Because Gerald lives close to the Weight Loss Team Center, his preparatory bariatric surgery consultation was spread over several days. His pre-op tests were completed in the days leading up to his surgery, rather than the day of surgery. During Gerald’s pre-op interview with Dr. Juan Hidalgo, the doctor explained the steps of his surgery, the possible outcomes, and Gerald’s role in a safe recovery.
Gerald: And then we did the pre-op interview with the doctor. We've already done the pre-op testing. This is the phase normally when the pre-op tests are being done and then the patients are typically waiting for surgery. We did those prior, and you've seen those in the prior chapter. Here now what we're waiting on is surgery. They've wrapped my feet. They've drawn . . . they've put the IV in. Everything is good to go, and we're just getting ready and waiting for Dr. Hidalgo to arrive. When he comes in he'll speak with us and see what he has to say, and then we'll go down for surgery and then we'll see how it goes. I'm ready. I'm excited and this is going to be the next step in my brand new life, so I'm looking forward to the next step. Dr. Martinez: Hi, Gerald. I'm Dr. Daniela. I'm going to be your anesthesiologist. Gerald: Nice. Dr. Martinez: How are you? Gerald: Good. Thanks. Dr. Martinez: Okay. Are you ready for the surgery? Gerald: I'm ready. Dr. Martinez: Okay. Perfect. In this occasion, your anesthesia is going to be a general anesthesia. You're going to be asleep all the time. You're not going to feel anything. You're not going to feel pain, and you're not going to remember anything in surgery. Gerald: Okay. Dr. Martinez: Okay? Dr. Hidalgo: Gerald, good morning? Gerald: Good morning. Dr. Hidalgo: Are you ready for the surgery? Gerald: Yeah. Dr. Hidalgo: How you feel? Gerald: Pretty good. Dr. Hidalgo: Yeah? Gerald: Yeah. Dr. Hidalgo: Okay. Well, about your surgery, your surgery going to be the revision surgery. Then the revision surgery is to remove the lap band, okay? And then we're going to see if it's possible the gastric sleeve or the bypass, okay? Depends on the conditions, okay, because you've been with the lap band 15 years? Gerald: Eighteen years. Dr. Hidalgo: Eighteen years. Okay. Well, okay. May I check your belly? Gerald: Sure. Dr. Hidalgo: Okay. One of the difficult things here it's the last surgery you had was an open surgery, so you have a big scar here in your belly. This is one of the reason why you've been waiting. So in this kind of situation, exactly really, we don't know. We should be going inside and depends internally how the conditions are. Sometimes these can scare us or just think many things, but sometimes it's like nothing, okay? Depends on your genetic conditions and basically, if you have or not the scar tissue inside, okay? So could be a really, really clean cavity and that's all, okay? So about the incisions will be a laparoscopic surgery, and basically, we use five incisions. These five incisions the most bigger is this size, almost one inch, okay? Basically, we're going to place here. We're going to try to use the last incisions, the ones you have. Obviously, you have a port. We're going to remove the lap band port. So maybe you have an extra incision, depends, okay? Sometimes necessary. About the surgery exactly the time, with an hour will be two and a half, three hours. This is the expected time. But we're going to see. When we finish the surgery you're going to have medication for controlling pain, nausea and vomiting. So it's possible you need extra medications for controlling the pain or vomiting, just call the nurse, and then the nurse will come back here and give you more medicine for control that, okay? All the staff here in the hospital it's amazing, okay? Whatever you need just call, just push the button, and the nurse is going to be here 24 hours. Try to move after the surgery. Stand up, complete few steps, okay? Don't push yourself, but be honest with yourself. If you can do it, do it, okay? Few steps for going to the bathroom, it's very important, okay? When you stand up and move you're going to improve the condition in your body. You're going to move the blood from your legs and going to prevent the blood clots, and you're going to absorb more faster the gas. So the gas which will remain in your cavity after the surgery is going to be much, much, better. You're going to feel less belly distention, okay? Questions? Gerald: No. I'm ready to go. Dr. Hidalgo: Yeah? Okay. After the surgery if it's a gastric, it's a 24 hour fast, no liquids, nothing, or if it's bypass, going to be 48 hours, okay? You could rinse your mouth, you could brush teeth, but just be honest. Don't pass water. Don't pass nothing. Gerald: Right. Dr. Hidalgo: Okay? If it's bypass with you, we're going to remove the gastric fundus for controlling the ghrelin production for avoid the hungry sensation, the starving sensation, okay? Gerald: Okay. Dr. Hidalgo: Basically, this is . . . so questions? Gerald: That's what I'd like to do, so. Dr. Hidalgo: Okay.