What is Dr. Howard's experience?

Dr. Howard is a board certified general surgeon who took an entire extra year of training to focus on bariatric surgery. Whereas many general surgeons also do bariatric surgery, not everyone has been through extra training in advanced laparoscopic and bariatric surgery.  Dr. Howard did his bariatric training at the University of Florida in Gainesville and is currently the only accredited fellowship trained bariatric surgeon in Montgomery County.

Is Dr. Howard a member of American Society of Metabolic and Bariatric Surgeons?

Yes. Dr. Howard is a member of ASMBS as well as a participant in the Surgical Review Committee and BOLD database that tracks Center of Excellence Surgeons nationwide.

Are there pre-operative tests needed?

Yes. There are a number of pre-operative tests needed, but they will all be set up for you after your first office visit and can be done in a timely manner.

At what hospitals does Dr. Howard perform operations?

HCA Houston Healthcare Conroe, St. Luke’s – Woodlands, Memorial Herman – Woodlands, Memorial Herman Ambulatory Surgery Center, and Houston Methodist The Woodlands

How long is the hospital stay?

It is our protocol to discharge patients one to two nights after surgery for laparoscopic gastric bypass or sleeve gastrectomy. After laparoscopic banding, most patients go home the same day or stay one night depending on their other health issues.

What is the age limit for surgery?

Our policy is to consider individuals ages 15 to 85.

What determines whether or not I can have laparoscopic surgery?

Most people are candidates for laparoscopic surgery, but this is determined on an individual basis. The most common reason not to be able to have laparoscopic surgery is previous weight loss or stomach operations.  Other common operations, such as gallbladder, appendectomy, hysterectomy and Caesarian section are usually not a problem.

What can I do prior to surgery to reduce the risk of complications?

We suggest developing a regular exercise program, even just taking a daily walk for 20 minutes. Exercise may reduce the risk of blood clots and helps get a person in better condition to tolerate surgery. Start taking vitamins with iron to build up reserves. And if you smoke, quit! You must be smoke free for two months before surgery and commit to a smoke free life after surgery. Also, watch your diet and don't go on a series of "last suppers." Any weight you lose before surgery makes for greater weight loss after surgery and makes the surgery safer. You will be given a three days liquid diet before surgery.

Should I drink protein shakes?

The liquid diet before surgery is essential, and during this time you should drink at least three protein shakes a day (A diet list and protein shake list will be given to you.) The protein shakes will need to be continued for four weeks after surgery. After four to six weeks after surgery most patients do not need to continue the protein shakes if they are getting protein two to three times per day from sources such as meat, fish, soy products, eggs and dairy products. Many patients may need to continue one protein shake a day following surgery (sometimes indefinitely) to meet daily protein goals.

What vitamins should I take after surgery?

Gastric Bypass -  two to three multivitamins, Iron, B12, and two Calcium Citrate daily OR four Fusion Completes daily, or 3 bariatric advantage capsules or chewable bites, Bariatric Advantage Ultrasolo once a day

Sleeve Gastrectomy - two multivitamins, Iron, B12, and two Calcium Citrate daily OR three Fusion Completes daily, or 3 bariatric advantage capsules or chewable bites, Bariatric Advantage Ultrasolo once a day

Gastric Band - one multivitamin with iron and calcium OR two Fusion Completes daily, or 3 bariatric advantage capsules or chewable bites, Bariatric Advantage Ultrasolo once a day

It is best the use chewable vitamins and absolutely do not use gummy vitamins. The office and dietitian will go over each of these.

How long of a surgery is the Lap Gastric Bypass?

Usually about two to two and a half hours.

How long of a surgery is the Sleeve Gastrectomy?

Usually about one to one and a half hours.

How long of a surgery is the Adjustable Gastric Band?

Usually about forty-five minutes to an hour.

How much water should I drink after surgery?

We recommend working up to 64 oz of total fluid (water, other sugar free drinks, etc) per day. 32 ounces per day is a minimum.

Is weight loss surgery safe?

"Safe" is a relative term. No surgery is "safe," if that means no complications can occur. Weight loss surgery is a major operation and can have major complications. In the hands of an experienced surgeon, major complications are uncommon, only about 1% to 3%. While there is some initial risk, studies have shown that patients mortality five to ten years after surgery is much lower than patients who did not have surgery.

Is weight loss surgery reversible? 

It depends. An adjustable gastric band is removable, although it does require surgery. Gastric bypass can be reversed but reversing gastric bypass is major surgery having a much greater risk than any original bariatric surgery, and is rarely done. The Sleeve Gastrectomy cannot be reversed.

What can I do to help prevent hair loss after weight loss surgery?

Some people do experience partial and temporary hair loss after weight loss surgery. Unfortunately, nothing has been proven to prevent or cure hair loss other than time. When it happens, hair loss usually starts three or four months after surgery, but the hair starts coming back by around seven or eight months.

How soon can I return to work after surgery?

Most patients can return to their jobs in one to three weeks. Heavy lifting or other physical jobs could be four to six weeks. It depends a lot on the person. Some people bounce back more quickly than others.

Will my insurance cover the surgery?

It depends. Many insurance plans cover the surgery but only if you have documentation of physician supervised weight loss efforts including an exercise program and visits with a physician and dietician or nutritionist. The sooner you begin documenting these things, the better your chances of getting your insurance to cover the surgery. Our staff can help with the process.

What can I do about loose skin?

There will be some loose skin when you lose a significant amount of weight. Most people do not find this to be a major problem. There is nothing that can be done to prevent loose skin, or make the skin shrink, even exercise. That leaves plastic surgery or just living with it. Many insurance policies do not cover surgery to remove the skin.  

We work closely with and recommend a number of plastic surgeons in the area who will do free consultations for our patients.

Is it okay to get pregnant after weight loss surgery?

Yes. Patients are advised not to get pregnant for at least two years after weight loss surgery and not before their weight has been stable for at least two months. As long as you are not having a complication from surgery, then the baby is not at any more risk than for a woman who has not had surgery.

Do I take my usual medicines after surgery?

Yes. Early on, people sometimes have problems with large pills and we recommend crushing all pills that can be crushed. Many of your medications will be reduced after surgery. Many patients have reduced or eliminated their medications in the months following surgery.

What if my insurance does not cover surgery?

Gastric bypass, sleeve gastrectomy, and adjustable gastric bands can be done on a cash pay basis. We have very competitive pricing for the area.  Please call our office for up-to-date pricing policies.

How and where are adjustments made to the Band?

Adjustments (often called “fills') are done in the office. The first adjustment is usually six weeks after surgery.

Do you have support groups?

Yes. We have support groups that meet once a month. Call our office for more details.

Who covers for Dr. Howard when he is away?

Dr Howard's partners cover for Dr. Howard when he is on vacation or away for the weekend. A surgeon is available 24/7 for all patients.  Call 281-419-8400 for the surgeon on call.