Transcription

Patient Guide for Bariatric Surgery04/2020

Patient Guide for Bariatric SurgeryContentsTable of ContentsPre-Op PreparationPrior to Approval for Bariatric Surgery—Pre-Op Checklist . 1Bariatric Information Sessions . 2Additional Pre-Op Steps . 3Bariatric Team . 4Psychologist Referral List. 6Labs. 7Goals Prior to Bariatric Surgery. 8Information Guide:Staphylococcus Aureus. 9Pre-Operative Instructions. 10Pre-Op and Post-OpSupport and ReferencesSupport Group Schedule. 12General Information—Items YouShould Know: NorthShore Rulesof the Pouch. 13Example of Bariatric Letter of Support. 15Exercise Expectations. 16Helpful Websites and Apps to Aid YourWeight-Loss Progress. 18Frequently Asked Questions (FAQs). 19Financial Considerations—see FAQs. 19Post-Op PreparationInitial Post-Operative Instructions. 24Department of General SurgeryPhone: (847) 570-1700Fax: (847) 733-5291

Patient Guide for Bariatric SurgeryPrior to Approval for Bariatric Surgery—Pre-Op Checklist 1. Emmi ProgramsBMI: 5. Dietitian Appointment(a web-based patient information site)If you are not seeing the dietitian for SMWL,you will need to have at least one pre-opappointment with the dietitian. It is best tosee the dietitian near the end of your monthly“supervised medical weight loss” visits, as youwill discuss post-operative diet progression.Patient education programs, called Emmi,are available for gastric bypass, sleevegastrectomy and lap band. We would likeyou to watch the Emmi program for theappropriate surgery you discussed with yourbariatric surgeon.It is important to continue appointments withthe dietitian after surgery AND for the rest ofyour life. Please note that the dietitianappointment may be an out-of-pocketexpense for you. You may be eligible for aself-pay discount. Please ask your dietitian. 2. Psychological EvaluationA psychological evaluation is required forapproval for bariatric surgery. Refer tothe Psychologist Referral List (page 6). 3. Monthly “Supervised Medical Weight 6. Letter of SupportLoss” (SMWL)Some insurances require a letter of supportfrom your Primary Care Provider (PCP). Pleasesee the example on page 15.You will need months of SMWL, whichequals visits with providers.These visits may be with: 7. Stop Smoking and Recreational Drug Use A psychologist who specializes in weightloss managementYou will need to be completely nicotine-freeprior to bariatric surgery, including e-cigaretteswith nicotine cartridge, nicotine patches,nicotine gum, etc. You will need a negativenicotine test for approval. If you have used anyrecreational drugs in the past 365 days, youwill need at least two negative random drugtests prior to surgery. We will call you in themorning and expect you to go to a NorthShorelab that same day for a drug test. Failure tocomply with this will delay your surgery. A bariatric dietitian (these visits MAY NOTbe covered by your insurance) Liz Farwell, APN, our Bariatric Coordinator,and Cassandra Snitowsky, CNP, canperform SMWL at NorthShore EvanstonHospital, NorthShore Glenbrook Hospitalor NorthShore Highland Park Hospital. 4. Support Group or Information SessionYou will need to attend at least oneNorthShore bariatric support group meetingor a NorthShore Bariatric Information Sessionprior to surgery. Please see the NorthShoreBariatric Support Group Schedule (page 12). 8. Sleep EvaluationIf it is determined you are at risk for sleepapnea, you may need to complete a sleepconsult with a NorthShore sleep physician. Ifthe sleep physician deems it necessary, youmay need to complete a sleep study. Sleepapnea occurs when your oxygen level dropsand carbon dioxide level rises during sleep.Please see the box for the Bariatric InformationSessions on page 2. Both meetings are free;and no advance registration is necessary.(continued on next page)1

Patient Guide for Bariatric SurgeryPrior to Approval for Bariatric Surgery (continued) 9. Weight LossTo increase your chance of insurance approvaland decrease your surgical risks, we encourageyou to lose 10 percent of your excess bodyweight prior to obtaining approval for bariatricsurgery. That 10 percent is based on today’sweight. You will NOT be allowed to proceed ifyou gain weight, we strongly encourage you toaim for 10 percent. 12. Exercise PhysiologistWe have an exercise physiologist availableto help you incorporate exercise into yourday. The cost for the exercise physiologistwill NOT be covered by your insurance. 13. Vascular ConsultIn some cases (prior history of pulmonaryembolism/deep vein thrombosis or higherBody Mass Index [BMI]), a vascular consultmay be necessary.10 percent is from today’s weight ofso your preapproval weightshould be less than . 14. Approval 10. Return AppointmentCall us when you have completed theabove items. Once your file is complete,we will submit to your insurance companyfor approval. We will call you as soon aswe hear a response, which may take fourto six weeks.A return appointment with your bariatricsurgeon expected 11. A1CIf you have diabetes, your HbA1c will need tobe 7. The Diabetes Nurse Educators areavailable for assistance.Bariatric Information SessionsWho:Any new patient considering bariatric surgery forweight loss. Feel free to bring family and friends along.When:Third Tuesday of every month from 6 until 7 p.m.Where: Northbrook facility located at 501 Skokie Blvd. inNorthbrook, IL (1st floor).Sessions are free of charge. Our bariatric team highlyrecommends that all new bariatric patients attend.We look forward to meeting you!2

Patient Guide for Bariatric SurgeryAdditional Pre-Op Steps1. Additional Diagnostic TestsAdditional labs, diagnostic tests or consultationsmay be necessary depending on your medicalhistory. If you have a pacemaker or a defibrillator,these will need to be evaluated prior to surgery.You may schedule this by calling Cardiology at(847) 570-2640.After you complete the appropriate tests, we willdiscuss the results with you and schedule yoursurgery.For Gastric Bypass, Sleeve Gastrectomy orLoop Duodenal Switch:4. Nasal SwabUpper Endoscopy (EGD)If you are going to have a gastric bypass, sleevegastrectomy or loop duodenal switch, you will havean EGD prior to surgery to make sure you do nothave any ulcers or erosions. This test is performedin the GI lab. A scope with a camera on the end ofit will look at your throat and stomach. On the dayof the EGD, you may NOT have any solid foods toeat. You may drink clear liquids up until six hoursprior to the EGD. A biopsy will be done at thesame time. The test itself takes about 15–20minutes, but you should plan to be there abouttwo hours. You will be sedated with conscioussedation.Thus, you cannot drive home afterthe test.All surgical patients at NorthShore need tohave a nasal swab two weeks prior to surgery.(See Staphylococcus Aureus, page 9.) If yourdoctor is not on staff with NorthShore, we willorder the nasal swab for you.5. Prior to surgery, please purchase at least twodifferent post-op high-protein supplements(specified in the dietitian binder) to be startedupon discharge after surgery. You will not feellike shopping after surgery, so it is important foryou to purchase these prior to surgery. One ofthese post-op high-protein supplements shouldbe “unflavored” so it can be added to food ifneeded (e.g. cream of wheat, yogurt, soup).You should not return to work after the EGD. Youshould refrain from making any important decisionsfor the remainder of the day. Biopsy results willbe available in 24–48 hours. You will be able toschedule surgery after we get your biopsy results.Prior to surgery, also purchase the vitamins youwill need after surgery.6. Follow-Up Appointments—Surgeon/Advanced Practice Nurse (APN)2. Scheduling SurgeryThe first follow-up appointment with your bariatricsurgeon or APN will be two weeks post-op. Youcan schedule this follow-up appointment at thesame time you schedule your surgery. You willalso see the surgeon/APN at eight weeks, sixmonths, 12 months and then annually for the restof your life. Additional appointments may bescheduled if needed.You will schedule surgery with your bariatricsurgeon’s office. You will need to follow the pre-opdiet for the time period listed below prior to yoursurgery date: BMI 30–39 2 weeks BMI 40–49 3 weeks BMI 50–59 4 weeks7. Follow-Up Appointments—Dietitian BMI 60–69 6 weeksThe first follow-up appointment with your dietitianwill be 30 days after surgery. Please schedule thisappointment once you have a surgery date. You willalso see your dietitian at three months, six monthsand 12 months post-op and then annually for therest of your life. Additional appointments may bescheduled with your dietitian if needed. BMI 70–79 7 weeks, etc.Please review the pre-op AND post-op instructionsheet and the information you received from thedietitian.3. Pre-Op History and PhysicalOnce you have scheduled your surgery, you willneed to make an appointment with your PCP fora pre-op history and physical. This should becompleted within 30 days of your surgery date.3

Patient Guide for Bariatric SurgeryBariatric TeamWoody Denham, MDSteve Haggerty, MDJohn Linn, MDMike Ujiki, MDLiz Farwell, APNBariatric SurgeonsExercise PhysiologistFour Board-certified surgeons who specialize inbariatric surgeryAvailable to assist with a healthy exercise planAdvanced Practice NurseManages insurance approvals and hospitaladmission precertificationsReferral CoordinatorCertified in bariatric surgery, assists and counselsweight-loss patients; performs patient histories andphysicals; supervises medical weight loss, lap bandadjustments and follow-up appointments; helpswith insurance issues and any questions orconcernsClinics/Surgery SitesLicensed Clinical Psychologists Vernon Hills NorthShore Medical GroupPerform pre-operative psychological assessmentsrequired by insurance companies; available forongoing therapy and support throughout weightloss process Gurnee Immediate Care CenterDietitiansSurgery Sites:Specialized bariatric dietitians who provide initialsurgery evaluation and education, as well as followup counseling and education (related to vitaminsand food choices) Evanston HospitalClinics: NorthShore Evanston Specialty Suites Glenbrook Medical Office Building Highland Park ACC Specialty Suites Glenbrook Hospital Highland Park HospitalProceduresRegistered NursesTwo dedicated RNs specializing in bariatrics,available for questions and concerns during thepre- and post-operative periods; assist withinsurance approvals and communicating lab andtest resultsThe NorthShore Bariatric Surgery Program offersmultiple options to patients: Laparoscopic Roux-en-Y gastric bypass Laparoscopic sleeve gastrectomy Laparoscopic loop duodenal switchSurgery Schedulers Endoscopic sleeve gastroplastySchedule bariatric surgery and bariatric-related EGD(if needed) Laparoscopic adjustable gastric band (lap band) Revisional surgeries—laparoscopic andendoscopic revisions Gastric balloon4

Patient Guide for Bariatric SurgeryBariatric Coordinator:Diabetes Nurse Educators:(847) 926-5032Liz Farwell, RN, MS, APN, CBN(847) 570-1700NorthShore Medical GroupSleep Center Evaluation:Obesity Medicine Nurse Practitioner:(847) 663-8200Cassandra Snitowsky, MSN, APRN, CNP-BC, CBN(847) 570-1700NorthShore Medical GroupVascular Surgery Evaluation:Bariatric Staff Nurses:Kimberly Miller, RN, BSN, Jen Samuels, RN, BSN,and Christine Sula, RN, BSN(847) 570-1700(847) 663-8050Exercise PhysiologistsEvanston and Glenbrook Hospitals:To schedule, please call (847) 503-1400DietitiansYou will need to see a bariatric dietitian at one of thelocations below.Administrative ProvidersEvanston Hospital:Mary Suarez, RD, LDN(847) 926-6800Kathleen Kopp, Selma Zukancic(847) 570-1700Glenbrook Hospital:Marisa Spiegel, RD, LDN(847) 926-6800Exercise OptionsGalter Life Center:5157 N. Francisco Ave.Chicago, IL 60625(773) 878-9936Highland Park Hospital:Atara Schayer, RD, LDN(847) 926-6800YMCA:ymca.netSkokie Hospital:Marisa Spiegel, RD, LDN(847) 926-6800Local Community Centers or Park Districts:Check for workout facilities and exercise or danceclassesGurnee Medical Group Office:Atara Schayer, RD, LDN(847) 926-6800Health Clubs5

Patient Guide for Bariatric SurgeryPsychologist Referral ListAll patients need a pre-operative evaluation with a psychologist to determine their readiness forbariatric surgery and rule out any disorders that would interfere with the surgery and recovery. Ifyou have Public Aid: Please note, we do NOT have any Public Aid providers, so you will need topay out of pocket for your psychiatric evaluation with one of the providers listed below.Psychologist Provider ListingBe sure to ask if the psychologist accepts your insurance plan when you call.Always verify with your insurance if the provider is in or out of your network.1. Dr. Dawn Epstein l * 9669 Kenton Ave., Suite 204Skokie, IL 60076(847) 425-6400Dr. Leslie Guidotti Breting l909 Davis St., Suite 160Evanston, IL 60201(847) 425-6400Dr. Ashley Rolnik l * 2300 N. Lehigh Ave., Suite 215Glenview, IL 60026(847) 425-6400Dr. Laura Pettineo * 2180 Pfingsten Rd., Suite 2000Glenview, IL 60026(847) 425-6400Kayleigh Parent, MSW * 2640 Ridge Ave.Evanston, IL 60201(847) 425-64004. Dr. Jeremy Clorfene l * 185 N. Milwaukee Ave., Suite 210Lincolnshire, IL 60069(847) 877-13315. Dr. Brad Saks l * (payment required up front)707 Skokie Blvd., Suite 600Northbrook, IL 60062(847) 509-75606. Dr. Tom Alcock l * 2402 N. Lincoln Ave.Chicago, IL 606141845 E Rand Rd., Suite L111Arlington Heights, IL 60004Phone: (773) 469-66757. Dr. Rachelle Gold l7101 N. Cicero Ave., Suite 203Lincolnwood, IL 60712636 Church St. Suite 714Evanston, IL 60201(773) 991-72242. Insight Behavioral Health *333 N. Michigan Ave., Suite 1900Chicago, IL 60601(312) 638-2246Also has therapists available at:500 Davis St., 10th Floor, Suite 1003Evanston, IL 602011535 Lake Cook Rd., Suite 303Northbrook, IL 600628. Dr. Arina Polevoy l * Progressive Psychological Healthcare1100 W. Lake Cook Rd., Suite 130Buffalo Grove, IL 60089(847) 979-02689. Dr. Angela Eads l Grand Oaks Behavioral Health1800 Hollister Dr., Suite 201Libertyville, IL 60048(847) 549-11893. Dr. Diane Copeland l * 747 Lake Cook Rd., Suite 112WDeerfield, IL 60062(847) 707-4585Legend: Initial psychiatric evaluation* Monthly medical weight loss6 Post-op counseling

Patient Guide for Bariatric SurgeryLabsPre-OpVitamin DLabsWith any bariatric surgery, it is important to monitoryour lab work to ensure that you are nutritionallysound. Thus, we will draw labs at various intervals,starting at your initial bariatric consult. Thus, as youwork through the pre-op process, we will have timeto correct any deficiencies, ensuring the healthiestbody possible on the day of surgery.We obtain most of our vitamin D from the sun. Weare not exposed to enough direct sun, as we live inthe Midwest and the use of sunblock is encouraged;thus, many are low in vitamin D. Believe it or not,very few dairy products actually contain vitamin D.Read the labels and see for yourself. We wouldneed to be unclothed outside in the sun 15 minutesa day in order to absorb the vitamin D we need ona daily basis from the sun.Any lab result that is low and needs to be treatedwill be reassessed to ensure effective correction.Some people prefer to have their bariatric coverageverified prior to having their initial lab work done.Low levels of vitamin D have been associated with: OsteoporosisVitamin D and calcium work together to promotestrong bones in men and women of all ages. Weused to think of osteoporosis as a brittle bonedisease for “little old ladies.” However, we arenow seeing the effects of poor bone health inindividuals as young as 30 years of age.If you choose not to have your labs done at yourinitial bariatric consult, please be sure to go to aNorthShore lab and have them drawn as soon asyour bariatric coverage has been verified.The orders will be in your chart. You do not need anappointment. You do not need to fast. Colon cancerPost-Op Breast cancer Prostate cancerWe will check labs at the two-month post-opappointment, six-month post-op appointment and12-month post-op appointment and then annuallythereafter. Any lab result that is low and needs to betreated will be reassessed to ensure effectivecorrection. Memory issuesNormal vitamin D levels are 32–50. Researchis suggesting levels 50–80 are preferred for optimalbone, colon, breast and prostate health in bariatricpatients.The most common form of replacement is vitamin Dergocalciferol 50,000 international units (IUs) once aweek. (This drug is not measured in milligrams; it’smeasured in international units.) Most multivitaminscontain about 400–600 IUs of vitamin D. We will notbe able to raise your level with only 400 IUs. Weneed 50,000 IUs and still it may take six months ifyour level is very low.If you have any questions about the above information, please do not hesitate to ask. That is why weare here.7

Patient Guide for Bariatric SurgeryGoals Prior to Bariatric SurgeryRemember, any improvements you make before surgery will help make the transition after surgery easier.Here are a few goals to get you started.Diet ModificationsBehavior Modifications Consume three meals daily (breakfast, lunch anddinner). Do not skip meals. Exercise goal is six or seven days per weekfor 30 to 45 minutes each day. Reduce or eliminate caffeine and carbonatedbeverages. Reduce overall portion sizes. Use a smaller 8”–10” plate for meals to helpcontrol portion sizes. (This is similar to the sizeof a salad plate.) Consume balanced meals—choose three foodgroups per meal. Begin reading food labels to compare items.Choose items lowest in fat and calories. Eliminate snacking between meals. Keep a food journal to be aware of what youconsume. There are over 2,500 weight-losswebsites and apps, many of which allow you totrack food intake. Examples include LoseIt.comor Lose It! app, MyFitnessPal, etc. Eliminate fried foods. Do not allow more than five to six hours betweenmeals. Check blood sugar levels as needed. Use grocery lists, and do not shop for food whenhungry. Reduce or eliminate liquids with meals. Plan menus ahead of time. Avoid trans fats (partially hydrogenated) andsaturated fats (fully hydrogenated). Do not eat while watching TV or reading. Consume at least one serving of fruit and oneserving of vegetables daily. Avoid liquid calories such as juice, soda, lemonade, sports drinks, etc. Choose olive oil or PAM spray for cooking. Avoidbutter and margarine. Switch grains from white to brown—for example,choose whole wheat pasta, brown rice andwhole wheat bread. Bake, broil or grill meats and avoid frying. Avoid foods with any type of sugar listed in thefirst five ingredients. Choose lean meats, such as chicken breast, fishand turkey, most often. Increase water intake—aim for six to eight ozglasses of water per day. “Water” includes anyNON-carbonated, NON-calorie (except G2)and NON-caffeine beverage. For example,Vitaminwater Zero, SoBe LifeWater, CrystalLight, sugar-free Kool-Aid, MiO drops, decaftea, decaf coffee or G2 (or diet Gatorade).G2 is OK even though it has 20 calories.Regular Gatorade is NOT OK.8

Patient Guide for Bariatric SurgeryInformation Guide: Staphylococcus AureusTo Be Done About Two Weeks Before SurgeryWhat is staphylococcus aureus?Hibiclens soap on days 1, 3 and 5 of nasal treatmentto lower the chance for infection.It is a germ, often called staph, that is normally foundon the body in 20 to 30 percent of healthy people.Throughout our lives, all of us have this germcolonizing us at one time or another. It usually causesno illness but occasionally can cause infections.These range from small sores on the skin, to boils(abscesses), to blood poisoning (infection of thebloodstream). Occasionally (less than 5 percent ofthe time) an infection develops after surgery. Wheninfection occurs after surgery, the single biggestcause is S. aureus.What is the difference between infection andcolonization?Infection means that the germ is causing a problemor disease in your body with symptoms such as fever,redness/swelling and/or pus at the site of yourinfection. Colonization means the germ has takenup residence in or on your body and is not currentlycausing infection. If you are colonized with staph, youhave the potential to develop an infection from it afteran operation.What can be done to prevent infection fromstaph after my surgery?What if my test is positive?If the test is positive for staph, you will receivetreatment prior to surgery with Bactroban nasalointment. If it is a methicillin resistant staph,you will also have to shower with Hibiclenssoap.Medical professionals have known for many yearsthat most staph infections developing after surgeryresult from the same S. aureus that you, as a patient,normally carry prior to your operation. During the lastyear, it was shown that getting rid of any staphsomeone may be carrying could reduce the likelihoodof an S. aureus infection after surgery by 50 to 70percent. In order to provide our patients with the bestpossible surgical outcome, we are now screening allpatients for S. aureus before any orthopaedic, cardiothoracic, vascular, general or neurosurgical operation.Those with a positive test will be treated with a nasalointment (Bactroban) for five days to remove thestaph. If your culture shows that the staph is methicillin resistant (MRSA), you will also have to shower withMedicationDosingInstructionsfor BactrobanPatient Notes: Apply the nasal ointment twice a day for five days(12 hours apart). Use a Q-tip or your finger to apply the medicine. Avoid contact of the medication with the eyes. Call your surgeon to discontinue usage of themedication if severe local irritation occurs.PEA-SIZEAMOUNTRemove cap from the tubeApply a pea-size amount in each nostrilusing a Q-tip or your fingerPress nostrils togetherand massage forabout one minuteInstructions for Hibiclens Shower if Your Staph Is Methicillin Resistant (MRSA)1. Shower or bathe with Hibiclens soap (4 percentchlorhexidine) on days 1, 3 and 5 of nasaltreatment.4. AVOID CONTACT OF THE SOAP WITH YOUREYES AS THIS CAN CAUSE IRRITATION. If somesoap gets in your eyes, rinse thoroughly with water.2. Use two tablespoons of soap as you would anyother liquid soap. It will not bubble or lather.5. Discard the Hibiclens container in a regulargarbage receptacle when finished with totaltreatment.3. Rinse completely after the shower or bath.9

Patient Guide for Bariatric SurgeryPre-Operative InstructionsPre-op medication instructions:Pre-op diet: Please notify your surgeon if you are takingblood thinners, for example: Coumadin,Ticlid, Plavix, heparin, lovenox, Pradaxa, etc.The doctor will determine the date we will stopthese medications prior to surgery—and whetheryou need another form of blood thinner. Liquid diet: ONE weight-loss drink four timesa day. Please refer to the binder you will receivefrom your bariatric dietitian.Drink a minimum of eight glasses of water a day.You may have raw, fresh vegetables. No cannedvegetables, no frozen vegetables, no avocados,no salads and no dressings. You should continue taking aspirin withoutinterruption unless directed to stop by yoursurgeon. If you receive other instructionsregarding aspirin, please call us to confirm.– If your BMI is 39 or less, you will be on thepre-op diet for two weeks prior to surgery.– If your BMI is 40–49, you will be on the pre-opdiet for three weeks prior to surgery. If you take metformin (Glucophage, Fortamet,Glumetza, Riomet) for diabetes, this medicine willneed to be stopped 48 hours before surgery.– If your BMI is 50–59, you will be on the pre-opdiet for four weeks prior to surgery. If you are taking weight loss medications, pleasediscuss these with the bariatric surgery team, assome may need to be stopped prior to surgery.– If your BMI is 60–69, the pre-op diet will includefive drinks per day for six weeks prior to surgery.– If your BMI is 70 or greater, the pre-op diet willinclude five drinks per day for seven weeksprior to surgery. You will need to stop any blood-thinning productssuch as: nonsteroidal or anti-inflammatorymedication (NSAIDs). Examples include:Motrin, Ibuprofen, Mobic, Advil, Aleve,Lodine, Anaprox and Naprosyn. Please do not start the pre-op diet until you havebeen given a specific surgery date. Please take a multivitamin every day while on thepre-op diet. Stop taking any blood-thinning herbs orsupplements, such as: fish oil, green tea,vitamin E, glucosomine and garlic pills. Please treat constipation as suggested on page23 if you have not had a bowel movement in twodays. You may use Tylenol or Extra Strength Tylenolfor pain. Make sure you have purchased the highprotein supplements you will need post-op.Please refer to the dietitian binder.Evening prior to your surgery: The hospital will call you the business day prior tosurgery and tell you the time you should arrive.If you have questions, you may call theAmbulatory Surgery Center: Make sure you have purchased the variousbariatric vitamins you will need post-op.Please refer to the dietitian binder.Evanston Hospital: (847) 570-2150Glenbrook Hospital: (847) 657-5832Highland Park Hospital: (847) 480-3729 After midnight on your day of surgery, do not eatany fresh, raw veggies or drink any protein drinks.You may have clear liquids until two hours beforeyour scheduled arrival time to the hospital.10

Patient Guide for Bariatric SurgeryOn the day of your surgery: Robe, slippers, loose comfortable clothes towear home On the day of surgery, please do not eat anysolid foods. Please do not drink your proteindrinks. You may have clear liquids up until twohours before the time you are told to arrive at thehospital. Clear liquids include non-calorie noncarbonated non-caffeine beverages. Please alsoavoid red and purple beverages at this time. Copy of your advance directives, if you have suchdocuments Personal toiletries such as shampoo, deodorant,toothbrush, toothpaste, denture cream andmoisturizerNote: Please do not bring anything of value, including credit cards and jewelry. The hospital is notresponsible for lost or stolen items. Take a shower and wash with soap. You may take your heart medications with a sipof water. If you have sleep apnea, bring your CPAP to thehospital with you.Morning of Surgery Instructions You will be walking in the halls every two hourswhile awake. Bring whatever you need to feelcomfortable—e.g., sweat shorts, pajamas,baseball cap.Getting dressed: Do not wear lotion, perfume, makeup, fingernailpolish, jewelry or piercings.Things to Bring to the Hospital Do not shave the area where the operation will beperformed. This booklet Deodorant is OK. Photo ID (driver’s license or state ID)Evanston Hospital—Please park in the mainstructure on the 5th floor (Notre Dame level). Walkthrough the entrance doors and proceed to theambulatory surgery check-in desk located on thesame level. You will be directed to your room. Put on clean clothes. Insurance card and information List of prescription and nonprescriptionmedications you take (including vitamins,supplements and herbal medications)Highland Park—You will enter through the mainhospital entrance. A staff member will greet anddirect you. You will check in at the front desk. Assistive devices such as walkers, crutches,canes, hearing aids and glasses. (Please labelall personal items with your name.) Names and phone numbers of family or friends tocontact in case of emergency11

Patient Guide for Bariatric Surgery2020NorthShore Bariatric Support Group ScheduleNo reservations are required. Support group meetings are held in two locations:225 N. Milwaukee Ave.Skokie HospitalVernon Hills, IL 600619600 Gross Point Rd., Skokie, IL 60076Abramson Conference Room (1st floor)DateTimeLocationLeader/TopicMonday, January 67 p.m.Vernon HillsBrad Saks, PhD/JSGetting Back on Track after the HolidaysThursday, January 167 p.m.SkokieRachelle Gold, PsyD/JS Coping Strategies to Keep You on Track,Even in the WinterMonday, February 37 p.m.Vernon HillsLiz Farwell, APNThursday, February 207 p.m.SkokieMary Suarez, RDMonday, March 27 p.m.Vernon HillsStephen Haggerty, MDThursday, March 197 p.m.SkokieCancelled due to Coronavirus PrecautionsMonday, April 67 p.m.Vernon HillsCancelled due to Coronavirus PrecautionsThursday, April 167 p.m.SkokieCancelled due to Coronavirus PrecautionsMonday, May 47 p.m.Vernon HillsWoody Denham, MDThursday, May 217 p.m.SkokieCassie Snitowsky, APNMonday, June 17 p.m.Vernon HillsDena Dobbs, Bariatric Advantage/KMSurgeries and SupplementsThursday, June 187 p.m.SkokieNadea Minet, Celebrate Vitamins/Atara Schayer, RDMonday, July 67 p.m.Vernon HillsMarisa Spiegel, RDThursday, July 167 p.m.SkokieDawn Epstein, PhD/Mary Suarez, RDMonday, August 37 p.m.Vernon HillsArina Polevoy, PsyD/KMThursday, August 207 p.m.SkokieMichael Ujiki, MDMonday, September 147 p.m.Vernon HillsDiane Copeland, PhD/JSThursday, September 177 p.m.SkokieJohn Linn, MDMonday, October 57 p.m.Vernon HillsJeremy Clorfene, PhD/KMThursday, October 157 p.m.SkokieAshley Rolnick, PhD/Marisa Spiegel, RDMonday, November 27 p.m.Vernon HillsLiz Farwell, APNThursday, November 197 p.m.SkokieLaura Pettineo, PhD/Mary Suarez, RDManaging Food Pushers During the HolidaysMonday, December 7Liz Farwell, APN7 p.m.Vernon HillsThursday, December 177 p.m.SkokieDena Dobbs, Bariatric Advantage/Atara Schayer, RDHoliday Deficiency Bingo12

Patient Guide for Bariatric Surge

2 Patient Guide for Bariatric Surgery Bariatric Information Sessions Who: Any new patient considering bariatric surgery for weight loss. Feel free to bring family and friends along. When: Third Tuesday of every month from 6 until 7 p.m. Where: Northbrook facility l