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Bariatric Surgery Process: Before, During and After Surgery


Before Bariatric Surgery

Bariatric surgery is a life-changing decision. Review the criteria for becoming a bariatric patient to learn if surgery is right for you.

  1. You must have a Body Mass Index (BMI) of 40 or greater.
  2. If your BMI is between 35-40, then you must have at least one significant co-morbidity (serious medical problem). Individuals with a BMI of 30 - 35 with at least one significant co-morbidity qualify for the LAP-BAND® Adjustable Gastric Banding System, BMI of 30-40 for Intragastric Balloon.
  3. Most patients are between the ages of 18 and 65 years old, but consideration for surgical treatment of morbid obesity is not based on age alone.
  4. You must not have any severe psycho-emotional or medical problems that would make surgery unnecessarily risky.
  5. You must not be drug or alcohol dependent, and if you have a history of such, you must be well into a qualified treatment program with at least one year of sobriety.
  6. You must be willing to abstain from using alcohol.
  7. If you smoke, you must stop at least three months before surgery, and quit smoking forever.
  8. You must have healthy teeth, in order to grind your food properly. If you are missing multiple molar teeth, we strongly encourage you to see your dentist to evaluate methods to address this problem.
  9. You must have an ongoing commitment to follow the nutrition, exercise, medication and laboratory protocols provided.
  10. You must have an ongoing commitment to attend face-to-face support group meetings on a regular basis and/or participate in our online support group via Facebook.
  11. You must make an ongoing commitment to return to the office for follow-up appointments.

Calculate your BMI now!



During Your Bariatric Surgery Procedure
Making an important decision to change your life can be difficult. Our program is designed to support you every step of the bariatric surgery process. Best of all, our program does not charge a program fee.

1. Research
We encourage you to learn as much as possible about your weight loss surgery process. The more informed you are, the better your outcome will be. 
2. Information Sessions for Bariatric Surgery
Our bariatric surgery patients are required to participate in a free information session before scheduling their initial consultation. These sessions are designed to introduce you to our program. You can attend an in-person session or participate online.   

Online Sessions
You may participate in the online session at any time. The online session lasts 35 minutes and you will be required to answer questions during the session so that we may ensure you have received the necessary information. 

Click here to start your online session. 

In-Person Sessions
Our friendly, in-person sessions are held on most 1st and 3rd Thursdays, 5:30 – 7:30 p.m. at Bon Secours St. Francis Hospital. To register or for more information, please call (843) 402-CARE or register online
3. Complete patient intake packet
During the session, you will be given a patient intake packet. Completed packets should be mailed, faxed or emailed to:

RSF Bariatric Surgery and Medical Weight Loss
2093 Henry Tecklenburg Drive, Suite 202 & 205 East
Charleston, SC 29414 
Fax: (843) 606-7996

Once we have received your completed packet, we will verify insurance, review your medical records and call you to schedule an appointment for an initial consultation.
4. Initial Consultation 
During the initial consultation, you will visit with Dr. Mitchell / Dr. Thomas to go over your medical history, surgery options and answer any questions. Based on your medical history, the surgeon will determine the tests and clearances needed to proceed with surgery. During the initial consultation, you will also meet with our Program Specialist who will help prepare you for surgery by scheduling all of your pre-operative tests and clearances (to examine the esophagus, stomach and part of the small intestine).
5. Pre-admission testing and teaching
Pre-operative tests and clearances may include a sleep study, EKG, chest x-ray, lab work and consultation with an anesthesiologist. Each patient must have an evaluation by our clinical therapist and an EGD two weeks prior to surgery. In addition, each candidate is required to attend a mandatory patient education class.
6. Surgery All surgeries are performed at Bon Secours St. Francis Hospital. Bariatric surgery patients will stay on 5 SPCU, a dedicated bariatric surgery unit with specially trained nurses. The nurses will assist with your post-operative nutrition and exercise recommendations. (Take a virtual tour of the unit). The length of time you spend in the hospital will depend on which procedure you have: gastric bypass, adjustable gastric banding or sleeve gastrectomy. The intragastric balloon is an out-patient procedure.



Life After Bariatric Surgery
Your surgery is only one step in your weight loss surgery process. We want you to have excellent results and are committed to helping you achieve your goal of better health for a lifetime. 
The First Year Post Surgery
The first year after your surgery you will have monthly follow up appointments where we will monitor your progress and offer assistance. Occasionally, if you're doing well, your visits could possibly be lessened to every six weeks.

A typical first year follow up schedule for a patient is detailed below:

One Week After Bariatric Surgery
You will attend a one-week post operative nutritional class with other patients and the bariatric dietitian.

Two Weeks After Bariatric Surgery
You will be seen in the office for your first postoperative visit. Your wounds will be checked and any questions you have will be answered. If you are doing well, you will make the transition to the next phase of your diet. You will begin taking your life-long regimen of vitamin and mineral supplements.

Three Weeks After Bariatric Surgery
You will attend a three week post operative nutritional class with other patients and the bariatric dietitian.

Four Weeks After Bariatric Surgery
You will visit the office for a routine check-up to assess your dietary intake, determine how well your wounds are healing, obtain anthropometrics (body mass index, body weight, fat mass and fat free mass) and ask any questions you have. You may also see another member of the team such as a mental health provider, spiritual counselor or physical therapy, if warranted.   

Monthly Routine Post Bariatric Surgery
Each month, you will be seen for the general assessments described above. You will be given a prescription for blood tests to be performed two weeks prior to your six-month postoperative appointment. You may also be seen by other team members if it is advised by the nurse or doctor.

Six Months After Bariatric Surgery
Prior to this appointment, you must have the six-month series of blood tests at your primary care physician’s office or at your designated laboratory. Because there is a possibility of vitamin and mineral deficiencies and associated complications, such as anemia, you must have the following blood tests: Complete Blood Count (CBC), Complete Metabolic Panel (CMP), liver function tests and blood tests for measurements of certain vitamins, iron, and thyroid and parathyroid function. Your surgeon may add or delete certain tests as warranted on an individual basis.

If you do not have your labs completed prior to this appointment, you will be given a prescription for them at this time.

During the six-month visit, anthropometrics will be measured (body mass index, body weight, fat mass and fat free mass), and quality of life status and eating behaviors may be determined from standardized questionnaires. Furthermore, you will have dietary assessments and may be seen by nutrition or exercise professionals. Consultations with the behavioral health provider are optional and available.

One Year After Bariatric Surgery
Again, you will have the above mentioned labs conducted at this time. During the yearly visit, you will have a routine follow-up examination, measurement of anthropometrics, assessment of quality of life status and your picture will be taken. Dietary concerns will be addressed, as will optional consultations with the dietitian and behavioral health provider. 

Annual Lifetime Office Visits 
We need and want to see you annually. We are committed to your health and expect you to be dedicated to lifelong follow-up care. It is important that we help you keep track of your progress.

On-Going Support and Support Groups

Support Groups
We are here to assist you throughout your weight loss journey and encourage you to join our support group. It is helpful to share with others who are experiencing many of your same thoughts and feelings in a caring environment. Visit our calendar of events for detailed information on our support groups. Prospective and current patients and supporters are invited and encouraged to attend.
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