Read before you go!

Weightloss Surgery Arrival Instructions

Arrival and the first few days! SATURDAY

On arrival at Wroclaw International Airport; we ask that you switch on your mobile telephone and send a text message to our driver Jack picture to the right on this number +48 601 426 066 Please store this number in your telephone in advance. The new airport has restrictions on time allowed to stop outside; so text only once you have collected your baggage.

Jack will be waiting at the pick-up point outside the main entrance (exit the nearest door to you) in white Volkswagen Passat (no taxi stickers) In the case if your mobile doesnt work in Poland Jack will check when your plane lands and will be waiting by the main entrance. You can always call me on +44 745 022 0123 JACK

Once Jack collects you at the airport he will take you to the 5 star Sofitel where you will spend your first evening. I will meet you at the entrance as Ill have already checked you into the room so your arrival will be extremely smooth.

On the Saturday evening we will have already started a group meal at the Mosaiq restaurant (which is directly opposite the Sofitel) and we welcome you to join all the other patients and surgeons for an informal light meal. See menu: http://mosaiq.pl/en/main-menu/

SUNDAY
Please remember NO BIG BREAKFAST IN THE HOTEL. You can have a light liquid breakfast. Sunday morning we have arranged a tour of our medical facility in Wroclaw and I welcome you to join all the other patients. The Taxi will collect you from outside the Sofitel at 9.30am. Please pack your suitcase and bring it with you.

At around 12noon Jack our driver will collect you from EMC and take you and the other bariatric patients to Orthos Multidisciplinary Hospital.

On arrival you will be met and welcomed to Orthos youll be met by your PA Agnieszka Poprawska at the clinic reception. You can call her Aga! The receptionists may make a copy of your passport and prepare your patients card. You will also receive all the appropriate forms you need to fill: a simplified medical questionnaire, anaesthesia informed consent and consent form for the surgery with the terms and conditions. You will not sign these until you have consulted with the medical team and understand everything. All of these forms are written in Polish with court sworn English translations and applicable to the appropriate rules, regulations surrounding patient care in the EU & Poland.

The medical staff will show you to your private room and you will get settled in. They will then commence many test, checks such as, blood pressure, height weight, neurological, taking blood and urine, ECG, Xrays/scans. Then, according to the clinic programme, you will go through these consultations (the order is subject to change):

BARIATRIC CONSULTATION: This will be with your bariatric surgeon Dr. Mateusz Glod, MD, PhD (who will perform the surgery) This will give you the opportunity to understand everything that is going to happen during your surgery, discuss risks and complications as well as have the opportunity to ask an exhaustive list of questions so that you are fully aware of everything.

VIDEO GASTROSCOPY: This will be performed endoscopy normally with local anaesthetics and through the nose, which is usually perceived as a much better option.

ANAESTHETIST: You will meet your Anaesthetist Your anaesthetist specialises in the care of anaesthetised obese patients, and has specific skills in foreseeing any obesity related problems. Please prepare a list of all medications that you take in advance along with frequency and dosage, Please also bring any information relating to past bariatric surgeries. You will be asked for this. After these consultations and tests, you will go to the reception and pay the balance of the treatment price. Complete and sign the Informed consent Informed consent and payment cannot legally be completed until all consultations have been completed, and patients have had all questions asked, satisfied by our team of medical professionals After all of the above You will then take time to rest and relax in your room in preperation for surgery the following day. You will be given a light meal/drink. NIL BY MOUTH The time this will start will be advised by the medical team on arrival

Vitamins:
We are delighted to advise that you will receive a complimentary 6 week starter pack of bariatric vitamins and calcium to supplement your diet. These will be sent directly to your home address. Please start taking these at 8 weeks post op. For an increasing number of people weight loss surgery means a new lease of life. To support your body at this stage, it is important to take an adequate amount of vitamins and minerals. This isnt always easy because, following gastric bypass procedures, the absorption of vitamins and minerals is more difficult for the body. You will also find you eat less and this results in a loss of key vitamin and mineral supplements. For these reasons WLS Forte, a supplement specifically tailored for people who have undergone gastric bypass procedure. This supplement contains vitamin B12, vitamin D and iron, amongst other key vitamins, to help you get back to your best as quickly as possible. WLS Forte A multivitamin supplement specifically tailored for people who have undergone gastric bypass surgery, a biliopancreatic diversion procedure or a duodenal switch operation Helps bolster the bodys natural defences and immune system One capsule a day will help supplement your diet

Calcium Plus

Helps to maintain strong bones and teeth Enriched with vitamin D3 for better absorption Contains highly absorbable calcium citrate

Calcium is a mineral that helps to maintain strong bones and teeth, and it is important to ensure you take an adequate daily amount. Calcium Plus has a base of calcium citrate, a form of calcium that is absorbed well by the body. As a supplement to your diet, Calcium Plus ensures that you acquire an adequate amount of this mineral. In addition to calcium, Calcium Plus capsules also contain vitamin D3. This allows the calcium to be absorbed more easily by your bones!

Things to consider Packing in your suitcase

Toiletries Baby wipes Dry Shampoo Lip Balm Entertainment Magazines DVD's Download skype & viber Camera Book Food English teabags Clear cupasoups, stock cubes, Bovril incase you dont like hospital offerings Miscellaneous Euro adaptor for your laptop/ipad/mobile telephone Loose clothing that is light weight to carry You dont need to pack towels as these are provided at both hospital.

Things to consider before travelling

1. Have you got a copy of your surgery booking confirmation - you need to print this and take it with you. 2. Have you checked-In for your flights. Youll need your passport details to have to do this. 3. Have you read through the list of things to consider packing in your case??? 4. Have you popped all contact numbers in your telephone? 5. Have you read through things to do to prepare for surgery? 5.1 http://secret-surgery.com/2012/08/24/prepping-yourself-for-surgery-medications/ 5.2 http://secret-surgery.com/2012/09/24/prepping-your-home-before-cosmetic-surgery/ 5.3 http://www.secretsurgery.co.uk/faqs-before-surgery/ 6. Please check with your mobile telephone network provider that you'll be able to use your telephone in Poland You may be able to buy a bolt on product to allow you to make and receive calls at minimal cost. 7. If you have any concerns thoughts or need help with anything please feel free to ask! 8. Have you purchased specialist Medical travel Insurance? If NO then get a quote on this link... 8.1 http://medicaltravelshield.com/buy-now/secsur 9. TV ABROAD: There arent that many English channels so its best to pack DVDs or subscribe to a service that will let you watch the latest soaps. Its 6.49 a month and you can cancel your subscription via paypal when you get back http://www.viewtvabroad.com/

Online Check-In for the flight:

The check-in for your flight is now open - Please click on the link depending on what airline you booked with: Ryanair: http://www.ryanair.com/ Wizzair: http://wizzair.com/en-GB/Search Please message us to confirm that you have done it OK. You will need to have the following information to hand: * Passport Number, Nationality, Passport Expiry Date, Place of Issue, Date of Birth

In case you get lost!

Sofitel Hotel: witego Mikoaja 67, 50-127 Wrocaw, Poland Phone:+48 71 358 83 00 Mosaiq Restaurant: ul. witego Mikoaja 12, Wrocaw Orthos Hospital: Wrocawska 2a, 55-229 Komorowice, Poland Phone:+48 71 735 87 00 Puro Hotel: Pawa Wodkowica 6, 50-072 Wrocaw, Poland Phone:+48 71 772 51 00 Wroclaw Airport: Graniczna 190, 54-530 Wroclaw, Poland

Contact Numbers whilst in Poland:

Angela - 0044 745 022 0123 Aga - 0048 608 031 168 Jack - 0048 601 426 066 Dr Glod 0048 505 505 644

FAQs
What to wear:
Wear what you want and will feel warm and comfortable in. Layers is often suggested as indoors is warm. Pyjamas for abdominal surgeries is a must.

Telephone Calls:
Please make sure you download the FREE app www.VIBER.com ; so we can all stay in touch - its free to call UK when connected to wifi

Health Insurance Card:

Make sure you apply for your EHIC card - Its free..... Click on this link for information and how to apply http://www.nhs.uk/NHSEngland/Healthcareabr oad/EHIC/Pages/about-the-ehic.aspx

Important Dates & Diet advice

On 24/3 Please start your pre-operative liver reduction diet I have attached a PDF plus details are on this link: http://www.scribd.com/doc/101438395/Bariatric-Surgery-PreOperative-Liver-Reduction-Diet On 9/4 Please start your post-operative 4 stage eating plan I have attached a PDF plus details are on this link: http://www.scribd.com/doc/209805315/4-Stage-Eating-Plan-Postoperative-bariatric-diet On 2/6 Start taking your vitamin and calcium supplements. Please follow the Instructions on the packs and take at separate times not together. We only provide the initial supply but more can be purchased on http://www.fitforme.co.uk Advice relating to exercise can be found on this link: http://www.secretsurgery.co.uk/?p=2688

FAQs Before Surgery

In todays busy world, most patients arrive at the hospital on the day of their scheduled surgery. We dont do this as there are certain protocols surrounding air travel and anaesthesia. The following information is designed to provide patients with answers to some of the more commonly asked questions about this part of the hospital process. Please take this as general information and always take any specific advice that is meant for you as the thing to follow: Can I eat or drink before the surgery? It is important to have an empty stomach prior to surgery, and some foods take longer to digest than others. For this reason, guidelines for healthy patients have been established to give food and liquid time to be digested. Conditions like diabetes, acid reflux disease, hiatal hernia, pregnancy, obesity, nausea or bowel obstruction may slow the normal emptying of your stomach. If you have any doubts, please ask your surgeon or anaesthesiologist for advice. N.P.O. (Nothing By Mouth) Guidelines These guidelines keep our patients safe. If these guidelines are not followed, procedures may be delayed or cancelled. 1. PILLS & CLEAR LIQUIDS: Up until 6 hours before surgery, patients may drink up to 2 ounces or less of clear liquids, such as water, tea, black coffee (NO CREAM), or clear fruit juice. Fruit juices with pulp are not allowed. 2. ANYTHING ELSE: Your surgery may be done earlier in the day than originally scheduled, so please do not eat or drink anything from the evening before your surgery unless you speak to your surgeon or anaesthesiologist first. Can I chew gum prior to the surgery? No. Chewing gum increases the amount of acid secreted in the stomach, and this may increase the risk of lung problems and pneumonia after anaesthesia. Can I take my medications before the surgery? You should take most of your regularly scheduled medications with a sip of water but always discuss this with the surgeon. It is particularly important to take medications for heart disease or high blood pressure. Also, if you regularly take any medications for acid reflux (heartburn), asthma, bronchitis or emphysema, please take these as well. Patients taking blood-thinners or diabetes medications should discuss these medicines with your surgeon or anaesthesiologist before surgery. If you have any questions, please contact us and we can review your medication list with you. Can I smoke prior to the surgery? It is always a great time to quit smoking. Stopping smoking increases the safety of your anaesthetic and lets your recover more quickly! In particular, we ask that you avoid smoking for at least 24 hours prior to the surgery. This allows your blood to carry more oxygen during the surgery. In addition, your lungs and upper airways will be less irritated and will respond less to breathing tubes and anaesthetic gases. Plus recovery afterwards will be faster if you remain without a cigarette.

When should I come to the hospital for the planned surgery? In general, you should arrive in the hospital for check-In by 3pm the day before your planned surgery. If you need additional testing, you may be asked to arrive even earlier Especially Breast Implants as these are ordered specifically to your measurements. The reason to be here so early is to allow time to complete the admission paperwork, pre-operative evaluation & medical history with several doctors and nurses. Some patients requiring extra testing or preparation all patients are admitted to the hospital the night before the surgery.
Should I bring my medications from home? It is often a good idea for you to bring your medications or a complete list of names and doses with you to the hospital. Then, we can see the medications and doses you require. If you bring the medicines, we will probably make a list and then return them to you. The hospital pharmacy will dispense the medications you need according to your physicians requests. There is no need to take any of your own medications while in the hospital. In fact, it may be dangerous to do so without prior agreement with the medical staff. What else can I bring from home? If you plan to be in the hospital for a few days, you may wish to bring a robe, slippers and reading materials. The hospital provides a gown, soap, shower gel, razor, towels etc. Please note the hospital does not have 3 prong electrical plugs so bring your travel adapter. Valuables are best left at home although there is a lockable area where they can be stored. It is not a good idea to bring lots of money, credit cards, jewellery or expensive watches. Can I wear my contact lenses? It is best that you leave your contact lenses at home where they will be safe. If you need to have your contacts or glasses to read consent forms or brochures, please bring them. At the time of surgery, you will be asked to remove them. If you choose to wear your contact lenses to the hospital, please bring your lens case for storage. Can I wear makeup or jewellery? Make-up must be all removed along with false eyelashes and nails along with polish. Eye makeup can smear and cause irritation to your eyes upon waking up from anaesthesia. Please leave valuables and jewellery at home. If you have a piece of jewellery with particular sentimental value, for example a wedding band, then the ring will be taped during the procedure. Body piercing should also be removed prior to surgery, or replaced with a non-metallic version. Many anaesthesiologists will not anaesthetize a patient with a tongue piercing in place because the ring or stud may interfere with placing a breathing tube.

Should I bring my hearing aids? Absolutely. If we need to remove them for your surgery, we will keep them in a safe place and return them to you as soon as possible after surgery, usually in the recovery room. We prefer that you wear your hearing aides for communication purposes. Can I keep my dentures in? You can keep your dentures in until the time of surgery. For your protection, when having a general anaesthetic, we will ask you to remove your dentures for the surgery and return them to you as you wish after surgery. If you are having a local or regional anaesthetic, you may be allowed to leave your dentures in place. Ask the medical team on arrival. Will I have an IV before the surgery? We know that getting an IV can be the hardest part of your anaesthetic and surgery. An IV is necessary for several reasons. It allows us to give you fluids to make up for skipping breakfast. It also allows quick access for medication if any emergency should arise during surgery. Finally, an IV allows you to receive the pain medications, antibiotics, and fluids your body may require following surgery. Almost all patients need an IV before surgery. Our nursing staff and Anaesthesia team take great care to make the IV insertion as pleasant and painless as possible. Numbing medication to the skin can be requested before starting will often ease the process. Can I bring my friends and relatives with me? It can be a very anxious time for both you and your family, we recommend that patients bring only a few close family and friends to the hospital for emotional support. Also, with your permission, they can pass along information from your doctors and nurses to your other family and friends. Although the Recovery Room does not typically allow visitors, we may allow a short visit after 6pm on the day of surgery. Please ask the team on arrival. Is there a waiting area for friends and relatives? We suggest your companions spend the day in Wroclaw town until the surgery is finished. There is a waiting room on the ground floor in outpatient Surgery entrance with a vending machine for coffee and snacks. Will someone inform my family and friends of the progress or results? With your permission, when your surgery is finished, we can arrange for someone to notify your family and friends. If the surgery takes longer than expected, your surgeon and nurses will keep your family and friends informed. For privacy reasons, your surgeon will only relate information about your surgery with your approval. Please discuss this with your surgeon prior to your surgery. I am very nervous and anxious. Will I get some medicine for that? Many patients experience fear of the unknown. Knowing exactly what is going to happen to you and understanding how the system works in the hospital will help to decrease most patients anxiety. If you are admitted to the hospital on the day prior to your surgery, your anaesthesiologist will visit you and may prescribe medication to help you relax before surgery. If you are scheduled to arrive at the hospital the day of your surgery, then you may ask your surgeon for a sedative to be taken either the night before or the morning of surgery. In addition, your anaesthesiologist will administer more medication through your IV to make you relaxed before surgery.

Will I meet my Anaesthesiologist before the surgery? Certainly. Your anaesthesiologist will prescribe a combination of medicines specifically for your surgery and state of health. To design this plan, your anaesthesiologist will interview you before your anaesthesia to gather information and answer your questions. He or she will review results of lab tests, along with medical, surgical and anaesthesia records and any history of allergic reactions. The risks and benefits of the prescribed anaesthetic, along with any alternatives, will be discussed at this time. Will I get the chance to talk to my surgeon if I have some questions? YES You will have the opportunity to meet 2 or 3 times and discuss and exhaustive list of questions with our surgeon prior to surgery, If you forgot a specific question let your medical co-ordinator know and she will make sure that you receive no sedative medication before your surgeons answers the questions. Your surgeon will always see you prior to the procedure. He will never administer sedative medications are before he arrives, as you may not remember any conversations you have! Besides an IV, what else might I need before surgery? For major surgeries it is often necessary to place other specialised monitors or tests. Your surgeon or anaesthesiologist will discuss the need for these kinds of monitors during the preoperative assessment. Can I drive myself home after my surgery? No. You MUST make arrangements to have a responsible adult to provide you with transportation from the airport on your return. CALL BELL BUZZER In Poland this is used for everything not just in an emergency situation. so whatever you want/need never be scared to buzz for a member of staff! They expect you to use it