Question:
What does your surgeon require?

While getting ready for my first consult with my surgeon, I have ordered many books online about weight loss surgery so that I could get a better understanding of everything and feel comfortable in my decision to have the surgery. So far, I have learned a lot and enjoyed most of the books. However, I just finished reading a book called, "Weight Loss Surgery , Understanding and Overcoming Morbid Obesity" by Michelle Boasten. In her book in chapter Five, she lists what HER surgeon required of his patients for surgery. Some of the criteria bothered me and got me to wonder and ask questions. ARE these requirements normal for all surgeons, most surgeons, or just a few? Are all surgeons different in what their criteria is? Please read below, and please let me know what your surgeon expected from you that is different or the same. Thank you so much! SOME OF WHAT HER SURGEON REQUIRES FOR YOU TO GET THE SURGERY: 1) A well-functioning email address that can accept attatchments. (Wouldn't a telephone or regular mailing address be sufficient enough? Now you have to have a computer in order to get the surgery? I have one of course, but why should it be a requirement?) 2)A body weight of no more than 350 lbs. ( I know operating on people with higher weights than this can be more dangerous, but aren't these the individuals who need it most? A BMI is not listed here..just the weight. So, it is ok to operate on a 5'2 woman who weighs 350lbs, but not a 6'0 man who weighs 355lbs?) 3)Patient's must be presently working..in or out of the home( Why should this matter at all??? What about stay at home mom's or wives? So what if you are unemployed...what does that have to do with your health status and your need for surgery? If you have the means to pay for this surgery without being employed personally...I think NOT being employed can make things actually easier. NO scheduleing time off work, chance of losing your job etc.) 4)No history of any previous obesity surgery ( why not? what if the surgery you had failed and you needed a revision?) 5)No history of any major abdominal surgery (Does this include removal of the appendix or gallbladder? Why should this exclude you from having the surgery? It is like saying that if you already had your uterus removed, we cannot operate on your kidneys if you need it! This makes NO sense to me!) 6)Patient must have evidence of a stable family structure, AND have the doccumented support of their immediate family ( this really gets me! If you needed life saving heart surgery, would you be expected to get written support from your family in order to get it? And even if you need plastic surgery to get a breast job or face lift...you are usually not required to get permission from a family member to get it. This surgery is a medical necessity and to me is considered a very personal decision. Although most of us tell our loved ones and usually get their support, it should not be a requirement! So, if you are going through a divorce, you can't have the surgery? That is just insane!) 7)No history of major psychiatric illness (I was hospitilized as a child for clinical depression. So does this mean that I wouldn't be eligible for this surgery under this surgeons rules? I am perfectly and mentally fine now) Gee..under these guidlines I might as well forget having the surgery! Sometimes my email doesn't always work right, I had my gall bladder removed when I was 16 yrs old,I am not technically employed although I do have full coverage health insurance, I weigh almost 350lbs, I had a history of depression as a kid, My very skinny husband is not 100% for the surgery, and I do not think he would let the surgeon actually doccument his support....hmmmm... I know surgeons have to have guidelines...but this sure excludes me! How bout you guys?    — Shawnie S. (posted on December 21, 2001)

December 20, 2001
Every surgeon seems to have their own particular criteria, but this is a classic example of why it is beneficial to talk with more than one surgeon before making your selection. These requirements are extremely rigid and are not likely to be found with most surgeons, although a few of them have some legitimate basis in fact. My bariatric surgeon, specializing in lap WLS, is not concerned whether his patients have email capability; has performed lap WLS on patients weighing up to 600 lbs; accepts insurance or self-pay, but does not question if you are employed; routinely performs revisions of prior WLS; and has no problems with patients having had previous major abdominal surgeries (I had had 2 C-sections, an abdominal hysterectomy, and a classic gallbladder surgery). Having a "stable family structure" is not a pre-requisite for WLS, but most caring, compassionate physicians would like to think that their patients have access to a strong support system, both physically and emotionally. In reality, that is not always possible, and there are many single individuals who have very successful surgeries and post-op courses without the benefit of family to provide physical assistance and emotional support. These are instances where close friends, co-workers, church family, etc...can be very helpful. My surgeon does not routinely require a pre-op psychological consult, but does have in-depth conversation with potential patients regarding their "motivations" for seeking WLS. Psychological consultation may be particularly helpful for individuals with a long-standing history of anorexia or bulimia, but clinical depression in childhood seems unlikely to be a factor in determining eligibility for WLS as an adult. One of the most important tasks for potential WLS patients is to research the subject and be as well-informed as possible. It sounds as if you have done a lot of work in that area. Now just put together a list of questions and take them with you when you go for your consultation appointment(s). Responses will vary somewhat from surgeon to surgeon, but this approach will give you the opportunity to choose a surgeon who best meets your particular needs. Good luck!
   — Diana T.

December 21, 2001
My surgeon takes a case to case basis! I was 513 lbs going in. I had my gallbladder removed. I had to do a psych test but all he was looking for was that I had an in-tact support system. My surgeon required a pulmonary and cardiac clearence because of my size.. I have a history of clinical and "cirumstantial" depression (I've "lost it" several times during my battle to get my surgery approved) .. I couldn't work, heck I could barely MOVE less not work. And after our initial meeting I grew really attached to my surgeons style.. My mother and husband even liked him and they hate doctors.. So don't get hung up on this "criteria" it seems a little... far fetched to be typical ...
   — Elizabeth D.

December 21, 2001
Surgery is a BUSINESS, and buisiness folks sometimes try to optimize their business. This probably gets him the most ideal candidates. He limits the higher risk ones, which probably minimize his death risk. His OR and equiptement is likely not designed for the Super morbidly obese either. LAP equiptement varies between my surgeons differing hospitals he operates in. The more challenging cases use Presby. Of course my surgeon does revisions LAP and has operated on a 1,100 pound person. If your unhappy with the rules you can always find a different surgeon. My surgeon Dr Schauer has patients from ALL over the country because he specializes in the TOUGH cases other surgeons dont want. It appears your surgeon just wants a select group, the most commn easier cases. Nothing wrong with that! If he want YOU then you are a lower risk patient, and thats always good news.
   — bob-haller

December 21, 2001
My surgeon's only "requirement" was that I gain NO weight between the first appointment (Nov 7, 2001) and my next appointment (Jan 9, 2002), and also NO weight gain right before actual surgery (Jan 31, 2002). I take anti-depressants now, and was very honest with the doctor about it. A lot of people who are morbidly obese suffer from depression. I have had abdominal surgery before too, two cesarean (sp?) sections to have my two kids. Good luck in your search!
   — [Deactivated Member]

December 21, 2001
First off: just so all of you know, I am pretty sure these are not the requirements of my surgeon. I actually don't know for sure yet..since I haven't had my first consult. THis is just something I read in a book. I just was wondering if it was the "NORM" because this paticuliar surgeon's rules do seema bit rigid to me!
   — Shawnie S.