Moral delima (being honest with the doctor)

Mike here's what happened in my case... you be the judge.  I started the process for WLS back in April 06. Due to ins not cooperating I had to wait and change ins at the enrollment period in Nov, which takes affect at the beginning of the next year. I feel a civic responsibility to donate blood. Don't know why just do.   Well this year started and we got the process started again with the new ins. While waiting I had made another donation to the local vampires not thinking that it could effect my surgery. The next week I had blood drawn for my endo/diabetes doc.The next day I got a call saying that ins had approved me for wls.The following week my endocrinologist said it seemed like I might be anemic but I got a copy of my blood work results. I then called my wls doc office and asked if they wanted a copy, since these were the most recent. I gave them a copy of the results. I want to say that I said to the nurse that my blood count seemed down, but right now I just can't say yes I did as I don't remember. The doctor never said anything about my blood count being low on my preop surgery visit. I didn't think to ask him about it or mention that I had donated blood recently. We had talked about be donating blood for myself to use but the nurse didn't think I would need to do that and I left it at that.  The point you ask???? AFter my surgery my body went into shock from the loss of blood. My Blood count went down to 5.3 and my iron level was almost nonexistent. I was in ICU for 4 days and was given 6 units of blodd and a huge bag/unit of IRON along with a unit of potassium and an ungodly amount of saline. NOw had I thought it was relevant to inform the doctor that I had made a recent blood donation we probably would have postponed my surgery for a month and built my iron level up. Instead I spent four days in ICu and a total of six days in the hospital for a lap-RNY.

From my experience...  There are two aims my doc wants  pre-ops to lose weight. 1.) He doesn't want to work around that HUGE liver us big guys have. Losing ten pounds comes mostly out of our liver. That way, a Lap doesn't turn into an open procedure. 2.) He wants to see if you are compliant. If you don't do the right things and try pre-op, chances are you may not be compliant post-op. He somehow forgot to ask me to lose prior. I later learned that I was not necessarily in the zone to require pre-op loss. But, I tried anyway. If I truely worked to lose weight yet did not achieve the desired number, the tech said he would probably have pressed with surgery anyway as long as the success outweighed risk. Work hard and correctly to lose the weight. Tell the doc the truth... good and bad. He may proceed! But, really, what's the worst thing that could happen? Reschedule you? It would suck green persimmons but, it's not the end of the World. Your health and success is in his (and your) best interest. Win or, lose, Mike, the next bottle of water is on me!

Mike,

I'm not going to tell you if it is right or wrong to deceive your doc. I think you already know the answer yourself, but the part of you that is anxious to have the surgery done was hoping that we would tell you it is OK. It is OK -  to be anxious to have the surgery that is. I think we all were really anxiious about it, I remember when I was waiting for insurance approval that I called the insurance company to check the status so often that I actually memorized my member ID# !!! You will get there pretty soon though. I was thinking though if you want to lose ten pounds sooner rather than later you might want to try the pre-op diet I was on. The details from Duke Weight Loss Surgery Center:

1. Beginning one week before surgery, change your diet to the one below. This diet will help shrink your liver and make surgery safer. It will also introduce you to what the typical postoperative diet is like:
2. Eat more high protein, low fat foods: Lean meats, poultry, fish, seafood, eggs, low fat cheese, light yogurt, skim milk, cottage cheese, tofu, beans/lentils.

• Eat less than 4 servings per day of these high carbohydrate foods: (1 serving = ½ cup or 1 piece of fresh fruit or bread). Fruit/fruit juice, breads, pasta, crackers, cereal, rice, potatoes.
• Avoid: sugary foods and beverages, desserts and candy.
• Limit these high fat foods and condiments: Butter/margarine, oils, salad dressing, sour cream, mayonnaise, cream, gravy, cream cheese, chips, high fat meats, bacon, sausage, fried foods, desserts.

I wound up eating mostly south beach diet frozen meals, but only the ones without starches like potatoes or pastas. I followed diet strictly because I didn't want to risk having a liver to big for lap and wake up with a six in*****ision. Hope this helps. Mike Columbia, SC

Thanks for the suggestion.  I'm almost on it, that is, i've been on the "Atkins" diet, the first part is meats, eggs, cheese.   But, I have been curious about the Post-Op Diet.  So now I can at least get an idea of what it will be like.  Thanks again. Mike Ray

I have always been taught and still teach my kids that "honesty is the best policy" and "the truth shall set you free". If you want people to be honest with you then you have to be with them. This is especially vital when it comes to your doctor, he should know that 5lbs in one week is an awesome number! Your doing a great job and keep it up!