Frequently Asked Questions

1. What Should I Expect from Start to Finish?
2. How long will my wait be from the time I start the Center of Excellence Program until my surgery date?
3. Do I really have to loose weight prior to surgery?
4. Why do I have to quit smoking prior to the operation?
5. What if I need to get a hold of my surgeon?
6. How do I determine what operation is right for me?
7. What do I have to do to prepare for the surgery?

1. What Should I Expect from Start to Finish?
The Baker Bariatrics process begins with an interactive Introductory Program Meeting held at Unity Hospital. These meetings are scheduled every other Tuesday evening, every other Thursday afternoon and on specified Saturday mornings. They are free of charge for anyone interested in weight loss. Program Director, Janet Rudlong, introduces potential weight loss candidates to the different procedures offered through our program. Janet also outlines the different requirements as dictated by the various insurance companies in order to receive authorization for the weight loss surgery. These requirements do vary from carrier to carrier and may include, but are not limited to, meeting with a nurse clinician, meeting with a dietician and/or working with an exercise physiologists to develop an exercise regiment that will help to ensure the success of the weight loss surgery. For most insurance carriers, the patient will also need to undergo a psychological evaluation to ensure that mentally and emotionally they are prepared for this life changing process. It is important that the prospective Bariatric patient contact their own insurance company to fully understand the requirements needed for authorization and to understand what their financial responsibility, if any, will be for the procedure. Once all of these programs are completed, the patient's chart will be forwarded for the authorization process. The surgeon will review the patients history and then dictate a letter on the patient's behalf specifying the medical necessity for each patient as to why they are in need of weight loss surgery. This information, along with supporting documentation is then submitted to insurance for approval. Once the patient has been approved for surgery, that patient will then be scheduled to meet with the surgeon. During this meeting, the patient will receive a surgery date, will undergo an evaluation and given teaching specific to the operation that they have decided upon. Standard hospital stays for the laparoscopic and open operations is one to two days. (Standard hospital stays for the LapBand™ operation is one day.)

One week following surgery, the patient will again return to the surgeon's office for a post operative evaluation. Those patients who have had the Roux en Y operation, will be seen back at 5 weeks, 3 months, 6 months, 9 months and then yearly there after. These post operative follow up visits will continue throughout the patient's lifetime. The Lapband™ Gastric Banding patient will see the surgeon for their one week post op and then again six weeks later for their first saline solution fill. Fills will continue on a monthly basis until the patient and the surgeon agree that the right fill amount has been achieved. This "point" will be the balance where the patient is feeling fullness while still loosing weight at the same time.
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2. How long will my wait be from the time I start the Center of Excellence Program until my surgery date?
This time-frame can range anywhere from three months to over six months, depending on what is required by the individual's specific insurance company. The Unity Bariatric Center is a Center of Excellence and thus is required to ensure that patients have had the teaching and training as required by the insurance companies as well as to best prepare the prospective surgical candidate emotionally and physically for the operation and the ensuing weight loss. The psychological evaluation is important as well as it helps to identify patients that might struggle with the procedure from past emotional experiences. The shared goal of Baker Bariatrics as well as Unity Center of Excellence is to ready the patient in every way to achieve the greatest level of success and to provide them a new and healthier way of living.

Again, insurance companies vary greatly on their requirements for each patient. The Unity Program and their team of experts facilitates each patient as they work through the appropriate requirements established by their own individual insurance. As a Center of Excellence, the Program is very versed on the different requirements needed and can effectively make sure that each patient meets the requirements set forth. Once the patient has met these requirements, their information is submitted to insurance for authorization. Once approval is received, the patient will meet with one of our surgeons to then schedule surgery. We understand that many of you want surgery "Yesterday!" Therefore, our surgeons manage their schedules to most often book within a two week period from the time they meet with the patient following insurance approval.
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3. Do I really have to loose weight prior to surgery?
The answer is, yes. Our surgeons require a 10% loss of the targeted overall weight loss prior to surgery. The reasons for this are two fold. First, mentally, emotionally and physically, the patient is preparing for the best result with the operation. Loosing weight and getting into that "mindset", helps to solidify the level of patient commitment and it helps to prepare the patient for the life after the operation. Second, when the patient has lost weight, there is more room in the abdomen. This allows for the surgeon to better operate and to better maneuver the surgical tools during the operation. It allows for a better operation and helps to ensure the best possible surgical outcome for the patient.

4. Why do I have to quit smoking prior to the operation?
Our philosophy is that, if our patient is taking the drastic step of surgery to help them to loose weight and to better their health, then every other aspect of health needs to follow. It is a win-win for the patient on every level to unequivocally embrace health in every aspect. We expect the highest level of performance from our Program, the nurses, dieticians, psychologists and surgeons. We expect the same level of commitment from our patients. We are there to make a difference and it is a team effort every step of the way. The patient is the key to that team.
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5. What if I need to get a hold of my surgeon?
The Baker Bariatric surgeons carry a pager 24/7. That pager number is given to each patient with the commitment again to the patient that, if need be, the surgeon is only a phone call away. The nurse clinicians are also available Monday through Friday should a patient have a questions that doesn't warrant paging the surgeon. We are committed to supporting our patients through out the process, whether that be a day out from surgery or ten year post operative.

6. How do I determine what operation is right for me?
Most of our patients, following the program meeting, have a fairly good idea as to what type of operation that they would like to have. Many are electing to have the LapBand™ Gastric Bypass operation over the Roux en Y procedure. This weight loss surgery is less invasive to the patient and is reversible. The weight loss may not be a rapid with this operation but it is certainly a viable alternative for those who may not have as much weight to loose or for those who are more tentative about surgery. The Roux en Y operation, again now performed almost exclusively in our practice laparoscopically, is a viable choice for rapid weight loss. There are those patients who's medical or surgical history dictate the need for the open Roux en Y operation and that is always an option.

7. What do I have to do to prepare for the surgery?
You must have a physical evaluation with your primary doctor to make sure that your general overall health is in good standing. For those who are having the laparoscopic Roux en Y operation and who have not had their gallbladder out, a ultrasound of the gallbladder is required to determine if, at the time of surgery, the gallbladder should also be removed. One day before surgery, the patient must go on a liquid diet, and, as stated before, the patient must continue to loose weight prior to surgery.

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