pre op requirements

[itsmekarenlee 129]

I'm reading some people have to do a sleep study, ekg, and endoscopy. If I had to do those i wouldn't be doing the surgery. They wouldn't be able to get any result from the sleep study because I will not sleep if someone is watching me. No way.

Endoscopy? Really? Isn't the surgeon going to look and fix (if anything) at all that anyway while in there?

Though an ekg also isn't required for us (my husband and I) per our insurance and surgeon, our MD needs to write "cleared for surgery" on his recommendation letter and that might mean he'll want to do an ekg tomorrow morning. I have much anxiety at a drs office and testing so I hope we don't have to do it. I've never had to do any if this stuff before anyof my surgery, latest one being six months ago.

Sure is interesting to see everyone's different requirements.

[Cupcake 801]

Hi it depends on your program , insurance and your surgeon, I did not have to do a sleep study but I did have to do a EKG and exercise eval, as well as 6 months mandatory programing then the wait list for the surgeon. My surgery is this Monday and I started my journal in Aug of last year.

[itsmekarenlee 129]

congrats and good luck!!!

[jtickle 295]

If you want the surgery bad enough you will sleep during your sleep study. It's not hard to sleep thru them. I have been on both sides of a sleep study. First of all, I have had 4 sleep studies. Plus I am a respiratory therapist so did clinicals in a sleep lab. They actually don't watch you sleep. The point of checking to see if you have sleep apnea is that your chances of having a heart attack or stroke is greatly increased because you stop breathing in your sleep. Most surgeons will postpone surgery 30 days if you have sleep apnea so you can get some therapy from the cpap machine. Oh yeah, you can request a sleep aid during your test.

As for the endoscopy or egd, it's done to check your esophagus, to make sure you don't have a condition such as barrets esophagus, or to check for a hiatal hernia. They check your stomach and the beginning of your small intestine as well. They will probably take a biopsy to check for h. Pylori if you haven't done the breath test.

Everyone that wants to get WLS has an EKG. They do it to check for any heart disease, if they detect something on it they will send you to see a cardiologist.

They will check your respiratory system too. Some have to go see a lung doctor.

Some of us have to visit all the specialists, that the surgeon refers us to. They want to make sure you are in best physical shape possible to have surgery. WLS is a major ordeal and you need to be as safe as possible.

[itsmekarenlee 129]

I understand. What I don't understand is why none of that was needed/done for all of my previous major surgeries. Weird.
Also, if there was a problem with my heart wouldn't it show up on the leads/monitor during/after surgery six months ago?

Edited May 13, 2014 by itsmekarenlee

[jtickle 295]

Actually you can see a heart attack on an ekg. I has to do with the elevation of the s-t wave portion of QRS complex on the ekg. Anyway don't want to get real technical... Lol! You can see other things on their as well. I understand what you mean when you wonder they don't do all this testing for other surgeries. I have had six back surgeries and just had blood work and chest x-ray for each one. At the seminar I attended, the surgeon basically said he would not do WLS on a person who major heart or lung problems because they would be just to unhealthy and their risk of dying on the table is to high. Good luck with your surgery! Do you have a date set yet?

[itsmekarenlee 129]

Thank you. No date yet. We see the nut in an hour and psych on Monday then it goes for approval then we'll get a date. I have a 6 day road trip mid July so hopefullt the sooner the better.

Had our MD appt this morning. I worried for nothing if course. Didn't do an ekg since its not required. Just did blood work which needed to be done anyway. Don't know if surgeon needs the results though.

I got a new anxiety med too to take as needed. Hopefully that will help. I will probably continue to see the psych to help me fix that problem. : P

[Ginger Snaps 1,323]

What is required preop varies based on your medical history, your surgeon and your insurance requirements. My surgeon requires psych, cardio and pulmonary clearance. I'm not sure if my insurance requires all of those but they don't require anything beyond those.

I already have sleep apnea and use a machine, so the pulmonologist that sees me for that just wrote up a clearance letter saying my apnea was well controlled. The cardiologist said everything on the EKG was fine but she wants to do a stress test just because I've never had one before and this will give us a baseline. UGH -- one more test. My psychiatrist interviewed me for about 20 minutes and wrote up his clearance letter.

My doc doesn't require any GI testing but I had some done 2 years ago, so he's getting copies of those reports just to make sure we're doing the right procedure (have pretty bad reflux and a hiatal hernia that he will repair).

I've had other surgeries too and been put to sleep for those but I think the big difference is that this WLS is still considered elective, no matter how bad you really need it. And, the surgeon just wants to cover all his bases and make sure you are as safe as you can be during and after the surgery.

[kmamaward 3]

Hi I have to get all those clearances, heart, lung, and sleep study. I have congestive heart failure and a stress test showed I may have blockages. I am going in for an angiogram next week to check on those. I also have the sleep study. The pulmonary doc will give me clearance on June 5th if I keep up with my treatment plan. I have severe asthma allergies and can barely walk without coughing. If I cannot be cleared and must do this on my own I have learned some tools through the 6 month program I went through and from the Nut I saw. Good luck to you.