PROCESSING NEW PATIENTS

YOU ARE ABOUT TO EMBARK ON A NEW JOURNEY TO HELP YOU RECAPTURE YOUR LIFE, as you decide to make your commitment to our comprehensive program which includes medical, nutritional, psychological and exercise counseling. Bariatric surgery is a tool to help you achieve your weight loss goals. Along with it, you will also have to adhere to a recommended dietary program, exercise and make lifestyle changes.

Ultimately the success of your long-term weight loss will be reflected in the decisions you choose to make. Dr. Neil Floch, Dr. Craig Floch and their team will provide you with the necessary support to enable you to achieve your goals.

OUR TEAM WILL GUIDE YOU THROUGHOUT THE ENTIRE PROCESS TO HELP YOU MINIMIZE YOUR ANXIETIES AND FEARS AND TO TRY TO HELP YOU OVERCOME YOUR CONCERNS. We realize that making the decision to proceed with weight loss surgery might seem difficult and frightening. Our team will guide you through out the entire process to help you minimize your anxieties and fears and to try to help you overcome your concerns. We will support you and make every effort to make your experience a pleasant one and trouble free, as we assist and guide you on your journey to a new life and freedom from obesity. We've outlined our program so that you will have a complete understanding of the steps involved and what you can expect. Our team is always available to answer your questions and provide you with encouragement and support.

1. All patients are required to attend one of our free information seminars before being seen in our office. If you have not already done so, you may register now. If you are unable to attend a seminar please call our office and speak to one of our staff members.
2. At the seminar, you will be presented with a bariatric questionnaire. It is important that you answer all of the questions. This is necessary because it will enable us to obtain approval for your weight loss surgery from your insurance company.
3. During your initial consultation with Dr. Floch, your questionnaire will be reviewed and your weight loss options will be discussed. He will help you decide on the procedure best suited for your individual needs and lifestyle. You will also be given the opportunity to meet with our other team members.
4. Based on the surgical procedure you have chosen, as well as your BMI and past/current medical conditions, additional consultations will be arranged with the following: your primary care physician, Nutritionist (required), Mental Health Counselor or Psychiatrist (required) and gastroenterologist. Many patients will have to see a pulmonologist, endocronologist or cardiologist.
5. If you are already under treatment by a cardiologist, endocrinologist, mental health counselor, etc, an additional consultation may not be necessary.
6. Please be aware that insurance companies will not approve surgery without consultations from a nutritionist and a mental health counselor. Unfortunately, not all medical insurances cover these expenses. You may incur fees for these visits "out of pocket". Your insurance may then reimburse you according to the terms of your individual plan.
7. In addition to the consultations mentioned above, the doctor may order one or more of the following blood tests and/or radiological exams: Blood Test for H. Pylori, Liver function tests, Thyroid screen (blood test), Ultrasound of the Gallbladder to rule out Stones, Upper GI Series and additional tests as needed or recommended by another medical specialist.
8. You may need to take part in a 3 or 6 month medically supervised diet with a nutritionist who will have to be seen each of the 3 or 6 months. This requirement is dependent upon your insurance company.
9. Your primary care physician may be asked to examine you to provide pre-operative clearance stating that you are physically able to undergo the procedure.
10. After you have been cleared by Fairfield County Bariatrics, all your information will be gathered and submitted to your insurance company for approval. Our office staff will be available to assist you in the approval process and in the coordination of your pre-op work up as necessary.
11. Once approval has been obtained, you will be scheduled to meet with Dr. Floch for a preoperative interview and to review consent forms. You will have the opportunity to again discuss your procedure and go over any questions you might have. We will review the hospital process, what you can expect while in the hospital, and when you get home. During the preoperative visit our surgeon will decide if you will require a blood thinner to go home with after surgery, what medications to take the morning of surgery and he will review the preoperative diet.

PLEASE NOTE: We understand your desire to complete this process and schedule your surgery as soon as possible. Our office staff will make every attempt to expedite the process for your surgery. However, there are many steps that simply take time to complete. If there is an occasion when you feel you would like to speak to someone in our office please do not hesitate to do so. A member of our team will always be available for you. You may contact our office via e-mail at chad@fcbariatrics.com or call us at (203) 899-0744 or toll free at (877) 659-0011.

Prior to your surgery you will have the opportunity to see your surgeon and ask questions before going into the operating room. Our mission is to provide you with the highest standard of safe surgical care.

1. Do not eat or drink anything after midnight the night before surgery.
2. Most of your medications, if you have any, should be taken right up until the time you come to the hospital. This is especially true for heart medications, blood pressure, and diuretics. Take these with only a small sip of water. Your surgeon will review the instructions during your preoperative visit.
3. If you take insulin, take half of your normal morning dose, at your usual time the night before surgery, but none on the day of surgery.
4. If you use a C-pap machine at home, you will need to bring it with you to use in the hospital.

• You will be admitted to the hospital on the day of your surgery.
• After completing some paperwork in the admitting office, you will be directed to the operative floor waiting area. Your relatives will be allowed to stay with you until you are called into the operating room.
• You will receive a special gown and stockings. An IV will be placed in your hand or arm to administer fluids and antibiotics. You will also receive an injection to help prevent blood clots.
• A nurse and the anesthesiologist will interview and examine you.
• You will then wait to enter the operating room. The time of surgery you have been given is only an estimate. All surgeries take as long as necessary to provide the best results, which may result in a delay of several hours. We understand that you are anxious, but we appreciate your understanding. Please remember that when you are the patient in the operating room, the doctor will take as much time and care as necessary to successfully complete your procedure. Remember surgery is not a race, but a journey that must be performed completely and correctly
• You will be escorted to the operating room by a nurse, or taken by wheelchair or stretcher if you are unable to ambulate.
• At the time of your procedure, your relatives will be instructed to wait in the waiting area or the main lobby of the hospital. At St. Vincent’s Medical Center they will be provided with an in-house pager so the doctor may reach them when the procedure is complete. In Norwalk Hospital the patient will submit contact information to the waiting room attendant.
• Upon entry to the operating room, you will be asked to move onto the table and you will be given medications to help sedate you. After taking the medications most patients only remember entering the operating room. You will see the equipment and instruments in the operating room.
• The anesthesiologist will place sticky pads on your chest to monitor your heartbeat. An oxygen mask will be placed on your face and anesthesia will then be administered through your IV.
• The next steps occur while you are asleep:
• A tube is placed in your airway to provide your heart and brain with oxygen.
• In gastric bypass patients, a catheter is placed into the urinary bladder.
• Your surgery begins. It may last between 45 minutes and 4 hours. The operating staff will notify your relatives, and the surgeon will speak with your relatives once the procedure is complete.
• When you wake up from weight loss surgery, you may already be in the recovery room. If you aren’t, you will go there shortly after waking up. Your doctor will visit with you and talk to you in the recovery room, but you may not remember. Once you are breathing on your own and vital signs are stable, which usually takes several hours, you will be taken to a hospital room.
• Same day band surgery patients will be observed in the outpatient center. After drinking 30cc of liquid every 15 minutes for 3 hours, you may be discharged to go home.
• Your stay at our weight loss surgery hospital will generally be 1-3 nights depending on your surgical procedure.

OUR STAFF OF INSURANCE EXPERTS WILL ACQUIRE THE NECESSARY INFORMATION AND HELP YOU THROUGH THE PROCESS OF GETTING APPROVED FOR YOUR PROCEDURE.
Many weight loss surgical procedures are covered by health insurance. When planning for your surgery it is important to determine if your specific health insurance plan covers weight loss surgery. Please be aware that every plan is different and benefits are constantly changing. Unfortunately not every plan has weight loss surgery coverage.

IF IT IS DETERMINED THAT YOU DO NOT HAVE THE COVERAGE, PLEASE DON’T BE DISCOURAGED. OUR OFFICE CAN PROVIDE YOU WITH VARIOUS FINANCING OPTIONS. If it is determined that you do not have the coverage, please don’t be discouraged. Our office can provide you with various financing options. We can direct you to financing companies who specialize in funding surgical procedures. Packages can be designed to fit within your budget as these companies offer competitive rates. For more information, please attend one of our free seminars. If you would like to speak directly to someone now please call our office toll free at 877-659-0011 and one of our patient advocates will speak to you.

WE ARE HERE TO TRY TO MAKE YOUR DECISION TO HAVE THIS SURGERY COME TRUE. You are welcome to call our office with any questions and we will supply you with a free insurance evaluation. We are here to assist and support you from your initial decision, to the actual surgery and the after care for your long-term weight loss.

WE BELIEVE THAT POST-OPERATIVE NUTRITIONAL AND PSYCHOLOGICAL SUPPORT AS WELL AS POST-OPERATIVE EXERCISE SUPPORT ARE ESSENTIAL ELEMENTS TO THE SUCCESS OF OUR BARIATRIC PROGRAM. Counseling in these areas contribute to our patients’ success in achieving and maintaining their goals.

Our patients are provided with multiple monthly support groups and preoperative and postoperative nutritional assistance by a registered dietician, specializing in helping bariatric surgery patients achieve desired weight loss results and optimal health.

We offer psychological support groups for our bariatric patients in Norwalk and Bridgeport CT. They are run by a Licensed Care Social Worker, a Psychotherapist and an Exercise Physiologist. Each one is accomplished in their field and experienced in helping the postoperative bariatric patient achieve continued weight loss

Support groups are also offered to help in managing an exercise program that contributes to long-term weight loss.

We are committed to the long-term success of each patient and our support groups enable them to achieve it. Each one of our counselors is accomplished in their field and experienced in helping the postoperative bariatric patient achieve continued weight loss.

Through St. Vincent’s Medical Center we provide preoperative educational meetings as well as postoperative educational classes.

We also offer nutritional and pschological support in New London and the surrounding area.

Bariatric support groups led by psychotherapist, Anne Mata are free sessions intended only for post-operative bariatric patients. Attention is geared toward patients in early transition (6 months postoperative or less). Meetings are held on the first Tuesday of each month at Norwalk Hospital and the last Wednesday of each month at St. Vincent’s Medical Center. Groups are therapeutic in nature as Anne Mata takes on a cognitive behavioral approach.

These groups consist mainly of open group discussions in which a topic for discussion is usually prepared. Topics may include: adaptation to your chosen surgery, coping skills, change, awareness, taking care of yourself, social situations, fears, or other topics relating to your early postoperative bariatric journey in preparation towards long term success. On occasion, a group may involve a presentation by a guest professional on a topic relating to early postoperative care/support. All patients are given the opportunity to voice their obstacles or progress in relation to their postoperative bariatric journey. Participation is encouraged, not forced. The focus is on providing a caring environment, supporting each other toward a smooth transition – making positive change, and giving feedback in relation to your own experiences.

Anne Mata is licensed in the state of CT for counseling. She is also a certified clinical mental health counselor (CCMHC) and national certified counselor (NCC). Education also includes a Bachelor Degree in Psychology (with a minor in Art) and a Master of Science degree in Community Agency Counseling. She has been working in the mental health and addictions field for over 13 years. She is a member of American Mental Health Counselors Association and currently provides group and individual counseling.

All post-operative bariatric patients at different stages of their weight loss journey are welcome to attend this interactive 90-minute bariatric support group. Support groups are conducted twice monthly by skilled Eating Disorders Specialist, Mary P. Ziller, L.C.S.W. who inspires thought-provoking sessions to keep bariatric patients on track with the physical and emotional changes that occur.

The purpose of the group is for patients to learn how to effectively utilize their chosen bariatric surgery for continued weight loss and eventual maintenance and to achieve peace and emotional clarity regarding eating patterns and body image issues. In a trusting environment, Mrs. Ziller's focus is to guide patients to identify and release psychosocial stressors that block them from feeling good about themselves and contribute to emotional eating and weight struggles. Positive methods for self-care are highlighted and a series of individual skill-sets are reinforced at each support group. A few topics covered include: managing the medical and technical challenges of lap-band/ bypass surgery; differences between physical and emotional hunger; mindless/intuitive eating; cognitive eating belief levels; managing stressful events; pivoting off of negative thoughts; the tyranny of the “Shoulds;” 12-Step Principles and body confidence.

Mary P. Ziller is a Licensed Clinical Psychotherapist and Life Skill Coach specializing in treating specific anxiety, compulsive and addictive disorders. Mrs. Ziller is invested in working with Eating Disorders and morbidly obese clients, having successfully maintained an 80-pound weight loss for over 18 years. She fully understands the dynamics that come into play with emotional eating, body image issues and anxiety levels.
Mrs. Ziller is a dynamic presentation speaker having conducted many workshops the past 15 years on mindfulness stress reduction training, brain neurobiology/addictions, anxiety management, emotional eating/negative body image, value clarification, dating/coaching skills and support groups for post-op bariatric patients.

Led by Registered Dietitian Tamara Swett, Bariatric Nutrition Support Group Meetings are held every other month at Norwalk Hospital in the Nutrition Conference Room on the 5th floor. Various topics are covered related to staying on your meal plan after surgery, including getting enough protein and fluid, coping strategies, recipe exchanges and discussions on the importance of specialized bariatric supplements to long term health, including brain and nerve function. 

Tamara Swett RD, CD-N is a registered dietitian and has been an Out-Patient Dietitian at Norwalk Hospital since June of 2006. She received her first degree in Community Health at Western Connecticut State University and then followed her passion for nutrition by continuing her education at Saint Joseph's College where she received her degree in Nutrition. Tamara Swett is also involved in the childhood and adult weight loss programs offered by Norwalk Hospital. Ms. Swett provides nutrition counseling for individuals preparing for weight loss surgery. She runs one of the bariatric support groups at Norwalk Hospital, which is a Bariatric Surgery Center of Excellence®.

This group is led by Nancy Murphy, MS, RD, CDE, CD-N, who has been a registered dietitian for 20 years and a Certified Diabetes Educator for more than ten years. Nancy Murphy’s, nutrition groups are currently limited to a 1 hour group every three months so she tries to pack as much useful and useable information into them as possible. Hopefully, everyone leaves having learned at least one new & helpful tip to bring long-tern success one step closer.

Most patients embarking on bariatric surgery are going into it for the very first time. They may or may not have family or friends to guide them through much of the confusing and (at times) conflicting nutrition and behavioral information they have read on the internet, etc. and may feel quite overwhelmed after their surgeries. The main purpose of this post-op nutrition support groups is to provide our patients with reliable, accurate and understandable information about their post-op dietary needs and lifestyle challenges so long-term success will be the anticipated outcome. Some of the topics discussed in our groups include dietary/macronutrient requirements, supplements, caloric needs, appropriate portions, food preparation, meal structure, fluid requirements, relapse prevention and behavior modification

The topics presented must be relevant to our entire post-op bariatric population. Since Nancy Murphy feels strongly that it is willingness to make long-term changes and not a particular surgery that leads to long-term success, it is usually not difficult to find a topic that all our patients can embrace. The lifestyle goals that are often discussed & reinforced at post-op meetings are 1) healthy vs. rapid/excessive weight loss,
2) adequate daily protein & supplementation (to ensure healthy weight loss), 3) adaptation of a healthy relationship with food vs. pre-op “chronic dieting” mentality and 4) structured exercise as a critical component of long-term weight management.

Nancy Murphy’s M.S. in Clinical Nutrition from N.Y.U. was followed by more than ten years of clinical and research experience at Mt. Sinai Medical Center and St. Luke’s-Roosevelt Hospital Center in Manhattan. As an obesity research nutritionist at St. Luke’s and Lifestyle Coach for the Manhattan site of the (NIH-funded) Diabetes Prevention Program, Nancy had the unique opportunity to be involved with groundbreaking research in the areas of obesity, diabetes, metabolism, body composition and eating disorders. Her own original research and writing reflect a particular interest in eating patterns and behaviors unique to obese individuals, most specifically the night-eating syndrome.

Nancy is an advocate for a healthy diet as part of a healthy lifestyle and is not inclined to put her clients on diets. She strongly believes that successful weight and disease management are based on the following
1) understanding basic nutrition, 2) identifying how nutrients or nutrient combinations affect a given individual and 3) realistic goal-setting. She takes pride in her ability to raise her client’s nutritional awareness by identifying and modifying particular behaviors which will provide the greatest long-term benefits.

As her family grew, Nancy’s decision to work locally led her to a position as Director of Nutrition & Lifestyle Programs at Health Extenders, a wellness facility in Norwalk, CT. An overwhelming need for nutrition professionals knowledgeable in bariatrics has led Nancy to become a nutrition expert in the areas of the laparoscopic Roux-and-Y gastric bypass and Lap-Band procedures.

Nancy’s professional desire to see more emphasis on lifestyle modification as the most rewarding alternative to improving ones physical and emotional well-being has prompted her decision to start her own business, Fairfield County Lifestyle Consultants (FCLC). While nutrition is her area of expertise, Nancy believes that physical fitness and emotional well-being are equally important in establishing a balanced and healthy lifestyle. Thus, she chooses to work with many experienced professionals in the complementary fields of exercise physiology and psychology.

Our exercise support group is conducted Sarah Collins, the exercise physiologist for St. Vincent’s Medical Center, who is responsible for employee health and wellness. Exercise is an essential element to permanent weight loss, to improve skin tone, and improve energy levels both before and after bariatric surgery. The purpose of the support groups led by Exercise Physiologist, Sarah Collins, is to provide education and instruction regarding exercise program design. Information will be provided for enhanced back health with abdominal strength and endurance exercises, proper stretching techniques, resistance training for improved muscular strength and endurance (i.e. energy and vitality) and techniques to enhance cardiovascular endurance post bariatric surgery.

The support groups are a combination of lecture, PowerPoint presentation, and handouts. Exercise demonstration and participation provide a tactile, physical approach to correct technique for participants. Participation is encouraged, but not forced. The focus is on providing an environment that is supportive, offering modifications for all individuals to help all obtain confidence in approaching a more active lifestyle. Meetings are held the third Wednesday of the month, four times a year at St. Vincent’s Medical Center, Fitness Center from 7:00pm-8:00pm.

Sarah Collins is also the owner of Fit Solutions by Sarah, LLC, a personal training and pilates studio in Trumbull CT where her special focus is special populations. Sarah has her Master of Science in Gerontology with a focus in Exercise Science from the University of Southern California, is ACSM: Health Fitness Specialist certified, NASM: Certified Personal Trainer certified and STOTT Pilates certified in Reformer and Mat, AFFAA Advanced Personal Trainer and a national YMCA of USA Faculty Trainer