Preoperative Timeline

3 to 6 Months Before Surgery

• Attend a Surgical Weight Loss Informational Meeting with your bariatric surgeon.. For meeting dates and times, please visit HolyCrossHealth.org/WeightLossSessions or call 301-754-8800. Once a Kaiser patient has completed watching the EMMI education videos, they can call the Specialty Call Center at 301-386-6670 to schedule their surgical consult. For Kaiser patients, pre-surgical blood work should be completed before the initial surgical consult. 
• Start exercising 20 to 30 minutes, 3 to 5 times per week, per your doctor's approval. Holy Cross health offers a variety of fitness and movement classes.
• Schedule a sleep study (polysomnogram). The Sleep Center at Holy Cross Hospital can perform this requirement. For more information, call 301-754-7969. For Kaiser patients, a referral will be placed to the Kaiser Sleep Clinic for sleep apnea evaluation. 
• Meet with a nutritionist monthly or as required bu your insurance and get started on prescribed vitamins. Your bariatric surgeon’s office will provide the name and phone number of a nutritionist. Outpatient nutrition counseling is available at Holy Cross Hospital. For more information, call 301-754-7848. For Kaiser patients, members will meet with the bariatric surgeon to determine if they are a surgical candidate. Once candidacy is determined, a referral to Bariatric Nutrition will be entered. The Kaiser Bariatric Nutrition program will take 3-6 months to complete. 
• Meet with a mental health provider. For Kaiser patients, a referral will be placed to the Behavioral Health Department. Patients who have Kaiser Medicaid will receive special instructions on scheduling the behavioral health evaluation. 
• If you are diabetic, stick to your diet and check your blood sugars as directed by your primary care physician. The goal blood sugar is 100 to 180 mg/dl. Kaiser patients who have diabetes will be required to achieve an HgbA1c goal of 7% or less. 
• Manage any chronic health conditions, obtain your pre-operative clearances, and take all your perscibed medications.
• Make arrangements with your employer to take time off, secure help at home from family members, etc.

• Complete all of the above. If your initial sleep study diagnosis is obstructive sleep apnea, get the second (titration) sleep study done and start using your prescribed CPAP (Continuous Positive Airway Pressure) mask right away.
• Make sure you have all appointments with the necessary specialists scheduled to obtain medical clearance.

• Arrange any necessary pre-operative testing with your primary care physician.
• Stay on course. Follow your preoperative diet goals as discussed with your nutrition team. Exercise. Take your vitamins and medications as prescribed. Use your nasal CPAP.

• Your surgeon may require you to begin a low carbohydrate, all-liquid diet at this time. Closely follow the full liquid diet as reviewed by your surgical and nutrition team.
• If you have not yet been contacted to schedule a pre-admission testing appointment, call 301-754-8200 to inquire. This appointment should take place one week prior to your surgery. During your appointment, you will be interviewed by a nurse. In order to do a complete review of your medical history, all pre-operative testing should be completed prior to your pre-admission testing appointment. Ensure your primary care physician or bariatric surgeon faxes your H&P (history and physical) and current laboratory work, EKG and chest X-ray results.
• Pre-admission Testing E-Fax Number for Holy Cross Hospital: 484-518-7521
• Pre-admission Testing Fax Number for Holy Cross Germantown Hospital: 301-557-5550
• A hospital staff member will also contact you before the day of your surgery to gather pertinent information including hospitalization/insurance coverage. You will also be informed of any financial obligations.

• Do not take aspirin, aspirin products, or any type of blood thinner for seven (7) days before your day of surgery. Examples include, but are not limited to, ibuprofen (e.g., Motrin, Advil, Aleve, Alka Seltzer) and other cold medicines.
• If you take any medications (prescription or “over-the-counter”), please check with your physician and/or anesthesiologist about whether you should take them on the day of your surgery. 

• Follow your preoperative full liquid diet, as directed by your physician.
• Do not drink carbonated beverages (this should have already been discontinued months before, but this is also true for the day before?) on the day before your surgery.
• To reduce the risk of infection, follow your surgeon’s instructions regarding washing your skin in preparation for surgery. Do not shave the hair on your abdomen.

• To reduce the risk of infection, follow your surgeon’s instructions regarding washing your skin in preparation for surgery.
• If you have a CPAP machine, please bring it with you to the hospital.