Preparation

The sequence is in How we choose. This page is the practical list that follows a decision — or that sometimes changes the decision.

Typical work-up

• Psychological evaluation: capacity to decide, ability to accept irreversible eating-behavior change, compliance with diet and vitamins, coping and follow-up, support system
• EKG, chest x-ray as indicated
• Labs, including vitamin D, thiamine, B12, folate, iron, fat-soluble vitamins, zinc, copper, calcium
• Sleep study when apnea is likely
• Cardiac clearance when indicated
• EGD — Barrett, hiatal hernia, bile reflux, gastritis, polyps
• Age-appropriate screening: colonoscopy, Pap/GYN, prostate, mammography

EGD is not a formality. Hernia, bile reflux, and Barrett change whether a sleeve is wise. Missing a large polyp before a hernia or bariatric case is a missed chance to treat the more important problem first.

Disease that changes the plan — Barrett’s, GERD, hernia, prior limb lengths, Crohn’s, deficiency — is on Considerations.

The office will provide your intake, privacy and payment forms and instructions for securely sharing records. See financial and insurance arrangements.

Before the operation

• Bring a complete medication and supplement list, including diabetes medicines, weight-management medicines and blood thinners. Obtain individualized instructions from the surgical and anesthesia teams.
• Review protein intake, deficiencies and the preoperative eating plan with the team. Follow the fasting instructions supplied for your procedure.
• Discuss tobacco use, sleep apnea treatment, prior clotting problems and support at home.
• Arrange transport, recovery help and follow-up, and confirm that your questions about risks, alternatives and financial arrangements are answered.

Bring prior operation reports, endoscopy, imaging and recent labs for revisional consultations. Use the office’s secure process for sending records.