Struggling Through The Bariatric Pre-Surgery Medical Clearances

Part 1 - The Life That Led Me to Bariatric Surgery

Part 2 - The Road to Bariatric Surgery - Full of Pothole

As I discussed in the previous installment, The Road to Bariatric Surgery – Full of Potholes, there was a laundry list of requirements to qualify for weight loss surgery.

This installment will explain my navigation through the medical clearance requirements. I needed clearance by my primary physician, cardiologist, and a mental health professional, such as a psychiatrist, psychologist, or social worker.

I had been a patient of my primary physician for 13 years. He was thoroughly familiar with my weight issues, but unlike every other primary physician I had seen over the years, he never nagged or humiliated me about my weight. That is the reason I continued to see him. He understood how difficult it was for me to lose weight, and he always let me bring up the subject if I chose to do so. Neither one of us had ever discussed weight loss surgery. Ever.

So, I can still see the look of shock on his face when, during a regular appointment at the end of 2018, I told him that 2019 was going to be the year I made the decision as to whether to undergo weight loss surgery. It was only then that he encouraged me to do so. Given my reasonably decent health at the time, and my “young” age, (He’s a geriatric specialist, so my age of 70 at that time, was a youngster to him.), he felt I would be quite successful. Clearance- check

My cardiologist had done an echocardiogram the previous year, but it had been three years since my last stress test. Although sure that I was an excellent candidate for the surgery, he ordered another stress test just to be sure. Because of my weight and severe back pain issues, he determined that I could not do a treadmill stress test and ordered a chemical stress test.

Having endured one of those torture tests the last time, I swore I would never go through it again. Well, “never” came when he insisted on the chemical test. If you have ever been through one of those, you will understand my hesitation and downright fear. Once that chemical hit my system, it was not as I had expected, which was to be out of breath. It was as if my heart was racing toward an explosion. I could not breathe.

I happen to have a kind, caring, understanding cardiologist, who stayed with me throughout the test, counting down for me. 30 more seconds; hold on; just 20 more seconds; you can do this; almost done; 10 more seconds. Done! Good job. When I passed that test, he was excited and enthusiastic about me having the surgery. Clearance - check.

The next hurdle was an upper endoscopy, which " is the insertion of a long, thin tube directly into the body to observe an internal organ or tissue in detail." It "is used to diagnose and, sometimes, treat conditions that affect the upper part of your digestive system, including the esophagus, stomach and beginning of the small intestine (duodenum)." ( source - Google)

As I was lying on the gurney, waiting for my bariatric surgeon, the nurse explained that they were going to give me Propanol, which was a fast-acting anesthesia that would put me out quickly, and would enable me to awake just as quickly. Uh, that sounded familiar to me. “Wasn’t that the drug that killed Michael Jackson?”, I asked.

“You did great”, she said. What? Huh? What happened? I was out and awake before I heard the answer to the Michael Jackson question. My surgeon was standing over me, explaining that everything looked fine for the surgery, but they did find a small hiatal hernia, which was common, and he would fix it during the surgery.

I have to take time here to explain a bit of my medical history that ended up having a huge impact on the bariatric surgery. 20 years ago, I had MAJOR emergency surgery to correct a strangulated hernia that was about to kill me if it was not repaired immediately.

During that open abdominal surgery, the surgeon implanted mesh inside of my abdomen to keep my insides intact. It was common practice at the time.

However, I suffered 2 years of complications and infections from the surgery, the extent of which I explained to my bariatric surgeon. I warned him that I had no idea what was going on inside of me currently, nor did I know how much scar tissue he was going to encounter. He insisted that he could handle anything and that he could do it laparoscopically, as was how the bariatric sleeve surgery was done. I was skeptical, for good reason as it turned out, but endoscopy completed – check.

My next appointment was with a psychiatrist's assistant for my psychological clearance. I expected to ace it with flying colors. I’m not always correct in my assumptions.

NEXT: Failing the psychological clearance