This is What Happens at the Pre-Op Consult for Bariatric Surgery

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Bariatric surgery wasn’t real until I had my pre-op consult for bariatric surgery. I mean, I knew I was working towards surgery, but until this appointment, it didn’t feel real. I was nearing the peak of my journey but still had a few things to do. At this visit, you’ll review your medical and surgical history with your surgeon. He or she will order final pre-op testing. They will give you instructions for the pre-op and post-op diets, as well as sign consent forms for surgery. It’s a really exciting and nerve-wracking appointment, but it’s also one of the final opportunities you have to ask questions before surgery. Come prepared with your last-minute questions. Everything becomes real at this appointment. The pre-op consult for bariatric surgery is one of your last appointments and reviews final instructions for before and after surgery.

It’s the Final Countdown

The pre-op consult for bariatric surgery happens a few weeks before surgery. At this point, you’ll already have completed your pre-op clearances, like cardiology and pulmonology, as well as had some pre-op testing, like a sleep study and an upper endoscopy. You’ll have satisfied your surgeon’s requirements for surgery and have already received authorization from your insurance for surgery. Your surgery date may have already been selected, and the final countdown to surgery is on!

It’s an exciting time but also a scary time. You’ll probably still have some final questions for your surgeon. One of the things I did for this appointment was to write down my questions before the appointment. I knew that my nerves and excitement would soon take over, and I’d forget what I wanted to ask. I felt satisfied that I was ready for surgery because I prepared this list of questions beforehand. Also, I can remember feeling proud of all I had accomplished to this point but nervous for the journey ahead. It’s completely normal to feel this way!

Reviewing Medical Histories

I hope I can help relieve some of your nervousness for your pre-op consult for bariatric surgery by explaining to you what happened at my appointment. Each physician and hospital is different, so it may not go exactly how mine went. However, my experience should give you a good idea of what to expect at your pre-op consult appointment. After the formalities of any doctor’s appointment are over, like height, weight and vital checks, you’ll have a discussion with your doctor about surgery.

One of the first things you may discuss is your medical history and current medical problems, particularly those associated with obesity. For me, it was polycystic ovarian syndrome, obstructive sleep apnea, hypertension, pre-diabetes and acid reflux. You’ll also discuss your surgical histories and if there were any complications from those surgeries. Before my bariatric surgery, I had two upper endoscopies, a right ovarian cystectomy and my tonsils and adenoids removed. I had no issues with the surgeries. Your doctor just wants to be prepared for when he operates on you. He does not want any last surprises before he surgically alters your body.

Pre-Op Diet and Instructions

After your surgeon has all the information he needs to proceed with surgery, he’ll review your pre-op diet and instructions with you again. You’ll most likely review the requirements for your liver-reducing diet. You need to be able to follow the plan exactly as your surgeon tells you. If you don’t, you risk your surgery being canceled because your liver did not shrink enough to operate. Make sure you fully understand what is required of the liver-reducing diet and ask any remaining questions you may have.

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Your surgeon may also give you instructions on what medications you can take during the pre-op liquid diet, as well as what you can’t take. For me, I wasn’t allowed any NSAIDs or blood-thinning products for five days before surgery. I was only allowed to use Tylenol for pain relief. Additionally, the doctor’s office gave me a bottle of Hibiclens and instructed me to scrub my body from my chest to the pubic area in the morning the day before surgery. I could only have clear liquids that day. I then had to scrub my body again with the Hibiclens before bed. This helps reduce infection rates. Follow your doctor’s advice for your skin and medication prep.

Post-Op Diet and Instructions

As part of my bariatric surgery requirements, I had to take six nutrition classes. In one class, we discussed the post-op progressive diet, from clear liquids to solid foods. At my pre-op consult for bariatric surgery, we reviewed the post-op diet to make sure I clearly understood his instructions. My post-op diet was the following:

• First Stage–Surgery-5 Days Post-Op: Clear Liquids Only
• Second Stage–Days 6-19: Full Liquids
• Third Stage–Days 20-33: Blended/Pureed Foods
• Fourth Stage–Days 34-60: Soft Foods
• Fifth Stage–Days 61+: Regular Bariatric Diet

Your post-op diet may differ, so always follow the instructions set forth by your surgeon. He also informed me about what medications I’ll need to take after surgery, things like Carafate to help heal my stomach and Dulcolax for constipation. We also discussed what pain medication I will be taking and how to take it safely. He also told me about walking and using my incentive spirometer to ensure I don’t get blood clots after surgery. Your doctor may give you similar advice, so make sure that you follow what they tell you exactly.

Final Surgery Review

At the pre-op consult for bariatric surgery, your doctor will go over the risks, benefits and possible complications of surgery. This part of the appointment isn’t to scare you from surgery. Rather, this part of the appointment is to make sure that you are fully aware of what could happen after surgery. Remember, all surgical procedures carry risks. Bariatric surgery is as safe as having your gallbladder removed or hip replaced.

But, there are some risks to surgery, and your surgeon will want to make sure you understand all risks. There are so many benefits to bariatric surgery, that if you’re like me, you’ll realize that the benefits outweigh the risk. I knew that death was a possibility, and I thought that I was either going to die trying to make a positive change in my life or die because I ate myself to death. I chose to make a positive change, and it was one of the best decisions I have ever made. Once you understand all risks, complications and benefits, the surgeon will have you sign a consent form for surgery.

Final Pre-Op Testing

You may feel like you’ve already been put through the wringer with all of your pre-op testing and appointments. However, you’ll need some final testing before surgery. My doctor ordered a pre-op exam with my primary care physician. Since bariatric surgery is a multi-disciplinary approach, he wanted final clearance from my primary care doctor.

My surgeon also ordered final blood work for me, including a complete blood count and a comprehensive metabolic panel. He wanted to make sure I wasn’t at any deficiency before surgery that could put me at a greater risk for post-op complications. He also ordered a final EKG to make sure there weren’t any issues that popped up with my heart during this time. Luckily, all systems were good, and I could proceed with surgery. Your doctor may order some additional testing or maybe not even order everything my doctor ordered. Just do whatever the doctor instructs you to do so that you can ensure you’re ready for surgery.

Pre-Op Consult for Bariatric Surgery

If you’ve made it to your pre-op consult for bariatric surgery, congratulations! It won’t be long now until your joining us on the loser’s bench! After reviewing your medical and surgical histories, the surgeon will explain the risks, benefits and complications of surgery. The doctor gives you final pre-op and post-op instructions. You’ll also sign consent forms. You’ll have a few final tasks to complete, like blood work and an EKG. Otherwise, you’ll be ready for surgery in a few weeks. The pre-op consult for bariatric surgery is one of your last appointments and review final instructions before and after surgery.

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