Question:
How can I prove to my PCP that the surgeon knows what he is talking about?

Today I saw my primary care physician to renew prescriptions and to tell her of my approval for the RNY surgery. She didn't try to dissuade me but she didn't encourage me either. She did agree that she could help me with my insulin adjustments after the initial recovery period is over. She felt that it might be best for me to have someone at the hospital where the surgery will be preformed take care of the adjustments before and during my hospital stay. I mentioned to her that the surgeon had explained to me that after a period of 3 months I should no longer need to take any insulin at all. She said she didn't think that was realistic - that she knows thin people as well as heavy people who are predisposed to diabetes and regardless, must take insulin. I was pretty disappointed to hear her remarks. I was hoping she would be encouraging to me. So I came away with a let down. What do you think of all this? My husband who had the surgery in November says not to lose hope in what the surgeon told me, as he is the expert. I'd like some feedback.    — [Anonymous] (posted on January 16, 2002)

January 16, 2002
I am having my surgery Friday. My PCP who was fully supportive since my first suggestion of this surgery says I should be off my oral diabetes meds by 60 days after surgery, not because of being thin or fat, that's not the point. Its because during a normal day for those who have not had WLS we eat many things that contain sugar, and do not even think twice about it. However, when we have our surgery, we eat NO sugar, and dietary sugar is a BIG deal pertaining to diabetes. So, when our sugar intake goes down to practically nothing, our blood sugar then plummets. Its one of the main reasons I am having WLS. I DO NOT want to have to be on insulin, ever. Thank God for this chance. Best Wishes, Donna
   — donnalawbabe

January 16, 2002
Warning here. I'm about to get on my soapbox. It sounds like your PCP is not very knowledgeable about diabetes. Yes, both thin and fat people can be pre-disposed to diabetes. But, if you have Type 2 diabetes, you probably will be able to be off meds fairly soon after surgery. The part I worry about is making sure that your control is as good as you can possibly manage before, during and immediately after surgery. High blood glucose is the main cause of slow healing in people with diabetes. If you can, get your PCP to send you to an endocrinologist, if only to have someone help you get ready for surgery and get you through it. Also, if it were me, I'd have my surgeon put me on some antibiotics starting a day before and at least through the end of the hospital stay.
   — garw

January 16, 2002
Dont worry, 85% of Type 2s are cured of diabetes, that is off ALL meds within a matter of months. I was off my pills in less than a month. Blood sugars dropped like a rock. Your PCP has no experience in this area. Ask your surgeon for the doctor to doctor medical literature on WLS and espically pertaining to diabetes handling after surgery. Get it too your PCP! Look at the bright side, once your PCP sees your results they will be recommending surgery to others. YOU will help save other peoples lives!
   — bob-haller

January 17, 2002
Hon, trust your surgeon, and keep a close watch on your sugars. I have not had to take any of my diabetic meds or insulin since the day before the surgery!!! I am only five weeks out, and my highest sugar reading to date is a 130!! I have lost 67 lbs since the surgery, and going strong... If you keep an eye on your sugar, and modify your insulin accordingly, things will work out! :) Good Luck... "unrealistic" things happen all the time! :)
   — Sharon H.