Your PCP and WLS

So ... this post will garner a "duhhhhh ... no ****" response from some and it will be an eye opener for other. Here goes:

This is about the relationship between your surgeon and your PCP and how critical it is that we Pre-Ops understand this. For weeks I have been (i) dreading a conversation with my Primary Care Physician (PCP) and (ii) trying to determine why surgeons push you so fervently to get clearance from your PCP. My thought process was that I could care less about my PCP's take on surgery so long as I did not need his clearance for insurance purposes. In my case I did not.

Now let me clarify something: my PCP is excellent. He is very well-educated and he truly cares about people (perhaps too much!). I was dreading the conversation because I believe that he fundamentally wants to see his patients diet / exercise and lose weight. It is what it is. I finally go to see him for pre-op testing and for a gout flare up that I'm having. He does not lecture me about surgery. He supports it in fact. What he did say, though, was that while my surgeon will operate on me my overall health is HIS responsibility. He said that if I have gout going IN to surgery then that is a sign that there is a chemical imbalance inside me that will leave me in a world of hurt after surgery. He knows that I'm anxious but wants me to have a complete battery of additional tests to make certain that I am chemically balanced prior to surgery.

I told him that I do not intend to delay surgery. He said that that was HIS decision and that he would see where I stood once the results of my blood work were in. I did not argue and left it at that.

I was slightly pissed until I thought about more deeply. Then I thanked God that I had health care providers -- PCP / Surgeon / NUTS -- who truly give a damn and who are responsive to my needs. Rather than fight against their recommendations I will embrace them fully. Rather do the right thing and end up on the loser's bench in good shape than buck the system and end up in dire straights.

Net: Pre-Ops -- get ALL THE TESTING YOU CAN! I say this to my team at work constantly: "The more prepared you are the less brave you have to be ..."

I had no pcp and no pcp clearance was required.  I kicked mine to the curb when he told me that eeryone gains all the weight back anyway.  He's entitled to his opinion, but ignorance will not be tolerated.  What other uninformed notions is he holding that could harm my health? 

Clearences are critical and no responsible surgeon will proceed without them.  My cardiologist put the breaks on m rny after he had cleared me when another physician informed him that my bp spiked and a routine medical treatment had to be cancelled. 

I had to have both a cardiac and renal catheterization as a percaution.   For those who don't know, this is an invasive procedure where they thread a catheter through your groin into the heart and kidneys searching for blockages while you are sedated but not asleep.   Next I had to do well on meds for a few months before he would clear me again.  I'm not mad at him.  I could have stroked out otherwise. 

With significant non obesity related health issues I needed each specialist to sign off and to coordinate with the surgeon and anesthesiologist.  They took percautionary steps so I had no problems during or after surgery. 

The surgeon was surprised at my quick recovery.  No pain at all.  My wounds were closed in ten days.  None of the potential issues the different doctors anticipated may happen happened.  Oh,  and did I mention they were at three different hospitals 1200 miles apart?  

I had a higher than average potential for serious complications but the easiest recovery of anyone I know.  An excellent surgeon.  Communication and thoroughness among clearing doctors.  Delayed surgery until all was certain.   Plenty of protein and limited carbs pre op to ensure no fatty liver issues and optimal wound healing.

I'd rather wait and have a good out come than look for whose to blame and who I can sue afterwards.  I did not want to be that 0.5% mortality.   Excellent post. 

 

Wow - ticked because your PCP is going to make SURE you will make it thru surgery without complications that he could help avoid????

Oh yea - stop seeing that dude RIGHT away...... LOL!!!

Yea - it is a duuuuhhhh moment - glad you have a doc that cares, clearly - you need the assistance for levity!!! no - that's not being being a smart azz.   There are those *****search and ask questions thru the yahoo (as in me) and still get things wrong (as in my first round of plastics).  BUT - thru my research and constant badgering, I actually came up with a vitamin and supplement routine that my 2nd PS asked for and uses with his post WLS patients.

I'd say you should spend more time researching things on your own to REALLY know and appreciate all the stuff your PCP is trying to avoid for you.  You'd be surpised at how a slightly elevated level of say - potassium - can cause issues in a surgical setting. 

So, if it does get delayed - it's to keep you alive.  No way can you get pissed with that!  Trust me - recover from the surgery itself is a BYTCH with a cold shoulder and short temper - don't add to it!  LOL

Keep us posted - and hug your doc next time you see him!

Thanks Ladies!