Help! Sleep study doctor might not approve me

[Tootles1975 59]

So I've been trucking along with all my appointments, completing everything but the endoscopy, one nutritionist visit and the sleep study. I met with the sleep study doctor today and his first response to me (after a bunch of questions then sitting in weird silence for ages while he typed on his computer) was that I have "much more important problems to worry about than a sleep study."

Apparently, he's very worried that I had a pulmonary embolism almost 20 years ago. I had a vena cava filter installed at the time and took blood thinners for six months and had an MRI afterward and was told it all cleared up on its own. I see a vascular surgeon (and have for the past five years) who monitors the filter --- I just recently had a X-ray of it to make sure it hadn't moved (he actually was going to suggest removing it until I told him I was preparing for gastric bypass). Neither he nor the bypass surgeon had any real concerns about this history, they just said they would prescribe blood thinning injections pre-op and/or post-op for me.

Well this doctor was very negative and thought I should reconsider the surgery given my history with the embolism, and kind of freaked me out by telling me that it was probably a bad thing that I'd had the filter for so long, and that he wanted to order a whole new battery of tests (Ultrasound, nuclear medicine, echo doppler, PFT) in addition to the sleep study (which...I don't even think I HAVE sleep apnea) and extensive boodwork to see if I have any pre-indicators for clotting, and then see me again in a month.

So now I'm a bit worried about all kinds of things, and while I know it's better to be safe than sorry, it makes me a bit angry that the vascular surgeon and the bypass surgeon didn't seem nearly as concerned about this as he was. He did concede he might be erring too heavily on the side of caution, but still seemed very negative about the whole thing. He said if it comes back that I do have genetic predisposition markers, I should really consider if it's worth doing the surgery or trying instead a medically supervised weight loss program. I tried to explain to him that my primary motivation for surgery is that it will severely minimize and maybe eradicate my diabetes, which diet/exercise won't do at this stage of advancement, even if I can lose and maintain, and that I know anyway that regular diets only generally have a 5% success rate long term, but he seemed pretty skeptical about my claims.

I'm not sure what to do now. My husband thinks I should cancel all the tests he scheduled and go to a different doctor for the sleep study. But now I'm worried, and I'd rather know if there's a problem or not. And another doctor may just raise the same concerns I suppose.

But...I don't want it to prevent me from getting the surgery either. If he refuses to approve, can I still go ahead with it?

It's just so weird to suddenly be worrying about a medical problem that happened 20 years ago, and hasn't really been an issue since.

Anyone have any embolism history that put obstacles in their way to surgery?

[SugarFreeMe 293]

I'd call the surgeons office and talk with them about it. Explain everything you said here and see what he/she says. Do they suggest all the additional test? Could they suggest a different sleep study group, or if the results of the sleep study show no apnea, would that be sufficient for them if the vascular surgeon is prepared to approve you? Don't over analyze the situation until you've consulted your surgeon. You'll make yourself nuts and it may not even be an issue.

[Tootles1975 59]

Thanks. I'll call the bypass surgeon's office tomorrow. I also called the vascular surgeon today but had to leave a message. I probably am worrying unnecessarily, but his tone just really threw me.

[rhodywoman 145]

I know it may not be what you want to hear but each doctor has a specialty and although the others may not be concerned in his specialty perhaps his reasons for such concern are valid. Ultimately, the goal is to have the surgery to improve your health but if you rush it you can get the surgery but lose your quality of life or even your life. I'd err on the side of concern and check everything out before switching to another doctor. Best of luck with this.

[Tootles1975 59]

Thanks to all of you for the feedback. I agreed that it was better to be safe than sorry and went for some of the tests today. The doctor called me back this afternoon and said everything looks good and was much more optimistic and friendly today. His verbiage changed from "if you get the surgery" to "when you get the surgery", so I'm taking that as a good sign! (And of course, it's great to have a clean bill of health.)

[Tootles1975 59]

@@rhodywoman I'm a fellow Rhode Islander! Who is your surgeon? We should chat!

[rhodywoman 145]

What a super small world (and state)! I'm going through Miriam Bariatric and I have Dr. Ryder. I'm so impressed with the support from there. My pre-op appt is Aug 18th so I'm pretty close. Getting excited and nervous. I live in Charlestown, you?

[Tootles1975 59]

Oh nice. I'm going through Roger Williams with Dr. Pohl, and I live in Johnston. I'm thinking I might get a surgical date in late October/early November hopefully.

[ready2B 263]

I have the Factor V gene mutation (one instance of it, you can have one or two) that predisposes me to blood clots. I had a DVT about 10 years ago and then a partial one a few years later, so the finally did the testing. Having the genetic test didn't really change much, I already have to take Lovenox and use the leg pumps whenever I have a surgery because of my previous DVT history.

Being obese certainly makes my risk of clotting higher as well as the high postmenopausal estrogen I have due to obesity. And I am pretty sedentary because it is so difficult to be active when I am carrying all this extra weight. So having the surgery, while taking all the necessary precautions, will help reduce my risk of future clots significantly.