Q. How much does surgery cost? I have private health insurance.
A: If you have appropriate private health insurance, you could be covered for gastric banding surgery. There will be a “gap”. This amount is not covered by your fund, and takes into account your pre operative appointments with our consultant nurse, Dr Blair Bowden, dietitian and psychologist as well as the fees for Dr Blair Bowden, his surgical assistant and anaesthetist when the procedure is performed. All subsequent visits with Dr Blair Bowden will attract a fee which a rebate is claimable from Medicare. Most levels of private health insurance cover weight loss surgery, but some of the more basic levels of cover may not. There may also be a waiting period, especially if you have recently joined a health fund and this is usually for 12 months. It is important to check with your private health insurer that you have the correct level of cover and to do this you will need to quote the item number of the procedure you are considering; for lap-band surgery the item number is 31569, for Roux en Y gastric bypass the item number is 31572 and for a sleeve gastrectomy the item number is 31575. For more information we recommend phoning the clinic.
Q. How much does surgery cost? I do not have private health insurance.
A:: If you do not have private health insurance you can still undergo weight loss surgery as a self funded patient. Unfortunately the public health system does not currently have a waiting list for public surgery. Queensland Bariatrics offers two options for uninsured patients, you can choose to be admitted to the Wesley Hospital as a private patient in a private hospital or alternatively you can choose to be admitted to the Royal Brisbane and Women’s Hospital as a private patient in a public hospital. The costs do vary with the Wesley Hospital fees being higher than those at the Royal Brisbane and Women’s Hospital. There will be a “gap”. This amount is not covered by Medicare, and takes into account your pre operative appointments with our consultant nurse, Dr Blair Bowden, dietitian and psychologist as well as the fees for Dr Blair Bowden, his surgical assistant and anaesthetist when the procedure is performed. All subsequent visits with Dr Blair Bowden will attract a fee which a rebate is claimable from Medicare. For more information we recommend phoning the clinic.
Q. Can I withdraw money from my superannuation fund to cover the cost of surgery?
A: In certain circumstances, you may be able to access your superannuation funds early to cover the cost of your surgery. It is important to remember that the funds you withdraw from your superannuation fund is classed as income, so we recommend that you consult with your financial advisor or accountant to see if this is right for you. You will also need to check with your superannuation fund directly to see if this possible, and contact the Department of Human Services to obtain the ‘Early Release of Superannuation on Specified Compassionate Grounds – medical, dental or transport’ application forms. These forms can also be downloaded from www.centrelink.gov.au;and we also keep copies and information in the office.
Q. How much weight and at what rate should I expect to lose my excess weight?
A: This is variable and will differ between sexes, ages, and the excess weight one has to lose; weight loss will also differ to those who adhere to the dietary changes and amount of exercise done post surgery. Generally bigger people lose more, they have to use more energy to carry their bodies around, and females, in particular, tend to vary during the month due to their hormonal cycle.
Q. Why am I required to go on a pre-operative VLCD (very low calorie diet) program?
A:A pre-operative VLCD program is very important in reducing the fat in the liver, allowing easier access to the area around the top of the stomach during surgery. By reducing the size of the liver prior to surgery it in turn decreases the risk of damage to other organs during surgery.
Q. How long does surgery take and how long do I have to stay in hospital?
A: Surgery to have a lap-band inserted usually takes about 30-45 minutes of general anaesthetic and provided there are no complications you can generally go home the next day. The sleeve gastrectomy and gastric bypass surgeries do require a longer general anaesthetic as well as a longer hospital stay; usually about three days for a sleeve gastrectomy and about five days for gastric bypass surgery.
Q. How long will it take to recover after surgery?
A: Most patients who undergo lap-band surgery or sleeve gastrectomy will require about a week off work and for patients who undergo a gastric bypass will need a couple of weeks off work. Every patient is different and recovery times will vary patient to patient. We do recommend that at least a couple of days are taken and then for four to six weeks refrain from any heavy lifting.
Q. I’m hungry in the post op liquid phase, what should I do?
It is not uncommon in the first couple of weeks to feel hungry, as the band does not hold up fluids and therefore the stomach empties quicker. We suggest that you try something slightly thicker, perhaps in the way of low fat drinking yoghurts or protein drinks.
Q. I’m tired and weary after surgery, what should I do?
Most patients will find that they are tired after undergoing surgery, and this is very common after undergoing a general anaesthetic, let alone a major operation. An increase in light exercise, moving around and a good night’s sleep will often unleash additional energy.
Q. I am sore after my surgery and the pain is increasing, what should I do?
The pain from your surgical wounds should fade very quickly and the very uncomfortably pain that tends to loiter in your shoulder is due to the gases used in the abdominal cavity, the gas is used to provide a working space for Dr Blair Bowden to perform the surgery. One suggestion for shoulder tip pain is Degas tablets or peppermint tea and this can often shift the gas hanging around. If the pain continues after a couple of days it is best to contact the office and speak to one of the doctors.
Q. What if I break the rules?
A:Don’t be afraid to call us if you may have ‘fallen off the wagon’, give the rooms a call and have a chat to one of the staff members. It’s good to remember that we are all human and it’s almost impossible to be good 100% of the time.
Q. I think I have a blockage in my lap-band, what should I do?
A: Always keep some diet soda water or Diet Coke in the fridge for ‘in case of emergency’, trying this immediately in small sips may just dislodge what has become stuck. We suggest soda water and Diet Coke as they are the most carbonated and the bubbles may move what is stuck. If this doesn’t work you need to contact the office immediately to arrange to get some fluid removed to flush through what is blocking your band.
Q. What if I think my band is too tight?
A: Ring us straight away if you think your band is too tight. Adjustments are very quick and easy and we can point you in the right direction to get some fluid removed by either Dr Jennifer Duncombe or Dr Fran Bruce. We do offer our patients 24/7 help so if you find yourself in trouble on the weekend or a public holiday – just contact our emergency contact number.
Q. Who does the lap-band adjustments?
Lap-Band adjustments are performed by Dr Jennifer Duncombe or Dr Fran Bruce as well as Dr Blair Bowden. Adjusting the lap-band is considered extremely important part of the success of lap-band surgery. Prior to a lap-band adjustment all patients are required to only have fluids for two hours and then remain on a fluid diet for 24-48 hours after the adjustment is performed.
Q. Will I feel hungry or deprived with the lap-band?
The lap-band 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 that the lap-band is a tool to help you change your eating habits.
Q. 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 A, D and B12, folic acid, and iron.
Q. 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 visit your general practitioner who prescribes these medications.
Q. 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.
Q. 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.
Q. 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 may be greatly reduced or cancelled. Some patients may have difficulty with certain foods such as white bread, dry chicken and steak if it is not chewed properly or it is overcooked.
Q. 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 fibre. This should not cause you severe problems. If difficulties do arise, let us know as soon as possible.
Q. What will happen if I become ill?
One of the major advantages of the lap-band 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.
Q. 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.
Q. Can I participate in contact sports, like rugby or soccer, with a lap-band?
Yes, there are no restrictions on sport participation other than heavy lifting and light exercise in the first four to six weeks following surgery.