Question:
What are the medical tests and evaluations I'll need before surgery?
I was told today that the surgeon I'm considering only orders blood work and a chest xray before surgery. I've read many profiles and it appears to me that they are having more that blood work and chest xrays. Is it my pc's responsibility to know what test to order? I know I need a stress test. My pc is not very knowledgible about wls. Is it my responsibility to find out what test should be done? It appears to me that sleep apnea, pulmonary function and gallblader evaluation, and echocardiograms are standard tests for most wls. Are those test ordered according to the patients present health? — ginny B. (posted on July 3, 2004)
July 2, 2004
Honestly, I would RUN not walk away from that surgeon. He or she is putting
you at great risk of ending up on our memorial page. Things like
undiagnosed sleep apnea KILLS. I nearly died after minor knee surgery from
this. I quit breathing it was horrible.. That was before my WLS. Had no
trouble for weight loss, since they knew what my problems were. Surgeons
who dont proper testing give WLS a BAD name and make insurance reluctant to
approve it. PLEASE dont use this surgeon, find anyone else. I hope the NIH
come up with a required protocol of tests to minimze hazards. <P> Now
even if you get the proper tests thanks to your PCP I still wouldnt use
your surgeon because he knowlingly is putting patients at risk.
— bob-haller
July 3, 2004
I think pre-op testing is an individual thing. My surgeon based MY pre-op
testing on MY needs and symptoms. I did not snore, had restful sleep and
didn't require a sleep study. If my memory serves me, I had an Upper GI,
and a gall bladder ultrasound. I was never a smoker and my lungs were
clear, my heart was fine so no need for a Chest x-ray or pulmonary test.
So many times unneccessary tests are ordered, causing an incredible
increase in insurance premiums. Now, I am not saying that pre-op testing is
not important, but it really should be an individual thing. If your doctor
treats everyone with the same tests, THEN I would be concerned. However, if
your lack of comorbidities do not require further testing, then don't
worry. Oh, and to answer your question, your surgeon is the one to order
the tests. Your health during and after surgery are HIS responsibility.
Good luck! Shelley
— Shelley.
July 3, 2004
I wanted to add, that if you have concerns and feel the need for more
testing, then ask the surgeon. He might develop the same concerns if you
mention that you snore or don't get enough rest. THese questions should
have already been asked and addressed, but if you ever feel that your
surgeon should be more aware of symptoms. You should ask him if he feels
these tests would be a good idea. Although, my last answer said that your
surgeon was responsible for your health (I was actually differentiating
between the surgeon and the PCP), you should also be your own advocate.
Shelley
— Shelley.
July 3, 2004
Before my LAP RNY, I had an EKG, Chest X-Ray, various blood tests, blood
gases, and an ultrasound for gall bladder disease. The doctor didn't
order a sleep study because I had no symptoms of sleep apnea. Just make
sure your doctor is aware if you're having sleep irregularities so that can
be included.
— Cathy S.
July 3, 2004
Testing is individual to the patient. But sleep apnea if unknown can and
does kill. I forget which member here dierd after wLS because they werent
tested, she is in the memorial page. gall bladder ultrasounds, complete
bloodwork, EKG, chest X ray, Referal to specialists like cardiac doctors,
espically if someone is diabetic, is the norm, because diabetes causes
heart disease. Often pre op tests uncover problems we didnt know we had.
Its a sad fact of life being MO isnt healthy. I had severe sleep apnea but
was never tired. There are surgeons locally who reaquire little testing. I
refer friends for WLS to only the best. Ones that do complete work ups. Our
lives are on the line
— bob-haller
July 3, 2004
Ginger Brewster died because she didnt get proper pre op testing, heres her
sad story.<P>
http://www.obesityhelp.com/morbidobesity/profile.phtml?N=B1027392789
— bob-haller
July 4, 2004
My doctor not only required a sleep apnea test (I have very MILD sleep
apnea, only 10 instances/hr and ONLY on my back,and still had to have
oxygen..DEFINITELY encourage this test!), but has a form for patients to
complete the following:
Psychiatric Evaluation
Dietician/Nutritionist
Physical Therapy
Cardiac Clearance (this included a stress test, EKG and chest x-ray)
Pulmonary Clearance (test to find out how much of your lungs you are
currently using, so they know what to expect during/after surgery)
Preoperative GTT (3-hour Glucose Tolerance)
Preoperative Labwork (bloodwork to form baselines on calcium, potassium,
cholesterol, WBC, etc prior to surgery)
It was also optional if you wanted to donate your own blood should it be
required after surgery. I chose not to, but later regretted it (had to
have two units).
He had me take a "test" in his office to make sure I understood
both my expectations and his during and after surgery. I was also required
to join the local WLS Support group prior to surgery.
I agree with what some of the prior posts said though. Even if your PC
orders these tests, if he/she doesn't know what to look for, they will be
of little help. Might want to shop around-
— Evangeline H.
July 4, 2004
There are times when co-morbidities cause you to need more testing prior to
surgey. I had OPEN DS 5 weeks ago and didn't have to obtain any testing. I
did have to see the nutritionist & psycholoogist before hand. You are
right in thinking that the patients medical condition is reason for those
test...
— smoore_911
July 4, 2004
My surgeon gave a checklist that he gives to everyone that he is going to
do surgery for. It was then my job to get my pcp to order the tests. They
included the pulmonary function test, EKG, Echocargiogram, Psychiatric and
nutritional evals., endoscopy, ABG, chest x-ray, 3hr glucose tolerance test
and lots of blood work. The only thing I did not have done was an
ultrasound of my gallbladder because it was previously removed. The
required tests by my doc are the same for everyone he operates on. I had
never been checked out more in my life.
John F. -- Lap RNY 6/21/04
— jforten
July 4, 2004
My surgeon requires blood work, pulmonary function test and pulmonary
clearance, endoscopy, chest xray, an ultrasound of my legs and medical
clearance from my PCP. My PCP had also requested a cardiac stress test
and cardiac clearance. The pulmologist recommended a test for sleep
apnea, but the surgeon didnt think it was necessary, they said they would
do it only if the insurance needed another push.
— Cheri M.
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