Question:
Tricky Question Here
Hi Friends. I've been around this site for several years now and some of you know that I am the Bariatric Program Coordinator for a large hospital. I read the Q&A every day and try to answer a few questions to sort of pay it forward because I don't know if I would've made it without this site when I was an immediate post op. I have a tricky question and would love to get some honest answers from you guys. Our program is based on criteria set forth by the N.I.H. (National Institutes of Health) and the ASBS (American Society of Bariatric Surgeons). We require quite a bit of pre-operative testing including Patient Seminar, Internal Medicine, Sleep Evaluation, Psychological Evaluation, some patients must have a Cardiac Work up or Pulmonary work up, Support Group attendance, Prep Class Attendance, etc. We require that our patients use the physicians that practice at our facility because, in the event of a complication during surgery, it wouldn't do much good for the patient's physician to be at another hospital or even in another town. We put alot of emphasis on pre-operative wellness and sometimes ask our patients to lose weight or have a few sessions of counseling or wear a CPAP. This is all done because a healthier pre-op patient is more likely to be a healthier post-op patient and less likely to become a statistic. This all makes so much sense to me but it's possibly because I work in the field. We've been accused of sending people for pre-op testing in order to make money for certain docs that we like and we've even been accused of sending people for pre-op testing because we get financial kick backs. None of this is true. We are simply striving to get our patients healthy and give them the best surgical experience possible. O.K......here's the question........Why does this make people so angry? I see posts on here where one patient will tell another patient to get another surgeon if they are having to undergo a full pre-operative workup. I've seen surgeons called jerks, nutritionists called idiots and hospitals called money-grubbers. Where is all this anger coming from? Speaking as a patient I can tell you that I wanted it as fast as I could get it too but I would have appreciated some pre-operative testing. If someone needs brain surgery they're perfectly willing to undergo all sorts of tests prior to surgery. The same is true with cancer, gynecological problems and more. Can someone explain to me why patients feel that requiring pre-operative testing and wellness is a bad thing? I'd really like to understand it. As always, thanks for your unending help and assistance. — ronascott (posted on May 25, 2004)
May 25, 2004
I too wanted my surgery as quickly as possible but I also wanted to wake up
alive after the surgery. I think all the pre-op tests that they did on me
were very necessary although time consuming for me and that they just
reassured me that I would come through this surgery fine. I am 21 months
post-op and have had absolutely no problems at all and I am sure I owe that
to a wonderful, caring surgeon that required me to have quite a few pre-op
tests done and demanded we follow his rules while in the weight loss
process..Good luck to all pre-ops and post-ops out there but remember- this
is a tool, it will work unless you make it work for you!!
— Sharon1964
May 25, 2004
I guess I am biased:( I nearly died once after minor kneee surgery from
undiagnosed sleep apnea. I BELIEVE in extensive pre op testing, counciling,
the whole 9 yards. Look everyone wants surgery fast. But a few month delay
is really important for their later success and possibly survival. Unknown
problems lead to people dying, and that memorial page is way too big as is.
The delay is good too. It weeds out those not devoted. Gives everyone time
to think consider and plan. Some drop out for one reason or another.
EXCELLENT they werent ready! <P> The prefered docs are best too. I
once had a sleep study done at a convenient hospital. What a mistake the
pulmonary doc dissed WLS said it wouldnt work and in a year I would be back
having been thru major surgery and having regained the weight. That was 3
years ago, I am still at goal, working at it but still at goal.<P> In
summary your program is doing the right safest best thing and take those
unhappy with a grain of salt. Your group is doing the right thing!!@!!
— bob-haller
May 25, 2004
I am also very biased when it comes to pre-op testing because my best
friend, Ginger Brewster, who's story is on the memorial page of this
website died because of complications she had due to her having the surgery
with undiagnosed/untreated sleep apnea. I understand that people want to
get the surgery done as soon as possible, but to those people who just want
to get the surgery and don't want to bother with pre-op testing in order to
avoid or at least minimize chances for complications, please ask yourselves
if it is worth losing your life!!!
— Hackett
May 25, 2004
I think a lot of people wishing to get this surgery know what their health
problems are and don't feel they need testing. I also think they think it
is a stall on the part of the insurance company and that certainly if they
are having to pay more than a copay for these tests, it may be a problem
for them financially. I would be very upset to be told I had to see a
specific nutritionist or psychologist or cardiologist, especially if my
insurance might not include those providers on my plan. Fortunately in my
situation, my doctor at the time recommended people for the tests, but did
not force a person to have tests done only by these people. That may have
chanced not as he now has a full blown program.
I agree that it is best to know the risks going in and it is helpful to
understand your total health and what issues you may have that could pose a
problem with recovery. I did have to have blood work, psych eval,
dobutamine echo and EKG as pre-op tests. I wasn't thrilled about it, but I
did it because it was required. I think a lot of people don't really
understand WHY they are having these tests done. They don't see it as
preventative medicine but instead hoops they are forced to jump through. I
think that the initial seminars should introduce people to complications
and even deaths and explain that testing is done to prevent these things,
etc.
That is just my opinion.
Christy
— Christy L.
May 25, 2004
For me, my frustration with the whole process of being approved and all the
tests required is that some of them can be redundant. I had allready been
to a dietician, ordered by my pcp, but it wasn't good enough. I was
required to go to another who gave me exactly the same info as the first,
only this time it cost me. I don't believe everyone needs to be tested for
each and everything that is presently required, only if there is an
indication of need. It use to be that before you entered the hosp. you were
required to have a chest x-ray, urine analysis, and blood workup. Now it is
not required unless it is actually needed.
There are also Drs. who do send people for testing that is unnecessary in
many instances. People have a fear of being used and abused by the system.
The medical system has not always been nice, there has been a tendancy in
the past where the medical system made people feel inferior, stupid. Don't
question, after all you have not been to medical school, nursing school,
and so forth.
I do believe that any and all testing and/or evaluation should be justified
to the patient. Don't just say this is the requirment. Justify it with an
explenation of why it is required. I decided not to use a dr. because he
basically said we didn't have the right to question his reasons. What?
We most certainly do. To often office staff and Drs. are indignant when
questioned. Give me a break. Why is a Dr. above questioning? Why shouldn't
a patient question?
Just a few thoughts and comments.
— bubbleboo K.
May 25, 2004
Personally, I would be nervous if my surgeon didn't order all the tests he
ordered before my surgery. People who think they can just walk in a doctors
office and tell them what they need done are not good candidates for this
surgery. Having this surgery is NOT a quick fix for your weight issues.
Yes, you may lose weight, but the key is to keep it off and that is the
hard part surgery or not. If people feel the doctor is running unnecessary
tests before surgery,(another words they aren't trusting his judgement)
they aren't going to follow his direction once the surgery is
performed...they aren't ready for the surgery.My opinion
— sac287
May 25, 2004
I can only speak from my own, as well as, a few friends experiences with
the medical/insurance community about this. I am a licensed Life and
Health broker in the state of Connecticut. As such, I am in direct contact
with insurance carriers and their SALES REPS. Where the anger is coming
from Rona, is due to the fact that pre-ops feel that ALL of these tests are
just another way for the insurance company to find a way to DENY the
procedure. I went through TWO gastric by-passes, but I only went thru Psych
Eval, normal Hospital pre-op testing and an Endoscopy. Since I had no Sleep
apnea, I did not go thru any tests for this. As a former obesity patient,
I and most people empathisze that you want the weight off YESTERDAY amd now
that there is FINALLY a tool to help you, you are just so excited, scared,
ecstactic, etc that you will finally be accepted as NORMAL that you become
IMPATIENT for your turn at surgery. This impatience leads to frustration
which often leads to anger. Remember when you were a small child and had to
go for a long car ride-what would you constantly ask? "Are we there
yet"? "Are we there yet"? It's the same thing with the
surgery- the journey is never ending UNTIL the actual date of the surgery.
I think all the anger is just a form of releiving alot of stress associated
with any surgery.
— Elaine S.
May 25, 2004
I was pleased with the extra care my surgeon took in arranging preop
testing. I felt that the psyc testing was extremely important. The sleep
study was another story, after my second test I was told I was boarderline
had to purchase the cpap and pay a inflated price for my study to be read.
The whole situation was ridiculous! I only used the machine a week prior
to and during surgery ...the surgeon felt I didnt really need it. Such a
waste of money for me and the insurance company! The time during
pretesting is very difficult to go through, it seems like it takes forever,
and you are at the mercy of the insurance companies, hospitals, and most of
all the schedulers. My scheduling was being delayed so finally I went to
the "top brass" at BTC and got scheduled. It is very important
that you are healthy enough prior to surgery...patients just feel so lost
during this time and can easily be taken advantage of.
— debmi
May 25, 2004
I am not opposed to all of the testing. I think the problem is when they
tell you you only need test "A" and then after you do it and
think you're gonna get a date they tell you "oh yeah and you also need
"B" and "C". Then when you call to schedule the tests
they give you an appt 4 weeks away. (First of course you gotta get a
referral) Then after they're all done you might have to repeat one anyway
'cause it was "so long ago" .... read my profile; you'll see what
I mean. This whole process had me sooo upset I can't even describe it.
— pattybre
May 25, 2004
Some people do not understand the seriousness of this surgery, or how it
will impact their lives forever. I've met people that almost seem to look
at this as just another weight loss program and don't seem to understand
the major life changing consequences it can have. If this is true, then
they may see your program as overkill. I would try educating them as to
WHY these things are required. WHY the tests and eduction is necessary for
their long term success. I see so many post-ops that don't have a clue
about how they should be functioning post-op, or why they need to follow a
program. You can tell them that they may find a surgeon that does not have
these requirements, but their chance of long term success will be much
lower.
— mom2jtx3
May 25, 2004
My surgeon says what kills isnt known problems but combinations of unknown
one.Known ones in advance can be managed. Myself I had no common symptoms
of apnea but had severe sleep apnea nevertheless. Stuff like this is
dangerous and tests and follow up tests are for OUR SAFETY. Run dont walk
from any surgeon who doesnt insist on comprehensive pre op testing even
when it delays your surgery date.
— bob-haller
May 25, 2004
There are many kinds of patients that try and get this surgery. The
process of getting to the surgery is so laborious and long that it tries
the patience of many--especially the insurance approval process. But I
agree that the education is probably the most important part of the process
(in hindsight). Making a decision to have gastric bypass was something I
was doing to try and save my life and the delays were just angering to me.
You wouldn't keep someone with brain cancer waiting--so why was I kept
waiting? I do agree also that many think this is just another weight loss
program--you can tell that by some of the messages you read on this board.
This is a life changing experience and needs to be treated as such for the
rest of our lives--and not something to be taken lightly.
— Cathy S.
May 25, 2004
Original poster here. Thank you so much for your comments. Please keep
them coming. Just as a side note - when I had surgery I had no pre-op
testing at all....NOTHING. They drew blood the morning of surgery and that
was it.I had no pre-op or post op education and every day was a struggle
for me. Even with no testing at all I still waited 3 months but looking
back that gave me time to spend on this site learning things and preparing
myself for the life change. I had a very difficult surgery experience and
wasn't prepared at all for it - didn't even know what the complications
could be. I'm one of the ones who wishes I had had lots of pre-op testing.
But of course, we all want what we don't have, huh? :) Thanks again for
the comments and keep them coming. Best wishes to all in your journey.
— ronascott
May 25, 2004
Consider that most of us have health problems when we start on this course
of action. I know I, myself was tired of all the tests. There is also the
problem of money. Many of us have to pay part, some all of the medical
bills. I know this is not an excuse for bad planing. Are all the tests
needed? It depends on the persons health. Is it needed for every person or
should they be evaluated on an indivual basis?
— stewdons
May 25, 2004
Hi Rona,
As much as I didn't want to go through all of the "stuff" I knew
my surgeon was looking out for me. As an example, I have had Deep Vein
Thrombosis (DVT) in the past. My surgeon required me to have a filter
inserted into my vena cava before my WLS. That was the last thing I wanted
to do! He said to me, "It would be a shame to for you to have a
sucessful surgery and then die from a blood clot". That really did it
for me. Everything was now in crystal clear perspective. Any thoughts of
"why do I have to go through this stuff" was gone. I just became
so thankful that I had someone who was going to take every precaution to
make sure my son still had a mom when all was said and done. I will be
forever grateful...
— Jodie B.
May 25, 2004
I think the initial anger is directed at 'the corporation', the nameless
and faceless entity that makes us jump through seemingly rediculous hoops,
buit I am willing to be that if a specific terst had not been performed or
called for, and a complication arose because of the lack of that info, they
would be the first to holler 'suit!'. I guess it's just todays societal
litigal nature. I was prepared for a lot of hoops, but got very few. I
understand why folks get angry, it is mostly impatience, with the doctors
staff, with the transcriptionist, with the document delivery service, with
the automated phone system at any one of a number of people whom you need
to talk to right away. My mother was disgnosed with any number of ailments
for over 60 years, most of them 'phantom' or 'mental' and I saw the pain
she was in, and it took a doctor from India less than an hour to determine
that one of her kidneys was larger than the other, offsetting the balance
of her spine, leading to those 'imaginary' pains that had her writhing on
the floor. My father worked his hands raw to pay those doctors and
insurance companies to deal with that, and not one of them found that
problem. As far as most of the folks involved, it was a 'sorry' we didn't
know, and the rest just figured they had found someone who wouldn't
question things and continue to pay. It's instances like that, that
irritate us at the speed or the slowness or the number of tests. Probably
not a 'true' indication of the situation, but what was seen by our young
eyes. I myself was glad to do anything and everything needed to get this
surgery, and the only bump in the road were the nutritionists in the
hospital and food service area who insisted on giving me sugar and caffiene
laden fried and creamy foods on my 2nd day after surgery, even though my
doc had written in large red letters, NO SUGAR/NO CAFFIENE/NO FRIED -
LIQUIDS ONLY across my medical chart. And thier inane insistance that I
have to eat a little of everything on the tray before I could leave the
hospital. It's the little things that stick in our heads, that drive folks
nuts when we sense an apparent 'injustice' perceiver\d or not, when it
comes to our personal health.
— track
May 25, 2004
Maybe the anger comes from the "one size fit all" mentality.
Though I was well over 100 lbs overweight I did not have co-morbidities.
None. My doctor recognized this and I had minimal hoops to jump through.
I had Psych eval, nutritionist chat and basic physical and these were all
done at the consultation. Before surgery I had ab sono, chest x-ray, blood
work and electrocardiogram. He had all my records from my primary
physician. I really appreciated this no nonsense approach tailored to me.
I'm just short of one year out and have gone from 287 to 169. It has
worked for me (and others with this surgeon) without going through all the
other mumbo-jumbo. In short, it should be tailored to the patient.
— ReneeJune03
May 25, 2004
Rona~Other posters have given good answers, I think. I would add that
another possibility is that we live in an "instant" society,
where we've come to expect everything right now. I think some people see
the pre-op tests and programs as a roadblock delaying them getting what
they want. They don't see it as a way to help insure success and health.
"I want the surgery and I want it now" gets in the way of
sensibleness and caution. None of us think we will be the one with a
complication, so "don't waste my time with the preliminary stuff--get
to the main event"! I'm glad that my surgeon required a battery tests
before the surgery so that he knew what problems there might be, and be
prepared for them. I'm in the process of getting approved for
recontructive surgery, and that surgeon is also requiring a battery of
pre-op tests, even though I'm in better health now than I was before the
bypass surgery. Granted, that prep doesn't include education classes, but
I'm glad he's looking out for my long-term health and well-being by
ordering the medical tests and giving me lots of edicational materials.
— Vespa R.
May 25, 2004
I, too, was thankful for all of the pre-op testing that was required of me.
But, I have to say from personal experience as well of those from my MO
friends/relatives, that the medical world is just not nice to overweight
people and to have to be told to see all of these medical professionals is
anxiety provoking. During my preop tests for WLS, a doctor was making fun
of me for having to use the larger blood pressure cuff and saying how her
arm was going to break while trying to pump it up. Um, hello, I was preop
for WLS. Everything from ingrown toenails to ear infections has been blamed
on our obesity. We just don't feel like going to more docs to talk about
weight. Could you directly ask what the problem is? You could say something
like "I understand the process seems tedious, but is there something
else causing your anxiety?" That might open up the doors to some
communication where you can justify the process. Good luck and thanks for
giving back!
— Yolanda J.
May 25, 2004
I, too, was thankful for all of the pre-op testing that was required of me.
But, I have to say from personal experience as well of those from my MO
friends/relatives, that the medical world is just not nice to overweight
people and to have to be told to see all of these medical professionals is
anxiety provoking. During my preop tests for WLS, a doctor was making fun
of me for having to use the larger blood pressure cuff and saying how her
arm was going to break while trying to pump it up. Um, hello, I was preop
for WLS. Everything from ingrown toenails to ear infections has been blamed
on our obesity. We just don't feel like going to more docs to talk about
weight. Could you directly ask what the problem is? You could say something
like "I understand the process seems tedious, but is there something
else causing your anxiety?" That might open up the doors to some
communication where you can justify the process. Good luck and thanks for
giving back!
— Yolanda J.
May 26, 2004
As someone with a foot-thick medical record (from just the last 4 years!) I
am so thankful for the pre-op requirements. It was a walk in the park
compared to trying to climb a flight of stairs before I lost my excess
weight.<br><br>
Let's be clear - this is a MEDICALLY NECCESSARY procedure - why else would
we ask our insurance companies to pay for it? To do "our parts"
and comply completely with the medical staff is in our best interest. And
for the people who submit our paperwork, it helps to have their bases
covered, to make sure we are approved. Also, there are too many who
temporarily comply with pre-op requirements, and fudge their way through
beforehand, who are suffering for it later - maybe not the next day, but in
the following years when the psychological aspects start to hit home....
like head hunger, bad habits, food and alcohol addictions, etc. Take
advantage of that pre-op screening!<br><br>
There isn't a day I don't thank Buddha for the Team I had on my side, and
the fact that my surgeon (Dr. Shanu Kothari/Gundersen Clinic) spent a year
perfecting his craft in a fellowship, instead of learning Lap RNY on a pig
in a weekend seminar, then in practice moving people in and out of the OR
on a conveyor belt... and with no follow-up.<br><br>
Anyone with a full, compassionate team will tell you they wouldn't have it
any other way. My team even hosted a conference for WLS professionals to
show them the benefits of setting up a great team - and how to do it. Talk
about "paying it forward"! <br><br>
Shelli K, www.rnylacrosse.com
— kultgirl
May 26, 2004
I think many people do not like being told that they HAVE TO see certain
doctors to have the pre-surgery tests done. However, if your clinic is
more comfortable with the staff they have put together for this purpose
that is the "clinic rules" for people who come through you. I
would think that unless you have a captive audience (meaning you are the
only game in miles and miles and flexibility might be in order) it is your
right to set up the rules of engagement for working through your facility.
Perhaps an informational packet that goes to anyone who inquires about your
services that states what the objective is, the requirements are, the
reasoning behind the requirements and then let the prospective patient make
the decision about whether the program fits them. My clinic did the PAT
blood work, sonogram for the gallbladder, xray in the clinic. The
remainder of what I needed to have done was done by doctors of my choosing.
I appreciated that because I had doctors that I had used in the past so
was able to follow through on my cardiologist appointment with someone who
had my records. I was not required to have a sleep study done, but I had
done enough research to realize that apnea could be a problem for me and I
elected to have one done because I wanted to live. I had severe sleep
apnea, but ended up only using my cpap for the month pre-surgery and found
it most uncomfortable after surgery so discontinued use. I am grateful for
my decision to do this because the staff at the clinic was aware to watch
me. I no longer need my Cpap at all. I also arranged my psych appointment
based upon recommendations from other WLS people in the area. What I would
LOVE to see happen in the WLS industry is continuity between clinics so we
are all starting from the same page. I find it frustrating that some
surgeons have their patients doing flintstones and tums for vitamins and
calcium (fortunately not mine). I find it frustrating that some will not
accept the importance of protein shakes as part of our new lifestyle. I
really find it frustrating that the post-surgery blood tests can be either
missing or severely lacking in what should be done and important
vitamin/mineral deficiences are not discovered until they are a real
problem. Part of my frustration with this is the misinformation that I see
spread because of what "my doctor told me to do" type of
response. It is obvious to me that some surgeons are in on a booming
business opportunity and some are actually in it to improve the health of
their patients which includes developing a comprehensive program that does
not rely on flintstones and tums as the answer to supplementation. Sandra
— Arizona_Sun
May 26, 2004
My surgeon requires a particular psych doc, since he is part of the
educational process. Anyone who has gone thru doctor fridays explnation
knows what I mean. Better we be well prepared and educated, than to do what
someone did here many years ago. Just out of the hospital after WLS he ate
beef jerky, ruptured his new pouch and very nearly died. It was a member
here and not one of my surgeons patients. These rules are for our safety.
— bob-haller
May 26, 2004
I'm grateful for all the pre-op testing. My surgeon orders tests based on
individual needs. I was required to have cardiac and pulmonary clearance
with associated testing, an EGD due to GERD, physc eval etc... I went to
all my own doctors ( none referred by surgeons office). In fact, surgeon
required clearances from ALL my doctors. (neurologist, internist,
pulmonologist, cardiologist, rhuematologist, gastroenterologist). That
being said, he insisted on ICU for the first night after RNY due to mild
sleep apnea. I acquired MRSA pnuemonia 2 days post-op and a long lists of
other problems. I am 49 yrs old and started as a "lightweight".
5'3" and 221 lbs. See profile for more info. My surgery was done more
for co-morbities I had. I have had a host of problems including bacterial
endocarditis, but, I am grateful for all the pre-op testings and never once
considered that it was just a money making proposition. I also know that
you can develop serious complications even with all the testing.
Nancy M. RNY 12-3-03 221/144/133
— nancymc10
May 26, 2004
I had some other thoughts on this question I'd like to pass along. Many
overweight patients have had nightmares with the medical community as a
whole. Granted there are some very good healthcare professionals, but I
seem to run in to lots of 'think they know what's best for you' and it's a
real turn-off. Or dismiss what you're saying like you don' what you're
talking about. I've always been a big proponent that healthcare
professionals should spend some time in the patient's shoes from time to
time--probably the entire healthcare profession would change if that
happened more often. Sometimes they don't know what's best--they just
don't always listen because of pre-conceived notions about the patient.
— Cathy S.
May 26, 2004
Rona, I can understand some anger at being "forced" to see a
particular doctor, especially if that doctor is out of the patient's
insurance network and the patient has to pay out of pocket for those
expences. Or if they have to have tests, or counseling, done at a certain
place and they aren't covered by insurance. Ouch! Our particular insurance
plan does not pay for the psych eval - the surgeon requires this but the
insurance company does not. The patient must pay for this. The biggest
problem I see is that the vast majority of people DO NOT READ what their
insurance plans do and do not cover, and they get all mad when something
isn't covered "because it should be". It's awfully easy to blame
the insurance company for everything, too. As for losing weight before
surgery, I just don't get that - if I could have lost anything before
surgery, I sure would have. I think your company might want to be a bit
more sensitive to the insurance coverage your patients have. My PCP did
not practice at the hospital where I had surgery, but he was only a phone
call away (should he have been needed). I had surgery at a major teaching
facility and every sort of specialty I could possibly have needed was
available for a consultation. I would think the PCP I have seen for years
would know me and my history better than some doc I saw once. What good
would having a particular doc available in a facility be if I had a
complication during surgery? What if that doc was, say, busy with another
patient? Requiring patients to see physicians that practice at your
facility seems a little on the fishy side. (I've been nurse for over 25
years, working in hospitals, homecare and insurance, and I am a post op RNY
patient.) I do agree that pre-op testing and evaluations MUST be done for
the safety of the patient, and if people don't want to do them, the option
to NOT have surgery is there, too. (My surgeon's group also requires
attendance at an informational meeting, the packet of information must be
filled out and returned in a certain length of time, one must attend a
support group meeting pre-op, pay a program fee to cover diet classed and
counseling sessions, have a sleep study, psych eval, and anything else the
surgeon thinks is appropriate.)
— koogy
May 26, 2004
While I think the pre-op testing is necessary (and should possibly be
mandatory), what I think would really help the overal success of anyone who
has this surgery is to have it done at a place where all of the pre-op
testing,counseling, etc, and the follow-up are coordinated. It saves time,
possibly aggravation (for everyone) and it might even save lives. Yes, the
waiting is a PITA but what if you have never been screened for sleep apnea
or blood clot problems, you have the surgery and you die from these
problems? I wanted the surgery badly, but not badly enough that I would
flout common sense and not be screened.
My insurance is a little different than others (Group Health) in that your
PCP refers you to the Bariatric Program and they take it from there:
reviewing your chart, ordering the appropriate testing, making sure you
talk with a social worker, etc. There are BMI and co-morb requirements.
They require you to participate in nutritional counseling post-op (done
over the phone), which you must pay for 30 days before your surgery. They
schedule all of your follow-up appts with the surgeon and his staff,
ordering all labs and other tests. They provide you with a guidebook and a
day-long orientation before your surgery. They have a support group at
their facility and in facilities in the surrounding areas. I find their
approach to be comprehensive and pragmatic.
I'm not saying this way of doing things is better than others but I just
saw another new post-op ask a question about what the nutritional
requirements are for post-ops and that sort of thing just makes me crazy!
These types of questions should never have to be asked if pre-op
care/testing is adequate. It is unconscionable for a new post-op to have to
have the most basic of questions answered by us and not by her own surgeon.
I'm not bashing the poster but rather her caregivers: How can you perform
this very serious and life-changing surgery on someone who is not fully
informed about what happens afterwards? No one should have this surgery
performed by a surgeon who does not provide decent pre-op, follow-up and
aftercare.
— lizinPA
May 26, 2004
I know this was submitted a while back but I am knew to this site. And I'll
give my feedback. I personally agree with the testing prior to surgery I
had and EKG, Upper G-I, bloodwork twice,and a gallbladder scan done twice,
and I had NO co-morbidities for surgery all of these test were performed by
my general practiioner, after I was approved for surgery I then saw my
surgeon and upon pre-op I had blood work again, and EKG, gallbladder scan
and another upper G-I, did I like all these tests (not including psych
exam) no I didn't but I would have done them ten times if it made my
surgery safer. When my dog was spayed I had pre-op bloodwork done on her
why would you not agree to all of this for your safety. As for wellness ..
obviously I didn't have much of that I was 150 pounds over weight what did
I know about being well, I would have and still do take any advice that is
given to me freely or otherwise. How can I learn to deal with my new body
and of course all of the new feelings that I have never experienced. Anyway
I think we complain because it delays things, surgery, evaluations etc.
etc. And we don't like delays one we have been approved. As for the anger I
can't really answer, except, that at my largest weight I was the angriest
person I knew I knew two emotions anger and food!!!! And I needed a person
to blame for my delay so why not the doctor, the insurance, the physician,
the tests, the wellness people and the list goes on and on. I know I have
rambled and I am sorry but your Question hits a true mark for me. I work
for the phone company and you would be amazed at all the people the phone
company has done wrong!!!!...people make thousands of dollars of calls per
month and then call to scream at me as to how much they pay the phone
company.. well thought don't have a phone if price is an issue. Same with
surgery don't have it done if you have a issue with the tests etc....It's
only your life..and health.
— Julie B.
May 26, 2004
Rona, I had wls at MCE. I went thru your program. I found out alot that I
didn't know, to start with. I am very thankful for all that you do. 8
months post op and almost at goal. Keep up the good work. It is hard to
find the time for all the test. But, some people don't care that the Dr.
might find something that could SAVE their life.
— LeeAnn W.
May 27, 2004
I had blood work, EDG, Liver and Gallbladder Ultrasound, EKG, and more
blood work, sleep study (2 of them) and a CPAP class, nutritional classes
and a psy eval. I didn't mind doing all this, my issue was the fact that
it TOOK SO LONG. It took 8 months to complete these tests, then another 4
months of waiting for insurance approval. I would have preferred to do all
my testing over the course of 1 month and been done with it. That's what I
found annoying...that it took so long.
— Renee B.
May 27, 2004
First off I would like to say that anyone who has a chance to have wls with
a real team of medical professionals to educate, help, diagnose and guide
you through all that is involved with this major, life altering surgery
then go for it and don't complain about it. I have a surgeon, that's it
and he is 3 hours north of me. He talks but doesn't listen. There is no
psych eval, no dietician, no counseling for eating disorders, no
information sessions, NO TEAM TO HELP ANY OF US HAVING WLS. The surgeon
does it all in a very basic way for each patient. I got the very minimum
as far as preparation goes. What I did get was an sleep study showing
moderate sleep apnea, cpap was covered under our insurance, endoscope,
ultrasound of the gall bladder, liver and kidneys, an EKG, blood work(very
low in iron but no body told me). There is no formal followup except to
remove stitches and get weighed. No counsellor, no dietician. My family
doc in my city does all my blood work and ASKS ME HOW I REALLY FEEL. He
takes good care of me thank God. So basically, I've had to find my own way
through all of this. I have found an eating disorder clinic to help me
deal with the binge eating I had as a preop, which BTW turns into graze
eating disorder postop. I've got bad acid and bile reflux that my surgeon
is treating with meds but won't do a scope to have a look inside. I
suspect that the system here is so tight with money that the surgeons and
doctors can't get the tests and programs that they need because the
government is too busy wasting money on crap that the public doesn't give a
darn about. I did feel safe going into surgery, I did feel that I would
survive and that the staff would take good care of me and they did. All of
you who live in the US and have access to a good wls program, please be
grateful that you get all the needed testing and psych help, followup and
support groups. It is all available to you, covered or out of your own
wallet. I, as an over-taxed, medically-underserviced Canadian am very
envious. The full team approach is just not available here for any amount
of money. Read my profile to see another side of the wls battle.
— mary ann T.
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