What You Need to Know Before Your Appointment
New Patient Evaluation
Your first evaluation as a new patient will take about four hours. During this time, you’ll participate in several group education sessions, as well as individual assessments with members of our team.
The Advantages of Group Education
Our bariatric team meets with patients in group settings, followed by an individual assessment. The group education model has been shown to improve health outcomes in people with chronic diseases such as diabetes, high blood pressure, and other medical conditions related to obesity and metabolic syndrome. Many of our patients appreciate the opportunity these group education sessions give them to interact with others going through similar experiences.
How to Prepare for Your First Appointment
We know a 4-hour meeting makes for a full day, so there are definitely breaks built into the schedule. Please feel free to bring healthy snacks and beverages, but keep in mind that we do not allow any fast-food items or unhealthy food/beverage choices.
Bring A Support Person
We encourage you to bring someone with you to the New Patient Evaluation. In fact, it might help you to identify a support person who can attend appointments with you throughout the process. Please understand that children under 12 cannot be left unattended in the waiting area.
What We Cover at Your First Evaluation
Individual Surgical Consultation
You’ll meet individually with one of our medical providers. If you haven’t already determined who will be your surgeon, we will assign one for you.
Your surgeon will review your health history and conduct a medical evaluation to determine your individual risk for surgery. Your surgeon will also determine what you need to do in advance of surgery to optimize your health and lower your risk. They will order a series of tests, after which they will discuss the weight loss surgery options that would best help you meet your expected weight loss goal.
Each person has their own reason for choosing weight loss surgery and their own unique goals. We want you to keep an open mind. There are many factors to take into consideration when choosing which procedure is right for you. Our bariatric surgeons will review the pros and cons, as well as the benefits and risks of each procedure. After your testing and your individual surgical consultation, you’ll have a better understanding of which procedure will help you best achieve your goals.
Long-term success after surgery requires a commitment to adopting proper eating habits, taking vitamins, and monitoring vitamin levels for the rest of your life. You'll be asked to complete a nutrition survey and food diary in My Duke Health before this session so we can tailor our discussion to the participants in the class. We will give you an overview of nutritional expectations for the whole process, including before and after surgery, so you know what to expect.
Undergoing weight loss surgery requires many changes in the way you think about yourself, interact with others, and handle life’s many challenges. You will be asked to complete questionnaires about your mood, relationships, and health behaviors. These will be reviewed with you in a two-hour individual consultation with one of our behavioral psychologists. They will discuss your lifestyle habits; your mood and psychological functioning; your motivation, relationships, and support for weight loss surgery; and your goals.
We understand that the cost of bariatric surgery and the lifestyle changes it warrants can be considerable. We want to make sure you understand the process, what your insurance requires, and what expenses you may expect. For example, depending on the surgery you have, there will be expenses related to a lifelong need for vitamin supplements, protein shakes, and healthy food choices.
Before your first appointment, we will use our patient portal, My Duke Health (previously Duke MyChart), to send you an estimate of the costs you will incur before, during, and after bariatric surgery. At the meeting, our financial coordinators will review the information with you to help you understand the insurance process so you can budget appropriately for surgery.
What Tests You Should Expect
A series of medical tests will help us assess your current health, determine which weight loss procedure will work best for you, and minimize your risk of complications. You may be able to have these tests at the hospital on the same day as your new patient evaluation. If so, please allow for more time. It’s possible these tests may point to the need for additional testing. The full list of tests follows, but each person will have a different combination of tests.
Blood and Urine Tests
These tests will look at the health of your organs and any abnormalities in your body fluids and hormone levels.
Chest X-Ray and Electrocardiogram
These images of your heart may be required, depending on your medical history.
Ultrasound
We may perform an ultrasound of your gallbladder to look for signs of disease.
Endoscopy
Your doctor will pass a long, flexible tube with a camera at its tip through your mouth and down to your stomach to assess the health of your esophagus and look for signs of GERD, the presence of hernias, and other conditions that affect your GI tract.
Sleep Study
You may undergo a sleep study if you experience sleep apnea.
Pulmonary Function Testing
These tests may be performed if you have trouble breathing.
Following Your First Appointment
Our Nurse Navigator will Guide Your Path to Surgery
Our nurse navigator will coordinate the findings from your meetings with the bariatric team and ensure you have completed all the necessary tests. She will also help you make sure you are meeting all the requirements of your insurance plan.
Medical/Surgical Review
Once your testing is complete, our team will meet to review your results and determine if you are eligible for surgery. If the team concludes that you are ready, your information will be submitted to your insurance company. Your surgery will be scheduled once it has been approved.
