Sharon1964

Just thought I'd throw out there the questions I asked my surgeon today. Surgery is Saturday! Q: What size bougie do you usually use? A: (laughing) why does that matter? Me: It doesn't; on the forum I hang out on, I've seen people talk about the size of the bougie the surgeon uses, and I figured I would ask! Doc: 34 Q: Do you suture over the staples on the sleeve? A: Yes and sometimes over the sutures I also use (dang, I can't read my notes. Can't remember if he said a surgical mesh or a surgical glue or what). Q: Do you close with staples? sutures? glue? A: Usually I used sutures and/or steristrips, but since you have trouble with tape (it gives me welts), I'm going to use surgical glue and sutures where necessary. Q: Do you do a leak test before discharge? A: I do the leak test while you're under anesthesia, by endoscopy. I do everything I can while you're out and I don't see any reason to wait to do a leak test until you're awake (shaking his head). Q: Do you routinely use catheters on your patients? A: Sometimes, and I think we will for you. Me: Good! Doc: (laughing) Why "good"?? Not having one is an incentive to get up and walk! Me: Because when I have to pee, especially in the middle of the night, I have to go RIGHT NOW. So I'm picturing me struggling to get out of the bed, not making it, and leaving a pee trail to the bathroom. Doc: (still laughing) that's why we have linoleum floors. Me: And then I slip and fall in the pee and break a leg or my hip or something and then you have to operate on THAT! Doc: Yep, a catheter it is! Q: Do you usually leave in a drain? A: No, not routinely. Not usually. Q: Is anyone else going to be working on me or is it just you? A: I have assistants and residents, and if a resident is near the end of their training, they'll do much more than if they are at the beginning. I'll be there the whole time. Me: So I'll always be in your talented hands? Doc: Yes, until I go to Starbucks for a coffee halfway through! (this is in reference to a local cardiac surgeon who got into serious trouble for leaving patients in the middle of surgery and telling his PA to finish up the surgery - clearly out of the scope of practice for the PA).

My aim was to communicate. I did not intentionally use words and phrases you did not understand. You didn't put this in the rants section, and it was not clear to me what the rant was about. It's still not. I hope whoever you want to stop doing whatever it is they are doing, does so soon. It seems terribly distressing to you.

Has an unruly teenager taken over your computer?

Is English your first language? The phrase "I beg your pardon" or "beg your pardon" or "begging your pardon" means either you did not hear or you did not understand what someone said. I could not discern if you were angry at people for being against you having weight loss surgery, or if you were angry at people for suggesting you have weight loss surgery, or something else. I could not figure out if you thought people who needed insulin were defiling God's work, or if you thought they needed insulin because they didn't take care of themselves. Your post was so confusing that I thought perhaps you were having a cerebral vascular accident.

Just for insurance... Okay, back to the topic at hand. My next guess is alcohol poisoning. Have you been drinking?

Perhaps you should call emergency services. Stroke is a real possibility. As is a seizure. Diabetic emergency. Low blood sugar. Pesticide poisoning.

My surgery is Saturday! I'm so excited!

I don't understand your post so I was asking for clarification. Are you having a stroke?

Mistie: It sounds like your surgeon is like mine. Mine requires all of the age-appropriate testing be done prior to surgery. Since I was 50 when I started the process, and hadn't had a colonoscopy, I had to have one. Pap smear had to be within 2 years (I think). Mammogram had to be within a certain numbers of years. All of these timeframes were the accepted standard of care in place at the time. Since I have a history of PVCs (premature ventricular contractions) caused by sleep apnea, I had to have a cardiac stress test for cardiac clearance. I use a v-pap (variable pressure) now so I didn't have to have any sleep testing. He only required it if you had not had the test. My insurance required a psych eval and 6 months of nutrition visits (although they dropped that requirement on 7/1/15), along with a BMI of a certain amount. All of the other things were requirements of my surgeon. I had an upper GI to check for a hernia. I had an upper endoscopy during my colonoscopy. Today at my preop I had an EKG, a chest xray, and blood work.

Beg your pardon?

Updated and good luck to us all!

It's not like you're laying there naked on the table. Whatever they don't need access to, they keep covered up.

Updated.

Updated.

Got it!

Here is info from someone in San Joaquin County (which, as you know, is one county west of Fresno County): http://www.bariatricpal.com/topic/221572-anthem-blue-cross-medi-cal/ I would do one or both of the following; 1. Call the member services number on her insurance card and ask what the coverage is, and the requirements are, for bariatric surgery. 2. Call ALSA (Advanced Laparoscopic Surgery Associates), the office of Dr. Kelvin Higa. Dr. Higa has a reputation as the best in Fresno and is the only surgeon my own primary care doctor would let me see. Ask them if they are still on the Blue Cross Medi-Cal plan (he is currently listed as being on the plan). And then lastly, she should make an appointment with her assigned primary care doctor and ask for a referral for a bariatric consultation.

I truly don't understand why there are so many differences. My preop diet is one day. Full liquids, doesn't have to be clear. I'm having more trouble with the fact that I've had to stop my daily anti-inflammatory since my surgery is in one week. My knees and feet are hurting me in a way they never have before.

I love your style!

I tried very, very hard to resist. I did, really. Sigh. I lost the battle. Dude, you're smoking it right now, aren't you???

This. Totally.

He needs to get a copy of their policy regarding weight loss surgery. If it doesn't say he must stay the same or lose weight during the nutrition portion, then he should be able to successfully appeal. In that case, it would be the insurance company's doctor's OPINION to deny, and he is not following the written policy.

When I was pregnant, I got tired of intrusive people. When someone (particularly a stranger) asked when I was due, I would say, a little loudly, "I'M NOT PREGNANT, I'M FAT!" Yah, I can be a pain sometimes.

I had a hard time reading this, with sentences that are clearly missing words. It appears that you meant either "over a 100 pound weight loss" or "over a major weight loss period". I think you will put forth a better image if you spent some more time editing. And as someone else mentioned, the pronouns need help. And lastly, over $30,000? Most people I know cannot relate to that (including me). I'm guessing that was over one or two years, so either around $2500 per month or $1250 per month. That's more than my rent.

I was surprised that stress incontinence was on the questionnaire at my surgeon's office. We talked about it specifically, and he said the majority of his patients with it report significant relief after surgery. I take a diuretic now, so combined with stress incontinence, it's a disaster waiting to happen. It's one of the improvements I'm looking forward to after surgery.