Surgeon's pre-op requirements

I ask you to reflect back on what your surgeon required you to do as a pre-op. I spent two years in Kaiser's bariatric program. I did all the required steps (i.e. sleep study, Freedom from Diet classes for 12 weeks, attending pre-op support meetings, sessions with nutritionist and phsychologist, etc.) The two things I was not able to do were lose 7 percent of my body weight and proof that I was excercising several days a week. I was made to feel that I was not demonstrating a committment to a lifestyle change, and that their surgeon thinks patients who don't lose weight and excercise prior to surgery don't have as good long term success. Physically I was barely making it through my day, and it took what little mobility I had to do the things I had to do to keep my family and household going. The desperate hope and desire to get surgery didn't help me adhere to a diet at that time either. Lucky for me my insurance changed. Eight weeks later I had a surgery date. My surgeon encouraged me to lose weight - asked that I not gain any. He didn't threaten my surgery date if I didn't. He didn't require any proof I was excercising. He had strict screening protocol and plenty of hoops to jump through, lots of education about the surgery itself and lifestyle requirements afterwards. I know about the shrinking liver theory. Some doctors believe that is relevant - some don't. There are not actual studies to back it up one way or another. I don't dispute it. As a post-op I think I have been very adherent. I excercise now that it doesn't hurt to do it. As I suspected as a pre-op...I feel more mobile and able to do it now and am more willing to try to do it. I am committed to my changed eating habits. The reason I ask is that someone on my local board inquired about her surgeon requesting that patients go on a six week skim milk only diet prior to surgery - to lose weight and shrink the liver I guess. I think that's whack and know I would never have been able to do it. I feel like pre-ops are vulnerable to feeling bad if they can't do something like that and blaming themselves for being so weak. Without a surgically altered stomach there's no way I could do that diet. It just bothers me that some folks are expected to behave like a post-op when they are still a pre-op. Patty

OMG, a 6 week skim milk diet??? First off, that seems really unhealthy, not to mention it teaching nothing about chosing the right foods in a post-op word. I did a 1 week pre-surgery liquid diet.... that sucked enough!! I can't imagine a 6 week milk diet. You might as well shoot me. I understand why that would bother you, but on the other hand, I am seeing alot of people lately being approved for surgery showing no dedication whatsoever, no attending meetings or even knowing what they are getting into. Michelle

I agree that there are way too many people that seem like they are going forward without a full understanding of what they are in for and what's expected of them.

If I had had to lose 7% of my body weight I'd still be waiting for surgery. If I could have lost through diet, I would have done so. 2 years before I had surgery I was faithful to Atkins for 3 months. The first 2 weeks I lost 11 lbs and I though I was going to FLY, the next 10 weeks I lost 3 lbs. and I was faithful to the 25g of carb per day!!! Before the surgery I was diabetic and hypothyroid. I absolutely could NOT lose weight. I eat the same amount now that I did before...but I'm still loosing weight. Go figure huh! There is much more at work here than calories in and energy expended! Pat -122 with 60 left to lose

I too would still be waiting. I still grieve a bit that Kaiser held me off for two years and was saying "your not ready" and wouldn't refer me on to see the surgeon. I think a lot of us wish we could have done this ten years ago. I feel there was a lot of time wasted after I had really made up my mind that I wanted surgery, had become extremely educated about it (from doing all of Kaiser's education programs and this site of course), met the physical criteria, was entitled to the procedure under my coverage. I'm convinced that to some extent it is a corporate strategy to stall people until some give up or move on to other insurance. It worked for me - they didn't ever do my surgery. I really have let it go. I look forward not backward - it's just this person's post brought me back to those days trying to get approved.

isn't it crazy? you need surgery to lose weight, but if you don't lose weight you can't have surgery? wtf are people supposed to do?

I will be honest, My requirements basically were showing up at the consult. being approved fby my insurance, and preop testing 1 week prior to surgery, Blood testing, chest xray, ekg, at that time I also met w/ a dietician. At the initial consult The surgeon gave me a list of support groups and recommended (not required) me to attend if possible. I did not have a psych consult, altho others that went to the same doctor did. I think he did those on a case by case basis. I think the requirement to lose weight or go on a weird diet has no bearing on success post op. I never would have been able to do that with out my tool, If I had been able to, I wouldn't have needed surgery to lose weight. Have I been successful? In my eyes, absolutely. Although I am about 20 pounds over my "ideal" body weight, I am very physically fit and muscular. I am at a weight that I can maintain and have for over 2 years within 5 pounds. the ability to incorporate healthy habits has nothing to do with following a weird diet for a few weeks. My biggest motivator was my health and second a sense of responsibility to my ins comapny who paid all this money, my surgeon who gave of his time to operate on me and my family who had to pick up a lot of extra responsibiity when I was recovering.

You are absolutely a success! You really inspire me and I appreciate your insight. I too feel that gratitude helps me to keep the good habits up as a post-op.

Where is this person located. I have alot of friends who have had surgery in OR and have not had to do that diet. I agree with the others, I don't see what the individual will learn about choices, post-surgery. My physician did require a two week pre-surgery diet. I did not have to do it since I had already lost 91LBS., but it was for liver shrinking. Stacey

I believe it is Dr. Cagle who must be somewhere in the Portland area because both ladies were from Battleground, WA - inquiring on the Oregon board. I don't know what she actually requires - and the woman was early in the process and was asking on the local board if anyone had heard of this, and another person who also goes to this surgeon responded that she had been told about this also. I'm approaching two years and it seems like a million years ago, yet I do remember so very well the stress of getting that surgery date!