Switching Surgeons/Office post approval but Pre-Op

[jayeedee 7]

Hi Everyone,

Nice to meet you. I had a question about switching doctors.

The background:

I am working on something of a compressed timeline, but it was doable. I had never thought about weightloss surgery until my BP skyrocketed and my PCP was hesitant to put me on medication due to my age. However, my metabolism died post children, and to lose weight I apparently need to eat 1000 calories or less a day to bring my weight down, something that is not sustainable for me without surgery. Without staying at that level, my body is happy between 235-245... but then the BP thing happened. I went to a seminar, the initial appointment with my surgeons office and found out everything I needed to do before going in to surgery for the insurance and for the doctors office. I had two weeks set aside where my schedule was mostly open to take care of all the appointments that were needed. On Friday the surgeon's office called and said that they want me to have a sleep study, something that was not mentioned in the original meeting. I have never had sleep problems, not a snorer, I have one of those fancy sleep bracelets to monitor my sleep cycles and I sleep perfectly well through the night, and all my weight is in my hips, thighs and butt so this was surprising to me, especially since it wasn't mentioned when I went to the appointment and asked about all of this over two weeks ago.

I am a bit uncomfortable with all of this as I can find nothing on the sleep center that they recommended except a Facebook page with 2 likes. Also, if I have to go to a sleep center, I would like to speak with a sleep specialist. I am trying to form a team I can go to if I have problems post surgery. That is what I based my per-approval nutritionist and psychologist on. This sleep center seems to be only associated with practice and I am not finding anything about an affiliated MD that deals with sleep disorders. Further, I don't have a flexible schedule due to work and school, and the sleep center they referred me to is not very flexible or open with the times I can come in and they require three weeks per the message I received to analyze the data they collect. Right now the earliest appointment is 3 weeks out, and that pushes all of this past the original timeline I went over with the surgeons office and makes it so there is a chance I won't be able to have surgery until March, when I have my next break. Needless to say, if I have to do the sleep thing, I would rather go somewhere else, and would really prefer to go to an MD to discuss everything. Honestly though, if my insurance doesn't require it, I am also a bit upset that this happened without consulting with me first since it is another thing that will be billed to insurance. In the event that there is no way around going to this specific sleep center with this doctor, I might need to change surgeons or go without the surgery until March and get on BP medicine

The Question:

Has anyone managed to change their surgeons once they received approval from their insurance? I'm done with all my pre-approval requirements, so I am now just waiting to hear back.

Thanks for any input you can provide.

[Corrigan 75]

In my case, it was an insurance co. requirement.

[jayeedee 7]

In my case, it was an insurance co. requirement.

This is definitely not an insurance requirement for me (checked with the insurance company). I asked the office and they said this is being requested by them. I just looked up the whois of the parked domain the emails are coming from from the sleep center are coming from and it looks like it is owned by the surgeons office so... yea. Not so comfortable with all of this.

I will probably call tomorrow to see if I can get a referral to an actual sleep specialist and do the testing at one of the sleep centers recommended by The American Academy of Sleep Medicine and maybe begin seeing about switching surgeons too, just in case the timeline seems undoable with the surgeon I am currently seeing.

Needless to say, anyone successfully switched?

[nayttap 4]

The sleep Centers I've worked with are extremely busy and booked weeks out. Usually you see the sleep physician 2-3 weeks after the study for the results. Often the sleep study is required by the physician, or by insurance. What they are asking of you is not unrealistic....just not your plans.

[nayttap 4]

From Bandwagon on the Road....a blog by Jean McMillan 11/14/11 on the importance of treating sleep apnea to increase success from lap band surgery:

" Non-restorative sleep - sleep affects the production of hormones (leptin, grehlin, cortisol) that are key to the experience of hunger, appetite, and satiety. Poor sleep tends to decrease leptin (satiety hormone) production and increase grehlin (hunger hormone) production. It also seems to increase sensitivity to pain. If you have sleep apnea or another type of sleep disorder, or even subclinical sleep disturbance, it's likely that your physical hunger is increased and your sense of satiety is decreased. The adjustable gastric band can intervene on your behalf, but it doesn't correct the hormone production problem."

I realize that this still doesn't answer your question about changing surgeon's.......but the requirement is valid in my opinion and worth taking the time to ensure that you have maximum and optimal success from the life changes that you are making.

[Shellyac 22]

I have switch surgeons post approval. I was originally going to have my lap band done in Baltimore but my Dr. tried to convince me to have the bypass done. As a result I was going to switch to the sleeve but my BMI wasn't high enough to have it covered by insurance. While doing research about the sleeve I found out about sleeve plication in addition to the band. Unfortunately there are only a few doctors in the country that do it so I ended up switching to a doctor in Hollywood, FL. At the point the point that I switched, I had pretty much all of the pre-op tests and requirements done and had scheduled my surgery, The process of changing was very easy, I had the original office send all of test results and documentation to the new office prior to my first consultation. The only thing that I had to do over was meeting with the new office's nutritionist. I was also lucky that I was able to do the consult via Skype.

I also had to do a sleep study as part of my Pre-Op and I'll second the importance of having the sleep study done because I although I felt that I didn't have any sleep issues, I was diagnosed with mild sleep apnea. It is minor enough that I don't really need any treatment and just need to try to sleep on my stomach to prevent episodes but I think that knowing that I am prone to episodes on my back is important information for the anesthesiologist during my surgery.

When I scheduled my sleep study I was also told that it would take several weeks to get my results back and they even scheduled my follow-up when I made the original appointment but I was also told that it usually doesn't take that long and that they may move up the follow-up appointment which they ended up doing. I think there might have been no more than two weeks in between appointments.

[jayeedee 7]

Thanks for all the replies everyone. I'm not against the sleep study, just the way this was all organized. I found an actual sleep center, on that is recognized by the AASM, that can see me next week. Like I said, I don't want to just have a one off doctor's appointment. I am trying to let these appointments be the first step in establishing relationships with doctor's and clinics I can continue to go to post surgery in the event I have any problems.

I am going to see how the next few appointments go with the doc before I make a final decision on switching or not.