DEBORAH A. WARNER, MD
Give our office a call to schedule an informational session where we go over the process of Bariatric Surgery from Day 1 to after surgery. Here in the office our main goal is to have happy and healthy patients. Bariatric Surgery is a lifestyle change and we want to equip you with the knowledge to help maintain a healthy lifestyle long-term.
Is surgery appropriate for you?
While the risks of surgical treatment of obesity are comparable to those of other major surgeries, surgery for weight loss should be used only after all other attempts have failed. Patients must have a Body Mass Index (BMI) of 40 or higher, or possibly 35 or higher if other health problems such as sleep apnea, arthritis or heart disease are present.Use this link to find out if surgery is appropriate for you: Your BMI
The process, from the beginning until your surgery
Generally speaking, these are the steps that occur during your time with us:
1. Have your primary care provider send a referral
to our office. The referral should include your name,
a good way to contact you, your current height and
weight, and whether or not you have any health
conditions (comorbidities) related to your weight.
2. On receipt of your referral our office staff will call
you with in 24-48 business hours. At that time we
will ask for additional information, including your
insurance coverage and schedule you for a new
patient orientation. If you are a smoker, stop
smoking immediately or upon our receipt of your
3. Attend a new patient orientation given by
Dr. Michael A. Todd, and several of his staff
members. Orientation will help you understand
exactly what weight loss surgery is, what
requirements you can expect from your insurance
company, what you can expect to occur during your
pre-operative and recovery periods and it will
help you make an informed decision regarding
weight loss surgery options.Please bring the
following with you. – Driver’s license or other picture identification. – All insurance cards, Medicare card and Medicaid included.
4. At your first appointment we request the following: Please come in 15 minutes before your scheduled appointment. If you are out of town we would like for you to come at 8:00am so we can get your fasting tests done whereas if you are in town we would like you to come at 8:15am so we can get your vitals. A completed Medical History Questionnaire is preferred to be filled out prior to your visit with Dr. Todd and would be extremely helpful to have completed at least 2 days prior to your Orientation Attendance.
5. Attend your second appointment at Alaska Bariatric Center 30 days later as you continue to complete the pre-operative work-up appointments and all medical records/results are received by us.
6. Attend at least three (3) Support Group Meetings hosted by the Alaska Bariatric Center before surgery. There is a copy of the scheduled times and topics enclosed in the packet you received at your orientation. You can also find a complete schedule of our events here.
7. Complete your pre-operative work-up. As you complete your appointments, please be sure to have the results sent to us. We will also need a copy of your medical records from your primary healthcare provider.
8. Attend your History/Physical appointment in our office no more than 7 days prior to your scheduled surgery.
9. SURGERY DAY
10. Attend all post-operative appointments as scheduled Please bear in mind that the above will take time to complete. We appreciate your patience and diligence.
Description of Pre-Operative Work-up
This is a list of the standard pre-operative tests that you may be required to complete. Not all patients will be required to complete these exact tests. In addition other studies and consultations may also be required so that we may provide you with the best care possible.
1. Chest X-Ray (CXR): This test is to evaluate your lungs and heart.
2. Electrocardiogram (EKG): This test is to screen for and diagnose a variety of cardiac conditions as well as to monitor the heart’s response to therapy.
3. Abdominal Ultrasound (Abd. U/S): To check for any organ abnormalities, cysts, gallbladder disease.
4. Upper Gastrointestional Test (UGI): This test is used to look at the esophagus, stomach and other parts of the upper intestional tract to see if any problems exist.
5. Mammogram: Test to detect abnormalities and disease of the breast.
6. Echocardiogram (Echo): This test is to diagnose abnormalities and valvular function within the heart.
7. Pulmonary Function Test (PFT’s): This test is to find out how your lungs are working.
8. Arterial Blood Gases (ABG’s): This test is to determine how well the lungs are functioning and the acid-base status of your blood.
9. Psychological Evaluation: To determine general candidacy for Weight Loss Surgery including a realistic understanding of the nature of the surgery, outcome expectations and any of the risks involved.
10. Dietary Evaluation: To discuss pre-operative and post-operative dietary issues.
11. Internist: Doctor to address medical (non-surgical) needs.
12. Gastroenterologist (GI): Doctor that evaluates and diagnoses any problems from the esophagus (swallowing begins) to the duodenum (past the stomach). For example, reflux disease known as GERD.
13. Pulmonology: Evaluation and diagnoses of any lung condition such as sleep apnea and asthma.
14. Cardiology: Evaluation and diagnoses of any heart condition such as a heart murmur.
15. Various Labs: These tests are to evaluate different blood levels, nutritional status, and to screen for specific conditions such as diabetes and hypothryoidism
If you need to see us at any point after surgery do not hesitate to contact our office to schedule an appointment.
1. Two to three days after surgery the nurses will
give you a call to see how you are feeling.
2. One week after surgery you will have a follow
up with the nurses and get labs drawn. If you are
out of town you will be cleared to go home.
3. Once you hit six weeks you will be able to
transition into solid foods and will have a visit
with either our dietitian or the nurses with others
who had surgery around the same time as you
to discuss this graduation of purees to solid food.
4. Three months after surgery we like to see you
for a follow up and have you come in for fasting
labs. At this point you will be finishing the
Potassium and Prilosec.
5. At six months we like to check in on you again and have you come in for fasting labs.
6. Annually we like you to see Dr. Todd and get fasting labs and make sure everything is going as desired.
7. 18 months out we like to check in on how you are doing once more and for most this is when they have achieved their estimated weight loss.
8. You are our patient FOR LIFE, After 18 months we recommend our patients come in annually and see Dr. Todd or the nurses while also still seeing us for support group or monthly B-12 shots.