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Does this sound strange to you??



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:ohmy:Ok, Today I had my first consult w/ surgeon. He said I need to go through a psyc eval, meet w/ diatician 2x, meet with trainer 2x, and wait for ins to approve. NO labs, no ultrasound, no preop livershrinking diet, no required wt loss b4 surgery... I'm not complaining at all, but I just don't want any surpizes at the last minute. He even let me pick my port site, and told me I could eat whatever I wanted up until 8pm the night b4 surgery. I will get my date when the reports from psyc and dietary are in. This Tuesday I go for dietary consult, but I can't get into psyc unti 3/14/08.:rolleyes2:. They told me first and foremost to expect 4-6 months before banding, and I can be patient... NO I cant! I just can't wait for this to all be over with and start at the same time!!

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yes i have heard of people not having to do the diet before surgey. BUT i did have to be checked out by a cardiologist before i could have the surgery. My doctor required it and so did my insurance.

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You know what? I know you are eager and really want to get this done. But there is a voice inside you telling you that something isn't quite right here. I would trust that voice. Have you researched this surgeon? How many bands has he done? Ask around on the boards and see who else has used him?

Even if you are slightly overweight you can have a fatty liver. If you liver is enlarged it raises the risk of complication significantly. I am right on the threshold for BMI required and I am still having to shrink my liver. My surgeon had pictures showing the difference between a properly prepared liver and one from a surgery where the patient didn't follow pre-op instructions. The difference was remarkable. It was so bad, he closed her up and wouldn't do the operation.

So yes, I would be asking a lot of questions and finding out why he doesn't feel shrinking the liver is neccessary.

Good luck!

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Thank you all for all of your answers. To tell you the truth, I had never thought of it that way! He is a very experienced Surgeon, and has done thousands of bands over the past 8 years or so. I asked him at my appt why he didn't require the diet, and he told me that in his experience, it didn't seem to make a huge difference. I do trust him- I called him after my appt with some other questions, and he took the time to talk to me. I have already had most of the things he requires as far as labs, studies, etc, within the past 6 months- for other reasons, I hadn't even thought of the band at that time. SO, I guess you could say that I did everything without knowing it! I think, for my own safety and wellbeing, that I will go on the preop diets listed on here for a week or so before surgery. It can't hurt, and it will allow me to adapt to liquids before I need to.

on anther note, can someone help me put my ticker here? I made one, but I don't know how to get it from there to here!

Thanx again!

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Wow! It took me a little over 10 months to jump through all the hoops my drs practice required. Pre-surgery group meetings x2, Small groups x8, dr one on one x3, tests x3, pre operative physical, cardio tests, diet, nutritionist, psychologist and then we submitted to the insurance.

If I were you I would check with your state online to see how many bands your dr has done and check to see if he/she has any medical malpractice claims (just to be safe). If it checks out, good luck.

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My doctor didn't have me on any special diet before surgery either, but I did choose to try and lose a few pounds on my own. However I did not do liquids, just tried to make better food choices. The 2 week post-op liquid diet is hard enough!!!

I see your age at 29, I am 24...the nurses decided not to do the chest x-ray or an EKG on me because of my age and other than being obese I was pretty healthy. I might have felt safer if they had, but they are experienced and I trusted their judgement. Everything turned out okay!

So I guess what I'm saying is it doesn't seem odd to me. They might be basing it on your age, health, and past medical history. But if you don't feel safe, speak up!

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I think it just depends on your doc and what your insurance requires. My doc had me do an EKG and xrays and bloodwork. My DH was on BP medicine due to his blood pressure before surgery. My insurance requires psych eval, nutritional counseling and letter of recommendation from PCP. 2 week modified diet recommended by doc (2 Protein Shakes and low fat supper). If you feel comforable after talking to your surgeon, that's what matters.

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My doctor also didn't require any specific pre-op diet. I think he said cut out red meat the last two days before surgery or something like that. The main thing he sid was don't GAIN weight before surgery.

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I had my first consult with my doc on Jan 17. I asked about the pre surgery diet and he said right now they do not require it unless someone is over a certain weight. He did say that his partner is pushing to start the pre surgery diet and by the time I get around to having my surgery(should be June or July) they may require it then. I only have to have the psych eval and the sleep study done. I am 31 and my doc said based on my history besides being obese I am healthy there I do not need all of the other testing done.

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It makes no difference if your surgeon is a "bad" one or not - many docs do NOT require any pre-op diet at all. My doc is a top one in the world for lap bands and he has found (in his experience with requiring them in the past) the pre-op diets to be virtually ineffective in shrinking the liver...so he doesn't require them either. Don't let that be any kind of red flag. I only had to be on Clear liquids for 24 hours before my surgery, take a couple Dulcolax and stop eating at midnight the night before. If your surgery is a whole 4-6 months away, why would you get instructions for that right now anyway? I wouldn't worry about it. Also, you will probably get a PAT (pre admission testing) day where they do all that bloodwork. Since you have a very long time, they probably just didn't tell you about it yet. I didn't learn about my PAT requirements until 3 weeks before my date when they called me and said I had to have a day of PAT 2 weeks before my surgery. That's when they scheduled it.

You are a long way away still. Don't worry about so much right now. It will probably all happen the way your surgeon sees best. It does not always signal a red flag, and it does not always mean you need to find a different location. That rationale seems kind of absurd to me.

Also, I'm surprised you didn't need that psych eval before your insurance approval? Mine would not approve me without it. So...sounds like your surgeon is ahead of the game and things are actually happening faster for you than for most people.

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Bandme08, The appt. with the nutrionist and trainer will help you start your wgt. loss if you follow the advice they give you. It's important to change your eating habits, and start exercise (yeah, yeah, yeah, you say to me...well this is what they are going to help you with)

I'm so excited for you!! Do you know how much you want to lose?

FF

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I haven't been approved yet, but when I went to the surgeon's seminar at the hospital, they had all the information put together regarding what the insurance companies require for approval. They even had a letter with sample wording for the primary physician's referral letter. Very organized. They don't seem to want to mess around with the insurance companies. They get as much info to them up front as possible. For instance, my first appt is in a week and a half, and I'm seeing the surgeon, the shrink, & dietition one right after the other. (3 hour appointment total) I have to bring a 3 day food log for the dietition. I didn't need referral for my BC ins, so I saw the sleep Dr a few months ago and have been on the C-PAP machine already. I had a physical & bloodwork done a few months ago as well. I'm still worried though!

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I think there is a red flag here. A surgeon who doesn't know what your baseline is prior to surgery is not the surgeon you want. The reason to be on a preop diet is because it helps shrink your liver which has to be moved during surgery. You should have a cardiology workup and upper GI series to rule ouit any anamolies....run..run fast to another surgeon. I am a registered nurse and have seen some pretty botched up surgeries. Anyone who has 100 lbs to lose is at risk for a lot of things. You should have a sugar test to rule out diabetes a disease that is often hidden.

Sharon

RN/MSN

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    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

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