Ready to get started?

Call Angela today at 
740-654-6213 to get started on the pathway to surgery!

Your new life isn't as far away as you think. This is your step by step pathway to surgery. 


Step 1 - Education

The decision to pursue weight loss surgery (WLS) should not be taken lightly. Pursuing this step will likely change the course of your life. Indeed, most have been considering surgical weight loss for at least 2 years before scheduling a consultation As such it is imperative that you spend some time educating yourself about various implications of this decision and details of these procedures. To that end, our website has been carefully designed to provide you with an ample amount of clinical information such that you can make an informed decision. If in that process you determine that weight-loss surgery is for you, we ask that you contact us at (740) 654-6213 to schedule a phone interview with one of our staff.

 

Step 2 - Telephone Interview

After our initial contact, Angela Rowe, LPN, (740) 654-6213, will spend a few minutes with you on the phone going over a screening questionnaire and obtaining pertinent insurance information. 

After this we will perform an insurance verification and get back with you concerning the specific requirements in regard to your benefits.  If your plan excludes bariatric benefits we will assist you with exploring other options .

Once the verification is completed, we will contact you to schedule an initial surgical consultation.   Please note: It is imperative that you commit to this appointment only after thoughtful consideration and education. This is not an informational seminar, and you are expected to have a working understanding of the options available to you. Further, these appointments are scheduled several weeks in advance, and occupy a significant time slot. You are free to cancel with 24h notice, but be advised that“no shows” will not be rescheduled.

 

Step 3 - Surgical Consultation

We believe that it is important to meet and connect with your surgeon early in the process, as this is a relationship that will continue for years to come. We therefore will schedule a Consultation with Dr. Custer as the next step in our process. This is a detailed evaluation where Dr. Custer will :

  • Review your medical history and have a discussion with you concerning the unique aspects of your situation.
  • Determine what medical clearances will be needed, as well as other preoperative studies and/or procedures that may pertain to you. 
  • Have a discussion as to which procedure will be best for you and why. Please note that while we will discuss specific aspects of these procedures as they pertain to your case, you are expected to come having reviewed and acquired a basic understanding of the surgical options available. 

After meeting with Dr. Custer, you will meet with Angela, our Bariatric Coordinator.  She will review with you our preparatory program, and discuss issues in that regard that may be unique to you. You will receive a tentative schedule and a timeline, such that there will be no ambiguity as to the plan and expectations during this process. 

You are encouraged to bring a family member or support person for this visit. Please do not bring children, as you will need to plan to be here approximately2-3 hrs.

 

Step 4 - Preparatory Program and Medical Clearance

After your consultation, we will enroll you in our Preparatory Program. This unique multidisciplinary program has been created to accomplish two goals: The first is to satisfy insurance requirements that usually accompany most plans, but more importantly it is designed to ensure that you are well prepared for surgery and the changes that you will experience thereafter. This program spans approximately three months, and includes interaction with multiple members of our team:

  1. Individual dietary consultation with Emily our Dietician on two separate occasions.
  2. Group classes focused on nutritional and lifestyle habits critical to success.
  3. Individual consultation with our Exercise Specialist Chris, followed by creation of a customized exercise regimen.
  4. Psychological evaluation with Dr. Jeanine Abbot with recommendations for further support as needed.
  5. Medical Evaluation with Bariatrician Dr. Robert Zee pursuant to medical clearance, preop weight loss, and referral for additional testing/consultation as needed.

After completion of the Program, we will conduct a multidisciplinary Review of your case to ensure you are adequately prepared to proceed with surgery.

Once this is completed, most are ready for insurance submission for surgery approval. We will submit a letter of recommendation to your insurance carrier, along with the required documentation. We have included in our program most of the stipulations which are required by most insurance carriers. However, there are several we work with which may ask for more than what our program includes. This will be anticipated, and those situations will be addressed on a case-by-case basis. Also note that for those whom are “self pay” (and therefore going outside of their insurance) the preparatory program is still a required and vital part of our process. 

 

Step 5 - Insurance Approval

Once approval is obtained, we will schedule you for a Preoperative Appointment with both Dr. Custer and Angela Rowe. This is a time to review our workup, and go over any final concerns and/or issues that may have arisen over the previous weeks.

 

With Dr Custer you will review the details of the anticipated procedure, as well as the expected hospital course. We will once again review the choice of procedure anticipated and finalize that decision. This is also an opportunity to address any questions that may have come up during our preparatory program. Informed Consentwill be obtained as well.

When meeting with Angela she will review the details of the hospital process, risks of surgery, dietary phases, and our preoperative diet (to be followed starting one week prior to surgery). In addition she will review with you our postoperative follow up plan.  A “before” picture will be obtained for our records (so dress nice!). 

You will meet with our Financial / Budget / Insurance Counselor to answer any remaining questions you may have.

You will meet with our Scheduler, and set a surgery date.  In addition preoperative procedures (such as endoscopies/IVC filters) that may be required will be scheduled accordingly. Any labs/xrays that may still be needed will also be ordered.

 

Step 6 - PAT  I  Surgery Scheduling

In most cases, you will be admitted to the hospital the morning of surgery, and be called the night before to be told when to arrive. You can anticipate arriving at the hospital about 2 hrs prior to surgery. Intraoperative time is typically 1–2 hrs,  followed by about an hour in the post op care unit. We anticipate you will go to our Bariatric Unit thereafter. 

We have a very specific postoperative protocol which all of our patients follow. You will be cared for by specialized nurses trained in the care of bariatric patients.  A typical hospital stay is 1 to 3 days, depending upon the procedure performed. 

You will receive a complete set of post operative instructions upon discharge, and our dietician will review you dietary progression once again prior to going home. In addition you can anticipate a call from our coordinator within 24 hrs thereafter to check up on your progress.

Most patients return to work within 4 weeks of surgery, but this varies depending upon each individual’s situation.

 

Step 7 - Surgery  I  Hospital Stay

Although surgery is a key step in the process, this is only the beginning, and judicious follow up is critical to achieving your goals.  As such, we have established a specific post operative follow up protocol . 

This starts within a week of discharge, and involves ongoing support from all those with whom you have come to know over the preceding months. There are multiple visits throughout the first year, as this time period is critical in establishing habits which will be vital to your long term success.  

This is a very exciting time, as we anticipate you will experience many radical and positive changes in your life. There will no doubt be challenges and difficulties, and it is important to us that we can walk with you through this process. 

Routine Follow up is typically at 1 week, 6 weeks, 3 months, 6 months, 12 months and then annually. Follow up with Dr. Zee may be indicated on a case-by-case basis, but we recommend you visit your Primary Physician frequently in the months following your surgery.  We will keep them abreast of your progress as well.

We hold our post op regimen to be as important, and sometimes even more important, than our preop preparation. In that regard, input from all members of the team throughout the entire spectrum of your experience is a critical component of success. This is, after all, the whole point of a multidisciplinary approach. 

We will continue to be involved long term, and you can anticipate an annual visit with our team. In addition, we will be readily available for any new concerns or problems, as we consider our relationship to be one which will last for many years to come. 

 

Step 8 - Postoperative Program

Although surgery is a key step in the process, this is only the beginning, and judicious follow up is critical to achieving your goals.  As such, we have established a specific post operative follow up protocol . This starts within a week of discharge, and involves evaluation and ongoing support from all those with whom you have come to know over the preceding months. There are multiple visits throughout the first year, as this time period is critical in establishing habits which will be critical to your long term success.  This is for us a very exciting time, as we anticipate you will experience many radical and positive changes in your life. There will no doubt be challenges and difficulties, and it is important to us that we can walk with you through this process. Thereafter, we will continue to be involved, and anticipate an annual visit with our team. In addition, we will be readily available for any new concerns or problems, as we consider our relationship to be one which will last for many years to come.