What are the standard pre-surgery examinations?

Before undergoing surgery, a series of essential tests are conducted to ensure a comprehensive evaluation of your health status. These include a Complete Blood Count (CBC), Urinalysis, and a Chemistry Panel, providing detailed information on approximately 20 blood chemistry values. Additionally, a Glucose Tolerance Test is often performed to assess the risk of diabetes, particularly in overweight individuals. All patients, excluding the very young, undergo a chest X-ray and an electrocardiogram. Women may undergo a vaginal ultrasound to detect abnormalities in the ovaries or uterus, while many surgeons recommend a gallbladder ultrasound to identify gallstones. Additional tests, such as pulmonary function testing, echocardiogram, sleep studies, gastrointestinal evaluation, cardiology assessment, or psychiatric evaluation, may be requested as deemed necessary.

What is the purpose of all these tests?

The primary goal is to conduct a thorough and accurate assessment of your health before surgery, aiming to prevent complications proactively. Specific attention is given to thyroid function, as inadequate function (hypothyroidism) can lead to post-operative sudden death. For diabetic individuals, special measures are taken to control blood sugar levels. Given the increased cardiac stress during surgery, a comprehensive heart evaluation is conducted. These tests aim to identify potential issues such as liver malfunction, breathing difficulties, excess fluid in tissues, abnormalities in salts or minerals in body fluids, and abnormal blood fat levels.

Why do I have to have a GI Evaluation?

Patients with significant gastrointestinal symptoms, such as upper abdominal pain, heartburn, or belching sour fluid, may have underlying issues like hiatal hernia, gastroesophageal reflux, or peptic ulcer. Symptoms like reflux may indicate early changes in the esophageal lining, affecting up to 15% of patients and potentially predisposing them to esophageal cancer. Identifying these changes is crucial for planning appropriate surveillance or treatment programs.

Why do I have to have a Sleep Study?

A sleep study is crucial for detecting a tendency for abnormal breathing cessation during sleep, often associated with airway blockage when muscles relax. This condition carries a high mortality rate. Post-surgery, sedation and pain medications further depress normal breathing and reflexes, making airway blockage more dangerous. Understanding and preparing for these dynamics are essential for a safe recovery.

Why do I have to have a Psychiatric Evaluation?

A psychiatric evaluation is commonly ordered by insurance companies to assess your understanding of the risks and complications associated with weight loss surgery and your ability to adhere to the basic recovery plan.

What impact do my medical problems have on the decision for surgery, and how do the medical problems affect risk?

Serious heart or lung problems can increase the risk of any surgery. However, if these problems are weight-related, they may also heighten the necessity for surgery. Severe medical conditions may not necessarily deter a surgeon from recommending gastric bypass surgery if it is otherwise appropriate, but they do elevate the patient’s risk level.

If I want to undergo gastric bypass, how long do I have to wait?

New evaluation appointments are typically scheduled 4-8 months in advance. Once seen, if both the surgeon and patient agree on the appropriateness of the procedure, the operation can usually be scheduled within 8 weeks. This wait time is attributed to the higher demand for weight loss surgery compared to the availability of qualified bariatric surgeons.

What can I do before the appointment to speed up the process of getting ready for surgery?

To expedite the preparation process for surgery, take the following steps:

1. Select a primary care physician if you don’t already have one and establish a relationship.
2. Collaborate with your physician to ensure routine health maintenance testing is up to date, including pap smears for women, breast exams for those over 40, and prostate-specific antigen tests (PSA) for men.
3. Compile a comprehensive list of diets you have tried (a diet history) and share it with your doctor.
4. Bring any relevant medical data to your appointment, such as reports of special tests (echocardiogram, sleep study, etc.), or hospital discharge summaries if applicable.
5. Provide a list of your medications, including dose and schedule.
6. Cease smoking, as tobacco product use increases surgical risk.