Question:
My surgeon doesn't seem to require a lot of pre op 'hoops', should this worry me?
My surgeon only required an upper GI and a psych eval for pre op. No cardio or anything like that. He does not require people to quit smoking and he has also only done 3 surgeries. I like him and he is very knowledgable and has a great bedside manor. I think I am just freaking out because I never thought I would get this far. Should I worry? — Nancy S. (posted on May 14, 2003)
May 14, 2003
Someone with at least 200 surgeries is my own personal requirement. I
personally would find another surgeon.
— SJP
May 14, 2003
That's a difficult question. If your surgeon has only done 3 surgeries,
I'd be worried - but if he has a lot of surgery experience, and has only
done 2 bypasses, that might be OK. The sugeon I wanted to go to has not
done that many RNY, but has YEARS of gastric and general surgery experience
and is a pioneer in the field of laparoscopic surgery. Every doctor I see
in my health group thinks he walks on water. If you have a good feeling
from your surgeon and if he has a lot of experience in other surgeries,
that may not be so bad. You could see what others say about him. You need
to feel comfortable with your decision. Good luck!
— w8free
May 14, 2003
Personally, I would be worried. My surgeon has been doing weight loss
surgeries for over 20 years and does other surgeries as well and he
requires lots of tests: Upper GI, Echocardiogram, EKG, Pulmonary Function
tests, galbladder ultrasound, Sleep Study, lots of blood work...I even have
to have had my pap smear and mammogram within the last year. I trust him
because I know that he will know exactly what he is dealing with before he
gets me on the operating table, making any surprises less likely. There
can still be surprises, but he will know all of my systerms that are
involved with the surgery. We are really high risk patients because of our
weight and its important that the surgeon know about any comorbiities and
potential problems. It seems like some of the deaths described on the
memorial section of this site could have been prevented had the doctor
known more ahead of time. Those are just some of my thoughts from all my
research. I also think that you deserve the very best care that is
available to you.
— Good_Courage_Ruth
May 14, 2003
I totally agree with Ruth. The "hoops" are not intended to give
you a hard time or lengthen ur journey, but to prevent your name from
coming up in the memorial page due to a clot or something that might have
been detected pre-op. If he was honest, he would make u quit smoking for at
least 1 month pre-op. Smokers have any increases risk of blood clots. Plus
their lungs aren't as strong for the operation & anesthesia. A month
break from cigerettes makes a big difference in the prevention of
complications. Unfortunatly, a doctor who wants to have a record of more
than 3 patients (for the next person who asks) may accept patients
regardless of the circumstances. I don't mean to worry you but its
something you should know. I pray that you make a wise decision. Best of
Luck ~Laura~
— Laura R.
May 14, 2003
Original poster here. To clarify this. My surgeon has been practicing in
the US for 14 years and has assisted and observed many RNY surgeries. He
has just only done 3 of them on his own. He would prefer you to quit
smoking but does not require it.
— Nancy S.
May 14, 2003
My surgeon had done 700 sugeries before mine. I would look for someone
with more experience and a total program of pre & post-op care. I had
no complications and have been entirely happy with my results. I am over
two years post op and have had no negative health issues of any kind as a
result of surgery. This surgery changes your anatomy for life. Make sure
you get the best doc you can find.
— Lisa B.
May 14, 2003
My surgeon says smokers get more leaks. Personally I ould be concerned.
According to my surgeon known problems that are managed arent dangerous.
Its the unknowns like sleep apnea that can kill. I am a prime example of
that. A few years before WLS I had minor knee surgery and quit breathing.
It was HORRIBLE! I came very close to dying. You dont want to go thru that.
— bob-haller
May 14, 2003
Not all people have to have all the tests. The surgeons usually go by how
you fill out your quesationaire. (sp) If you have a bad medical history,
they test more. If you answere questions that you have no problem in
certain areas of your health, they usually don't test. For example if you
tell them you have no trouble sleeping or being tied or snoring, they
likely don't order a sleep apnea test. But, I would not want to go into
surgery without at least an EKG done prior to being put to sleep.
Sometimes this is done the day before or the day of your surgery, when your
labs are done at the hospital. When you register for surgery.
— Delores S.
May 14, 2003
IMHO, you should be VERY, VERY worried. These test are not done just
because but could save your life. They are not "hoops" to be
jumped or taken lightly. Please find another surgeon who will have your
best interest in mind. Sidney Open RNY 10-23-02 down 90+
— Siddy I.
May 15, 2003
Nancy, I don't think you need to be worried. It sounds like your surgeon
has plenty of experience. Not only that, he may very well have another
surgeon with him when he does your surgery. Some people don't like to hear
that, because they want to be sure that their chosen surgeon is actually
doing the surgery. (I know the first surgeon I chose was going to have
another surgeon more versed in lap surgery with him, as well as a Fellow
who had even more experience at another facility! BTY, the first surgeon
wound up not doing my surgery due to a scheduling conflict, so the one more
experienced in lap surgery and the Fellow did it, and I was really happy,
since I liked all of the docs!) I noticed that you are not that old, nor
are you super obese. You seem to be in relatively good health, so your
surgeon has probabaly assessed your needs for further testing and found it
not necessary. I didn't have a lot of hoops to go through, but my husband
had to do more because he had a congenital heart defect corrected back when
he was a teenager. And, I hate to say it, but surgeons operate on smokers
every day. When my DH was in the recovery room after his RNY, they brought
in a fairly young woman who had just had some major, major vascular surgery
done to her legs. She was barely conscious, but her first words were to ask
for a cigarette! Surgeons can use the "stop smoking or no
surgery" to cut risk, and they know they have some real leverage in
getting people to quit smoking if they require before surgery. For over 13
years I worked with people who had heart surgery and you wouldn't believe
how many of them couldn't wait to get out of the hospital - so they could
have a cigarette! I also know that, since I was in a teaching hospital,
residents and medical students would be present and assisting with my
surgery. (The medical student was so sweet - her job was to hold the camera
still! And I know the Fellow is the one who "created" my pouch.)
If you feel comfortable with your surgeon, go for it and don't be worried.
No surgeon can just decide they want to start doing WLS and just do it.
They have more training before they can do it on their own.
— koogy
May 15, 2003
Nancy, I read your profile and I am really concerned for you. You seem to
have some significant co-morbidities. Mainly it is your sleep apnea and
shortness of breath and worry me. I hope your sleep apnea is being treated
and that your surgeon has planned precautions that he will take for you
having it. Having surgery with untreated sleep apnea can be Deadly! The
anesthesia and the morphine they give you can make you stop breathing!
Please read the memorial I wrote on my best friend, Ginger Brewster, on the
memorial page of this website. Please be safe! If you do choose to have
this surgeon you will need to be very vigilant in having your co-morbids
managed properly. Best of luck for a safe and successful surgery.
— Hackett
May 17, 2003
Bloodwork and EKG are usually done for any surgery. I had to have them
done before a D&C. And you didn't mention anything about seeing a
nutritionist pre-op. Bedside manner doesn't matter if you don't make it
back to your bed!
— Sarahlicious
May 18, 2003
The first surgeon I had selected to perform my surgery(he left my insurance
network prior to my surgery, which sent me scurrying for a new surgeon),
required you to attend his three hour informational session and nothing
else--no psych eval, no dietary consult, nothing! In addition, he didn't
even initially consult with you until a week before your surgery. Yet, he
is a very reputable bariatric surgeon in my area. However, given all of
the hoops I had to jump through when I scurried to find a new surgeon, in
retrospect I'm wondering if his popularity is actually related to his
surgical abilities or the fact that getting surgery through him is easy and
uncomplicated. Still, a lot of his patients and former patients have a lot
of good things to say about him. Overall, I would say that if you are
comfortable with it, then I wouldn't worry about it. However, I would
start asking questions if your surgeon has no plans to at least send you
for pre-op testing--if for no other reason than to consult with the
anesthesiologist. Before administering anethesia, a lot of
anesthesiologists prefer to have some knowledge of you previous medical
history and existing conditions before deciding which combination of drugs
would be best and safest to use on you.
— Amanda S.
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