Questions to ask at the consultation

[joe7777 1]

I am having 2 consultations in about a week. One phone, one in person. What should i ask to be sure i am going to choose the right place?

Things such as:

How many theyve done, complications, stats? Pre-op diets, post-op stuff.....what would you say is a good question to ask, obvious questions and also something weird or obscure that would be good to ask.

Just trying to be as prepared as possible

Thanks!

[Donna D 1]

Ditto for me Rob

[faithmd 14]

Welcome to LBT! Take a while, look around. There is a forum that has just the questions you are looking for, here's the link, but you can find it on the main page under Lapband FAQ's and References.

http://www.lapbandtalk.com/lap-band-faqs-f73.html

Here's a list I took with me:

Questions to ask during consultation:

2) Research the doctor.

What kind of follow up care is provided? (ie: fills, unfills, endoscopies, fluroscopies, port revisions, removal, etc).

Ask to speak to about 5 or 6 of his patients before you make a decision. Ask those people if they have any complaints or issues with their care before, during and after the procedure.

How many of the procedures has he done?

What types of complications can occur from this procedure and how frequently do they happen? (ie: perforations, etc)

What types of complications has he personally ran into doing this procedure?

What is his policy when a complication occurs during a procedure? (ie: does he discuss options with family or immediately convert to bypass or other WLS).

Is he Inamed approved for the procedure? If not then who qualified him to perform the procedure and can you have literature to verify this?

3) Research the procedure.

How is the procedure performed? Will you use the Pars Flaccida approach?

What type of sutures do you use? Can I request glue and not staples?

Will I have a catheter placed?

If I am on my menses, can I wear a tampon?

What will I need to have prepared when I get home in way of food items?

What are the short term issues?

What are the long term issues?

How will I be able to take my pills?

Will you write today for liquid pain meds?

Do you want me to take antibiotics post-op? If so, will you write for Diflucan?

4) Follow up care.

What is the schedule for fills?

When can I get my first fill?

How is the fill procedure performed? (ie: with or without fluroscopy)

What is the cost for fills? (under fluro and not)

How often will I need to be seen?

Will I have access to a Nutritionist?

How do you handle unfills?

Is there a direct line in case of Emergencies?

Does your doctor have email address?

Should I continue to take Metformin?

What Vitamins should I be taking?

Will I need to crush my pills? If so then for how long? Are there any pills that cannot be crushed? If so then how will I be able to take them?

[argon 3]

I found these in another post, and I think almost all of them would be good. Hope they help!

Questions about surgery

About the surgery

What is the exact name of the surgery and how is it done? Write down the name if you don't think you will remember it.

Why do you need the surgery?

Will you be able to go home the same day of the surgery (outpatient surgery)? If so, will you need to have someone take you home after the surgery?

Does the surgery require an overnight stay in the hospital (inpatient surgery)? If so, how long will you be in the hospital?

What will you need to do to prepare for the surgery?

What are the risks and benefits?

How often is this surgery successful? What does a successful outcome mean?

What can you do to improve the likelihood of success (such as changing your diet or beginning certain exercises)?

What is the risk of death or disability?

What is the next step if the surgery fails?

What is the likelihood that your problem will return after surgery?

What kind of anesthesia will be used (local, regional, or general)?

How long will the procedure take?

What is the cost of the surgery? Is it likely to be covered by medical insurance?

About your surgeon

What is the surgeon's experience with this procedure? How many procedures has he or she done per year? What is his or her success rate?

Does the surgeon have board certification in this area?

Will another doctor be assisting your surgeon?

Will the surgeon be using a new instrument or piece of equipment during the procedure? Has the surgeon been fully trained in the use of the instrument or equipment?

Who will be giving the anesthesia? Discuss the anesthesia options with your surgeon ahead of time.

Will anyone be in the operating room other than the doctors and nurses needed to perform the surgery (such as a person involved in training the surgeon on a new piece of equipment)?

About your recovery

What should you expect during the recovery period? What is normal?

What kinds of self-care could you be doing to help your recovery?

Will your activities be limited during the recovery period? If so, which activities and for how long?

What help might you need while you recover?

What symptoms should you call your doctor about?

Partnering with your doctor

Tell your doctor your preferences for treatment. Are there other options you would like to consider other than surgery?

Discuss your biggest concerns about the surgery.

Tell your doctor the results you expect to get from the surgery. What outcome would you consider to be a success? What would you consider a failure?

[argon 3]

oh faith... one second earlier and I would have beat you!

[faithmd 14]

Here's the list I took to the Bariatric Surgery information session, there's a few that are the same, but some that are different:

Pre-op Questions

1. Does the surgery require an overnight stay in the hospital (inpatient surgery)? If so, how long will you be in the hospital?

1. What are the hospital visiting hours?

1. What will I need to do to prepare for the surgery?
   
2. Do I need ABG? Why?
   
3. Upper GI?
   
4. ECHO or EKG? (last Echo in August; EKG/Stress Test in January)
   
5. PFT?

1. Can I buy my own pre-op diet? Do you require it?

1. How many bands have you done?

1. What is your rate of erosion/slippage/revision?

1. What size band do you usually put in? 4cc or 9cc or 10cc Vanguard? How do you decide?

1. Where do you place the port? Can I mark my skin where my waistband and bra sit?

1. What is the follow up care like? How often do I come in for follow-ups?

1. Who decides on the fills, doctor, nutritionist or me? Are they done under fluoro? Who does them? What is the cost for fills?

1. How many of the staff have the band, how many have had any weight loss surgery?

1. What is the “success” rate and what does “success” mean?

1. Is there a resident involved, or is there teaching during the case?

1. Can I use my own psych? Nutritionist?

1. How long do you have patients on clears, then creamy, then mushies post-op? Do you have an office visit before advancing?

[faithmd 14]

And here's the last few for the surgeon:

What are the chances of infection? Does an occurrence of infection always mean the band must be removed?

How often do your patients need their band removed (or any other additional surgical procedures)?

Since I carry a lot of weight in my abdomen, does that increase the complexity or risk of complications with a laparoscopic procedure?

Does my abdominal fat increase my chance of needing fat pads removed from my stomach?

Does that have any risks associated with it?

What are the chances I will need my gall bladder removed? Is there anything I can do dietary-wise to reduce the risk of gall stones?

[faithmd 14]

oh faith... one second earlier and I would have beat you!

Great minds think alike!

[Donna D 1]

Wow ladies your lists are fantastic. I really appreciate these.

I am off for the nite. Thanks again, D

[susieq321 31]

I would make sure I am confy with the clinic and the surgeons I choose first and foremost

I would ask how many bands have they done?

what types of bands they use (yes this does matter different body types work better with different bands)

how many complications they have seen (ask for a percentage the more bands someone has done the more complications they have seen)

What type of complications have they seen (disconnects, slips, erosions etc)

If you have a complications what is the procedure? Who pays?

If the band fails or you have an issue/reaction to the band what happens to you? (there have been some reactions to the materials of the bands themselves very very rare but happens) so what else can that surgeon do for you do they offer other types of WLS or only the band. (I can think of one person I know who had an allergic reaction had the band out her surgeon only did banding he refunded 1/3 of her money and said he would help her with other alternatives and she never heard from him again)

What type of pre-op diet do they have you do

What is your post-op routine?

What is their post op support for patients (do they offer seminars, counselling, online support groups, dieticians, nutritionists, fitness etc etc)

Are any of their staff banded? I find this helps in having people who understand where you are and when you have an issue they get it.

What is their typical fill routine? (does the nurse ask how you are doing, what you are doing etc?)

Again remember this relationship isn't just one surgery it is a lifetime relationship. You will need fills, defills, support etc. I am 5 years + out and I was at my surgeons office yesterday for a small de-fill, I am not there often but I still get them.

[Donna D 1]

Lappers -When you have done your consults and asked all these questions was the surgeon uncomfortable with sooo many questions or happy to do it. I know it should be the latter but just checking.

[faithmd 14]

I could care less if he is uncomfortable. If he is, then I would probably rethink choosing that surgeon. Asking him his statistics is the bare minimum we should do to protect ourselves as clients. Remember, you are hiring him to work on your most valuable and precious asset, YOU! Would you think twice about rigorously interviewing someone who is going to remodel your home? And if they got squirrley during that interview, what would you do? You wouldn't hire that contractor, right?

But no, I have yet to encounter a GOOD surgeon who isn't happy to answer these questions. The only caveat I have for you is that sometimes they are very short or quick with you. Do not mistake that for not being comfortable. They are taught from day one to keep moving, time is money and lives. But do not be afraid to tell them up front that you have quite a few questions, that way they are prepared for it.

Good luck!

[Donna D 1]

Thanks Faith, you guys really are a great source of education and support. I am so looking forward to a new me.

[joe7777 1]

Thanks everyone for answering very thoroughly. It will help greatly, and will hopefully make my decision easier, and i will know what i need to know at the consultation rather than think about something i wanted to ask when its over. Thank you.

[Donna D 1]

Robgoblin - I answered on another thread about the consult today at TCC, but I forgot to mention that this Lori said there was no pre op diet. I am taking everything she said with a grain of salt cuz I don't think she knows much. She did say that Dr.T was head of surgery at Credit Valley Hospital and that he had done many of these surgeries. I will be away on vacation from April 5 to 12 and told her that I needed my appt for after that. I will post as soon as I have been. Good luck at your appt.