JourneyLite Physicians-Weight Loss Experts!
Your team for all your weight loss needs! Gastric sleeve, gastric bypass, gastric balloon, appetite suppressants and more!
If you are from out of town and having surgery at Christ Hospital where an overnight stay is required, and you have a family or friend that wants to stay neary the hospital, we recommend SpringHill Suites Mid Town.
If you received a text with a link to this page, your balloon prescriptions have been sent to your pharmacy. Please pick them up prior to surgery, and if you haven’t already looked over the gastric balloon pre-and-post procedure instructions, you can check them out here.
One of the medications prescribed for your procedure is a powerful anti-nausea medication called Emend (generic: aprepitant). Bring this with you to your procedure as you will take it on arrival to the center. You will also take it the following morning at home. If this is not covered by your insurance, this link explains how to reduce the cost of the medication using the GoodRx app.
You will get a call from the surgery center the day before your procedure with an arrival time. Please have nothing to eat or drink after midnight, and have a responsible adult drive (not a Lyft, Uber, or Taxi) available to drive you home from the procedure.
See you soon!
JourneyLite Physicians
GoodRx has an app which can help save you money when you get your Emend (generic: aprepitant) script filled.
To use GoodRx to find the nearest pharmacy to you with the best price on this powerful anti-nausea medication:
Sometimes in weight loss surgery we make use of Jackson-Pratt drains, or “JP” for short. Usually these drains are used in stapling procedures such as a gastric sleeve or bypass, and very commonly in revisional weight loss procedures. A JP drain is a long, soft silicone tubing with holes or grooves in the end of it, connected to a suction bulb that is easily empied by the patient.
The purpose of the JP is for the tubing to lie next to the staple line, so in the unlikely event of a staple line leak, any gastric contents that leak out would be collected by the drain rather than forming an abscess.
When JP drains are utilized, they are usually left in for 7-14 days and are removed in the office. There is typically suture in the skin right next to where the drain exits that secures the drain in place.
Typically there is also a “split sponge” around where the tubing exits, to collect any fluid that might leak around the drain. This leakage is common, and not to be concerned about unless it is excessive. If your split sponge becomes soaked or comes loose you can change it as needed:
You JP should be emptied three times a day and the volume and color recorded on the JP Drain Output Log sheet. If you don’t have a printer you can just write the info on a sheet of paper. Emptying the drain is easy:
This needs to be done when you first wake up in the morning, right before you go to bed, and about halfway in between. It also needs to be done any time the bulb is completely full.
Below is a good video that shows how to take care of a JP drain. This is from a plastic surgereon, but it nicely illustrates everything discussed in this article.
NOTE: These instructions do not apply to gastric balloon insertion or removal.
Click here if you need to go there!
Upper endoscopy, esophagogastroduodenoscopy, or just “EGD” for short are all terms for the same thing – examining the esophagus, stomach, and duodenum (the first part of the small intestine) with a lighted, steerable scope.
EGD’s are done with patients completely sedated, but breathing on their own. While the patient is asleep, the scope is advanced down through the mouth and the anatomy is inspected. Often times we take biopsies to have examined by a pathologist, or to rule out a bacterial infection called H Pylori. The procedure typically takes less than 30 minutes, and you can be on your way home around 30-45 minutes after completion. You will need the entire day off work, you cannot go back to work or drive for the rest of the day due to potential lingering effects of the medications used.
If you are scheduled for an EGD, there are a few important things you need to know to be ready for your procedure!
If you have any questions about your procedure, call us at 513-559-1222, or text us at 513-540-1207.
For patients who have a cardiac history, we frequently will request clearance from cardiology prior to doing any weight loss procedures. This is done in order to minimize the cardiac risk of the procedure, or to determine if a patient has a prohibitive risk from a cardiac standpoint.
Sometimes your cardiologist may want to do some testing prior to clearing you for your procedure, so its best not to wait until the last minute! On the flip side, however, we don’t want a clearance to be done too early in the process as it may need to be repeated if its too old. We recommend optimally have your clearance done about 6-8 weeks prior to your procedure.
If we ask you to obtain cardiac clearance, giving this form to your cardiology team will greatly expedite the clearance process! Please check the box next to your procedure on the upper third of the document – if you are unsure please speak with a member of our team!
Undiagnosed and/or untreated sleep apnea has been shown to increase the risk of post-op lung complications such as pneumonia. For this reason, we have our patients who have not been diagnosed with sleep apnea and have never been tested to complete two different screening tests for sleep apnea.
For patients who have been diagnosed with sleep apnea, we also require compliance with CPAP (or whatever device was recommended at the time of testing). This means if you have a CPAP machine (or other device) we need you to use it!
If a patient has been prescribed CPAP shows up for surgery and is found to be non-compliant, it is possible that anesthesia personnel will cancel the case, so this is an important step in the pathway to a safe, low-risk procedure!
The impact of the COVID-19 pandemic has been felt around the world, and is causing people to think hard about their overall health. The reason this is happening is that there is a wide spectrum of severity of COVID-19 infections. Healthy, young, normal-weight patients tend to have minimal to no symptoms, while older patients and/or those with multiple medical issues tend to present with much more aggressive cases that carry a higher risk for death.
The CDC has weighed in on what conditions can increase the severity of COVID infections. In addition to older adults in general, people of any age with the following conditions are at increased risk of severe illness from COVID-19:
With regard to obesity and severity of ilness, nearly 40% of Americans have a BMI of 30 or higher, so this puts A WHOLE LOT OF PEOPLE at increased risk. Although we don’t yet have reliable statistics, there is a good chance that the risk of severity doesn’t just go up at a 30 BMI and stay put, it most likely continues to rise with BMI. So patients with a BMI of 50 likely have a significantly higher risk of death than patients with a BMI of 30.
If you are overweight or obese, now is the time to act, as it is a tragic event to think of a potential COVID-19 fatlity in a young, otherwise healthy but obese patient from COVID-19. We have surgical, incisionless, and medical-only options that can help patients lose weight and hopefully reduce the risk of severe ilness or death in a patient who contracts coronavirus.
If you are interested in learning about weight loss options, try our online weight loss navigator to learn what programs for which you might qualify.
GoodRx has an app which can help save you money when you get your Adipex (generic: phentermine) script filled. Note that GoodRx does not typically help with savings on Qsymia, Contrave, or Saxenda as each company has its own savings program.
To use GoodRx to find the nearest pharmacy to you with the best price on Adipex (generic: phentermine):
Many times patients who do not have coverage for weight loss surgery will ask us to file an appeal. Will this work? The short answer is no. Read on for the long answer…
If your insurance does not cover weight loss surgery, this is called an “exclusion.” This means that the employer who provides the insurance chose to exclude surgical weight loss from coverage in order to purchase a cheaper plan. Once you understand this fact, it’s easier to understand why you can’t file an appeal and get them to cover it, no matter how severe your obesity might be.
If insurance companies were to allow this, then no employer would ever opt for the more expensive plans that do cover bariatric surgery. They would just buy the bare bones coverage and then tell their employees to all file appeals to get it covered anyway.
Unfortunately, when patients call their carriers, someone on the other end of the line (who actually works for the insurance company) will tell you that you can file an appeal. This is technically true, as you can file an appeal for anything your insurance denies. However, in this case the appeal will never work because the issue is not one of medical necessity; in otherwords the insurance company is not saying that you don’t need the operation, they are denying it because you do not have the right type of coverage. It would be somewhat like having a tree fall on your house and asking your car insurance to pay for it. Or, perhaps more appropriately, asking your homeowners to pay for flood damage when it is specifically excluded from your homeowners policy. It simply isn’t going to happen.
Also unfortunate (at least in Ohio, Kentucky and Indiana) is that marketplace policies purchased by individuals under the Affordable Care Act also exclude weight loss surgery. Medicare, Medicaid, and most managed-care Medicaid plans such as CareSource, do cover weight loss surgery, however.
We wish that all Americans had access to life-saving surgical weight loss procedures, and maybe some day that will happen. In the meantime, patients with exclusions essentially have two options:
