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Frequently Asked Questions

General

Where can I find parking?

St George Private Hospital has two public car parks. One below the hospital is full throughout the day and is reserved for patients with disabilities, and one over the road off Montgomery St. If you are unable to park in the private hospital’s car parks there is another larger car park further along South Street which has ample parking. Both car parks charge an hourly rate which can be paid via cash or card. There is also limited street parking around the hospital (2 hours maximum stay), this is free of charge.

What if I need to rearrange an appointment?

If for some reason you are unable to make your scheduled appointment, then please call our team who will be able to reschedule this for you. Please allow as much time as possible when changing appointments times and avoid if possible, as due to busy schedules you may not be
able to get an appointment within the same date range as your original appointment.

What do I need to bring to my appointment?
  • GP referral
  • Medicare/private health card
  • Patient information form (if not completed online)
  • Scans/X-rays
  • Blood test results

Payment

How do I pay for my surgery?
Credit card, bank cheque or directly in to our account.
When do I pay for my surgery?

1 week before.

Do you offer payment plans?

We don’t offer any payment plans for surgery, payment is required in full one week before your surgery date. Bank details are provided to make payment via EFT. You can pay for your surgery using a credit card or bank cheque. Please call our office for more information.

What private health funds do you accept?

All.

Is there a no-gap or known-gap scheme through respective health funds?

Surgeons at our practice can participate in both the no-gap and known-gap schemes for certain procedures undertaken. Whether we participate depends on the health fund and the complexity of the procedure.

What if I don't have private health insurance?

In this situation patients will have to cover all of the costs associated with their admission. It is generally impossible to determine an exact figure for the total cost of surgery, for example, unforeseen events such as additional necessary treatment will incur further costs. To give you a rough idea of some of the costs involved in hospital admission:

  • Bed costs approx $1,200 per day.
  • Theatre costs approx $2,000 per hour, in addition to this the costs of theatre equipment, approx $2,500- $5000 depending on the operation.
  • Admission to Intensive Care Unit (ICU), if required, approx $3,000 per day.

Hospitals in Sydney, NSW will provide quotes to patients before admission and expect an up-front payment on or before the day of admission for the quoted amount. As well as the hospital quote, patients will need to get quotes from the Surgeon and Anaesthetist, and these fees will need to be paid before surgery.

How long does it take to access my super fund for bariatric surgery?

Accessing your Super Fund for surgery usually takes 2-4 weeks and these claims are made through the ATO.
https://www.ato.gov.au/Individuals/Super/In-detail/Withdrawing-and-using-your-super/Early-
access-on-compassionate-grounds/

What is the clinic fee?

The clinic fee is an aftercare package that includes:

  • Bulk billed follow up
  • Two Dietitian appointments
  • Nutrition pack consisting of
    • Portion Perfection bariatric bowl and plate
    • 1 month supply of bariatric multivitamins
    • A copy of Your Complete Guide to Nutrition for Weight Loss Surgery by Sally Johnston
  • Enrolment to the Fresh Start online support, education and coaching program

Bariatric Surgery

How soon can I have my bariatric surgery?

There are a series of steps that each patient has to take before surgery:

  • Usually 2 medical/surgical appointments and 1 dietician appointment are required before surgery, however some patients schedule potential theatre dates after their first appointment.
  • Access to funds (insurance, super, paying directly).
  • 2 – 3 weeks of Optifast to minimise liver size to make surgery safer.

Once the above have been resolved, surgery could be booked within a few weeks depending on your chosen surgeon, for example Dr Yee or Dr Maani can facilitate surgery for patients with minimal wait times.

How much weight will I lose following surgery?

The amount of weight you can lose following surgery will depend on the type of surgery that you undergo, a patient’s genetic makeup, and their adherence to the post bariatric program (diet, exercise). On average patients who have a lap band will lose 15 – 25% of their total body weight (TBWL). A sleeve gastrectomy will give you 25 – 30% TBWL and a gastric bypass would be around 30 – 40%. However, surgery such as the gastric bypass will mean taking vitamin supplements for the rest of your life and is a more complicated operation.

How quickly will I lose weight following weight loss surgery?

Generally, after a sleeve gastrectomy we expect to see 50% of the total expected weight loss to occur by 3 months following surgery and the remaining weight loss by 12 months. This can average out at about 1 – 2 kg of weight loss per week, but plateaus when no weight loss is experienced are normal and can last several weeks. It is important for patients to come to their follow up so that we can track their weight loss and make adjustments to their diet/exercise plan to ensure that they are on track. Occasionally patients will require medication to improve their overall weight loss.

Will I experience a lot of pain following weight loss surgery?

As with most keyhole operations, surgery is well tolerated with pain not being a significant complaint. Most patients will require some oral pain relief for 2 – 3 days post op. Occasionally whilst in hospital patients will be administered a PCA (patient controlled analgesia).

How long will I be in hospital following my weight loss surgery?

Most patients will stay in hospital for 2 nights, although on occasion 3 nights. Generally, once a patient can tolerate a litre of fluid within 24 hours, and are comfortable on oral painkillers, and are mobilising freely, they are safe for discharge.

Do I have to lose weight before surgery?

Yes. We recommend at least 2 weeks on a VLCD (very low calorie diet) prior to surgery, with guidance from our dietician on a meal plan leading up to surgery, such as Optifast. This helps to shrink the liver which sits above the stomach, thereby allowing us to perform the operation safely as there is more space to operate. Even 3 – 4 kg weight loss is usually sufficient for the surgery. This diet also kick starts the body into ketosis, the state your body will be in for the first 6 months following surgery. This is your body metabolising fat as energy.

How long do I need to follow a VLCD program prior to bariatric surgery?

On average, patients will need to follow a VLCD for 2 weeks prior to surgery, however depending on your starting weight and medical conditions, you may need to follow it for longer (4-8 weeks). If this is the case, you may require more than 3 VLCD products per day. This can be discussed with your dietitian.

What are the side effects of VLCD Programs?

Hunger, fatigue, headaches, nausea, bad breath and lack of concentration are common in the first 3 -4 days. Your body will adjust to the new energy-burning system and you will feel satisfied with minimal amounts of food. Most symptoms will pass by days 4-6.

So much emphasis is placed on protein after bariatric surgery, why do we need protein?

Protein is important while healing and to prevent muscle and hair loss while losing weight. Not eating enough protein can result in a weaker immune system and can result in inadequate weight loss long term. Always include protein rich foods at mealtime and ensure to eat your protein foods first for adequate nutrition.

I’m eating well, do I still need to take my multivitamin?

Sleeve and Bypass procedures will change your stomach function permanently. They lead to a permanent reduction in absorption of minerals which require stomach acid to be best absorbed (Iron, Calcium, Magnesium etc) and an increased requirement for some vitamins such as Thiamine. Patients who stop taking multivitamin supplements are almost guaranteed to get some sort of vitamin or mineral deficiency, however many of these can occur years after surgery.

I’m not opening my bowels daily, what should I do?

After weight loss surgery, many people will develop a new bowel habit. Opening your bowels every 2-3 days is ok as long as you’re not uncomfortable. During the recovery period, you may find your bowels behaving differently often from one extreme to another, but this should settle as you return to normal eating. Constipation is managed by ensuring adequate fibre, fluids and regular physical activity. As this may be difficult in the first 2 weeks, a mild laxative such as Lactulose may be beneficial during this time. As your food intake increases and you are able to include adequate amounts of fluids on a daily basis, a soluble fibre supplement such as Benefiber can be useful.

When can I start drinking alcohol after surgery?

Alcohol is a “triple threat”, it’s high in calories, it stimulates hunger and it promotes eating of high fat/high carbohydrate foods. Patients after many bariatric surgeries are at increased risk of developing alcohol dependency disorders after surgery, and regular alcohol consumption after Bypass surgeries will reliably cause stomach ulcers to develop.
With this in mind however, occasional alcohol consumption is safe once the stomach has healed at around 1 month post-operatively.

I do not suffer any reflux post surgery, do I need to take the anti-reflux medication and for how long?

We like patients to be on anti-acid tablets (Pariet, Nexium, Losec etc) for 1 month after Sleeve surgery and 3 months after Bypass surgery. Bypass patients who are on Aspirin or anti- inflammatories (Neurofen, Voltaren etc), who smoke or regularly take excess alcohol need to stay on these tablets lifelong.

Will I lose my hair following bariatric surgery?

Hair Loss generally occurs after significant weight loss for any reason, and this predominately relates to deficiencies in silica and protein intake. To minimise this it is best to take hair skin and nail supplements, as well as maintain a daily protein intake of around 60g.

When can I get pregnant following bariatric surgery?

Pregnancy should be delayed until your weight is stable for at least two consecutive months – approximately at the 12 month mark for Sleeves, 18 month mark for Bypasses.

Will I have excess skin following bariatric surgery? And what can I do about it?

As a result of bariatric surgery you will have some excess skin, however the amount of loose skin varies a lot from person to person. The older you are and the more weight you lose the more likely this is to happen. Unfortunately, there is no way of ‘getting rid’ of excess skin through any form of exercise/toning. The only way to deal with excess skin following weight loss from bariatric surgery is through body contouring surgery (plastic surgery). Around 1/3 of patients seek this option after bariatric surgery.

Can I get an endoscopic sleeve at Upper GI Surgery?

Dr Talbot is trained in ESG procedures and has done them. There is information about this procedure on our website in the Complete Guide to Weight Loss Treatments booklet. As this procedure isn’t covered by health funds and is more expensive than surgery, we see less and less people asking for it.

What is an EPC / Care Plan?
An EPC is a health care plan within the medicare system where GPs are able to plan treatment for patients who suffer from chronic health conditions with other medical providers/allied health.
If you are eligible for an EPC you may get a rebate from medicare for some of your dietician consultations at Upper GI Surgery.
You will need to make an appointment with your GP to ask for an EPC to be used for our practice Dietician Tania Chaanine.
Ensure a copy of your EPC is provided to the Upper GI Surgery practice. The EPC is only valid for one calendar year at a time.
What is the clinic fee?

The clinic fee is an aftercare package that includes:

  • Bulk billed follow up
  • Two Dietitian appointments
  • Nutrition pack consisting of
    • Portion Perfection bariatric bowl and plate
    • 1 month supply of bariatric multivitamins
    • A copy of Your Complete Guide to Nutrition for Weight Loss Surgery by Sally Johnston
  • Enrolment to the Fresh Start online support, education and coaching program

General Surgery

Can I eat before surgery?

It’s critical for anaesthetic reasons for patients to have an empty stomach before surgery. If someone has a full stomach at the time of surgery they can aspirate stomach content into their lungs which is very dangerous. Light meals can be had up to 6 hours before surgery and clear fluids (black tea, black coffee, water, pulp free fruit juice or cordial) up to 2 hours before surgery.