Question:
Anyone denied because the Dr felt you would not comply post-op?

   — kenhwilson (posted on December 7, 2003)

December 7, 2003
My doctor is Dr. Jamshid Nazarian. He is listed on this website. He deals with patients all over the world. And has conducted over 2000+ surgeries with no complications. He is an EXCELLENT surgeon and provides the best bed side manner. He is extremely thorough. He is in Beverly Hills, CA and works through Liv-lite out of Temple Hospital. Getting into see him isn't difficult. I would suggest you contact his office or the Liv-Lite office for help. But please understand, that you MUST do everything that the doctor and nutritionalist tell you. The doctor cannot lose weight for you. The surgery doesn't lose weight for you, all doctors will deny you if they feel you will not comply post-op. Please see this surgery is just as major as person with a heart or liver transplant. You have to maintain a health lifestyle. Good luck to you.
   — keishax

December 7, 2003
Why does your doctor think you won't comply? Did you do a psych eval and perhaps something came up on it? Do you have a primary care physician who may support you, and perhaps write to your surgeon that you would be a good candidate? Don't give up...surely there are other surgeons in your area. Perhaps your surgeon doesn't feel confident about doing your surgery and rather than being honest about it and giving you a referral to another surgeon, s/he is taking the cowardly way out...
   — Le P.

December 7, 2003
My surgeon does debny active drug or alcohoil abusers because they self destruct after surgery. If you dont mind me asking why? Just recently I think my surgeon is requiring smokers to quit. Any of this apply to you?
   — bob-haller

December 7, 2003
Hi Kenneth- I read your profile and saw that you will be self-pay for your surgery. If your Dr says no, because you are self-pay, you're not limited to only him/her :o) But I think you're doing the right thing by asking your surgeon why he/she thinks you won't comply. If you and the surgeon can't work it out, I would definitely start looking into other surgeons. Good Luck, Mea :o)
   — Mea A.

December 8, 2003
Our program has "pended" patients because we were concerned they would not be compliant after surgery. You don't say why there's a problem. Within our program there are several indicators of compliance. One, of course, is the psych eval. There are also other smaller indicators. For example - we ask all patients to lose 15 pounds in order to shrink the size of the liver. This makes the procedure easier for the surgeon thereby making it easier on the patient. Occasionally we have a patient who says they can't or won't do it. We all know that at 275+ pounds, losing 15 pounds isn't that difficult and if a potential patient won't do it then we're concerned about how compliant they will be after surgery. We require that our patients attend a support group meeting prior to surgery. If they won't or don't attend we will pend them. If a person can't take 2 hours out of their life to satisfy a preoperative requirement than how can we expect lifelong compliance? Our program advocates protein supplements and if we have a patient that says they can't find a single one they like then we worry about compliance. There are hundreds of products available and literally thousands when you consider all the protein recipes so there's really no reason a person can't find at least one they can tolerate. We also have serious concerns about patients with previous alcohol or drug addictions. And there are many other compliance indicators. We rarely have to completely cancel or deny a patient. We generally pend them and may approve them when they've demonstrated sufficient preoperative compliance or they've resolved the issues that caused the concern to begin with. Surgeons WANT to perform this surgery. It's how they make their livelihood. So, if you were denied then the surgeon must have felt there was sufficient cause and rather than just shopping for a doctor who will perform the procedure I'd try to work through the issues that initially caused the concern and stick with the surgeon who knows you. Best wishes to you.
   — ronascott

December 8, 2003
Hi Kenneth. I would do as you suggested and ask your doctor why he thinks you would not be in compliance. It is so very important that post-ops remain in compliance and committed to the program. You could shop around, since you are a self-pay, but it sounds like this doctor may be a caring professional with some legitimate concerns that could be worked out. I know many surgeons that have "postponed" surgery dates while their patients worked out their issues with a psych first. It will be worth it in the long run..good luck to you.
   — Cindy R.

December 15, 2003
If you have been denied why not go out of the country for surgery? It is much cheaper for a self pay. I suggest you check out the www.duodenalswitch.com site. At your super morbid obese BMI, the duodenalswitch is your best chance to get to a near normal wt, the RNY is not the surgery for that. There are great surgeons in Spain and Brazil that do WLS and many patients that have gone to them and had wonderful experiences. There are docs in this country that will take on self pays and have caps worked out at the hospitals they practice at so you have a set price no matter the compications or lack there of. Dr Elerany in Va and Dr K, I'll butcher his name if i try and spell it, a surgeon out of Delano CA, they have caps worked out, it is like 20 to 30,000 depending on the doc. Go to the duodenal site and check it out and then check out the Yahoo site for the duodenal and ask questions, you'll learn a lot. As far as what you say to doctors, whether it is the surgeon or the shrinks for the psych eval, remember, they want to know that you will be compliant as a post op. You do not need to tell them every detail of your life, you just need to be the model of the compliant pt. Be smart, you need this surgery, play whatever mind game they want out of you to get the life saving surgery that you need. Esp. with the duodenal switch, it is the surgery that requires the least amount of effort as far as only eating a teaspoon of food, screw that. Get the surgery that will enable you to lead as near normal of a life as you can good luck
   — Deborah M.