Surgical consent form and risks. I'M SCARED!!!

[HopefullXOXOXO 73]

I went to my first Orientation meeting 11/16 and have worked tirelessly to get approved by insurance for this surgery. I'm finally ready and saw the surgeon yesterday who had me sign a consent form for surgery. Of course, no time to look at it before I signed it! I just looked at it and the list of horrific possible outcomes is VERY SCARY! Including loss of life, paralysis, brain damage, loss of limb function, etc. etc. etc. I wish I had seen this on orientation day as I probably would have stopped then. Of course, the form says that the doctor discussed all of these with me, but he didn't. He did mention the usual leakage, nausea and vomiting, bleeding and stenosis and downplayed them all. He said he's done 1000 of these surgeries and only had two bleeding complications. At first I thought that sounds good, then I realized he's probably due (percentage wise) for something really bad to happen. LOL! The form also says that residents, fellows and students may participate in the procedure. I didn't sign up for that! I thought he'd do the whole thing. It also says that in addition to the surgery I'm consenting to an "Intraoperative Liver Biopsy", did anyone else have that? Listed as one of the possible, most common, severe complications is fatty liver disease. ??? Can VSG actually CAUSE fatty liver disease? I've never heard of that. I'm wondering if he wants to do the liver biopsy during surgery to cover his a** to prove what my liver was like at time of surgery.

I swear, I haven't been afraid once in the almost 2 1/2 years since I began this journey and have worked SO hard to get here. This really scares me though. The only reason I'm willing to go through with surgery is to SAVE my life. I sure as h*ll don't want the surgery to TAKE my life. Or give me brain damage, etc. I know to the doctor this is all routine stuff, but knowing I signed this and gave permission saying I'm accepting these risks just isn't true. Is there anything I can now do? Does anyone know? Can anyone answer my questions about the fatty liver above? I really appreciate whatever help you can give me. I have no one to talk to about this other than the doctor who was very rushed and didn't have time to answer the questions I had, never mind this! I'm going to a good hospital (Mass. General Hospital in Boston, Ma.) and he was probably rushing yesterday with threat of snowstorm coming in. Still, I'm very seriously considering backing out and just living the best I can with how I am and accepting that instead.

Edited March 22, 2018 by HopefullXOXOXO

[Creekimp13 5,840]

Surgery should always be looked at as risk -vs- benefit.

If you don't believe that the benefits justify the risk....you shouldn't do it.

If you do believe the benefits justify the risk...you should.

It's really that simple.

16 minutes ago, HopefullXOXOXO said:

but knowing I signed this and gave permission saying I'm accepting these risks just isn't true.

To me....this looks like you're not yet ready to accept the risks.

About fatty liver disease. Most people getting surgery (greater than 75% of obese people) already have fatty liver disease. I'm guessing the biopsy would be to stage it, if you have a particularly unhealthy looking liver at the time of surgery. Weight loss surgery generally helps to treat it. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061986/

If you have questions about any of this....talk to your doctor. It's what he/she is there for.

This surgery is safer now than gallbladder surgery. Particularly, with the preventative labs and imaging you'll be doing, (chest x-ray, ekg, imaging of your stomach, lab work)...there shouldn't be too many surprises. At a major hospital like Mass General, you'll be in good hands.

When weighing your benefits vs risks...

make sure you include the risks of obesity: increased risk of heart attack and stroke, increased risk of several cancers, increased risk of loss of mobility, increased risk of cellulitis, diabetes, sleep apnea, etc...etc...

You really do need to be 100% sure that you're comfortable with the decision you're making.

My first bariatric surgery consultation was almost 20 years ago...and I had my surgery almost 4 months ago:)

Part of me wishes I'd done this years ago...because I'm feeling fantastic and believe I made the right decision.

The other part of me is glad I waited because time and research opened up more options, and I found a group I absolutely love and feel comfortable with.

What ever you decide....best wishes:)

[Losebig 508]

If they're too rushed to adequately answer questions for you I would question your choice of surgeon. MGH is a great hospital, but in MA we are blessed with dozens of good hospitals and some great bariatric practices. I went to Emerson Hospital and they're practice is super attentive, they take plenty of time to go over everything and answer questions (even the surgeon does). They're a center of excellence for bariatric surgery, so do things like track their own complication statistics and a bunch of other best practices. I don't have first hand knowledge, but Lowell General also has a well known center of excellence.

For the consent form - at least mine listed things that were talked about (you mention many, though there was nothing about a liver biopsy). The stats they used in the consent were the national stats for complication (VS the practice ones, which were far better). Unfortunately this is major surgery and while complication rates are very low - the normal risks of any surgery apply (including everything up to death). The important thing is to understand what the rates are for your specific practice and what the surgeon thinks your personal risk is. In my case I was less risky than the average case and the risk of complications for the practice averages was so low that the drive to the hospital was more risky than the vast majority of the complications.

[Mattymatt 491]

36 minutes ago, Creekimp13 said:

Surgery should always be looked at as risk -vs- benefit.

If you don't believe that the benefits justify the risk....you shouldn't do it.

If you do believe the benefits justify the risk...you should.

It's really that simple.

To me....this looks like you're not yet ready to accept the risks.

About fatty liver disease. Most people getting surgery (greater than 75% of obese people) already have fatty liver disease. I'm guessing the biopsy would be to stage it, if you have a particularly unhealthy looking liver at the time of surgery. Weight loss surgery generally helps to treat it. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061986/

If you have questions about any of this....talk to your doctor. It's what he/she is there for.

This surgery is safer now than gallbladder surgery. Particularly, with the preventative labs and imaging you'll be doing, (chest x-ray, ekg, imaging of your stomach, lab work)...there shouldn't be too many surprises. At a major hospital like Mass General, you'll be in good hands.

When weighing your benefits vs risks...

make sure you include the risks of obesity: increased risk of heart attack and stroke, increased risk of several cancers, increased risk of loss of mobility, increased risk of cellulitis, diabetes, sleep apnea, etc...etc...

You really do need to be 100% sure that you're comfortable with the decision you're making.

My first bariatric surgery consultation was almost 20 years ago...and I had my surgery almost 4 months ago:)

Part of me wishes I'd done this years ago...because I'm feeling fantastic and believe I made the right decision.

The other part of me is glad I waited because time and research opened up more options, and I found a group I absolutely love and feel comfortable with.

What ever you decide....best wishes:)

@Creekimp13 It is probably good that you did the surgery now instead of 20 years ago because the surgical techniques have gotten vastly better. Nowadays, robots do much of the work. The net benefit is a much shorter recovery time and much cleaner, more precise surgical work.

[Natí Beesh 8]

DON'T BE SCARED! but I will say, if you cannot change your lifestyle after then this will not be for you. Its a full time Job. Takes a lot of self discipline and dedication to commit. You will not be able to enjoy foods like before. If you try its painful and you will feel like ****. On the other hand its the best thing i ever did for myself! I had zero complications and just followed exactly what my doc/ surgeon told me to do. I am 9 pounds away from my goal as of today! Congratulations <3

also I highly suggest you join a support group on FB! Find one that was sleeved/rny that same month as you so you have a group of people on the same page as you!

[HopefullXOXOXO 73]

Thank you all for your thoughts. I really appreciate it. I know I need to do this which is why I've fought so hard to get it done. I kept hearing about how "low risk" the sleeve is so I didn't worry about the risks until I took a good look at the consent form today and it freaked me out. Hopefully I'll feel better about it tomorrow after a good night's sleep.

[sillykitty 10,774]

4 hours ago, HopefullXOXOXO said:

I just looked at it and the list of horrific possible outcomes is VERY SCARY! Including loss of life, paralysis, brain damage, loss of limb function, etc. etc. etc. I wish I had seen this on orientation day as I probably would have stopped then.

These can't be a surprise though? These are risks to any surgery where you are under anesthesia.

4 hours ago, HopefullXOXOXO said:

. He said he's done 1000 of these surgeries and only had two bleeding complications. At first I thought that sounds good, then I realized he's probably due (percentage wise) for something really bad to happen. LOL!

So if he's had a bad run lately that'd be better because he's due for a successful outcome, right?

4 hours ago, HopefullXOXOXO said:

The form also says that residents, fellows and students may participate in the procedure. I didn't sign up for that! I thought he'd do the whole thing.

"Massachusetts General Hospital is the original and largest teaching hospital of Harvard Medical School, where nearly all of our physicians are faculty members. For almost two centuries, Mass General has been affiliated with Harvard Medical School" You will have to consent to student/resident/fellows participating or observing any procedure at Mass Gen. Since it's HArvard med students, I wouldn't worry too much

4 hours ago, HopefullXOXOXO said:

It also says that in addition to the surgery I'm consenting to an "Intraoperative Liver Biopsy", did anyone else have that?

I did. My surgeon says he does it for every operation. It's good to have one and he's already in there. I also consented to a hiatal hernia repair if needed (it wasn't)

4 hours ago, HopefullXOXOXO said:

knowing I signed this and gave permission saying I'm accepting these risks just isn't true. Is there anything I can now do? Does anyone know?

Your only option is to not have surgery. No Dr will operate on you without you signing a consent form on the risk associated with a procedure. If you want to have WLS you have to except there are serious, but rare, risks associated with it. It is not an option to say, I want WLS, but I want zero risk of death, brain damage, etc..

You realize there are risks to everything you do, right? The most dangerous thing you do is get in your car and drive somewhere. So will you become home bound to remove that risk?

It seems to me that this may be cold feet, and the risks are an excuse. You had a long build up anticipating this surgery, and now it's a reality. Take a hard look inside yourself to see what you are really afraid of.ny pro

[HopefullXOXOXO 73]

SillyKitty,

I've never had surgery or general anesthesia so this is the first I've heard of any life threatening risks. Until I read the consent form today, I thought the risks were only bleeding, leaks, vomiting. That's all I was told by every doctor and WLS expert I've spoken to. I had read about stenosis and vitamin/mineral deficiencies online. So, yes, every other possible complication is a surprise to me. I know MGH is a teaching hospital but in a million years I didn't think a student could be participating in the surgery. I guess I'm very lucky to be 65 and not have had any surgeries yet.

[Mattymatt 491]

@HopefullXOXOXO Honestly, I think you're worrying too much and blowing this way out of proportion. Statistically, it is more dangerous to cross the street in the heart of the city than undergo this operation. You will be under good care and the most critical parts will be done by the surgeon or under his or her direct supervision. At some point, new doctors and surgeons need training as well and it should be a point of pride that you're giving them that opportunity. The supervising surgeon will be present in the operating room and involved in your care at all times.

You know that the risks of not undergoing this surgery at all are much higher than post-surgical complications. I know that you don't want a heart attack, stroke, or early death. My advice to you is to put your faith in the training and competence of the surgeon and to focus on what you need to do to prepared. This is simply what I did.

Before surgery, I was at the penultimate low point in my life. I actually wished for death at several points during my journey to the day of surgery. So for me, there were only positive outcomes post-surgery. My clinical depression is beginning to ease and I am off 6 out of the 7 meds I was taking just to live. I don't mind taking the antidepressant but it took 5 medicines to control my blood sugar and 1 medicine for hypertension. I was a walking profit model for Big Pharma.

[frust8 963]

Hopefull,do you need an older perspective? I am 72, going to have RnY surgery within a few months and anticipating it being great. Yes I too read the" coulda" list, like the others said,there is more danger walking downstairs and you might fall, you could choke on your Breakfast, get run over by a bus or car, none of that has happened yet? Good, and the likely-ness of any of the others happening, even less likely. Life is a gamble but with all the advances in science and medicine you are holding a winning hand. I too will have my surgery in a teaching hospital, that doesn't worry me because those are the best cutting edge facilities. Shoot when I'm sprawled out, if I can help with their instruction, okay. I'm sure my doctor will have me surrounded with the best of the best, if there are junior doctors they will also be trained well or they won't be allowed to be present. Those bad things you've heard about are more likely to happen to someone my age. Am I concerned? Heck no, my life with surgery will be vastly superior to the life I currently live. I have had arthritis since 25, every bone is or has ached, I have had 2 knee replacements, I have a plate and 12 screws in my upper right arm that fixed a fracture. I have had a bunch of minor breaks that ache, they ache more because I am and have been obese for years. You do get sick and tired of being sick and tired. You have an opportunity to have your body repaired, realigned and made better. Do not wait as long as I have---please. Your skin will go back into shape and smooth out as you lose weight. Mine will probably look like a Shar pei, but guess what, its better to be a loose skinned puppy than lie dead in a casket. I may not have too many more years on this earth but I want to live them healthier fitter and smaller. The trade off for me: surgery and a renewed life vs. obesity and the chance of death? I chose life, my journey started in August 2015, many bumps and twists in the road there,but I'm sticking through to the finish. I feel I can do naught else. If you feel scared,if you feel nervous, talk to me. I have had a lot of life experiences, some scarred me but most have made me stronger. I am a tough old female who's going to win this battle. The world will not vanquish Major General frust8, I will fire every gun and cannon at my disposal until. my war is won. Can you do any less? Come join me if you can.

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