? About clearances

[Sajijoma 1,324]

I've noticed that some surgeons require sleep studies and stuff and was wondering what all exactly did your surgeon require before surgery? Does everyone have to get the upper GI thing and stomach biopsies or is that based on medical problems they suspect? I'd love to get as much of this stuff done as I can while I'm still finishing up my 90 days if I can, so I don't have to wait longer than I'd like to between being approved and the actual date picking, but I don't want to go finding problems I don't know about already prior to surgery if I don't have to either. Like as far as I know at this moment I do not have diabetes so if a diabetes test is not required, I don't want to go out of my way to have one and get stuck on a meter and a diabetic diet plan on top of all of this too should it turn up I did have diabetes. Does that make sense? What if anything do you all recommend that I should do now that is like a 99% guarantee that I'll have to get done prior to surgery that I could be knocking out of the way right now?

[losing_the_band 133]

I would not recommend trying to do the clearances yet, as most of them have to be done within a certain time period before surgery. You never know if you're going to have a fight with insurance, like I did. I had to go back and forth with appeals for 3.5 months before I was approved for my revision, so if I'd tried to do my clearances early, I would have just had to do them all over again, since they all had to be done within 30 days prior to having surgery. Now, once you get your date, I would try to get them done ASAP, because there might be follow-up things that you have to do that may require some waiting (a sleep study, in my case). I only had 3 weeks notice, and I wasn't going to be able to get in to see my PCP for a week and a half, so I had to go to a new doctor for my lab tests. Luckily, I was able to get everything done in about 1.5-2 weeks (delayed a few days because my pulmonologist required me to go for the sleep study before she would clear me), so now I'm just waiting for everything to be forwarded to my surgeon's office on Monday.

[dhrguru 1,238]

I've noticed that some surgeons require sleep studies and stuff and was wondering what all exactly did your surgeon require before surgery? Does everyone have to get the upper GI thing and stomach biopsies or is that based on medical problems they suspect? I'd love to get as much of this stuff done as I can while I'm still finishing up my 90 days if I can, so I don't have to wait longer than I'd like to between being approved and the actual date picking, but I don't want to go finding problems I don't know about already prior to surgery if I don't have to either. Like as far as I know at this moment I do not have diabetes so if a diabetes test is not required, I don't want to go out of my way to have one and get stuck on a meter and a diabetic diet plan on top of all of this too should it turn up I did have diabetes. Does that make sense? What if anything do you all recommend that I should do now that is like a 99% guarantee that I'll have to get done prior to surgery that I could be knocking out of the way right now?

the one I'd try to get out the way is the sleep study. Getting an appointment could take a while, and then if you need a c-pap it could take a bit to get it and have it adjusted properly. My surgeon required your cpap be taken to the hospital on surgery day so it's important.

My pulmonologist didn't order a sleep study, but from reading boards, that sounds like the longest step.

All the other tests I had could be scheduled with in a week of me calling,. (Upper gi, ultrasound, labs etc)

[James Marusek 5,244]

Take a deep breath and don't panic. Towards the end of the process, you will undergo around 4 hours of pre-op tests. This will tell if you have any preexisting conditions that could interfere with the surgery. After these tests, the medical team will determine if there are any potential problems that need to be looked at in finer detail. Then there is a second round of pre-op tests that are done by specialist in the specific field.

For example, I snored, so they set me up with an evaluation by a pulmonologist (sleep study). Because of other medical conditions, I had an hour of ultrasound testing that looked at potential blockages in my blood vessels. I also had an EKG test as part of the second round of testing. The point is that you may go through the first round of testing in flying colors and need no additional follow-on tests.

[Madtownsunshine17 42]

I'm probably odd, but I didn't have any pre-op testing. I am 27, and didn't have co-morbidities so the surgeon and team felt like I could proceed without anything. Just wanted to share so you didn't feel like every single person has pre-op testing. My process was:

• Consult with the surgeon
• 2 NUT visits
• 1 Psych Eval
• 1 readiness visit with PA
• 4 Educational Classes (3 hrs ea)
• H&P with the surgeon 1 week prior

Edited August 27, 2015 by Madtownsunshine17

[LoggedOutForGood 233]

@@Sajijoma Hey Doll! I personally had a long list of things that I had to do for my surgery. A lot of them I got done super early (like the psych eval, the abdominal ultrasound, the endoscopy, the pap smear, etc.) because they did not have expiration dates and then some of them I had to wait until closer to my surgery date because they did (specifically the chest xray and EKG). I was constantly doing blood work and I had to do 6 months of consecutive weigh ins. I also had to go to one seminar, support group and dietician class that my surgeon's office holds, which were all incredibly informative. So I got as much stuff done as early as possible, with the exception of the things I knew needed to be done closer to the surgery.

I did not have to do a sleep study, but I am reading that a lot of people did. This probably just depends on which route you're going (self pay or insurance) or what your surgeon requires.

Everyone's circumstances are different so I would recommend asking your surgeon or the office on what you can get done now, if anything, and what you need to wait on, that way you're not wasting your time doing them over and over again.

[Sajijoma 1,324]

Wow, somehow I didn't get any notifications of these replies! It's really weird to me how incredibly different everyone's pre op is! I'll be in the office tomorrow getting my psych eval anyway, so might just pop around the desk and ask if there's anything I can/should do early. I want to streamline as much as I can, because I've got 7 kiddos to consider and work around so things like sleep studies could be harder for me to arrange than just getting a date and going, so if it HAS to be done, I'd like to work on scheduling that baby now instead of trying to scramble 9 schedules to accommodate. As far as being ready for submitting, I've got appt #2 at the NUT this Wed and then 45 days later is my last of the 90 days and we can submit to insurance. I still want to try to lose another 20lbs before surgery(my next 45 day goal) so I'll be going in 40lbs lighter than my starting weight. God willing!

[Anxious2beme 93]

I meet with my surgeon for the first time this Thursday - can anyone tell me what to expect? I've already had my Psych Eval and my appt with the NUT is next week. All I will have left is the exercise specialist which is Sept 17th. Not sure what happens from here as my insurance does not require a non surgical weight loss monitoring before surgery. Anyone?

[LoggedOutForGood 233]

@@Anxious2beme Everyone's appointments are different but I'd be happy to share my experience.

My first surgeon appointment was on 8/6 and it was a great appointment. He introduced himself and told us a litle bit about who he was, where he went to school and how long he's been doing what he's doing. He then asked me questions about my lifestyle, my eating and dieting habits and what brought me to my decision to pursue weight loss surgery. He then had me stand up, lift up my shirt to help him better understand my body and how my weight was distributed and then we talked about my options.

He told me he would be ok with doing the RnY or the Sleeve, but recommended doing the RnY because I had a lot of weight to lose and believed I would be way more successful with it, so that is was what we chose. He spoke a little bit about the procedure, but since I had already attended his seminar I was aware of how it worked and the changes he'd be making.

He then made me promise that after he performed the surgery, that I didn't ruin it by having hot sauce or wasabi or anything like that. LOL

I see him again tomorrow for my Family Visit /Post Op Instructions and I can't wait to see him because he was so personable and friendly and really made me feel like I'll be in good hands!

2 weeks to go for me!

I'm sure your appointment will go swimmingly, too! xo

Edited August 19, 2015 by Nikikins

[Anxious2beme 93]

@Nikikins...thank you for sharing your story. When you say you have 2 weeks ... Is that to surgery? I saw my surgeon yesterday and he's writing the letter to my insurance company but the insurance coordinator said it wouldn't be sent yet. I don't understand the wait if I don't have one with my insurance company.

[WendyA 7]

Nervous about what to expect, for my situation and insurance, I had to be approved by our Insurance company before anything could even be started, we have an HMO.....I was denied a few years ago and decided to try again and I got approved was elated to say the least!!

Now I have my first appt which is Monday 8/31/15 my husband Is attending with me, it's an all day appt. from 9:45 to 4:30pm...they call it a Nurses Consultation, I guess its about information on pre op and post op and the various procedures available and anything else we need to be informed of, after that I have no idea what to expect. I just turned 60 and I know I have to see a Pscyh Eval..and Nut/Excerise and the surgeon(s) themselves, after that I have no idea, I don't know if I will be done this year with the surgery or it will be after the first of the year LOL I'm feeling anxious at times because I so want it to happen and waiting is not my strong suit LOL

I am 5'6 and 250 lbs but everyone is shocked when they hear I'm 105 lbs overweight, they stare at me like I have something dripping from my pores. LOL Even though it's obvious I'm obese.

Can anyone inform me of what the psych evals are like? That one for some reason makes me nervous LOL

Thanks and I'm new here obviously.

[LoggedOutForGood 233]

@@Anxious2beme Sorry for the delay in response. For some reason, I am not being notified when I am mentioned in posts so I'm checking my notifications to make sure I didn't actually shut something off.

Yes, at the time of my post to you I had 2 weeks left for surgery. I am now at exactly one week out. Are they not sending the letter yet because you still have a pending appointment in September?

Feel free to send me a message at anytime if you'd like to talk, I'm an open book for the most part

[LoggedOutForGood 233]

@@WendyA Hi! Congrats on making it this far and for making the decision to go down the WLS road!

My Psych eval seemed pretty cut and dry to me, but I've read other stories where the visit was awkward or horrible. I had to answer a 300+ questionnaire (some of the questions were downright strange and repeated in different ways) and then I met with my psych for about an hour. He asked about my family history, eating / diet habits, job, lifestyle and support system. It was a really quick hour and he signed off on my surgery while there. He even faxed it over to my PCP before I left. It went pretty smoothly.

Again, you'll read stories on here of people who had really bad psych evals and some that had easy evals, so don't let anything scare ya! I know its easier said than done, but try not to be nervous and go in with an open mind and a positive attitude and I'm sure you'll be just fine xo

Edited August 26, 2015 by Nikikins

[mommyfrog3 41]

It is true that all programs are different. I had to have 6 months of nutrition classes. My surgeon has requirements like visits to cardiologist and pulmonary drs. The pulmonary cleared me right away. But I do have to return to the cardiologist for a echo. No medical reason but just for precaution. Plus I had psychologist and nurse practitioner exams. It's a lot of appointments but they are required. Good luck and hope you have an easy process to finding the new you.

[toasty 371]

There were lots of hurdles to jump through on this journey, but honestly they weren't really difficult. I had to do a six-month medically-followed weight loss process, so my various other appts and tests were performed during that time. Psych eval was pretty easy, and I had to see a cardiologist as well, which was pretty much just a consult. I have been diagnosed with sleep apnea for over seven years, so the sleep study was not necessary for me.

I am two weeks away from surgery, so at this point I look back and it was all worth it to get to here!