Surgery on Wed - PCP Won't Clear Me

[NewLeaf15 20]

Hello,

I haven't slept all weekend because I'm a nervous wreck right now. On Friday I went for both clearances (PCP & Pulmonary Doctor) and I was cleared from the Pulmonary Doctor and my PCP said he was going to send his clearance. On Friday at about 4PM my PCP calls me and says that he won't clear me until I get a stress test. He said my EKG shows abnormalities. He said that he was surprised no one else caught it. He said he won't clear me for surgery until I go in. My insurance won't pay for that exam so he had to do a peer to peer to prove I need it. Now I'm scheduled for a stress test on Tuesday at 6AM, and I'm scheduled for surgery on Wednesday morning. I'm upset because this doctor since day 1 has ALWAYS given me problems. He didn't want to authorize the surgery in the first place so I pretty much had to plead him that I need this for me. Every single time I go to the doctor he gives me issues, and he said on Friday that if it doesn't come back normal that he won't clear me and I would need to go to a heart doctor and he could recommend one. He said you can just postpone it. I'm paying Cobra right now which is an arm and a leg for this insurance. I finally sorted out my insurance issue and now he comes with this last minute. He said it was a "mild" change on my EKG but he said he's not going to risk himself by clearing me. "I'll just have to wait." I'm beyond livid. He called my surgeon and my surgeon wasn't concerned at all, and my PCP was annoyed because the surgeon dismissed him as if he didn't have time. Well that's how my PCP explained it to me. My blood work and all other exams came back normal. I don't suffer from high blood pressure nor am I diabetic.

I bought relaxing tea over the weekend because I can't even think or sleep. Out of the entire process, he stressed me out the most on Friday. He has never wanted me to do this surgery. He was always against it. My mom keeps telling me to relax because it won't help with the exam on Tuesday. How can I relax when he pretty much told me he will cancel it if the exam shows something. He said, "You can just do it some other time." I plan to email the doctor's coordinator and get her opinion, but I'm seriously stressed out.

Any thoughts? Perhaps I just needed to Vent

[Miss Mac 6,262]

Just wondering.......is this doctor unsupportive in general? Does he dismiss your concerns on a regular basis? If you get denied this time around based on his recommendations which you do not agree with, that is the time for a new PCP and a second opinion. You are not stuck with this doctor forever, and his has to cough up your medical records when you demand them. I wish you the best.

[NewLeaf15 20]

Just wondering.......is this doctor unsupportive in general? Does he dismiss your concerns on a regular basis? If you get denied this time around based on his recommendations which you do not agree with, that is the time for a new PCP and a second opinion. You are not stuck with this doctor forever, and his has to cough up your medical records when you demand them. I wish you the best.

Thank you Miss Mac. I appreciate it. He's always like that.. I'm sticking for now because I need him to approve me, but I don't plan to see him ever again. The only reason I had picked him 2 years ago was because Cigna required you to pick a PCP and I went based on location, however it's ALWAYS an issue with this doctor. I'm hoping that the center would have another doctor in case this one doesn't clear me. He gave the original consent before the paperwork was submitted. Now he won't clear me. Honestly if it was another doctor, I wouldn't be acting like this but because since day 1 he has always given me problems, and making jump through hoops which makes me feel he is trying to stress me out right before surgery. Thanks again for your reply.

[AvaFern 3,516]

He's asking for the stress test because if you die in surgery because of a heart issue your family can sue him. If you only had an EKG within the last week or two, then it isn't his fault that you are now unfortunately trying to squeeze in a stress test before surgery. He is covering his a*s, which given the amount of malpractice claims in our country, is not surprising. If the EKG was done several weeks ago and only now this is a problem, then I say raise hell.

I am all about telling doctors where they can go. I have zero tolerance for those who are lazy or who think they get to play God when it comes to approving the surgery or for that matter approving anything I want that is medically valid. My own sleeve doctor hated me and I wrote several whoppingly bad reviews about him online, because I refuse to be treated like a fat lazy idiot who knows nothing about medicine and who has no say in my own health. If a doctor is sincerely being a jerk, you tell him where to go and if he doesn't want to be cooperative you tell him you will be happy to have your attorney contact him. If, however, as it sounds in this case, a doctor is being overly cautious because you are a high risk patient and he doesn't want to end up in court because a minor EKG abnormality resulted in a major heart issue during surgery, try to not freak out too much. If you were in his shoes and you could be sued because you didn't investigate a potential heart problem, you probably wouldn't care too much about making the patient mad either.

It is very possible the stress test will reveal nothing and you will be good to go for surgery. If, however the stress test comes back with a problem that prevents you from having surgery, your doctor being an overcautious pia could potentially save your life. Either way you end up alive....which is really the best case scenario even if it doesn't feel like it right now.

[rking 484]

I SO agree with avafern.

[Chele H 427]

What Avafern said! If it were me and ANY abnormality showed on my EKG or stress test there would be no way I would have anesthesia. Your primary is protecting himself and possibly you. You have waited this long, if you have to wait a little longer for your own safety, so be it.

Good luck on Tuesday with your stress test.

[cindyw41 761]

Question.. Does you PCP have to do your pre-op physical? I would check to see if you can get your pre-op/EKG repeated by a Occupational Medicine clinic (one that does DOT physicals). My doctor said if I couldn't get into my PCP I could go there.

[NewLeaf15 20]

Question.. Does you PCP have to do your pre-op physical? I would check to see if you can get your pre-op/EKG repeated by a Occupational Medicine clinic (one that does DOT physicals). My doctor said if I couldn't get into my PCP I could go there.

I'm going to email tonight the Surgeon's coordinator and see what she says... If I recall correctly, I think they have a doctor that would give me clearance, because I remember telling her from the beginning that he wasn't supportive and I believe that's what she told me, but I'm not 100% sure.

[NewLeaf15 20]

He's asking for the stress test because if you die in surgery because of a heart issue your family can sue him. If you only had an EKG within the last week or two, then it isn't his fault that you are now unfortunately trying to squeeze in a stress test before surgery. He is covering his a*s, which given the amount of malpractice claims in our country, is not surprising. If the EKG was done several weeks ago and only now this is a problem, then I say raise hell.

I am all about telling doctors where they can go. I have zero tolerance for those who are lazy or who think they get to play God when it comes to approving the surgery or for that matter approving anything I want that is medically valid. My own sleeve doctor hated me and I wrote several whoppingly bad reviews about him online, because I refuse to be treated like a fat lazy idiot who knows nothing about medicine and who has no say in my own health. If a doctor is sincerely being a jerk, you tell him where to go and if he doesn't want to be cooperative you tell him you will be happy to have your attorney contact him. If, however, as it sounds in this case, a doctor is being overly cautious because you are a high risk patient and he doesn't want to end up in court because a minor EKG abnormality resulted in a major heart issue during surgery, try to not freak out too much. If you were in his shoes and you could be sued because you didn't investigate a potential heart problem, you probably wouldn't care too much about making the patient mad either.

It is very possible the stress test will reveal nothing and you will be good to go for surgery. If, however the stress test comes back with a problem that prevents you from having surgery, your doctor being an overcautious pia could potentially save your life. Either way you end up alive....which is really the best case scenario even if it doesn't feel like it right now.

I absolutely agree with you. Honestly if it was any other doctor that told me to do a stress test, I wouldn't have reacted the way I am. This doctor has never been supportive about having surgery. He kept saying that I should just do it naturally. That I have time to lose weight. I told him I still wanted to move forward with the surgery and every single time I go to him for some type of approval, he is always protesting and giving me issues. I think that's the part I'm most upset at... at 4PM on Friday, he decides to call my insurance to have a stress test. He kept saying, "just pray it doesn't come out with any abnormalities. You need to just pray. I won't allow you to have surgery." I think his biggest offense because he mentioned it to me a few times is that the surgeon dismissed him on the phone when he called. Anyways, yes, if there is truly something wrong, then I completely understand, and I do hope so but they pushed this test to Tuesday morning.. the day before the surgery. Thank you for your reply. I appreciate it.

[cindyw41 761]

I hope he allows it. I mean those physicals are pretty basic.

One thing I know are PcPs and reading EKGs is that sometimes they overreact. I have an elderly Man that I take care of, his EKG showed a abnormality and she scared him. Faxed his EKG to his cardio, demanding he have a stress test and once his Cardio saw it...and repeated the EKG he says "there is a small abnormality, but nothing to worry about". Scared a 90 year old for nothing. Having a second pair of eyes will not hurt, especially since he's so against it

[NewLeaf15 20]

This morning the Surgeon's Coordinator emailed me and said:

You are absolutely not bothering me. Of course you're stressed out. You can see any physician to get your pre-op clearance, even a walk-in clinic. I have had patients with similar situations. We should be able to get the results tomorrow afternoon from the stress test. Where are you having it done?

I replied and asked her if she could possibly send me the paperwork just in case. I'm going to take the stress test tomorrow and hoping my primary will still clear me but I want to have a second opinion as well. These next 2 days will be the longest ever.

[cindyw41 761]

So glad you have a second option.

[MIMISAN 404]

My Cardiologist made me take a Chemical Stress test before he would talk about clearing me. Low and behold he saw something that made him uncomfortable so he strongly urged me to have a heart catheter to check this out. Sure enough I had to stints placed on August 28th. One was in the artery that they call the widow maker. I was disappointed that I was sidetracked for a while but very happy I listened to him.

Now I have finished all my other insurance requirement and we are trying to schedule me for Jan 26th which is 5 months from the time of stints. I will have to quit taking my blood thinners for a week.

I have my fingers crossed for you.

No matter what happens you probably should find a PCP that you are more compatible with for the long haul.

[cindyw41 761]

This morning the Surgeon's Coordinator emailed me and said:

You are absolutely not bothering me. Of course you're stressed out. You can see any physician to get your pre-op clearance, even a walk-in clinic. I have had patients with similar situations. We should be able to get the results tomorrow afternoon from the stress test. Where are you having it done?

I replied and asked her if she could possibly send me the paperwork just in case. I'm going to take the stress test tomorrow and hoping my primary will still clear me but I want to have a second opinion as well. These next 2 days will be the longest ever.

How are things going?

[NewLeaf15 20]

This morning the Surgeon's Coordinator emailed me and said:

You are absolutely not bothering me. Of course you're stressed out. You can see any physician to get your pre-op clearance, even a walk-in clinic. I have had patients with similar situations. We should be able to get the results tomorrow afternoon from the stress test. Where are you having it done?

I replied and asked her if she could possibly send me the paperwork just in case. I'm going to take the stress test tomorrow and hoping my primary will still clear me but I want to have a second opinion as well. These next 2 days will be the longest ever.

How are things going?

Thank you for asking. I haven't been on the site since last Tuesday. My update is that I went for the exercise stress test last Tuesday which was the day before surgery and that afternoon my PCP said he wouldn't clear me because it came back abnormal again. I did a lot of crying and I was down that night. The Bariatric center called me to reschedule surgery for Dec 21st (next Monday), until I received clearance from the Cardiologist. I saw the cardiologist on Thursday and he said that he believes it's a "false-positive." He said that at times it could be the breast affecting the test, which I thought it was a very odd thing but that's what he said. He said he wants to be 100% sure it's a "false-positive" before he clears me, so on Thursday morning they're doing an echo stress test.

He said that test will indicate if something is actually wrong or it's nothing. He thinks it's nothing but he doesn't feel comfortable clearing me until he's sure which I understand. Once/if the cardiologist clears me on Thursday then the PCP will clear me as everything else came back normal. I'm scheduled for next Monday, and at this point in the process I feel numb and I don't want to get my hopes up for another disappointment. I'm going on Thursday for that test and that same afternoon I should hear from the doctor what it is... fingers crossed.

Edited December 15, 2015 by NewLeaf15