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| How does Dr.
Warnock's mortality rate compare with
the national mortality rate? |
| The national mortality
rate is reported to be about 1 in
300, but Dr. Warnock's mortality rate
is less than 1 in 1000 gratefully. |
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| How long has
Dr. Warnock been doing bariatric surgery? |
| Dr. Warnock has been
performing bariatric surgery for over
25 years. |
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| What are the
most serious complications of bariatric
surgery? |
| All major surgeries
have certain common potential complications
whether it be bleeding, infection,
or injury to internal organs. The
most serious complications specific
to Gastric Bypass procedures include
leakage and peritonitis. When the
intestines are sewn together, this
connection normally heals quickly.
If not, a leak of intestinal contents
can occur, and this can cause peritonitis
and possible death. This happens to
be the most common cause of death
in bariatric patients nationwide and
is more common when the surgery is
done laparoscopically. |
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| Will I need
a blood transfusion during surgery? |
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Unless a patient has severe complications
during surgery, which is very rare,
blood transfusions are not needed.
You will be asked to sign a consent
should a blood transfusion be necessary.
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| After I recover
from surgery, what pain relievers
can I take? |
| Aspirin and ibuprofen
(i.e. Advil, Motrin) can cause ulcer
or gastritis in the bariatric pouch,
thus patients are advised to take
acetaminophen (Tylenol) gel caps. |
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| After surgery,
how much protein do I need to be getting? |
| The amount of daily
protein recommended for each patient
varies depending on height and activity
level. Dr. Warnock advises each patient
regarding protein on an individual
basis. |
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| How do I obtain
authorization for my consultation
to be covered by my insurance? |
| Please contact your
insurance provider by calling the
customer service number on your insurance
card for information regarding authorization. |
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| How do I begin
my insurance approval process for
surgery? |
As you complete the requirements on the Getting Started checklist, our bariatric team will check to make sure bariatric surgery is a benefit on your policy. After the initial consultation, our bariatric team will start the process for prior authorization for surgery with your insurance provider. Most patients will need a copy of their medical records from their primary care provider at this point. If possible, please bring your medical records to your first consultation.
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| What are my
co-pays? |
| Your co-pay for office
visits or specialist care is your
financial obligation for any consultation
appointment as listed on your health
insurance card. It is expected that
you will pay your co-pay at the time
of your visit. To find out about your
co-pay for surgery, you will need
to contact your insurance provider
by calling the customer service number
on your insurance card. |
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| Does insurance
usually cover bariatric surgery? |
| Presently, many insurance companies will cover Gastric Bypass and Lap Band surgery. |
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| What can I
do to get bariatric surgery-my insurance
won't pay for it? |
Unfortunately, many insurance companies do not pay for bariatric surgery of any type and some patients do not have insurance. Gratefully, there are other alternatives. Some individuals have chosen to use a portion of their retirement while others have taken out a home equity loan. Another option is a financing package that we have arranged specifically for our bariatric patients at very favorable rates. Many patients say what they save each month in medications and expenses equals what their monthly payments are for financing. Patients frequently tell us that if they had to choose between a new car and a new life, they would certainly prefer a new life. |
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| How long does
the Lap Band surgery take? |
| It generally takes
Dr. Warnock approximately 1 hour to
perform this operation. Hospitalization
is usually less than 24 hours. |
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| What dietary
guidelines are most important to the
success of my surgery? |
| All patients are instructed
as to the specific dietary guidelines
that will help them be successful
long term. There are some foods that
may predispose to blocking the stomach
pouch, other foods move through the
pouch too quickly, and fluid intake
during meals decreases satiety. Patients
are advised in each of these categories
and strongly encouraged to comply. |
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| Should I take
a vitamin supplement? |
| Yes. You may well be
taking sufficient vitamins within
your 3 small daily meals, 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 folate and
iron. |
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| How soon can
I return to work? |
| Most patients are able
to return to work within a week. How
soon you return to work depends on
the nature of your work and how quickly
you recover, which varies considerably
among patients. Ultimately, Dr. Warnock
leaves it up to the discretion of
the patient as to when to return to
work. Most patients can expect to
enjoy a much more active and better
quality of life than they have had
in many years. |
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| How is the
band adjusted and how frequently? |
| Saline is injected
or withdrawn from the Lap Band through
a fine needle passed into the port
under the skin near the belly button.
This usually takes just a few minutes
and most patients say it is not painful.
Patients follow-up for evaluation
every month. |
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| Does the Lap
Band seem tighter in the morning? |
| Patients report this
being a common feeling, especially
right after an adjustment. Additionally,
the water content in the body fluctuates
and can be decreased first thing in
the morning after not drinking all
night. It is helpful to start the
morning by drinking 1-2 glasses of
water before trying to eat any solids. |
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| How much weight
will I lose? |
| All of the patients
are variable in their weight loss.
It depends on how large they were
prior to the surgery and how faithful
they are to the guidelines we give
them, including engaging in an exercise
program afterward. On average, weight
loss is 0.5-2 pounds per week during
the first year post-op. The goal is
to achieve weight loss slowly over
an 18-24 month period. Published reports
show long-term sustained weight loss
around 40-60%. |
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| What if I
hit a wall in my weight loss progress? |
| For Lap Band patients,
this can be an indication that another
fill is needed to tighten the band.
Some patients stop losing weight before
they have reached their desired goal
because of non-compliance in how and
what they are eating. This is one
of the reasons why Dr. Warnock likes
to follow patients carefully. If you
are having any problem, then you need
to come in and see him. |
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| What about
pregnancy after surgery? |
| Previously infertile
women might more easily become pregnant
following surgery and weight loss.
In anticipation of pregnancy, getting
proper nutrition and vitamins (especially
folate) is essential even before pregnancy
occurs and certainly during pregnancy.
Patients should notify Dr. Warnock
as well as their obstetrician as soon
as they do become pregnant. If you
need to eat more while you are pregnant,
the band can be loosened. Then after
pregnancy, it can be tightened again
to resume weight loss. |
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| Is the surgery
reversible? |
| Yes. If there is a
problem with the band, if you simply
cannot tolerate the band, or if you
cannot adjust to the new eating habits,
Dr. Warnock may recommend removal
of the band. After band removal, the
stomach usually returns to its original
shape and normal function. However,
your weight will most likely increase. |
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| How long does
the Roux-en-Y surgery take? |
| It generally takes
Dr. Warnock approximately 45 minutes
to perform this operation, however,
most surgeons may take 3 to 4 hours
or longer. Hospitalization is usually
1-2 days. |
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| What is "dumping
syndrome?" |
| Dumping is a physiologic
response that can occur after Roux-en-Y
Gastric Bypass surgery due to the
change in the connections of the intestine.
It occurs when patients eat something
that is too fatty or greasy and will
result in abdominal cramping, nausea,
and sometimes vomiting. The symptoms
of dumping are very obvious. |
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| What dietary
guidelines are most important to the
success of my surgery? |
| All patients are instructed
as to the specific dietary guidelines
that will help them be successful
long term. There are some foods that
may predispose to stretching of the
pouch, there are other foods that
may predispose to obstructing the
pouch, some foods may interfere with
appropriate absorption of nutrients
or vitamins, and other foods predispose
to gastritis and ulcers. Patients
are advised in each of these categories
and strongly encouraged to comply. |
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| Since my food
intake will be greatly limited after
surgery, do I need supplements to
help avoid long-term problems? |
| All Gastric Bypass
patients have to take supplements
such as vitamins and protein supplements
for the rest of their lives and are
required to have annual follow-ups
and labs done. |
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| How soon can
I return to work? |
| Many of Dr. Warnock's
patients are able to return to work
within 10 days to 2 weeks, and once
they have fully recovered there are
no restrictions. How soon you return
to work depends on the nature of your
work and how quickly you recover,
which varies considerably among patients.
Ultimately, Dr. Warnock leaves it
up to the discretion of the patient
as to when to return to work. Most
patients can expect to enjoy a much
more active and better quality of
life than they have had in many years. |
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| How much weight
will I lose? |
| All of the patients
are variable in their weight loss.
It depends on how large they were
prior to the surgery and how faithful
they are to the guidelines we give
them, including engaging in an exercise
program afterward. Studies show that
most patients lose at least 50% of
their excess weight in the first 2
years. Published reports show long-term
sustained weight loss around 75-80%. |
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| What if I
hit a wall in my weight loss progress? |
| Some patients stop
losing weight before they have reached
their desired goal because of non-compliance
in how and what they are eating. This
is one of the reasons why Dr. Warnock
likes to follow these patients carefully.
If you are having any problem, then
you need to come in and see him. |
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| What if I
have difficulty with constipation
after surgery? |
Constipation is a frequent
side effect of Gastric Bypass. Dr.
Warnock always recommends 4 steps
for this problem, including:
1) Drink more fluids.
2) Consume more fiber, such as Benefiber, Fibercon
tablets, Raisin Bran or
dried fruit.
3) Take a stool softener daily and
avoid laxatives.
4) If necessary, Miralax can be prescribed.
This is a complex sugar mixed with
water that is not digested nor absorbed.
It is not a laxative. |
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| What about alcohol? |
| Due to the changed anatomy
of the stomach and intestines and the alterations
in digestion, alcohol absorption is much
more rapid in Gastric Bypass patients. This
results in as much as a 50% higher blood
alcohol level with a much quicker peak (10
minutes) even after just 1 drink. The majority
of patients claim they can "feel"
the effects of alcohol after having just
a few sips of a drink. Such effects can
have serious ramifications in driving a
car or performing other skilled or hazardous
tasks that can jeopardize the safety of
individuals. It may also predispose to gastritis and ulcers. Patient are strongly encouraged
to abstain from alcohol. |
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| What about pregnancy
after surgery? |
| It is strongly recommended
that birth control be used for at least
the first year following bariatric Gastric
Bypass, especially since previously infertile
women might more easily become pregnant
following surgery and weight loss. In anticipation
of pregnancy, taking needed supplements
for protein, folate, calcium, zinc, iron,
and vitamin B12 at all times is essential
even before pregnancy occurs and certainly
during pregnancy. Patients should notify
Dr. Warnock as well as their obstetrician
as soon as they do become pregnant. |
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A lot of experience and research has
shown that patients who have had bariatric
surgery are generally able to have a much
safer and easier pregnancy than before
surgery. Patients are generally able to
get pregnant more easily, but are much
less likely to have problems with high
blood pressure, leg swelling, diabetes,
and even complications at delivery. However,
patients are advised to speak with Dr.
Warnock personally about all of these
issues.
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| Is the surgery reversible? |
| The surgery under most circumstances
is reversible. |
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