General instructions and advice

• Do not hesitate to ask a lot of questions to your physicians. There are no “dam” questions, only “dam” answers.
• Be skeptical if your physician avoids to answer directly your question or answers disrespectfully.
• Ask your physician for their experience regarding the particular procedure you plan to do. What you need to know is how many of this particular procedure they have personally performed after the completion of their training.
• Ask you physician if he or she will perform the surgery as well as the names of all other staff that will be in the operating room.
• Make an attempt to verify your physician’s diplomas and certificates. US and EU associations are usually easy to verify online through the organization’s website.
• Take initiative and ask your physician about the potential complications and side-effects of the planned procedure. Be aware about answers such as “I have performed thousands and I never had a complication” without access to specific data. There are no procedures without complications, only good physicians who really care about their patients and try through their personal rapport with their patients to prevent complications and side-effects.
• Don’t be embarrassed to ask your physician if he has lost or settled a malpractice lawsuit.
• Ask your physician if he or she can bring you in contact with other patients of his or her own who had the same procedure. If applicable, ask your physician to show you pictures of his or her patients before and after the procedure you plan to do.
• If you are referred to a physician by a friend or a relative always remember that what a non-physician perceives as a “good” outcome may be relative. Specifically for bariatric procedures ask your friend or relative not only how much weight they have lost but also if they feel well and enjoy eating normal food.
• Lastly don’t forget that the goal of a bariatric procedure should not just be to lose “some” weight, but all or nearly all the excess weight. Therefore don’t be contempt with a moderate result especially if your physician tries to convince you so. A good physician needs to be always truthful and honest and put your well-being on top of his or her priorities.

 

Instructions for surgery

1. Preoperative

• Please complete and email us the requested questionnaire
• Scan and email us copies of all the reports of the preoperative work-up
• Specifically for the barium swallow and the computed tomography (if requested) Dr. Raftopoulos will need the actual CD with the pictures.
• It is very useful if you provide to us the contact information of all your physicians, as well as your liaison in your insurance carrier.
• Provide to us your telephone and email. It makes communication much easier. No one has access to your personal information except from Dr. Raftopoulos.
• If you take aspirin, or non-steroidal anti-inflammatory agents such as salospir, egicalm, ponstan, gadil, mesulid, biofenac, feldene, voltaren, naprosyn, nurofen, advil, brufen, xefo, Motrin, Advil, Aleve etc.), you need to discontinue them at least 2 weeks prior to your surgery date because they can increase the risk of bleeding.
• If you take “blood thinners” such as Coumadin, Sintrom ή Panwarfin, Pradaxa, Xarelto, or Eliquis) you need to discontinue them at least 1 week prior to your surgery date because they can increase the risk of bleeding.
• Please ask Dr. Raftopoulos if you will need to be “bridged” preoperatively with an injectable blood thinner.
• Discontinue any medications for high cholesterol such as simvastatin, pravastatin, atorvastatin, fluvastatin, lovostatin, gemfribrozil, fenofribate, ezetimibe, rosuvastatin, Crestor, Lipitor, Atorstat, Zocor or Lepur 2 weeks prior to your surgery date.
• If you take inhibitors of angiotensin receptors such as losartan, Cozaar, irbesartan, Aprovel ή Karvea, valsartan, Dalzad, emposartan, Teveten, olmesartan, Olartan, kantesartan, Atacand, telmisartan, Micardis, Pritor, or inhibitors of the converting enzyme of angiotensin such as Enalapril, Zofenopril, Imidapril), Capropril, Quinapril, Lisinopril, Benazepril, Perindopril, Ramipril, Cilazapril, Tralondapril, Fosinopril, they need to be replaced by other types of anti-hypertensive medications at least one week preoperatively. Please talk to Dr. Raftopoulos about it. You will be able to return to the original medication postoperatively.
• If you take diuretics such as Hydrochlorothiazide, furosemide, Lasix, spironolactone, indapamide, Fludex, Clorthalidon, Hygroton, Βumetanide, Burinex, or Aldactone, you will need to discontinue it two days prior to your surgery, only if you have been placed on a bowel prep for gastric bypass.
• Discontinue all vitamin and natural supplements at least one week preoperatively because they can increase the risk of bleeding.
• Purchase several 30 cc (1 oz) plastic medicine cups.
• Purchase before your surgery all medications, vitamins and protein supplements that Dr. Raftopoulos will prescribe you.
• If you take anti-depressant medications please ask your physician if they can be switched to a liquid, chewable, or injectable form, because you will not be able to swallow tablets and capsules in whole for the first six weeks postoperatively.
• If you still need medical coverage for diabetes after your surgery, oral diabetic medications will be replaced postoperatively with insulin. Talk to Dr. Raftopoulos about this. You should not take oral medications for diabetes especially the first few weeks postoperatively.
• Birth control pills need to be discontinued one month before surgery and can be re-started after the first month postoperatively.
• Preoperative blood work needs to be completed within six weeks from the surgery date. You need to fast for at least 12 hours prior to the blood test. Dr. Raftopoulos will advise you as to which blood tests you will need to do. The blood tests can be performed locally or at our facility.

 

2. Τwo days prior to your surgery

• You should not eat or drink anything after midnight before your surgery.
• If you are scheduled for gastric bypass, you will need to a bowel prep the last two days prior to your surgery, according to Dr. Raftopoulos’ instructions.
• If you use a CPAP or Bipap device, please bring it and the mask to the hospital with you.
• Bring all your medications with you at the hospital.
• Do not take any medications the day of your surgery unless we advised you to do so.

3. Postoperative instructions

• Recovery period is usually between 1-3 weeks.
• You should not swim, take a bath or use a whirlpool for the first 30 days postoperatively. For bariatric procedures you may take shower the day after your surgery. If you had a plastic surgery procedure only sponge baths are allowed until your first postoperative appointment with Dr. Raftopoulos.
• Walking and treadmill is recommended from the first week after your surgery. Weight lifting over 15 lbs is not allowed for the first month postoperatively.
• Specific instructions for your type of surgery will be given to you in writing by Dr. Raftopoulos and will be explained to you in detail.
• You will also have access to Dr. Raftopoulos’ cell phone and email.
• Dr. Raftopoulos will be calling you personally on a daily basis for the first few days to make sure that you follow and understand all instructions.
• If you traveling to Greece from elsewhere for your surgery, you will continue to have follow up with Dr. Raftopoulos on a frequent basis by phone, email or Skype even after you return to your country. A secure online website has been developed for this purpose. This is part of Dr. Raftopoulos’ lifelong commitment to your success.