Initial Meeting Options
Attend a Free Seminar:
The Coastal Center for Obesity surgeons host free seminars in various locations
throughout the year. These very informative seminars include information on
obesity, surgical choices, risks, benefits, and necessary life style changes.
Participants will have the opportunity to ask questions of surgeons and staff,
as well as speak to patients about their experience. For more information and
seminar schedule, visit www.coastalobesity.com
and select Attend a Free Seminar.
Coastal Obesity's online seminar is available for those who are unable to
attend a group seminar. High speed / DSL connection on your computer is
necessary for viewing. To view the online seminar, visit
www.coastalobesity.com and select View On Line Seminar. Additional
online education may be required for those choosing this option before
scheduling an appointment to meet with a Coastal Surgeon. Our staff will be
happy to guide you through our educational process.
For those who are unable to attend a group seminar, private consultations are
available. Coastal Obesity Online seminar, as well as patient
pre-operative education on line must be completed before scheduling private
consultations. The consultation fee is $150. The fee can be applied towards
surgical fess for those wishing to have surgery.
If you wish to proceed after attending an initial consultation, the Coastal
Obesity Surgeon will order laboratory tests to substantiate the need for
surgery. Depending on your medical history, the surgeon may also want you to
see a specialist. After you have completed the necessary tests, we will send a
letter to your insurance company requesting authorization for surgery based on
your individual medical conditions (diabetes, high blood pressure) that would
most likely improve with bariatric surgery. Please note that receiving
authorization for surgery from your insurance company does not obligate you to
It usually takes from one to six weeks to hear from you insurance company. In
rare cases, this process may take longer. Our patient coordinators will contact
your insurance company weekly to get a status report. Once surgery is approved,
our surgical coordinators will call to notify you. At this time we will set a
surgery date and schedule any necessary pre-operative laboratory studies and
physician appointments. Should you have questions about your surgery date or
your pre-operative medical appointments, please contact one of our surgical
Payment by Cash or Financing
Patients paying by cash or finance usually are able to schedule LAP-BAND®
surgery within 2 weeks. Coastal Center for Obesity's LAP-BAND® patients can now
finance all costs associated with LAP-BAND®.
There will be a non-refundable program fee. It is to be paid at the time of
your first visit with the surgeon. The fee covers items including educational
materials, patient manuals, interactive seminars ,on-line exercise, nutrition
and support group guest speakers. The fee includes 24 hour direct access to
Coastal staff including Physicians. (This fee is not covered by insurance)
Program fees are good for a life time. To view the Billing Information area of
To download the Coastal Center for Obesity Program Fee Form:
Microsoft Word -
download now | Adobe PDF -
After insurance authorization is confirmed, you will be seen a second time in
our office. This time a physical examination will be performed and your surgery
will be scheduled. You will also be asked to complete a true-false
questionnaire related to bariatric surgery and to sign a disclosure statement
regarding operative risks and blood transfusions. You will also be scheduled
for a pre-operative class taught by our program nurse. This class is designed
to give you an overview of your hospital experience, and give you specific
information about pre-operative and post-operative hospital procedures.
As part of our thorough, comprehensive medical care, every pre-operative
patient may need to see the following physicians for pre-operative
clearance. (Each individual physician's office will bill your insurance company
Psychologist (for evaluation)
Specialists such as a Cardiologist, Pulmonologist or Endocrinologist, based on
your individual medical history
Assistant Surgeon (not seen pre-operatively, but present on all surgical cases)
Support Group Meetings
All patients are encouraged to attend at least one support group meeting before having
surgery. While you are waiting for insurance approval, try to attend as many
support group meetings as possible. Support group schedules are available in
our office, and on our web site at www.coastalobesity.com.
Hospital admission is sometimes the day of surgery, and sometimes the day before
surgery. There will be some routine lab tests repeated in the hospital to be
sure that nothing about your medical condition (e.g. pregnancy) has changed.
LAP-BAND® Surgery is now available as an outpatient procedure. The course of
your experience will be similar to the hospital course, excluding admission.
Most patients will go home within hours of LAP-BAND® Surgery.
Morning of Surgery
An RN will prepare you for your surgery. During this preparation you will sign a
surgical consent and have your vital signs checked. An intravenous line will be
started, usually in the forearm, the back of the hand, or occasionally under
the collarbone. You will meet with the anesthesiologist and discuss what to
expect from anesthesia. You will be given antibiotics and other medications
prior to surgery. An incentive spirometer will be brought to your bedside and
you will be instructed in breathing exercises. You may also be instructed in
the use of a machine to deliver pain medication. Local anesthesia is usually
placed in the surgical incision to decrease post-operative discomfort.
Surgery by open incision usually takes an hour to an hour and a half, although
because of necessary immediate perioperative activities, the time during which
the patient is separated from his/her family is usually 3-4 hours.
(Laparoscopic gastric bypass surgery may take longer.) After surgery you will
awake in the recovery room. Here you will be carefully monitored while the
anesthesia wears off. A tube will be placed in your bladder to prevent
post-operative urinary retention and to help determine the amount of
intravenous fluids you will need. Y ou may also notice that you are wearing
leggings that rhythmically squeeze your legs. These were applied immediately
prior to surgery to prevent blood clots and are worn until you feel like
getting up and walking around; usually on the second or third post-operative
(Dr. Owens is a General Surgeon as well as a Bariatric surgeon, and is fully
qualified to take care of your other operative needs such as gallbladder,
hernia, appendix, etc.)
It is common to remain in the hospital for four days. After surgery you will be
allowed small amounts of ice and water, and this is usually a welcome treat as
a "dry mouth" feeling often occurs after anesthesia. Only ice chips will be
allowed to prevent nausea until your GI tract opens up and you have a bowel
movement. Once your intestinal tract is functioning normally you will be served
sugar free, clear liquids and protein shakes. Early ambulation is recommended
to help prevent respiratory complications and formation of blood clots. A
physical therapist will visit you to help you ambulate for the first time and a
respiratory therapist will also visit you to help you with breathing exercises
to prevent pneumonia.
The bladder catheter is usually removed soon after surgery. Gastrointestinal
activity usually recovers on the third or fourth post-operative day, and is
indicated by mild intestinal cramping, the passage of gas, or a bowel movement.
At this point, intravenous fluids are no longer necessary and you may go home.
We request that you call our office on your first day home to schedule your
first post-operative appointment. The office staff, nurse or surgeon can answer
any questions or concerns you may have at this time. Please call, so we can
First Liquid Meals
Your first meals after surgery will consist of liquid protein drinks carefully
balanced to provide adequate vitamins and nutrients for proper surgical
healing, while still permitting weight loss. It is unlikely that you will feel
hungry; most patients must make an effort to drink the proper volume of liquid
diet. Your surgery takes weeks to heal and it is desirable that you not stretch
the pouch or opening with solid foods during this period of time.
Protein shakes are your sole source of nutrition for five weeks following
surgery. It is required that you purchase at least a two-week supply of protein
shakes at the time of your pre-operative physical. This is a dietary
supplementation cost that is not covered by your insurance company. All
surgical patients should plan to purchase a five-week supply, at an approximate
cost of $52.00 per week.
Transitional Soft-Food Meals
When you stop the liquid protein diet, it is replaced with a soft food diet
which does not require chewing for a week or two before beginning to eat
regular meals. Good foods to eat during this period include scrambled egg
whites, oatmeal with nonfat milk, cream of wheat with nonfat milk, fat free
yogurt (Dannon makes a great yogurt), broth soups, tomato soup, split pea soup,
baby food meats like chicken or turkey, pureed vegetables, nonfat cottage
cheese, bananas, mashed potato (made with broth or nonfat milk), and
unsweetened applesauce. The recommended daily intake of protein from your soft
meals is 60-70 grams. Keep in mind the following tips when eating:
Eat slowly and chew well.
Do not drink fluids with meals and within one hour after each meal.
Sit when you eat.
Avoid concentrated sugars and fats.
Don't overeat. Your new stomach can only hold a few ounces, so you will fill up
Each meal should contain protein.
When not eating, drink plenty of water. (As noted above, do not drink during a
meal or within one hour after.)
In addition to eating soft foods, you should take BI2 and iron daily
(Ferotrinsic is best). Also take 1500 mg of calcium, and multivitamins with
antioxidant, daily. Most vitamins are available in our office. We try to be
less expensive than drugstores.
Dietary habits are hard to change, but the effects of surgery and the
post-operative liquid diet make it easier to begin new habits. You will be
scheduled to attend a nutrition class at the fourth post-operative week to help
teach you the best nutrition following surgery.
The following dietary rules should be followed.
Eat 3 meals a day no more than 5 hours apart.
Get at least 60 grams of protein a day, while not exceeding 20 grams of fat per
Eat protein first. Then a vegetable. Then a fruit.
Do not drink fluids with your meal or within one hour after your meal.
Wait one hour after a meal, drink plenty of water, eight glasses per day, if
possible. Start drinking water 1 hour after eating.
No snacking between meals.
Eat slowly and chew all foods well to avoid stomach distress.
Sit while eating
Take daily: Multivitamin, B12 and iron (Ferotrinsic or Trinsicon), and Calcium
Note that milk (lactose) intolerance is not unusual after surgery and may be
signaled by bloating, cramps, nausea and diarrhea. This may be corrected with
lactase drops to aid digestion or by the avoidance of milk products.
Lean meats, vegetables, and fruits should become your dietary mainstays. Fats,
concentrated sugars, and snacking are to be avoided. Meals are necessarily
small and food should be well chewed.
Here are some additional food tips.
Bake, broil, or BBQ meats - do not fry foods!!! Avoid foods that are greasy or
Read labels. Some foods are surprisingly high in sugar and fat; for example,
baked beans, BBQ sauce, salad dressings, mayonnaise, butter and spaghetti
Spice to taste. Salsa is a great taste to add to eggs, potatoes, salad, and
Use nonfat dressings and spreads. Use Equal or Sweet & Low. Avoid sugar.
Lean Protein Sources
Remember to eat enough protein. Our bodies need the amino acids and other
building nutrients found in protein foods. Protein builds and repairs muscle,
and is an energy fuel. Patients should attempt to get at least 60 grams of
protein a day.
Turkey, chicken, or beef - purchase 97% lean meat
Baked, broiled, or BBQd skinless chicken, white turkey meat, fish
Ground Chopped chicken or turkey (white meat) for salads (use nonfat dressing)
Lean deli meats (turkey, chicken)
Water packed tuna (1/4 cup = 1 oz meat)
Egg whites or egg substitute. (Yolk has all the cholesterol and fat, whites are
Nonfat yogurt(Dannon makes a great yogurt)
Cereals: oatmeal or cream of wheat with nonfat milk
Kidney beans, navy beans, lima beans, pinto beans
Baked potato. (Top with sa1sa)
Nonfat cottage cheese (great on a baked potato)
Cereals (read labels for those high in protein and fat free or lowfat).
Fish baked or broiled
Foods to AVOID
Nuts of any kind
Whole or lowfat milk, cream
Butter, mayonnaise (substitute with nonfat)
Ice cream (Sorbet is okay)
Cookies, cakes, popcorn, pies
BBQ beans and sauce
Muffins, coffee cakes, donuts
Snack ONLY if you are hungry. DON'T make snacking a habit - you can consume a
lot of extra calories with snacks. Here are some nutritional snacks.
Lean deli meat (turkey, chicken)
Nonfat cottage cheese
1/2 apple, 1/2 banana
1/4 cup dry cereal
Vitamin Supplements and Medications
All patients who have undergone gastric bypass surgery must take vitamin B12,
Iron ,and Calcium supplements for the rest of their lives. These supplements
are offered in our office at a reasonable cost. Depending on your prescription
benefit coverage, you may able to purchase the supplements at the best price
through your local pharmacy. If this is the case, we will write a prescription
Although medications in the form of capsules and liquids are well tolerated,
tablets should be crushed before swallowing. Non-steroidal medication, like
Advil, is not recommended.
Exercising on a regular basis is a necessary lifestyle change after surgery.
Exercising induces a sense of well being, increases overall energy, maximizes
fatty tissue weight loss, and minimizes muscle breakdown. \ Our
Physical Exercise page describes an exercise program which you can use.
Post Operative Visits
Postoperative visits with Dr. Owens will be frequent during the first three
months after surgery, and ongoing after that. It is very important that you
commit to attending all of your scheduled office visits.
Support Group Meetings
Information obtained through regular attendance at support group meetings will
help you with post-operative adjustments. Patients who attend support group
meetings on a regular basis seem to lose weight more successfully than those
who do not. No better opportunity exists to discuss the surgical experience
with other patients than at the support group meetings, and the
multi-disciplinary educational format offers a variety of topics to guide you
toward healthy lifestyle. Check our
schedule. Support group meeting
transcripts are also available.
Keeping in Touch
Even years after surgery we would like to keep in contact with you on a regular,
annual basis. We would hope to do this even if you have neither medical
insurance nor the financial means to pay for an office visit – in short, we
will see you for free, forever, if necessary. By maintaining contact we expect
to be able to offer you the latest information in the treatment of obesity as
well as counsel you in using your surgery to the greatest benefit. Information
on how you are doing also helps us in the management of other patients.
We are always available to answer questions, address your concerns, and provide
additional information. Please contact us at 888-527-5222.