Frequent Questions

Lap Band Adjustable Gastric Banding System FAQs

• Will insurance cover the cost of LAP-BAND Surgery? In some cases, the cost of LAP BAND surgery is covered by insurance. All insurances are different and all policies are different. If there is a specific exclusion for morbid obesity, insurance will not pay for it-no matter what. When calling your insurance company use cpt code 43770. For other questions regarding insurance call Leslie at ext. 111, or attend our free seminar.
• Can I eat anything in moderation? After your stomach has healed, you may eat most foods that don't cause you discomfort. However, because you can only eat a little it is important to include foods full of important vitamins and nutrients such as those recommended in the nutrition section of this booklet and as advised by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of "empty" calories, such as milkshakes, the effect of the LAP-BAND System may be greatly reduced or cancelled.
• Will I suffer from constipation? There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fiber. This should not cause you severe problems. If difficulties do arise, let us know as soon as possible.
• Will I be sick a lot after the operation? The LAP-BAND Adjustable Gastric Banding System limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well or that you are not following the diet rules properly. However, it could also mean that there is a problem with the placement of the band so you should contact us if this problem persists. Vomiting should be avoided as much as possible. It can cause the small stomach pouch to stretch. It can also lead to slippage of part of the stomach through the band, which would reduce the success of the operation. In some cases, it would also require another operation.
• What about alcohol? Alcohol has a high number of calories. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.
• What if I go out to eat? Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.
• Does the LAP-BAND System require frequent office visits after surgery? Check-ups are a normal and a very important part of LAP-BAND System follow-up. Two weeks after surgery, then at 6 weeks for first adjustment (fill), and then as necessary for your adjustments. If you can eat half a sandwich then it is time for an adjustment. The first year you could have as many as 8 adjustments and then the second year 2-4. We require that you come in yearly once you have a achieved your weight loss goal or anytime you need an adjustment to your band.
• What about other medication? You should be able to take prescribed medication. You may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. You should always ask the doctor who prescribes the drugs about this.
• Will I need to take vitamin supplements? You may. It's possible you may not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron. Usually a good multivitamin (Centrum with iron, One a Day, etc.) will suffice for LAP-BAND System patients. Other supplements as determined by periodic lab examinations.
• Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again, and you can resume lo Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again, and you can resume losing weight. Pregnancy should be avoided during the weight loss phase after banding (usually 1-2 years).
• What about pregnancy? Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again, and you can resume losing weight. Pregnancy should be avoided during the weight loss phase after banding (usually 1-2 years).
• What will happen if I become ill? One of the major advantages of the LAP-BAND System is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed. Anytime you are having any kind of health problems please notify our office by e-mail or phone.
• Will I feel hungry or deprived with the LAP-BAND Adjustable Gastric Banding System? The LAP-BAND Adjustable Gastric Banding System makes you eat less and feel full in two ways ? by reducing the capacity of your stomach and increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived. Remember the LAP-BAND Adjustable Gastric Band is a tool to help you change your eating habits.
• Is it true that the LAP-BAND Adjustable Gastric Band seems "tighter" in the morning? This is a fairly common feeling, especially for people with bands that are tight or just after an adjustment. During the night the water content in the body changes and this may cause the band to feel "tighter" some of the time. Some women have also noticed that the LAP-BAND Adjustable Gastric Band feels tighter during menstruation.
• Will I need plastic surgery for the surplus skin when I have lost a lot of weight? That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.
• Can the LAP BAND be removed? Although the LAP-BAND Adjustable Gastric Band is not meant to be removed, it can be. In some cases this can be done laparoscopically. The stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight or even gain more.
• Do I have to be careful with the access port just underneath my skin? There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed it should not cause discomfort or limit your movements or any physical exercise. The only sensation you may have from the port is when you feel for it yourself or if you lean up against something. Most of the time you won't even know its there. If you feel persistent discomfort in the port area, let us know as soon as possible.
• How is the band adjusted? Most times adjustments can be done in the clinic or office. Local anesthesia is used. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes. Most patients say it is nearly painless.
• Does the LAP-BAND Adjustable Gastric Band limit any physical activity? The LAP-BAND Adjustable Gastric Band does not affect or hamper physical activity including aerobics, stretching and strenuous exercise.
• How do the weight-loss results with the LAP-BAND Adjustable Gastric Banding System compare to those with the gastric bypass? You should focus on long-term weight loss and remember that it is important to lose weight gradually while reducing obesity-related risks and improving your health. In general bypass patients lose weight more rapidly, but at the end of 2 years, bypass patients and band patients have very similar results if they are compliant with diet and follow-up.
• How much weight will I lose

  Weight-loss results vary from patient to patient, and the amount of weight you may lose depends on several things. The band needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won't come off by themselves.

  It is important to set achievable weight-loss goals from the beginning. A weight loss of 2 to 3 pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. Remember that you should lose weight gradually. Losing weight too fast creates a health risk and can lead to a number of problems. Your main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.

• How long will it take to recover after surgery? If LAP-BAND Adjustable Gastric Banding System is performed laparoscopically, patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and a month to six weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

Gastric Bypass Surgery FAQs

• What if my insurance has a direct exclusion regarding the surgical treatment of obesity? If this is found to be the case, we offer a variety of options including financing.
• Will my insurance cover this? Every policy is different. We like each patient to check their specific policy, and then call their insurance to verify their coverage for this procedure. The code we use is 43846. We know that Qualchoice and Health Advantage do not cover weight loss surgery.
• How can payments be made for the operation? Payments must be made prior to surgery. Credit Card payments are accepted.
• What do you do in the event of a denial? We can appeal, pay privately, or change insurance plans if possible.
• How long does the work-up process take? It is difficult to say how long this will take, due to a variety of factors, but as the work-up process begins, we can provide you with a reasonable time frame of when your surgery can be scheduled.
• If patients come in from out of state, how long do they need to stay? Approximately 10-14 days, which includes your History and Physical and educational seminar (usually 1-2 days before surgery), your hospital stay, and your one week post-op appointment.
• Is there an age requirement for Gastric Bypass Generally this matter is addressed on a case-by-case basis. However, if a person is under 18 years of age, clearance by their Pediatrician or Primary Care Physician is required. 18-60 years of age is a guideline.
• Is a psychological evaluation part of the work-up process? This depends on your individual insurance, and what they require prior to surgery, and your medical history. Medicaid and Medicare require a psychological evaluation prior to Gastric Bypass Surgery.
• How long will I be hospitalized? The usual stay is 3-4 days.
• When may I return to work? Usually, it depends upon the type of work you perform. If sedentary, most patients are able to return to work in 2-3 weeks and up to 4-6 weeks if physical labor is involved.
• Will I lose my hair? Patients may experience hair thinning within 4-8 months post-op. However, this is usually a temporary condition and our staff can provide medical assistance with this matter.
• What is the mortality rate The national mortality rate is .5% or 1 out of 200 patients
• How long is the scar? The open gastric bypass is anywhere from 4-8 inches.
• Will my gallbladder be removed at the same time? Yes, because most gallbladders are diseased.
• After surgery, how fast does the weight come off? Most patients will lose 100 pounds during the first 6-12 months after surgery, depending on how heavy they were at the time of surgery.
• What is the average weight loss? The weight loss is greater during the first 6-9 months. This is termed the "rapid weight loss phase." Weight loss continues at a slower rate for 9-18 months post-op. Generally, heavier patients lose more total weight but as a percent of excess weight, most patients lose 35% of their excess weight by 6 months, 60% at 12 months and 72% at 18 months.
• Can I regain the weight I lose after a gastric bypass? Any weight gained is almost always caused by not following the dietary rules. Usually involving drinking with meals, eating small amounts of high calorie foods throughout the day, and eating softer high fat (chips) or high carbohydrate foods (mashed potatoes) rather than solid foods (proteins and veggies). While obesity surgery usually works, it only helps with weight loss and is not "magic," nor is it guaranteed.
• Do all gastric bypass patients have bloating and intestinal gas, and is it always foul-smelling? Intestinal gas and bloating can be caused by swallowing air too quickly or under stress, or by mixing the wrong foods at meals. Eating excessive fat, milk and sugar will cause even more distention and gas and will usually give rise to very foul smelling flatus. These can also lead to colonization of the bowel with the wrong kind of bacteria, which can cause foul odor and gas. We can treat this with antibiotics and dietary change.
• Will I vomit or have diarrhea after the gastric bypass? These are not expected outcomes, but they can occur. Call the office if you experience vomiting or diarrhea frequently more than 4 times a week. Certain foods can cause diarrhea. Yes, you can still vomit, if for example, you are sick, eat too quickly or swallow poorly chewed foods.
• Are there any foods I cannot eat after the operation?

  Yes, milk, and sugar. Eating sugar and milk causes weight gain in all patients, regardless of whether you are a gastric bypass or adjustable gastric band patient. These foods cause problems other than weight gain. In gastric bypass patients, eating sugar usually causes a variety of adverse symptoms called "dumping syndrome." "Dumping" occurs after eating milk, sugar or high-calorie liquids (even something as small as an M&M), causing you to feel heart palpitations, clammy, sleepy, shaky or gassy. Any combination of the above symptoms can occur either mildly or severely depending on what you ate. You just don't feel good.

  As for other foods, patients undergoing either surgery will have certain food intolerances, but they vary from patient to patient. If you try something and it does not agree with you, leave it and try it again a few months later. Fruits, meats and fats should be avoided during the first three weeks after surgery.

• What happens if I eat too much? You will vomit. When you start to feel full, you should stop eating.
• How will I know if I need a tummy tuck (abdominalplasty/panniulectomy)? You, the patient, will decide if you need one. If you have low back pain or if you look in the mirror and see excess skin, a bulging abdomen, irritated skin located in the pubic beneath the overhanging skin flab, you are a candidate. (Dr. Wellborn does not do this procedure).
• When can I drive after surgery? When you feel alert, can turn about in the car, and when you are no longer taking narcotics. Usually around two weeks.
• How often will I need to come in for my post-operative appointments? It is very important after this surgery to come back to our office yearly. If you are not able to, please call us so that we can make sure you are getting regular laboratory studies and experiencing no deficiencies of your proteins, vitamins and minerals.
• How long do I need to take vitamins and minerals? For the rest of your life. Vitamins are required for the rest of your life. Immediately after surgery you will begin taking two chewable multi-vitamins daily (such as Flintstones). After one month you will add Citrical + D or Calcium Citrate + D (1200mg daily).
• Why do I have to drink water? Water will help with your weight loss and help with the elasticity of your skin. (Tightening up).
• Is pregnancy possible after surgery? Yes, in fact weight loss surgery often increases fertility in those whom have had difficulty conceiving in the past. However, pregnancy must be avoided for 12-18 months post-operatively, until your weight has stabilized.