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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