Question:
I want WLS but do not want a psych or sleep apnea exam. Is it always a requirement?

   — Clare S. (posted on February 18, 2004)


February 17, 2004
Well it should be. Sloppy surgeons who didnt require a sleep study have had patients die. Undiagnosed sleep apnea does kill. Thats how some of our members ended up on the memorial page. I myself quit breathing after minor knee surgery. It was terrible. 2 years later I had WLS with no troubles. The psych exam is important too. This surgery and the weight loss that follows creates as much or more emotional and other changes as the physical ones. Although sadly a small percentage of psych docs try to profiteer from us. Its important they weed out those with troubles like active alcohol abusers who would self destruct after WLS. These requirements althoiugh a pain are there for our protection.
   — bob-haller

February 17, 2004
If your surgeon does not require either of these, I have only one word of advice .>>>....RUN..... Both are very very important.
   — Kathy S.

February 17, 2004
Why would you not want to know if you are healthy all the way around????? What are you trying to hide with not having a psych exam? And as far as the sleep study that is just plain dangerous, you can die from sleep apnea. My DH was only getting 36% oxygen due to his sleep apnea, he was dying in his sleep. He had to wait a little longer because of the tests but in the long run is doing great and is down 100#. Do yourself a favor and go for whatever test the surgeon wants you to go through in the long run you will end up healthier. Christine open RNY 5/7/03 241/160/130
   — ChristineB

February 17, 2004
I feel the psyc exam is one of the most important. If you are not ready emotionally to have this surgery then you shouldnt have it done. The same with the sleep study. If your surgeon doesnt order both...find another surgeon
   — debmi

February 17, 2004
I didn't have to have either of these but I do agree with the other posters. If they require it or even hint about it, it means that you should have it. You doctor knows what's best. Good luck Stacy
   — hawk4life

February 17, 2004
dont die! get a sleep evaluation. it is easy and painless. if you need a c-pap machine, it's no big deal. after weight loss, you may not need it. sleep apenea, for me, was, for example like driving drunk. i could have killed some one else besides my self, as i would often fall asleep at the wheel of the car. this, was in addition to just dying in my sleep by just stopping breathing, among other problems. the psych evaluation is mainly used to determine your ability to comply with the things you need to do to handle the requirements and changes you need to make with surgery. it would seem that by not wanting to comply with these two requirements, you may not be a candidate for wls. the bonus of starting these things now, is that you will get a head start on your other issues, and speed up your recovery! best wishes, harvey simon
   — harvey S.

February 17, 2004
Mine required it
   — Robert L.

February 17, 2004
I agree with the others. If your surgeon doesn't even mention sleep apnea or a psych exam, you need to find another surgeon. And if you aren't open to doing all the necessary tests to make sure you are healthy for surgery, you need to reevaluate whether WLS is right for you. There will be many, many requirements of you after surgery in order to remain healthy and you must follow ALL of them, not just pick the ones that you want to follow. So I'd worry that if you are unwilling to do what is necessary before surgery that you might not follow through after surgery.
   — antiques55

February 17, 2004
Ditto to all posters. Both are important. We, as MO people pose a challenge to the anesthesiologist with or without sleep apnea. The more information they have about our problems, the better they can treat us and keep us alive in the OR and beyond. Psyche evals. Yes, the compliance componant is extremely important to the whole process. There is nothing hard or threatening in there. (And, it is nice to have established an "in" so to speak, if you should need some counseling post op.) Take good care. Be patient with the process and all will work out. My best, Polly
   — Jackie O.

February 17, 2004
I for one would not want a surgeon that would not have these performed on a pre op patient. I feel as though, if you can not abide to having these tests ...you are not a good candidate for this surgey.
   — Hazel S.

February 17, 2004
A psyc evaluation is mandatory. If you are not well psychologicaly you may not be successful. I did not have a sleep study done, it is not mandatory.
   — bransonboy

February 17, 2004
I didn't have either, my surgeon only requires a psych eval if you have a history of depression, which I didn't. I'm 18 months post-op, size 6, at goal, and have had no problems whatsoever.
   — Angie M.

February 17, 2004
my surgeon did not require either test. however a surgeon that i met with, before i chose my surgeon ,required both. it doesn't hurt to meet with more than one surgeon. it's also good to check with them on after care procedures ( ie. blood drainage tubes, bial drains, etc.) every surgeon is different, go with the one that makes you most comfortable.
   — Michelle R.

February 17, 2004
My surgeon's office required a psych exam. It's purpose is to determine if you fully understand what you're getting yourself into and can do what it takes following surgery to follow a plan for recovery and lifestyle change. I think it's a good idea. Unfortunately, some who want this surgery are not doing it for the right reasons and they're the horror stories you often hear about following WLS. My surgeon's office only required a sleep apnea if you exhibited signs of sleep apnea or were diagnosed with it. I did not have to do that one.
   — Cathy S.

February 17, 2004
There is another reason for doing these tests, aside from the obvious need to ensure you are prepared mentally and from a respiratory standpoint. That is, if you are willing to do what is necessary, and what your surgeon orders, you likely will be willing and able to follow directions after surgery. Who likes to be stuck with needles? No one! But do you think anyone would say they "don't want" to have labs done before surgery, but they want WLS surgery? I don't mean to be harsh, but if you aren't willing to do whatever it takes to get to surgery, you aren't ready for this huge, life-changing, non-reversible event.
   — koogy

February 17, 2004
My surgeon says its the unknown health issues that cause problems as the known ones are manegable. My surgeons death rate is .4% which is much better than the nationwide average of 1 to 2% and my surgeons group does high risk revisions and 800 pound patients too. If your surgeon doesnt require conmprehensive pre op testing find one that does it might save your life.
   — bob-haller

February 18, 2004
My sleep apnea study probably SAVED MY LIFE! I would suggest you take a look at why you don't want these vital tests. Don't do surgery before you are ready to be compliant with all the regulations and behavior changes pre and post op. Ann in TX 414/414/282/140
   — Ann B.

February 18, 2004
I did not have a sleep apnea exam, but I did have a psych exam and it was just basically to make sure I had realistic expectations, a support system and no severe problems (had to take a 500 question test). Don't be worried. The exams are just designed to help locate any potential issues that could cause problems with the surgery.
   — Christy L.

February 18, 2004
The surgical group I belong to requires either a sleep apnea test or a pulmonary test as well as a psych eval. It happens that my insurance requires them as well. Even if you are a self pay at my surgical group, they still require these tests. I'm sure you can find surgeons who don't, but these tests are very important for your success before, during and after surgery. Good luck!
   — Shayna T.

February 18, 2004
Go to the Memorial page and read Ginger Brewster's profile. Her friend tells the story of how Ginger died due to undiagnosed sleep apnea. That should answer your question for you.
   — Denise B.

February 18, 2004
Why not? I see a lot of people post about being worried about the Psych evaluation, it's usually not a very big deal at all, I know in mine they really just talked to me to see if I had realitic expectations about the surgery, and was willing to comply with the aftercare rules.<br><br> As for the sleep apnea, it can save your life, my doctor didn't require it of me, but they told me most overweight people have some level of sleep apnea so they treat them as such.
   — Patricia T.

February 18, 2004
My surgeon didn't require either of these tests. But, why are you against having them? If you are already working with specialists in these areas, your surgeon may be satisfied with a written recent update of your conditions, if applicable. Good luck to you.
   — Yolanda J.

February 18, 2004
Clare you need to do both of these. I would have never gussed I had sleep apnea. Turns out I have very severe apnea. It can SAVE YOUR LIFE!! The phsyc exam was no big deal. He wanted to know that I understood the surgery and what to expect afterwards and that I had family and friends supporting me.
   — Randy W.

February 18, 2004
I had neither and was very satisfied with my care. Bariatric treatment center. My doc had done >1500 RNY surgeries at the time of my surgery 1 1/2 years ago. I trust his judgement and extensive experience.
   — **willow**

February 18, 2004
Would you expect a heart surgeon to operate on you without the apropriate tests first? If you want WLS, then you should be prepared to go thorough whatever tests your medical history indicates are necessary for you, according to your Dr. I personally would REFUSE to have surgery with someone who didn't feel it was necessary to explore all pertinent issues before hand. I did not have a sleep apnea test, because I had not indications whatsoever of apnea related problems. You Dr. is not going to arbitrarily make you take tests that you don't need to take. On a final note- WHY? What do you care what tests they want you to take to make sure you're ready and avoid complications? Perhaps you're not ready. This is a lifelone change you know. It's not something to be taken lightly. You do know you can die from this surgey, don't you?
   — LMCLILLY

February 18, 2004
Some surgeons require it, some don't. If your surgeon wants you to get one done, then do it. I guarantee it'll be more pleasant than the night before's colon cleanse.
   — mrsmyranow

February 18, 2004
I just wanted to ease your fears about the psych exam. I am a therapist and do psychological examinations for weight loss surgery. It is very important to have this session, as you will be able to identify any problems, anxieties, coping skill issues, fear etc. that might exist prior to surgery. I had Gastric Bypass (Open RNY) 03/07/03 and have lost 180 lbs. Remember that the exam is painless and very necessary. It is not as bad as most people think it will be. It also provides you with information regarding postop counseling, support group information and other good resources. Good luck!!
   — rpoepke

February 18, 2004
I just wanted to ease your fears about the psych exam. I am a therapist and do psychological examinations for weight loss surgery. It is very important to have this session, as you will be able to identify any problems, anxieties, coping skill issues, fear etc. that might exist prior to surgery. I had Gastric Bypass (Open RNY) 03/07/03 and have lost 180 lbs. Remember that the exam is painless and very necessary. It is not as bad as most people think it will be. It also provides you with information regarding postop counseling, support group information and other good resources. Good luck!!
   — rpoepke

February 19, 2004
Trust me, no one is more scatter brained than me and my psych seemed to think I was pleasant and normal...(my mother was surprised, seriously!) I'm not trying to paint the picture that I am a walking nutcase but I'm trying to make the point that even my mother thinks I'm crazy but I passed the psych eval. As far as the sleep study, I didn't have to take one. If you don't sleep all night, can hear yourself snoring, or you stop breathing while you sleep, you might want to get tested for your own benefit. My surgeon didn't see where it was necessary for me, plus my insurance UHC doesn't require it. My case is currently in review at this time, pray that they approve me already. The bottomline is that it depends on what your insurance requires, call them up and find out. Once you find out, ask your surgeon if he is anal about either one and tell him your insurance doesn't require it and you don't want to spend money doing something you don't want to do.
   — Shayla527

February 19, 2004
Hi, We may not want to have all the pre-tests before wls, but I think that the more thorough the medical staff is, the better off the patient will be. The tests can help spot potential problems on one hand, or help give the go-ahead that you are checked out for surgery. If it were me, I would feel that the medical staff might be negligent if they did not require pre-op testing for all of us. I've had several of mine now and glad to have them out of the way, lol. LM
   — catly

February 20, 2004
A psych exam is mandatory.
   — Kelly T.

February 20, 2004
No psych evaluation here- my doctor only reccomends if he thinks you need it.
   — Gloria B.




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