At Obesity centre we are committed to helping you lose weight.
When you decide to make a commitment for a better future, better health and a new beginning. Dr Tsang will offer you a range of procedural options that is best suited to you and make sure you are in the best health possible before undergoing any procedures. Our promise to you is that we will offer every patient:
Professionalism: Dr Tsang is an experts in the field of bariatric surgery and his team of support staff are dedicated and friendly.
Commitment: We will help you to beginning your new journey in life and beat obesity by providing you with the best care possible and monitoring your progress as you undergo treatment and recovery.
Support: Dr Tsang and is team will provide you with the care and assistance you need to adjust your lifestyle and diet, and achieve your weight loss goals. You talk directly to Dr Tsang if you need assistant is any way.
Assessment
The first step you take towards losing weight and improving the quality of your life is often the hardest to take. When you decide to undergo weight loss procedure, you can arrange an appointment with Dr Tsang in one of his consulting rooms or via video consultation. You will need to bring in a referral letter from your GP so that a portion of your fee can be rebated by Medicare.
Most patients will have done extensive research online and have alot of questions about their condition, weight loss, and their options for treatment. Based on your BMI Dr Tsang will discuss with you’re your best surgical option to result in the best possible weight loss outcome. He can also performs certain assessments or tests prior to the surgery. These assessments are performed to check your general health, behavioral health, current life situation, motivations and expectations. If there are any concerns he can offer suggestions to improve these issue before embarking on surgery. He will discuss your medical history, long term goals, and current health with you and answer any questions you may have about the benefits and risks of surgical treatment.
If there are behavioural health issues, these may includes assessment of your previous attempts at losing weight, eating and dietary habits, physical activity and health related risk taking behavior. If these are present you may be referred to see a psychologist.
He will also assess your motive to undergo bariatric surgery and what your psychosocial, emotional and lifestyle related challenges and expectations are following surgery.
Clinical assessments help your surgeon to know whether you are ready for the surgery in all ways.
Plan
- Chose an operating date that suits you best
- Ensure that you will have support at home post surgery
- Taken leave 7 to 10 days off work for office workers
- Check with the health fund for coverage if insured
- Book a date dietician consultation 2-3 weeks before surgery
- Commence Optifast diet 2 weeks before surgery.
Dietician/Psychologist preparation
Our dieticians are experts in nutrition and also address some of your behavioral eating patterns. When a patient makes a decision to undergo weight loss surgery, dieticians are required pre-operatively to assess their dietary and eating habits. These assessments help your surgeon to decide if you are ready for the surgery.
The assessments involve:
Tracking the change in your eating habits
Assessing your efforts to change your eating habits and live a healthy lifestyle over time
Collecting information regarding your dietary habits which may cause problems post surgically
Guide you through pre-operative very low calorie diet ( optifat )so that you can complete the 2 weeks program.
Psychologists are physicians who help you to cope with mental health issues. Dr Tsang will decide if you are required to see a psychologist prep surgery.
Preparation
- Do not eat or drink ANYTHING after midnight unless you have been instructed to take certain medications with a sip of water early the morning of surgery.
- You may bring pajamas, bathrobe, slippers, bathroom items.
- You may bring cell phone, iPod, tablet, laptop, books, photographs, etc .
- Do not wear jewelry other than wedding ring
- Bring your Incentive Spirometer that you were given at your pre-op visit with the
Respiratory Therapist. - If you have sleep apnea, bring your CPAP mask, tubing and machine.
Admitting
- Your first stop will be Hospital Registration
- Bring your insurance information
- You will be taken to the Pre-op holding area and your family will be shown where the surgery waiting room is located.
Procedure
Pre-op
- In the pre-operative holding area, you will change into a hospital gown, be weighed, then lie in a hospital bed
- You will have an IV started and an antibiotic given through the IV
- If you are diabetic or pre-diabetic, an accucheck will be done
- Women may have a urine pregnancy test done
- You will be given a Heparin (a blood thinner) shot to reduce your chance of developing a blot clot in your leg veins during surgery
- You will have compression stockings placed on your lower legs
- You will void before going back to the Operating Room
- You will meet the anesthesiologist who may give you a sedative through the IV
- Dr. Tsang will see you before you go into to the OR
Operating Room
- There will be large ceiling lights and many machines
- You will transfer to the Operating Room table, lying flat on your back with your arms extended on armboards
- You will be covered with a blanket
- Heart monitors will be placed on your chest
- An oxygen monitor will be placed on your finger
- The anesthesiologist will place an oxygen mask on your face, then will give you your initial anesthetic drug through the IV and you will go to sleep
- Once you are asleep, he will place a breathing tube in your trachea (wind-pipe) through which you will receive oxygen and anesthetic gas throughout the operation. You will not feel this.
- Once you are asleep, the Doctor may insert a catheter in your bladder which will be removed at 6 am the day after surgery
- The anesthesiologist will give you pain and nausea medications right before you wake up
- When you wake up, the breathing tube will have been removed, an oxygen mask will be on your face, and you will be in the recovery unit.
Post-op
Post-op Recovery Unit/ Post-Anesthesia Care Unit (PACU)
- You will be groggy, but breathing on your own
- If you have pain, the nurse will give you medication
- If you have nausea, the nurse will give you medication
- If you have sleep apnea, you will wear your CPAP in the PACU and each night in the hospital.
- After about one hour, you will be transferred to the Surgical Unit
Surgical Unit
- Your active participation is crucial to your recovery and will be expected of you.
- Your recovery will be aided greatly by remembering these three things:
- WALK: Walk in the halls at least every two hours beginning 6-8 hours after your surgery and each day from 6 am to midnight
- WATER: Drink and sip throughout the day
- WIND: Use your Incentive Spirometer (Triflow) 20 consecutive times every hour with the goal of reaching your pre-op level
- You will have a drain in your right side ( sleeve and bypass surgery) which will be removed the day you go home.
- You will have supplemental oxygen delivered through a nasal cannula which you must wear all night.
- You will have compression stockings on your lower legs. These must remain on your legs throughout your hospitalization.
- You may disconnect them from the machine ONLY when you walk.
- You will begin drinking ice chips and sips of water the afternoon/ evening of surgery.
- You will begin using your Incentive Spirometer (Triflow) 20 consecutive times every hour.
- You will begin walking every two hours the afternoon/ evening of surgery until midnight.
- If you have sleep apnea, you will wear your CPAP while sleeping each night.
- Your regular oral medications will be resumed.
- Dr. Tsang will see you every day while you are in the hospital.
Supporters and Visitors
- Spouse, significant other, parents, or a friend are encouraged to help you in your hospital recovery, by encouraging you, walking with you and helping you to remember to drink your water and use your incentive spirometer.
- One individual may be permitted to sleep in the hospital room with you.
- Visitors are not permitted to bring food into the hospital room.
- Do not bring family members or friends who are not supportive of your decision to have bariatric surgery.
- We do not encourage several or frequent visitors during your hospitalization. We want you to concentrate and participate in your recovery.
Discharge Instructions
- Most patients will be discharged two days after their surgery (Gastric Bypass or Sleeve Gastrectomy). Nearly all patients will be discharged within 3 days of the operation.
- The nurse will remove your IV and your drain.
How long will it take me to recover?
A majority of patients only need to stay in hospital for 24-48 hours after surgery, although others may need to rest up for several days before they have recovered enough to return home.
You will need to arrange to take a week or two of leave from work and move carefully. This means you will need to avoid driving or strenuous physical activity for two weeks.
Your doctor will provide you with strict instructions on how to ensure your recovery at home is smooth. These instructions will include a timetable for recovery, gentle exercises to help you stay active, and a detailed meal plan.
Maintenance
After bariatric surgery, regular post-operative follow up visits are important to ensure your complete recovery and a successful outcome. The discharge instructions will have the periodical follow-up visits listed.
Your first visit will be scheduled two after surgery with Dr Tsang. You will be required to visit your surgeon regularly – three months, six months and then annually if you have sleeve or gastric bypass surgery. For patient who had gastric banding surgery, your first band adjustment is at 6 weeks post surgery.
At each follow up visit, please keep your doctor informed of your recovery/progress and contact your doctor for any health concerns you have in between visits. Please call the office to make appointments for your visits.
You will also be seeing our dieticians before you progress to the next phase of your diet. Usually at 2,4 and 6 week interval. After this transition is completely, you change chose to see our dietician regularly.
