Frequently Asked Questions about
Obesity and Bariatric Surgery:

What is the difference between being overweight and being obese?

Being overweight means that body weight is above standard recommendations based on height and weight. Obesity is defined by the Centers for Disease Control and Prevention (CDC) as being 30 pounds or more overweight.

Medical approaches to weight loss, including diet, exercise and behavioral change, are recommended for those who are overweight, obese and severely obese. Akron General Medical Center offers medical weight loss approaches, including nutritional evaluations, LiteStyle – 10 weeks to a healthier body, and LifeStyles, a medically supervised exercise and membership program.

Surgical treatment for weight loss may be recommended for those with morbid obesity, or people with severe obesity who have obesity-related health problems, including:

The Body Mass Index, or BMI is often used as a tool to determine weight categories that may lead to health risks. (Top)

What is body mass index, or BMI, and what should my BMI be?

Body Mass Index is a calculation of measured height and weight that is one of the simplest, but most important, ways of tracking nutritional status. This information can be quickly used with the BMI scale to determine whether a patient is under- or overweight.

The BMI standards and definitions listed below are from the American Society for Bariatric Surgery (1999):

BMI CALCULATOR

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What is morbid obesity?

Morbid obesity is an increasingly common and serious disease, which afflicts over three million Americans. The National Institutes of Health has named it a major national health problem.

Morbid obesity refers to patients who are 50-100% (or approximately 100 pounds or more) above their ideal body weight. A BMI (body mass index) value greater than 39.9 may also be used to diagnose morbid obesity. (Top)

What causes morbid obesity?

Morbid obesity is likely the result of both genetic and environmental influences. Recent studies suggest that the tendency to have morbid obesity can be inherited. They also suggest that family cultural factors matter, especially those, which encourage high calorie food intake. (Top)

What are the medical complications of morbid obesity?

Over 60% of people who are morbidly obese develop high blood pressure.
Strokes and heart attacks are common causes of early death.
At least 33% of people who are morbidly obese develop diabetes.

Other complications of morbid obesity include:

High cholesterol
Respiratory dysfunction
Infertility
Arthritis
Gallbladder disease
Gout
Bladder incontinence
Sleep apnea
Asthma
Depression
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What are the social and economic consequences of morbid obesity?

Difficulty finding jobs. Employers anticipate a high absenteeism rate due to illness and/or risk of on-the-job injuries.

Many times a morbidly obese job applicant will be passed over for a job or a promotion, because they may not be perceived as attractive as, or feel as confident as other job candidates.

Decreased social activity as it becomes more difficult to fit in. It may become more difficult to get in and out of cars, fit into the seats at a theatre, stadium or ride on an airplane.

Activity such as, walking up a flight of stairs or from the parking lot into the store, requires rest stops for the individual to catch his or her breath.

Morbidly obese individuals may also find it difficult to bathe or clean themselves, leaving the individual to rely on family or neighbors to help with basic needs. This can be embarrassing and result in further isolation of the individual.

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Why is surgery a recommended treatment for morbid obesity?

Individuals who are morbidly obese or 100 lbs. or more overweight, rarely respond to diets. Even on strict diets, morbidly obese patients rarely lose as much as 40 lbs. After about six months, over 90% regain their old weight plus another 5%, on average. Therefore; surgery is recommended as the treatment of choice to help avoid the complications of morbid obesity.

Unless patients exceed their normal weight by over 100 lbs. or are obese and have complications related to obesity, a vigorous diet and exercise program are recommended. A physician’s supervision in weight loss is preferred, but some commercial dietary regimes may also be helpful. Akron General Medical Center offers medical weight loss approaches, including nutritional evaluations, LiteStyle – 10 weeks to a healthier body, and LifeStyles, a medically supervised exercise and membership program.

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What are the benefits of weight loss surgery?

Weight loss surgery, also called bariatric surgery, and a bariatric program, such as the Bariatric Center at Akron General Medical Center, offers individuals who are morbidly obese the best chance to lose a significant amount of weight and to help keep it off for life. Weight loss, in most cases, not only improves health problems related to obesity, but also enhances quality of life. Surgery is a starting point where patients can begin to make life changes. (Top)

How do I choose a weight loss surgery that's right for me?

Your health, lifestyle and weight loss goal are all things to consider when deciding to have weight loss surgery. Akron General's Bariatric Center works side-by-side with our patients to help them determine the type of procedure that is best for them, whether it's the Roux-en-Y gastric bypass or the LAP-BAND® System procedure. Each patient is evaluated thoroughly and has several meetings with surgeon and bariatric team staff. Our group-setting informational meeting can provide a lot of answers to questions potential surgery candidates may have, but we also give you individualized attention so that you can have all of your questions answered one-on-one, we feel this is key to understanding the options, the risks, the surgery and expectations after. We encourage patients to contact us with their questions both before and after surgery. (Top)

If I’m morbidly obese, is surgery my only option?

Currently, surgery is the most effective treatment for morbid obesity. However, there are now more options to choose from. The Roux-en-Y gastric bypass operation has been endorsed by the National Institutes of Health (NIH) and is considered the “gold standard” of obesity surgeries. The FDA approved the use of the LAP-BAND® System for weight loss in 2001. Although relatively new in the U.S., it has been used for over 10 years in Australia and throughout Europe with success. The Akron General Bariatric Center offers both surgeries, which can be done through a laparoscopic, or minimally invasive, procedure. (Top)

What is Roux-en-Y gastric bypass surgery?

The surgeon is able to reduce the size of the stomach from two fists down to the size of a thumb, with a row of staples. The stomach is able to hold less, so the patient feels full very quickly.

A part of the small intestine is re-routed, or bypassed, and the pouch is connected with a small opening (anastomosis) to the small intestine, which slows the progression of food through the GI tract.

The operation works in two ways:

1. Reducing food intake which creates a prolonged feeling of fullness
2. Producing mild malabsorption (your body doesn’t absorb as many calories) due to the bypassing of a portion of the small intestine.

This type of surgery is performed under general anesthesia in the hospital and requires at least a two- to three-day hospital stay.

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How much weight can I lose with Roux-en-Y gastric bypass?

On average, patients can usually expect to lose 30 lbs. within a month, 60 lbs. in six months and 100 lbs. in a year. Patients who exercise after surgery, as recommended, will experience better weight loss. People who are super-morbidly obese tend to lose weight at a faster rate. Men usually lose weight more quickly than women do, as they have more muscle mass and muscle burns calories more quickly. (Top)

Are there any risks with Roux-en-Y gastric bypass surgery?

Yes, there are risks with any abdominal surgery. These risks include bleeding, the need for a blood transfusion, infection, the need for reoperation, injury to other abdominal organs, pain, complications outside of the abdomen, including the heart (MI or heart attack, arrhythmia), lungs (pneumonia), blood clots and death. Risks specific to gastric bypass surgery include a leak, nausea, vomiting, dumping (especially if high sugar drinks or foods are ingested), temporary hair loss, failure to lose weight, vitamin deficiencies that may progress to (if not corrected) severe neurological abnormality and death. Risks and benefits of the surgery should be discussed in detail with your surgeon before you decide to have surgery. (Top)

What is the LAP-BAND® System Procedure?

The LAP-BAND® System procedure reduces the capacity of the stomach to approximately the size of a thumb, by looping a silicone band around the very top portion of the stomach. This surgery creates a small stomach pouch, without bypassing any of the intestine, as the Roux-en-Y gastric bypass surgery does.

The silicone band is anchored to the stomach by suturing the stomach over the top of the band. A small port is attached to the band and is positioned inside the body, between the lowest left rib and the left hip. The port will be used in the office by the surgeon, to adjust the opening of the band. The surgeon will access the port by putting a needle through your skin and into the port. Accessing the port does not hurt and does not require anesthesia or pain medication.

The LAP-BAND® System procedure is done in the operating room, under general anesthesia. It requires a one- to two-day hospital stay. (Top)

How much weight can I lose with the LAP-BAND® System procedure?

Weight loss occurs at a slower rate than with Roux-en-Y gastric bypass surgery. Patients typically lose 1-2 lbs a week, which is similar to non-surgical weight loss. Patients can lose the equivalent weight as a patient that had Roux-en-Y gastric bypass in approximately three years. (Top)

What are the risks with LAP-BAND® System procedure?

Again, there are risks with any abdominal surgery. These include bleeding, infection, the need for re-operation, injury to other abdominal organs, pain, complications outside the abdomen, including heart (MI or heart attack, arrhythmia), lungs (pneumonia), blood clots and death. Risks specific to the procedure include nausea, vomiting, band slippage, erosion of the band into the stomach, obstruction of the stomach, infection of the band or port, and complication of the catheter and/or port. Risks and benefits of the surgery should be discussed in detail with your surgeon before you decide to have surgery. (Top)

When is bariatric surgery a success and what should my weight goal be?

Bariatric surgery is considered successful when the patient loses 50% of their excess body weight and keeps it off for life. For example, if a patient who is 150 lbs. over ideal body weight loses 75 lbs. and keeps it off for life, then the surgery is considered a success. Successful outcomes occur in 85% of patients having a Roux-en-Y gastric bypass.

A weight goal is something patients work with the surgeon to determine. (Top)

How long will I continue to lose weight?

Weight loss for gastric bypass patients plateaus between 18-24 months. Weight loss plateaus at around three years for LAP-BAND® System patients. This happens because the body’s calorie intake equals its energy demand. In other words, during the weight loss period, the body becomes more efficient with the daily calories it needs (i.e., to make the brain think, your heart pump and your lungs breathe). At the end of the weight loss period, the calories consumed in a day are the number of calories you need for activities of daily living. (Top)

Will I regain the weight?

Patients sometimes regain 5-15 lbs. after hitting their weight loss plateau. However, it is possible for patients to still gain weight and “out-eat their pouch” by snacking or by drinking sweetened beverages and milkshakes. Patients who snack all day or “graze,” especially on high-calorie foods, will likely regain weight. (Top)

How long will I need to be in the hospital?

The average hospital stay is 2-3 days for gastric bypass patients and 1-2 days for LAP-BAND® System patients. The patient must be able to drink adequate amounts of fluids, have controlled blood pressure, blood sugar and pain before they can be discharged to go home. (Top)

What will my hospital stay be like?

Patients are admitted the morning of their surgery to the pre-operative suite, where they change into a hospital gown and receive an IV. The family can stay with the patient until it’s time to go to the operating room. At that time, the family can wait in the waiting room, located on the main level of hospital, off of the lobby.

The surgery will generally last 2-3 hours for gastric bypass and 1-1 ½ hours for a LAP-BAND® System procedure. Shortly after the surgery, the surgeon will come to the surgery waiting room to talk to the family. The patient will recover, or wake up from anesthesia, in the recovery room, which may take 2-3 hours. After recovery, the patient will be taken to the bariatric floor for the rest of their hospital stay.

Patients will have an IV in their arm, a Foley catheter in their bladder and a small drain coming through one of their incisions. The first day after surgery, the patient will begin drinking water and a high protein liquid supplement. The gastric bypass patient will have a liquid diet for the first two weeks after surgery (LAP-BAND® System patients will be on liquids for 6 weeks), drinking the high protein liquid supplement for meals. Other liquids patients may have include decaffeinated coffee or tea, skim milk, broth, strained cream soups, water, Crystal Light, diluted fruit juice (1/2 juice mixed with 1/2 water), sugar-free Jell-O and sugar-free Popsicles. The patient must avoid sugar sweetened and/or carbonated beverages and adding sugar. (Top)

When can I eat solid food again?

Gastric bypass patients will be advanced to a blended diet approximately two weeks after surgery (weeks 3 & 4), and LAP-BAND® System patients will be advanced to a blended diet approximately 6 weeks after surgery (weeks 6&7). It will include foods that are thicker in consistency, focusing on eating protein. Their diet will be advanced slowly so that new foods are added 1-2 weeks for the first eight weeks. At the end of two months, patients will be able to try new foods, in small amounts. By the sixth month after surgery, the patient should be able to eat approximately ½ cup of food per meal, depending on the density of the food. (Top)

I’ve heard that there are a lot of foods I will never be able to eat again after surgery, is that true?

This is true with gastric bypass surgery. There are some foods that patients will need to avoid because they can cause “dumping syndrome.” These include foods and beverages high in sugar, such as sweetened sodas, pastries and ice cream. Some foods, which patients can’t tolerate initially after the surgery, may be easier to eat several months later, such as bread, pasta and dry meats. Each patient will need to find the foods they best tolerate during the different phases of their weight loss process. (Top)

What is "dumping syndrome?"

“Dumping syndrome” is the body’s reaction to the sudden entry of sugar into the small intestine. Patients may experience symptoms resembling the flu, including cold sweats, lightheadedness, racing heart or palpitations, nausea, abdominal cramps, vomiting and/or diarrhea. Time and rest can help alleviate symptoms. For this reason, patients should avoid foods and beverages that are high in sugar. LAP-BAND® System patients do not typically experience dumping syndrome. (Top)

Is there anything else I’ll need to avoid after surgery?

Yes. Pregnancy within the first two years after surgery, nonsteroidal anti-inflammatory drugs (NSAIDs), including Ibuprofen (one brand name: Motrin) and Naproxen (one brand name: Aleve), and extended release medications. Before your surgery, you will be provided with a complete list of NSAIDs.

Preventing Pregnancy

Patients must take extra care to avoid pregnancy the first two years after surgery. Rapid weight loss during this period will put both the mother and baby at risk for complications including birth defects and possibly death of the unborn child. Birth control should be discussed with your gynecologist. Birth control pills alone may not be the best option - due to the change in your digestive process, it is believed that birth control pills drop their 98% effectiveness to 60%. The birth control patch is limited by weight, with effectiveness proven up to 198 lbs. Again, options for birth control should be discussed with your OB/GYN. Pregnancy is safe for both mother and baby after your weight loss has leveled off.

Avoiding Extended Release Medications

Extended release medications, which typically have the letters "SR, XL, CD, or CR" after the medication name will not be absorbed correctly after gastric bypass surgery. Medications for high blood pressure, urinary stress incontinence and depression typically come in once-a-day extended release form. Talk with your prescribing physician about changing medication dosage before your surgery. You may need to take the medication 2-4 times a day, compared to once a day.

Avoiding NSAIDs and Aspirin

NSAIDs are medicines commonly used to treat osteoarthritis, which affects many morbidly obese patients. Unfortunately, these medications can also cause gastric ulcers, which form in the lower portion of the stomach. This part of the stomach is now stapled off and no longer receives food. It is only accessible via surgery. NSAIDs can come in over the counter form or in prescription form. Some common medicines containing NSAIDs include: Motrin, Ibuprofen, Advil, Naprosyn, Aleve, Vioxx, Celebrex, Daypro, Voltaren, Lodine, Indocin, Orudis, Toradol, Relafen, Feldene, Clinoril and Arthrotec, cold and flu remedies.

Patients should also avoid aspirin and products that contain aspirin, including Pepto-Bismol and Alka-Seltzer.

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How will my health be affected by weight loss surgery?

Most patients will see their obesity related health problems, such as type 2 (adult onset) diabetes and high blood pressure, diminish, if not resolve. Roux-en-Y gastric bypass patients may experience a more rapid decrease in medical problems, than LAP-BAND® System patients. This is because weight loss typically occurs more quickly with gastric bypass than with gastric banding. LAP-BAND® System patients may also see most of their obesity-related health problems resolve by the time they achieve their maximum weight loss (approximately three years).

Patients may need to continue taking medications for diabetes, hypertension or high cholesterol, but probably in lower dosages. Your primary care physician will work with you to determine that. Other medical problems, such as osteoarthritis, infertility, urinary stress incontinence and obstructive sleep apnea, may resolve or lessen in severity over time.

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Can I have plastic surgery after my weight loss procedure?

The primary goal of weight loss surgery is to reduce the health risks of and related to morbid obesity. Some people do choose to have plastic surgery to reduce the amount of skin on their arms, legs and abdomen for both health and cosmetic reasons. Discuss your plans with your surgeon. Akron General can help you find a surgeon specializing in plastic surgery, who practices at Akron General Medical Center by calling 330-344-AGMC (2462) Monday through Friday, during business hours, or by visiting the Find a Doctor feature on our website. (Top)

Am I a candidate for weight loss surgery?

Candidates for weight loss surgery must have a body mass index (BMI) of at least 40 or a BMI of 35 to 40 with obesity related health problems, such as heart disease, diabetes, sleep apnea or hypertension.

The Bariatric Center at Akron General Medical Center accepts appropriate candidates between the ages of 18 and 65. Patients above age 65 may possibly be candidates.

Candidates must provide documentation that they have attempted weight loss under supervision (i.e., counseling from a registered dietitian or weight loss medication prescribed by a physician) in the last two years. Most insurance companies will no longer accept commercial programs, such as Weight Watchers, Jenny Craig, Physicians Weight Loss Centers, as documentation of a medically supervised weight loss program.

Candidates must be psychiatrically stable and able to understand all of the risks and benefits of surgery as well as alternative options.

Candidates must be at a reasonable operative risk. This will be determined after a thorough evaluation.

Candidates may not smoke for three months prior to surgery and must not have a history of drug or alcohol abuse in the preceding five years.

Candidates must demonstrate that they fully understand the procedure and the need for lifetime follow-up care. This includes daily vitamin supplements and modifying diet for life. Surgery is only the first step.

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How do I choose a bariatric program?

Many times, patients hear about weight loss successes and trials through friends and family. Patients should also consider a program, in which the surgeon is board certified in surgery and has additional training in laparoscopy and weight loss procedures. The surgeon should have experience performing a variety of weight loss procedures, including Roux-en-Y gastric bypass (traditional and laparoscopic) and laparoscopic LAP-BAND® System procedure.

Akron General Bariatric Center Medical Director, Walter Chlysta, MD, FACS, has performed over 100 laparoscopic Roux-en-Y surgeries and over 30 LAP-BAND® Adjustable Gastric Band procedures during his 12 years of experience with laparoscopic surgery and his seven years of surgical practice. Dr. Chlysta is a graduate of The Ohio State University College of Medicine. He completed a surgical residency at Akron General Medical Center and additional training at Yale-New Haven Hospital in Connecticut. He is board certified by the American Board of Surgery and is a member of the American Society for Bariatric Surgery. Being certified by the American Board of Surgery means that the surgeon has met a standard in surgery by fulfilling specified educational, evaluation and examination requirements. Dr. Chlysta is also a Fellow of the American College of Surgeons. The letters FACS (Fellow, American College of Surgeons) after a surgeon's name mean that the surgeon's education and training, professional qualifications, surgical competence and ethical conduct have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College.

The surgeon and hospital must offer a comprehensive bariatric program that is comprised of practioners experienced in bariatric surgery, including nurses, dietitians, psychologists, behavioral therapists, respiratory therapists & exercise physiologists, as well as hospital staff that are trained to care for your special needs. This means that there is a support team available to guide you through the whole process, from the first time you contact the program through your post-operative visits and support group meetings. Remember, this is a life-altering process, that’s why it’s important to look for a program that is willing to follow your progress, along with your primary care physician, for the rest of your life.

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Does Akron General have rooms, equipment and gowns to fit me comfortably?

Yes. Our patient rooms are equipped with appropriate sized beds and chairs to fit our bariatric patients comfortably. Patients will also find that gowns provide the privacy our patients deserve. (Top)

Will I get the nutritional and fitness guidance I need after surgery?

Weight loss surgery is a starting point at which patients’ lives, and many times their families', begin to change. The transformation requires lifestyle change by modifying your diet and by incorporating activity into a daily routine.

The Bariatric Center at Akron General offers the education and support patients need to achieve their weight loss goals. Nutritional education begins before surgery and continues as the patient begins seeing significant weight loss through to the point of success and beyond. We will teach you how correctly use your new tool for weight loss so that you can maintain your health for the rest of your life.

All of our participants receive a one-month membership to LifeStyles, a medically supervised exercise and membership program, located at the Akron General Health & Wellness Center - West, in west Akron, and coming in 2007, the Akron General Health & Wellness Center - North, located in Stow. Participants also receive a discount on enrollment fees for either an individual membership or a family membership. LifeStyles staff can help get you started and sticking with a fitness routine you'll enjoy with over 200 pieces of cardiovascular and weight equipment, indoor lap pool, steam room, sauna, whirlpool, gymnasium and more than 70 land and water aerobic classes, indoor and outdoor track, youth fitness area, indoor rock wall and many fitness and wellness programs for all ages and abilities.

Another program available through Akron General Medical Center, which is available for additional support after the program, for a fee, is LiteStyle - 10-weeks to a healthier body. It's a nutrition and exercise program, in which participants receive eight nutritional sessions that show you everything from shopping to eating out, plus 16 hours with a certified personal trainer. LifeStyles members and Bariatric Center participants receive a reduced program fee.

Akron General's Wellness Services Department also offers a nutrition and enrichment program for you and your children ages 8-12, because we understand that bariatric surgery is not just a change for the patient, but a change for the whole family. The program is called FitStyles for kids. Each week, parents get tips on meal planning, communicating with kids, positive self-image and getting the family moving. Kids enjoy awesome fitness activities, such as water aerobics, group exercise and the rock wall! Call our Wellness Services Department at 330-665-8022 for information about FitStyles for Kids and program fees.

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Will my health insurance cover weight loss surgery?

Most insurance carriers will cover weight loss surgery with proof of medical necessity. Each candidate will need to check with his or her benefits representative or read their medical insurance policy, as some contracts are written with exclusions for weight loss surgery.

We have experience providing weight loss surgery for patients covered by: Aetna, Anthem, Blue Cross Blue Shield, Cigna, Emerald, First Health, Flora Health Network, Medical Mutual of Ohio, Medicare, Ohio Health Choice, One Health, Primnet, Private Health Care (PHCS), ProAmerica, Prudential, QualChoice, Secure Horizons Direct, Tricare/Healthnet, Unicare and United Health Care.(Top)

How do I provide proof that the surgery is medically necessary?

Each individual will need to check with his or her policy and with a benefits representative about the documentation required. Typically, if the surgery is medically necessary, the surgeon will provide a letter stating so to the candidate’s insurance company, along with the request to provide surgery. The insurance company will then send a reply to the surgeon’s office, either approving or denying the request for surgery. If the surgery is denied, there will be a statement explaining why the surgery was denied and how to appeal the denial. (Top)

If my health insurance company denies the request for surgery, is that it?

The Bariatric Center at Akron General Medical Center can help you with an appeal. We may need you gather more information from your primary care physician or other physicians who may have treated you in the past. If the denial is based on an exclusion written in your policy, we may not be able to progress further with this insurance company. (Top)

Can I pay for the surgery myself?

We recommend exhausting all other options before opting to self-pay. Appeals to the health insurance company should be taken to the highest level. Candidates may also want to research switching to insurance providers that do not have an exclusion for weight loss surgery. After all other options have been exhausted, then contact the Bariatric Center at Akron General Medical Center about a self-payment option. (Top)

If I self-pay, can I have the surgery scheduled more quickly?

All patients must participate in the Bariatric Center’s program, which requires a minimum of three visits before surgery. Opting to self-pay will not help in moving up a surgery date. (Top)

How can I participate in Akron General’s Bariatric Center program?

1. Call the Akron General Need-A-Physician line 330-344-AGMC (2462), Monday through Friday, from 8 a.m. – 6 p.m. and Saturday from 8 a.m. – noon to talk to a friendly staff member about getting connected with the Bariatric Center at Akron General Medical Center.
2. Next, we’ll need to ask you a few basic questions about your health and weight history. You can download the forms here or ask us to mail you the forms. These forms will ask you about your health and weight history.
3. Mail these completed forms back to the Akron General Bariatric Center, 400 Wabash Avenue, Akron , Ohio 44307. Your information will be reviewed and you will be contacted regarding an appointment.
4. If the surgeon feels you are a good candidate after your initial appointment, all of your documented health and weight information and a request for surgery will be sent to your health insurance carrier.
5. Most insurance companies respond within four to six weeks of the request. While waiting for insurance approval, you will be given several things to do, which will include attending one of our informational support group meetings.

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What happens at the informational meeting?

This is your opportunity to meet several post-operative patients from our program and ask them questions directly. They will share their experiences, including successes and complications, and pass on helpful hints. The Bariatric Center team, including Walter Chlysta, MD, FACS, the program coordinator, dietitian, social worker and mental health specialist, will also be on hand to answer your questions. The meeting is conveniently offered every month. (Top)

What happens after the insurance company has approved my surgery?

If an approval for surgery has been granted, then your next two appointments and a surgery date will be scheduled.

At the second appointment, you will meet with the Bariatric Coordinator, who will check your weight and teach you about how to prepare for your surgery, in a small group setting. This includes what to expect during your hospital stay and how to prepare for your transition home. You’ll also meet with the dietitian, again, in a small group, to review your post-operative diet. All of your pre-testing labs, x-rays, and evaluations will be scheduled.

At the third appointment, you will meet with Dr. Chlysta who will review your pre-admission testing results with you. He will also go over the plan for surgery with you. The Bariatric Center Coordinator will review your hospital stay again and make sure all your questions have been answered.

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How long will I need to be off of work?

Plan on 1-2 weeks with the LAP-BAND® System procedure and 2-3 weeks with the Roux-en-Y. You will need a little more time off with the gastric bypass because of the fatigue caused by the quick weight loss.

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Are there any physical limitations I need to follow after surgery?

You will be limited to lifting 10 lbs or less for the first four weeks after laparoscopic surgery. If your surgery is done as an "open" procedure, that is, with a 6-8 inch incision, then you will be limited to lifting 10 lbs for 8 weeks. Regardless of which surgery, you cannot swim or take a bath in a tub for 2-3 weeks. Before you do so, you must have your incisions checked by Dr. Chlysta. The scabs from the incisions should have fallen off on their own, and the skin should be closed underneath.

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Can I shower after surgery?

Absolutely. You may shower the day after surgery. Soap and water are best for keeping your incision clean and decreasing your risk of infection. You should clean your incision everyday.

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What is "sleep apnea?"

The Greek word "apnea" literally means "without breath." People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

There are 3 types of sleep apnea, obstructive, central and mixed. Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.

Sleep apnea is very common, as common as adult diabetes, and affects more than 12 million Americans, according to the National Institutes of Health. Risk factors include being male, overweight and over the age of forty, but sleep apnea can strike anyone at any age, even children. Because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences. Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated.

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How do I find out if I have sleep apnea?

You will be required to have a sleep study during our evaluation process. We have a Sleep Disorders Center at Akron General Medical Center the Montrose Sleep Center, conveniently located at the Akron General Health & Wellness Center - West. Testing will require that you spend a night sleeping in our "lab" that looks very much like a hotel room, but allows our technicians and physicians to monitor you throughout the whole procedure. If you test positive for sleep apnea, as the majority of our bariatric patients do, you will be treated for sleep apnea before surgery. Most patients are able to stop the treatment once they have lost a significant amount of weight, as excess weight can contribute to sleep apnea.

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