Patient Journey

Dietary & Nutrition Support

The role of the dietitian is to guide and support each patient through the pre and post operation requirements including food texture changes to ensure a safe and healthy recovery. This journey is tailored to the individual to ensure success and longevity to build a healthy relationship with food. The long term success of an individual is with regular engagement with the dietitian to not only discuss what you are eating but the process that encumbers this – the why? the how?

Pre-Surgery Program

Your initial appointment is a discussion of your lifestyle, medical background, medications, bowel habits, eating and exercise patterns. We design short and long term goals to work through the journey. With this information, we create the ‘preparation phase’ nutrition plan that focuses on reducing fat accumulation around the liver (medically known as hepatic steatosis). The preparation phase typically lasts for 2 weeks however is altered to suit targets.

Post-Surgery Program

During the 6 to 8 weeks following surgery, you will have a progressive plan that increases the texture of your foods. This is to allow for healing of the surgical site and assist with increased gastrointestinal function. Phase 1 is the fluid phase which typically lasts 2 weeks followed by the puree phase also lasting 2 weeks. The final two phases sloppy and minced/mashed slowly upgrade you onto normal textured foods again. These final 2 phases will vary between 1-2 weeks each depending on various factors (e.g. tolerance, bowels, weight progress etc.).

Following surgery the priority of food groups transitions to protein, whereas prior to surgery the priority is carbohydrates. We will ensure that your protein levels are adequate to maintain muscle mass as you lose weight. Adequate protein will also ensure satiety and fullness.

Long Term Follow-up

Once you have safely upgraded to full foods we then explore your relationship with food and ensure your long-term success. Weight loss will continue over the initial 9 to 18 months following surgery. We will work alongside your goals to create new habits and rituals of eating, movement and exercise. You will build your nutritional knowledge using food to fuel yourself to long term success. 

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general questions

Frequently Asked Questions

Yes, you will need a referral to see Dr Puhalla. A referral from your GP is valid for 12 months, while a referral from a specialist is valid for 3 months. 

The initial consultation costs $250, with a Medicare rebate of $76. The pre-operative appointment costs $90, with a Medicare rebate of $38. You will need a valid referral to claim the Medicare rebates. 

No, weight loss surgery is not currently available in the public health system.

Yes, Dr Puhalla accepts uninsured patients. You can apply to the ATO for early release of your super, for which we can assist you. Medicare rebates are available for some fees, however you are liable for all costs.s

Unfortunately, Medicare and health fund rebates do not cover the full cost of providing you with medical care. This is because the rate at which successive governments have indexed the Medicare Schedule fees has been substantially lower than increases in the Consumer Price Index (CPI) and average weekly earnings. The reality is that Medicare rebates do not cover the cost of providing you with a safe and high quality service. The fees charged by this practice have to cover all of our practice costs.

Please bring a copy of your referral, along with your personal details, including Medicare card, private health insurance, and a list of medications. You will need to fill out personal details and medical history forms on arrival.

Yes, it is essential that you see a dietitian to support you on your weight loss surgery journey. This is to ensure that you have the best possible outcome relating to your weight loss and overall health.

Dr Puhalla will discuss your options with you to help you decide the best procedure for you. Your individual preferences, lifestyle and health are considered when determining your type of surgery.

Typically, the hospital stay is one to two nights. If you are undergoing revisional surgery or have a complex medical history, you may need to stay longer.

Depending on the procedure, you will need one to two weeks off work. We can provide you with a medical certificate if required.

We recommend you start driving a week after surgery, initially limiting yourself to shorter drives before returning to normal driving. 

Current wait times are around three to four weeks for appointments and surgery bookings. We also have a cancellation list, as patients often have to move their appointments, which means you may be able to be seen sooner. Please advise our team at the time of booking if you would like to put on the cancellation list.

The entire process typically takes around 8 to 12 weeks. Depending on the investigations needed, and whether or not you have private health insurance, this may be able to be shortened to around 4 weeks. We will do our best to meet your schedule, however we recommend you allow at least 8 weeks for the entire process.

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