A: It is advisable to see your GP and have a check-up, you may
need some antibiotics to help clear up any chest infection to get
you well enough for your surgery.
Q: Do I need to fast for my Pre-op bloods?
A: NO, these are not fasting bloods. They need to be done 3-72
hours prior to your operation, and in the Waikato Area.
Q: Am I able to use my own blood, should I need a blood
transfusion?
A: Yes, however the Surgeon/Anaesthetist
will need to complete a request form, advising how much is needed
and when it will be needed. We will give the form to you and you will then need to
contact the Blood Donor centre to organise this. This is done rarely
as the chance of needing a blood transfusion is minimal.
Q: Where do I get more pre-op diet food from?
A:
Please discuss all pre-op diet needs with our
nutritionist or dietitian.
Post-op General Questions
Q: What is a realistic amount of time needed off of work post
operatively?
A: Following a Bypass a minimum of 2 weeks, is the norm, if you
are returning to a desk-type job. We advise you not to do any heavy
lifting or strenuous activity for 2 weeks. Following the LAP-BAND®,
1 week should be plenty, again avoid heavy lifting/strenuous
exercise for 2 weeks.
Q: I am still in pain, what can I do?
A: We do not expect you to be in severe pain, however if you have
some pain, are you taking regular Panadol in gel cap form? If not
then please do. For more severe pain, please call the rooms who will
discuss with the Surgeon and we will call you back.
Q: I feel nauseated a lot of the time since my surgery?
A: On discharge from hospital did you get a script for some
anti-emetic (such as Maxolon or Stemetil)? If so, please start
taking regularly for the next few days and see if it settles. If not
we will fax/post out a script for you. Please let us know if it
doesn’t settle.
Q: My wounds look red and are not healing well?
A: Check for other signs of infection such as heat or pus
formation/oozing. Either see our nurse or your GP or even call back
to the Rooms for the Surgeon to assess. You may require some
antibiotics.
Q: I am feeling very tired since my operation, is this normal?
A: Yes, you can expect to feel tired for the first 4 weeks at
least, especially after Gastric bypass surgery. Take regular short
walks, around 3 times a day (5-10 minutes), and rest in the afternoons.
It should improve by 6 weeks when we see you for your follow up.
Q: I have been vomiting mucus since last night and have central
chest pain?
A: You have probably got something stuck. We will discuss this
with the surgeon and if needed arrange a deflation if you have a
band, or a gastroscopy if you have had a bypass. If you are able to
tolerate fluids, then continue. Also continue with Losec.
Q: Will I be constipated?
A: You may be. It is inevitable that, as you eat less food, then
you eat less fibre, and your bowel activity will decrease.
Q: I am getting constipated, is there anything I can use?
A: We advise our patients to drink plenty of fluids and use Bene-fibre, or Alpine Tea or Phloe tablets. If you have you tried
these and are still constipated, we will organise a script for an
aperient for you and fax/post it out.
Q: What about other tablets and medicines?
A: In general, you will continue to take the medications
prescribed. However, if they are in the form of a bulky tablet you
may need to break them up. Try them out. If they feel as if they
tend to stick at the bottom of the oesophagus, you may have to crush
them up and take them with some yoghurt to disguise the taste.
However, if you are going to do this, check with your pharmacist
first. Capsules should not be a problem to swallow as they are
designed to soften and melt inside the body.
Q: My doctor has started me on Voltaren, is this OK to take?
A: It is OK to take Voltaren, or any anti-inflammatories, as long
as you take them with food and Losec to help prevent gastric
irritation and ulcers forming.
Q: My doctor has given me a script for some antibiotics, am I
able to take them?
A: Yes, they are absolutely fine after the Bypass/Lapband.
Q: I have got a sore throat, can I take lozenges for this?
A: Yes, you can take sugar-free Strepsils.
Q: Do I need to fast for my Post-op Bloods?
A: Yes, you need to have nothing to eat or drink from 9 pm the
night before.
Q: When do I get my post-op bloods done?
A: We do not do bloods at 6 weeks. We would like you to get your
bloods done a week before your 3 month, 6 month and 1 year follow up
(after a bypass, after 12 months ONLY with a Band), so they can be
discussed at your consult. We will advise you if we need further
bloods done at different stages.
Q: I am getting a sharp pain under my ribs, is this normal?
A: It sounds as if it could be gallstones. We can discuss this
with the surgeon and it may be that you need an Ultrasound to
diagnose this. If so, we will send you a request as advised by him.
Or we will arrange a follow-up appointment as directed.
Q: I am feeling lightheaded and dizzy occasionally, what could
this be?
A: Are you on BP lowering medicines? If so then you should see your GP and
have your BP checked and the doses reviewed. Most of our patients
are able to have reduced doses of medication following weight loss
and it is important to review your BP checked every 4-6 weeks. If not, we
can send out a blood form for you to get bloods done and call you
back with the results. Check that you are drinking plenty of fluids.
Q: What do I do when dining out?
A: Because of the limited capacity of your new “virtual” stomach,
you must restrict yourself generally to an entrée size meal. Eat
slowly while those with you are overeating with two or three
courses. Social eating is one setting where we will excuse you from
the 20-minute rule. Because these occasions may go on for some
hours, we recommend that you pick very slowly at your food over this
time. Push it around the plate and nibble at it. If you
are visiting friends, it is probably better to advise the host or
hostess that you can only eat a small amount to save embarrassment
when you reject most of their carefully prepared food.
Q: What about alcohol after BAND surgery?
A: Alcohol has a high calorie content and is a liquid and
therefore, in theory, should be discouraged. However, there are
health advantages in a modest alcohol intake, particularly of wine.
Research has also shown that modest alcohol intake is associated
with improved weight loss. We therefore are happy to let you have up
to seven standard drinks a week, or an average of one drink per day.
Note that this is not a requirement; it is the upper limit.
However after gastric bypass surgery, you need to be more careful with alcohol intake. You absorb and metabolise alcohol more readily and this raises your blood alcohol much more quickly than prior to surgery. It also affects your liver more readily and can cause liver cirrhosis if you become dependent on alcohol long-term
Q: I think I can eat too much?
A: Do not worry about it, as long as you are sticking to the
rules of 3 small meals a day. Everyone is different, as long as you
are not vomiting, getting food stuck, etc. it is okay.
Q: I have got some food stuck, what do I do?
A: Stop eating,
try walking around. Drink diet ginger ale,
however over
the sink as it may cause the blockage to come up, or hopefully move
through. Eat soft foods for 24hours. Keep walking. When cleared,
continue taking Losec as needed. It is also a good idea to carry
Cinnamon mints with you. The cinnamon allegedly settles the
gullet/stomach and can help after an obstruction or discomfort.
Q: How long after surgery until I can go swimming?
A: You can swim and take a bath when all wounds are completely
healed, usually after 2 weeks.
Post-op LAPBAND® Questions*
Q: How long will it take to recover after LAP-BAND® surgery?
A: If LAP-BAND® surgery is performed laparoscopically (keyhole),
patients typically spend less than 24 hours in the hospital. It
takes most patients about a week to return to work and a month to
six weeks to resume exercising. In the case of open surgery, or if
there are complications, recovery may take longer.
Q: Should I expect a lot of vomiting after a BAND?
A: Really there should be no vomiting at all. The procedure is
designed to place a gentle restriction on your eating. If you find
that you are vomiting, then either there is something wrong with the
settings of the band or there is something wrong with your following
of the rules regarding eating. It is important not to have frequent
vomiting as this could lead to shifting of the stomach within the
band and compromise the outcome. Ideally there would be no vomiting
at all.
Q: What should I do if I get vomiting for other reasons when I
have a BAND in place?
A: Of course, you are at risk of vomiting just as anyone else
might, from food poisoning, gastroenteritis, pregnancy or for
numerous other reasons. Curiously, it has not proved to be at all
common and rarely has it been a problem. Your first task
is prevention. Avoid eating or drinking potentially contaminated
food or water. This is particularly important when you are
travelling. If you start vomiting and feel it may continue, seek
medical help to stop it as quickly as possible. If it continues,
contact the clinic and have some fluid removed from the band.
Once you start vomiting a lot, there is swelling of the stomach
inside the band, making it tighter. The swelling perpetuates the
vomiting. Removing the fluid breaks that cycle.
Q: Should I take a vitamin supplement after LAP-BAND® surgery?
A: Yes. You may well be getting sufficient vitamins from the food
that you are able to take, but as you lose weight you have a
particular need for additional vitamins and, therefore we strongly
recommend that you do take a multivitamin supplement. It is
particularly important that the supplement has sufficient iron and folate. A supplement such as a daily Berocca Performance is
sufficient and will fulfill these requirements.
Alternatively, you may wish to take a multivitamin such as Centrum.
Q: What happens if I become pregnant with a LAP-BAND®?
A:
The band itself does not interfere in any negative way with
the pregnancy. The likelihood of becoming pregnant is probably
higher, because having lost weight, your periods are often more
regular. The adjustability of the band makes managing the pregnancy
much easier because we can remove some fluid from the band if you
have a lot of vomiting early in the pregnancy or if you are not
putting on enough weight for you and the baby during the pregnancy.
Normally, we will adjust the volume of fluid in the band early in
the pregnancy to ensure there is optimal nutritional intake for both
yourself and the baby. Even if you put on some weight during the
pregnancy, we can tighten it up again later and get that weight off
again.
Q: I am 2 weeks following my LAP-BAND® surgery and feeling
hungry, can I have an inflation?
A: No, we generally do not do LAP-BAND® inflation’s until 4 weeks
post-op as everything is still healing and you should not be on
normal solid foods as yet. Please continue to make good food choices
until this time. We will see you as close as possible to the four
week mark.
Q: Is the silicone in the BAND dangerous to me?
A: We have no information to suggest it is. We have been using
silicone implants in various areas of surgery for more than 50
years. There were a lot of concerns and legal actions raised
regarding the liquid silicone used in breast implants. However, this
turned out to be more of a political and legal dispute than a true
medical problem. The LAP-BAND® is made of solid silicone
and has no liquid component. Therefore it cannot leak into the
tissues in the way that liquid silicone possibly could. We expect
the likelihood of any problem is extremely low. However, it could be
that information about problems relevant to this question may become
available in the future. If they do, we would let you know.
Q: How long will the band last?
A: We don’t really know. We have been using the LAP-BAND® for
more than 15 years and there has been no sign of it wearing out.
However, realistically we can’t expect a device such as this to last
40-50 years. We do expect that somewhere down the track there will
be failure of the adjusting balloon, in particular, and should this
occur, the band would need to be replaced. It is going to remain to
be determined if and when this should be necessary. We are hopeful
that you will get service from the LAP-BAND® for at least 20 years
and if, after that, we have to replace it, well so be it.
Q: Can the band be removed?
A: Yes. It can be removed quite easily. It is not our intention
ever to remove it, but should it become appropriate for whatever
reason, then it can be removed. If it has been placed laparoscopically, then it can be removed laparoscopically. After the
band has been removed, we would expect the stomach to go back to
normal. However, if the band was removed and no other
effective method for weight control was instituted, we would expect
that you would put back on the weight that you had lost. It might
happen slowly but it is most likely that over a 2-year period you
would return to your original weight.
Q: What should happen if I develop another illness?
A: A real advantage with the LAP-BAND® is its adjustability. If
you have some other illness that makes it inappropriate to have
restriction on food intake, then the fluid can easily be removed and
there would be very little limitation on nutrition. Once you have
recovered from the illness, even if you have put on weight, the
fluid can be added again and the original status can be restored.
Q: Can I burp with the LAP-BAND®?
A: Not so easily. As we eat we always swallow air and normally we
would bring this back up again quite unconsciously. The band
interferes with this easy bringing up of wind. It is common in the
first few weeks after the procedure for people to notice a
difference with bloating and the feeling that they want to burp but
cannot. This rarely seems to persist as a problem months later. We
presume that the stomach below the band changes its shape enough to
reduce the problem but for whatever reason it does not seem to
continue to be troublesome.
Q: How are the adjustments to the band done?
A: We generally will start tightening the band 4-6 weeks after
the initial operation. The adjustment is performed in the office at
the time of consultation. It does not require any anaesthetic. It
consists of passing a fine needle through the skin into the access
port. It only takes a few minutes to do and is not usually
associated with significant discomfort. If the port is difficult to
find, we will ask you to raise your legs and/or your head to make
your stomach muscles tight. This assists with locating the port. On
very rare occasions it will need to be performed in the radiology
department of the hospital where we can see more accurately where
the access port is. We will generally adjust the band
every two weeks until we feel that we have the right setting (in the
Green zone). This may take five-seven adjustments. Once the correct
setting is reached we would leave it at that level as long as the
rate of weight loss initially, and then the weight maintenance later
on, was satisfactory. Additional adjustments can occur whenever
necessary. When you reach the goal weight, we leave the setting at
that level so as to maintain that weight. If we reduced the setting
at this time you would expect to find an increase in your weight.
Note: There is a video on band adjustments under the Emergency Assistance for Medical Professionals button at the top of this page.
Q: Are the adjustments very painful?
A: No, they are not. Some people worry more about the adjustments
before they are done than they worried about the operation. Each
adjustment consists of a jab with a needle and then some mild
discomfort as we push on the access port. It usually only takes 2 or
3 minutes and doesn’t require any local anaesthetic. It would hurt
as much to have the local anaesthetic put in as it does to have the
whole adjustment. After you have your first adjustment you will be
reassured and no longer need to worry.
Q: What happens if I go overseas or to remote locations?
A: Generally there is no problem. You really don’t want to get
into any difficulties while away and therefore you have to be doubly
careful to follow the rules regarding the type of food you eat. Take
some information with you (like the LAP-BAND® Solution book), and
should you need any medical care while travelling, give the
physicians where you are as much of the information that they would
need to understand what has been done. We would hope that they would
telephone us and discuss the problem before they interfered in any
way with the device.
Q: Is airplane travel a problem?
A: Sometimes
it can be more difficult to eat when flying. There are often
little bubbles of air in the balloon of the LAP-BAND®. We try to
flush these out when we initially prime the band but we cannot clear
them all. Generally they don’t matter. However, when you are at
35,000 feet in a plane with a partially pressurised cabin, these
bubbles may expand enough to make the band tighter. You may find
that you have difficulty with solid foods and even with liquids. If
so, just relax and enjoy the trip. Watch the movie instead of having
lunch. When you return to ground level, the bubbles will shrink down
and you will be back to normal.
Q: How much weight will I lose with the LAP-BAND®?
A: Weight-loss results vary from patient to patient, and the
amount of weight you lose depends on several things. The band needs
to be in the right position, and you need to be committed to your
new lifestyle and eating habits. Obesity surgery is not a miracle
cure, and the kilos will not come off by themselves. It is very
important to set achievable weight loss goals from the beginning. A
weight loss of 0.5-1 kilo a week in the first year after the
operation is possible, but 0.5 kg is more likely. Twelve to eighteen
months after the operation, weekly weight loss is usually less.
Remember that you should lose weight gradually. Losing weight too
quickly creates a health risk and can lead to a number of problems.
The main goal is to have weight loss that prevents, improves or
resolves health problems connected to severe obesity.
Q: Does the LAP-BAND® limit any physical activity?
A: The LAP-BAND® does not hamper physical activity including
aerobics, stretching and strenuous exercise. Occasionally you may
feel tenderness at the port site if you continually stretch the
abdominal muscles, but this resolves when the exercise is complete
and doesn’t cause any on-going problems.
Q: Is it true that the LAP-BAND® seems “tighter” in the morning?
A:
This is a fairly common feeling, especially for people with
bands that are tight or just after an adjustment. During the day,
water content in the body changes and this may cause the band to
feel “tighter” some of the time. Some women have also noticed that
the band feels tighter during menstruation.
Q: Will I feel hungry or deprived with the LAP-BAND®?
A: The LAP-BAND® makes you eat less and feel full in two ways-
first, by reducing the capacity of your stomach and second, by
increasing the time it takes food to get through the digestive
system. After a small meal, the amount of which varies from person
to person, you should feel full. If you follow the nutrition
guidelines when you choose your food and then chew it well, you
should not feel hungry or deprived. Remember the LAP-BAND® is a tool
to help you change your eating habits.
Q: Can I eat anything in moderation?
A: After your stomach has healed, you may eat most foods that
don’t cause you discomfort. (For example, dough products such as
breads, and some meat may be difficult) However, because you can
only eat a little it is important to include foods full of vitamins
and nutrients such as those recommended by your nutritionist and as
advised by your surgeon. If you eat foods that contain lots of sugar
and fat, or drink liquids full of “empty” calories, such as
milkshakes, the effect of the LAP-BAND® may be greatly reduced or
even cancelled.
* The LAP-BAND FAQ's are taken from "The LAP-BandTM Solution: A Partnership For Weight Loss" by Paul O'Brien
Post-op Bypass Questions
Q: What supplements do I need to take after gastric bypass
surgery?
A: At your 6 weeks appointment, you will be started on a
Multivitamin, Ferrograd-folic (iron and folic acid) and Calcium, to
be taken every day, unless there are any contra-indications. We also
recommend vitamin B12 drops/dots/nuggets on a daily basis and this
can be started following discharge from hospital.
Q: I am struggling to take the Calcium Pill, is there an
alternative?
A: There is an alternative supplement for Calcium that can be
taken in a chewable form or in a less pleasant tasting dissolvable
form. If you would like this option then we will fax/post out a
script for you.
Q: I need a new script for my supplements?
A: Phone the clinic and we can organise a script for your
supplements. Once the surgeon has signed it then we will fax/post
out as requested. The supplements can also be arranged by your GP
and are cheaper that way
Q: I am getting Reflux, what can I do?
A: We will ask the surgeon for a script for some Losec and
fax/post out as requested. Please let us know if this has improved
your reflux, or if the problem continues. Please contact us, if the
problem does not resolve.
Q: How much are the scripts?
A: A script from us, as a specialist, costs $3 with a Community
services card, or if without, then up to $15 per item. All our
scripts from the GP would cost $3 an item.