This is where it all happens for the weight loss surgery patient. It is here that the mystery happens, and this place is most frightening because the patient must totally give up control to the weight loss surgeon. The operating room is a cross between the great temples of Delphi and the most modern NASA lab.

Gastric bypass or lap-band surgery operating roomLike most holy temples, those who serve must change from their work clothes to special clothes. We must, before we perform the holy act of weight loss surgery, cleanse ourselves from the commonness of earth. The bariatric patient is taken from this earth into the netherworld; his or her very life forces are in the hands of someone else. While sleeping on the altar they are opened and sacrificed, they become different inside than before, and are marked with the holy scar. Now, the characters in the bariatric operating room—far from being priests in cotton pajamas, are more akin to a group of highly specialized NASA scientists with randy senses of humor.

Operating rooms are filled with more technology than Microsoft can imagine, but we rarely can re-boot weight loss surgery patients. In fact, if you go to a microchip factory, the employees look very much like operating room types because they learned sterile technique from us. If you look are looking for sophisticated backup systems, fail-safe mechanisms, this is the place to go.

I realize this doesn’t sound too funny and it isn’t. The operating room is a serious place where magic happens. It is where a weight loss surgery patient is totally dependent on a team of people, their skills, their attention to detail, and for a period of time he is transported to the light.

During the operation, some weight loss surgeons like to play music. Some operating rooms have CD players that they give to bariatric patients and put the earphones on them, so during weight loss surgery they can hear their favorite music. Some weight los surgeons love rock and roll, some classical, some pop. I am convinced, however, that most postoperative nausea comes from listening to country western music. So, when asked what kind of music I like I say, “A.B.C.—anything but country.” Some weight loss surgeons like it quiet so they can concentrate. All have different styles and opinions as to how they want the area run. But make no mistake about it, when you are in the operating room it is the bariatric surgeon who will set the tone, determine the music, if any, and the people who work with the weight loss surgeon will either enjoy working with them or not.

Recovery…they aren’t angels, they are nurses

You will wake up in the operating room but it is unlikely that you will remember waking up, although you might remember being moved to your gurney from the surgical table.

Your first memory will be of the recovery area. Here you are awakening from your anesthesia. I love seeing weight loss surgery patients here and love telling them—”Hey the operation is over, and guess what? You woke up!” You will be in the recovery area for only a couple of hours. Here the nurses are trained to make certain you wake up adequately from your anesthesia. They will administer pain medicine so you are comfortable. They will try to balance the medication so you wake up yet are not in too much pain. They will monitor your vitals and once they feel you are ready, off you go to the next place.

The Intensive Care Unit (ICU)

Gastric bypass or lap-band surgery intensive care unitSome weight loss surgery patients go from the recovery area to the ICU. There are a number of reasons for this. For some bariatric patients who have certain medical conditions and may need one-on-one nursing, the ICU is a great place to be. Some weight loss surgery patients with sleep apnea need to be monitored carefully after receiving a general anesthetic and narcotics. The narcotics, which relieve pain, also depress the body’s urge to breathe—that is how an addict overdoses. Their body forgets to breathe. Bariatric surgery patients with severe sleep apnea are sometimes routinely placed in an intensive care unit for the first day or more in order to monitor their breathing.

If a bariatric patient has had a rocky course, the weight loss surgeon may wish to follow them carefully in the ICU for a day or so to determine if there is some underlying medical problem or until they are stable. Some bariatric patients are given a lot of narcotics during weight loss surgery and simply do not wake up enough for the staff to remove the breathing tube. These patients are watched in the ICU until they are safely able to breathe on their own, or they are sedated overnight so that the tube can be removed in the morning. There are a number of reasons to be in an ICU, and it isn’t a bad place to be. You receive very good attention from the nurses who are well trained to take care of any medical problem that might arise.

There are disadvantages to an ICU—one is that the ICU is not designed to let people walk. The other disadvantage is they have very strict visiting hours, although that can be an advantage.