The following is intended to give you an idea of what is involved in the whole process of bariatric surgery at MBSCE (Michigan Bariatric Surgery Center of Excellence, P.C.). The length of time involved between the first visit and the day of surgery is very different between one person and the next. This time is dependent only on: the extent of your pre-existing medical conditions, number and type of preoperative medical tests that need to be done, and the length of time for your insurance company to give pre-authorization for the surgery. No one is given special consideration based on the type of insurance they have or form of payment they are using. As a general rule, any medical work-up can usually be accomplished in the same amount of time it takes for the insurance company to give pre-authorization, provided you schedule your appointments and keep them in a timely fashion. This length of time can be from six to eight weeks or even longer in some cases.

Dr. Zoe Deol, M.D.
Your first visit will be with the surgeon Dr. Deol. She has established the guidelines for the preoperative and postoperative course that you would follow. You will have two preoperative visits with Dr. Deol.

Director
Michigan Bariatric Surgery Center of Excellence P.C.
Silver Oak South
43200 Dequindre Rd., Suite 109
Sterling Heights, MI 48314

Your first appointment is your initial evaluation. Once this appointment has been scheduled, you will be asked to return to this web site and print out the medical History Intake form. You will be asked to bring this form with you to your initial appointment. If you do not bring this form with you, your appointment may need to be rescheduled. This is due to the amount of time involved in completing the form. Trying to do this in the waiting room would cause yous scheduled after you to be significantly delayed. However, the information on the form is necessary for the doctor to have a meaningful consultation with you. To download this form please click here .

You will receive a call to confirm your appointment a day or two prior. Your consultation with Dr. Deol will last approximately 45 to 60 min. She will review your medical history, educate you about Lap-Band surgery, perform a physical exam, and answer your questions. Provided she feels that you are a potential candidate for the surgery, she will refer you to an Internist, a Psychologist, and a Nutritionist. When you schedule these appointments, you will be asked to notify our office of your appointment dates.

Your second visit is scheduled after your required medical, psychological, and nutrition evaluations have been completed. This is your one-week preoperative visit and should take approximately one hour. For this appointment, you will need to bring with you the person you consider to be your main support person. This is the person that should accompany you on the day of surgery and pick you up from the hospital when you are released. The purpose of this visit is to watch an informative video and answer any remaining questions that you and your support person may have.

IF YOU DO NOT BRING THIS SUPPORT PERSON WITH YOU, YOUR APPOINTMENT WILL HAVE TO BE RESCHEDULED AND THIS WILL DELAY YOUR SURGERY .

Internal Medicine Evaluation:
Your medical evaluation can by performed by your own family doctor. We will give you a list of blood tests and X-rays that we need your doctor to perform prior to surgery. If you do not have a family doctor, we can refer you to one.

Nutritionist:
Our nutritionist is Patrizia Jesue, R.D. Her method focuses on “learning nutrition from the neck up”. You will see her twice prior to your surgery. On the first visit, she will educate you on proper nutrition for Lap-Band patients. On the second visit, she will order you prescription pre-operative diet and give you instructions for your post-operative course. You will see her again one week after surgery; and, you will also see her once every three months for the first year after your surgery. She also co-proctors our support group meetings for post-operative patients.

Psychologist:
Our psychologist is Deborah Greening, Ph.D. She has a background in evaluating and treating psychological components of overeating. She has experience in preoperative evaluations for patient candidacy for bariatric surgery, and she co-proctors our support group meetings for post-operative patients. You will have two pre-operative visits. The first of these visits is to administer a written questionnaire and evaluate for any emotional or stressful situations that may be present in your life. The second visit is to review the results of the questionnaire and explain some of the changes (social and personal) that may occur in your life after the surgery. You will have the option of pursuing any additional form of therapy that you wish. Dr. Greening will be available for consultation during your postoperative course to address any personal issues that may arise.

Hospital:
Once your surgery is scheduled, you will receive a call from the hospital pre-admission testing. This is when you talk to a nurse who reviews the details of your medical history. They will tell you what to expect on the day of surgery with regard to being put to sleep for the procedure. You should ask any questions you have about the anesthesia at this point.

Hospital Course For The Lap-Band:
After your surgery, you will be encouraged to get out of bed and walk a few hours after surgery. This is to help prevent blood clots from developing in your legs. You will also have specialized, inflatable, “stockings” on your lower legs that you must wear while you are in bed. These also are used to help prevent blood clots from forming in your legs. You will be given a small device to help you “exercise” your lungs. This is to help prevent a lung infection. You are asked to use this device every hour while you are awake. Your nurse will give you pain medication around the clock that you do not even need to ask for. If you need additional medication, this will also be available for you. It is very important that you do not vomit in the immediate postoperative period. If you experience nausea, you can ask your nurse for medication to relieve the nausea. We recommend that if you request the additional pain medication, you should also request the anti-nausea medication at the same time. This is because the additional pain medication is known to cause nausea.

The next morning after your surgery, you will go to the radiology department for an x-ray study. You will be asked to drink something while the x-ray is taken. If the results of this x-ray are good, you will then be discharged from the hospital.

Postoperative Course For The Lap-Band:
For the first one to two weeks after surgery, you will be on a liquid diet or soft diet. You will see Dr. Deol one week after surgery. She will look at your incisions and give you instructions on what type of diet you should be on (liquid or soft). You will also visit the nutritionist who can help you choose foods that give you the best nutrition. By the third or fourth week you will be on solid foods. The Lap-Band is most effective if you eat solid foods and drink only after meals. Everyone is encouraged to take one chewable vitamin a day.

Most people return to work one to two weeks after surgery. As a general rule, you may return to work when you no longer require prescription pain medication.

Lap-Band Adjustments:
Everyone will have to have their band adjusted. Your first adjustment will be around 4 weeks after surgery. You can come in as often as you need to have your band adjusted. Just ask yourself the following questions: Are you still hungry after half a cup of food? Are you hungry between meals? Are you hungry more than 2 or 3 times a day? If the answer is yes, you probably need another band adjustment. It is important not to feel like “you have failed” if you need your band tightened. Imagine having a suit made at a tailor. You bring the fabric and then go for many fittings before the suit fits perfectly. The band is similar. It does not fit everyone the same way and needs to be adjusted for some more than others. As you loose weight, the belt around your waist will get looser; and, the Lap-Band around your stomach will get looser. Your stomach will actually get thinner. This is why you will need to return every so often for a band adjustment. Never try to “test” the LAP-BAND® to see if you can eat more. The purpose of the band is to take away your hunger , not to physically restrict your intake by causing you to regurgitate if you eat too much. Stop eating when you are no longer hungry, not when you are full. The key to successful permanent weight loss is learning to eat out of hunger only . If you find that you are eating out of stress or boredom, please contact the psychologist to discuss stress management techniques or diversion therapy to help you cope with these issues before scheduling another adjustment.

Dr. Deol accepts patient who have had their surgery done elsewhere in the United States and will do their adjustments for them. She simply requests that you discuss this change with your surgeon and get copies of your records from your surgeon. Please call our office for details (586) 737-2810.

Summary:
Our program at MBSCE is structured to give you the best chance of having a successful outcome with your surgery. It requires discipline and long term commitment on your part. As a team, we should be able to achieve good results from the surgery. It is important to keep in mind that this is not a cosmetic procedure and it is not a cure. The Lap-Band is a tool to be used in conjunction with proper diet and exercise. Living with the Lap-Band is very much like starting a new relationship. There is “the honeymoon period”, followed by some difficulties; but, after learning to compromise, you can live a long and happy life together.

Congratulations on taking the first step towards a healthier life!