Lebanon: Steps Before Surgery
Once you have attended an introductory session, you can begin the next steps before surgery:
- Worksheets, registration, medical records and required education - There are necessary tasks and paperwork to complete such as medical records, insurance forms, test results and registration.
- Appointments - There are two appointments before surgery where you will have an opportunity to meet with your surgeon and care team to ask questions.
- Preparing for surgery - Getting your surgery date scheduled, attending pre-surgery class and learning about the day before and day of surgery
Worksheets, registration and education
Complete initial medical and insurance worksheets
Your primary care provider will need to complete a 'Start Weight' form for you. You will need to complete a sleep apnea form and insurance worksheet. All of these forms can be found in the folder you receive at the introductory session.
Checklist for medical records and your requirements
Your care providers will need to complete:
- Medical records from your providers including a physical exam, a letter from your PCP and two psychological evaluations (at least 30 days apart).
- Test results - blood tests, sleep apnea evaluation, any other tests you have had recently.
- Other tests (as needed) may include a sleep study, stress test, upper endoscopy or cardiac echogram. Your care team will determine which test will be needed for your individual plan
You will need to complete:
- 7-day food journal
- Dieting history
- Medication log
- Signed patient agreement
- Weight chart
We highly encourage you to watch these educational videos as part of your introduction to the bariatric surgery process.
- Introduction to Bariatric Surgery at Dartmouth-Hitchcock
- Who is a candidate for weight loss surgery? This video discusses the criteria used to determine whether you might be a candidate for surgery. The video also discusses the differences between the types of bariatric surgery and returning to normal activities after surgery.
- Bariatric Surgery as a tool for weightloss. Our nutritionist discusses the pre-operation diet and nutrition requirements leading up to surgery.
- How safe is bariatric surgery? Dr. Billmeier discusses the benefits, risks, and some of the short- and long-term complications of bariatric surgery.
New patient appointment - Your first new patient appointment will be 2 hours long. You will be scheduled with the either the surgeon or the nurse practitioner and the dietician. Your previous dieting history, current dietary and lifestyle changes, as well as your medical and surgical history will be reviewed. Additional testing will be recommended, if needed.
Second appointment (shared medical appointment) - Your second clinical appointment will be with the bariatric nurse practitioner and dietician. This will be a shared medical appointment where you and your support person will be here for approximately 2 hours. You and up to 8 other patients will learn about the pre- and post-surgical diet as well as risks and benefits of your surgical options.
Preparing for surgery
Surgery date - After your first shared medical appointment most people will schedule surgery date.
DHMC Patient Access Department will contact your insurance company to obtain insurance authorization for your surgery. They will contact you if there is a problem or a denial from your insurance company.
Pre-surgery class - Once your surgery is scheduled, you will attend a 2-hour pre-surgery class. At this class, you review supplements, diet after surgery and what to expect during your hospital stay. You must attend a pre-surgery class within 30 days but not less than 14 days prior to surgery.
Day before surgery - On the evening before your surgery, you will need to stop eating and drinking completely as instructed by the preoperative nurse that calls you the evening before surgery. This is to make sure your stomach is empty. If you take either prescription or over-the-counter medications, including vitamins and natural supplements, you may need to stop taking your pills before your operation.
Day of surgery - You will meet with your surgeon and anesthesia provider and one of the nurses that will be with you during your bariatric procedure. We will start an intravenous (IV) so that it’s ready to deliver sedation during your operation. You can have a friend or family member keep you company in the pre-op area.
Afterwards, you will be escorted to the surgical suite where your procedure will take place. You can expect to spend about one to three hours in surgery. You'll be asleep for most of this time.
Support groups - we have support groups that meet regularly to discuss all aspects of life after surgery.