Homerton newbie with a few questions

[Londonchelle85]

Hi all,

I've been lurking round the forum for a while since my GP suggested referring me to the bariatric team at Homerton in August last year.

At the time I was quite annoyed, I'd only gone to him due to the arthritis in my shoulder playing up... I got very defensive and essentially told him to do one. However the conversation with him kept playing on my mind, I was 22st at the time (even heavier now) so I started doing research and eventually agreed to him referring me in September.

Fast forward to this week, I had my initial assessment with the nurse/dietician, group seminar, bloods and ECG. I have to say the staff at Homerton are very friendly and put the other hospitals in this area to shame.

I have my 1st surgeon appointment on 17th March, and after that it goes to MDT for discussion. From my research I think the Sleeve is right for me, but obviously will discuss this with the surgeon. I've been reading the forum and have a few questions that I hope someone will be kind enough to answer.

1- I've read on here that some people have to have Endoscopy before surgery, but some don't. Any ideas what would lead you to having to have one? I currently take Lansoprazole due to being on Naproxen long term, not sure if this makes a difference.

2- Random question, but I've also read that some people are catheterised and others not? Is that right? If you had the sleeve did you have a catheter? Same question with Enema really....

3-I know it's been asked a lot, but what do you tell work? I work on the railway, which is very strict with medical issues. All medications have to be checked by the occupational health team etc... I am however more office based now, so maybe that wouldn't be an issue. do I have to disclose what I've had done to them? It's a very male dominated industry, but just as bitchy as a group of women. I don't want the agro. Even my well meaning family are making comments.. I explained about the pre op diet and my aunt came back with, well if you do well on that you may not need the surgery!

4- The seminar mentioned the need to lose 5-10% before surgery, however the dietician only made me commit to keeping a food diary, and stopping full sugar drinks. Should I be focusing on losing 5-10% now, or weight until I see the surgeon? I'm also trying to give up smoking so it's a double whammy at the mo

5- Finally, are there any obvious questions I should be asking the surgeon? Went I went to the appointment on Monday I had a mind fart, and when it got to questions I blanked out.

Thanks for sticking with this long post... good luck to all on your journeys!

 

[TiaLi]

Hi and welcome!

I'm London-based too, but with King's College Hospital. I'll be having a gastric bypass in March. I originally wanted the sleeve but since my reflux is really bad the bypass is a better option (with a sleeve you will increase the pressure inside the stomach, so people who already have issues with reflux tend to get worse). I can try to answer some of your questions, and then hopefully some sleevers will come along and shed light on the ones I'm unsure about:

1. Not entirely sure about this one, but I would imagine that they would want to do an endoscopy as part of the pre-op assessment if you have a history of stomach ulcers etc. If you have a history of ulcers a bypass is generally not a good idea, since the large remnant part of the stomach that is left inside you can still develop ulcers even if it is no longer "used" for food. The problem then becomes that since it is detached from the "active" stomach pouch you can no longer get to it with an endoscope, and you can no longer treat it with oral medicines - so the risk for ulcers to start bleeding becomes much greater.

If they do ask you for an endoscopy, don't worry too much about it. I have had one before, and they are really not that bad, at least if you choose the sedation. Not sure I'd wanna do one with just the numbing spray though. With sedation you'll be knocked out and won't remember much (if anything).

2. Whether you have a catheter or not seems to be mostly a choice of preference by the surgeon to be honest, it doesn't really have anything to do with sleeve versus bypass as I understand it.

3. I have my own business so I luckily don't have to worry about this, but if I was employed by others I personally would not say anything to my colleagues. That's just me though, I'm a very private person and have only told two people about the surgery. If you feel uncomfortable disclosing it to your colleagues, I'd simply say I'm having my gallbladder removed. That's a surgery with similar recovery time, also laparoscopic, and also in the gastric area. In terms of your employer potentially wanting to check medicines, this surgery doesn't really add anything to what you are already taking, since you are already on Lanzoprasole. Everything else is vitamins, I wouldn't count that as a medicine that needs to be disclosed.

4. Weight targets vary so much between hospitals, mine doesn't set one for example. I don't think you should wait till you see the surgeon though, start trying to make changes now (at least try not to gain anything between now an your appt with the surgeon) in order to prepare mentally for life after surgery. I fully empathise with it being difficult to quit smoking at the same time though!

5. Personally I didn't really take any questions with me to the meeting, they just sort of organically came up during our conversation. I had already done lots of research though, so I felt I already knew a lot about the different options. You could always ask him your questions above about what to expect in hospital (catheters etc) if you want. Some people ask about their surgeon's stats (complication rates, how many surgeries they've done of each type etc) but I was reluctant to do that face to face and managed to find it online instead.

Good luck!

 

[MrsLee88]

Welcome to the forum, i am also a newbie and having surgery in March at the Homerton

1. Dr Koak at the Homerton referred me for an endoscopy as i have occasional heartburn - If they refer you for one, PLEASE take the sedation, i opted out so i could get in and out quicker and regretted it instantly! The numbing spray is as useful as a chocolate teapot lol! Scarred me for life!

2.I am lucky to have 3 relatives who have all had RNY procedures, and they all had a catheter (Husband and mother & sister-in-law) but i am at a different hospital to them, so can't comment for the Homerton.

3. I was honest with work, and only told a handful of colleagues - dealing with my own family has been hard enough! Work have been fine, so long as i have a medical certificate there is nothing else they can say.

4. The 5-10% is to more about the action to show you are committed to having the surgery and making long term changes, however being on the pre-op diet is sure to make you loose a lot (my husband lost 2 st on 2 weeks!).

5. Questions depend on individual circumstances, from my experience the information provided at the group session and from the support team has given me everything i need to know. I feel fully prepared - but if you are not sure, call the Bariatric line, consultants are not the most approachable people, the team around them are great however

Good luck, look forward to following your journey

 

[Hannah2]

Hi

Not in your area so can't comment on specifics but can try and answer some of your questions - I suggest reading a lot on here you will pick up a lot from other people's experiences. Try and research as much as you can.

1) endoscopy either because of symptoms or due to surgeons/teams preference. Definitely have sedation - I had one with throat spray only as I didn't have anyone able to go with me - big mistake! Was traumatic. Really wish I could have had the sedation!

FYI - you will need to check if you can have naproxen after the op - normally we shouldn't have NSAIDs after the op, especially not longterm.

2) catheter will depend on the surgeon/team - not heard of anyone having an enema

3) telling work - I didn't tell my boss what op I was having, just that I was having an op. However, the hospital put gastric bypass on the fit note - this went to the admin office and HR so they will know what I had done - this should be confidential though. Don't lie about which op you are having but they don't need to know - I think my boss just assumed it was women's issues! They know now as the time was right to explain as they have noticed my weight/fitness change!

For the LRD diet, if you could do that longterm and it was healthy then yes it would work - but it isn't healthy to stay on longterm and you wouldn't be able to stick to it! Just ignore the comments!

4) yes definitely start adjusting your diet - we had to make sure we were having 3 meals a day, stop drinking with meals and start with multi vitamins. Any weight loss you have now before the op shows commitment and also makes you healthier for the op.

5) you will come up with questions the more you read/pick up from the site.

I would want to know what psychological support you will be given through your journey - a major part of the journey.

Good luck!

 

[Londonchelle85]

Hi everyone, thanks for all your replies.

@MrsLee88 good to meet someone else from Homerton! Good luck for your surgery. I've just received an appointment for the Bariatric Physio- did you have this? I'm not sure what to expect. Also did you have to see a psychologist? Do you know what sort of counselling they provide, if any? Sorry for bugging you with all the questions.

 

[Tracey]

I was at homerton ..
I had the sleeve with no catheter
I found it OK losing the 5%as I wanted the op so much ..
Didn't stop smoking until I started the LRD ... so was smoke free for 2wks then started again 3wks after op
Lovely people at homerton .. x