I went to my first appointment today with my surgeon. After taking my medical history (which is pretty extensive), he informs me I have to lose 40-50 lb before he will operate. I weigh 380 right now (BMI is 65.) After I picked my jaw off the ground, I replied that if I could do that, what do I need him for. He said the band will help me keep it off permanently.

I have kidney disease and all the other junk that comes with obesity, so I retain pounds and pounds of Water. If I could get it off, don't they realize I would have by now? And if I don't have this surgery soon, I will go into renal failure and lose my kidneys anyway. It's a vicious circle.

He is afraid I won't wake up from the anesthesia. Part of me is tempted to fly to Mx and take my chances rather than jump through hoops here in the states.

No one else that I've read about has had to lose that much weight pre-surgery. Does anyone think he's just being super cautious... any advice is appreciated.

Thanks,

Tina

How about a second and or third opinion? There is more than one surgeon out there.

I would IMMEDIATELY LEAVE THAT DR. and get a real weight loss surgeon. If you could loose the weight who would ever PAY him for help? I think he is off his bean, You need to protect yourself, and getting help to loose weight will definitely help your over all health. I'm sorry you had to PAY him to hear him say that. I'm sorry if he even said it for FREE.

That is crazy.I too would find another Dr.,one with a more realistic approach.

some docs require you to lose wieght so that your BMI is closer to 50. It seems to be a magic number. Some even charge more if your BMI is above 50. also, some docs require that you lose weight right before surgery so that your liver has less fatty deposits on it. It also helps to shrink the fat pockets around the stomach so that placing the band is easier. Its not that he is a quack. He just does not have a very good manner. Did you ask him why? If he won't give you specifics then leave. And by all means, if you are not comfortable with him then you should not be his patient. But if he explains that it is one of these reasons, it is not uncommon. A little respect should have been paid, and consideration for your situation should have been taken.

I agree with the others - get another opinion. They are operating on people a lot bigger than you. Granted it, the risks are higher, but as you said if you could do it alone you would. Most doctors will put you on a liquid diet several weeks before your surgery to help shrink your liver. You can do that as you know it is temporary and will help you with surgery. This doctor doesn't understand the issues with obsese patients and the quicker you find one that does you will be on a better path. Remember, after care is just as important as the surgery. Good luck

I didn't ask him which of my several medical problems was the reason for his weight loss demand but he just said he wants me to have the best chance to wake up from anesthesia. I understand that, but they *are* operating on people a LOT bigger than me and doing more dangerous surgeries like gastric bypass without blinking an eye.

I have limited funds, and am self-pay, so I hesitate to just throw good money after bad trying to find a doctor who will say something different.

The only thing I haven't tried to do is starve myself totally. What he is asking of me feels like pure torture. Is that melodramatic? lol I hate feeling hungry which is why I want the band in the first place.

So I'm trying a liquid diet now and will give it a month to see the results. My dad suggested a weight loss hypnotherapist too (he's paying!). If I don't make progress, I think I'll have to choose a doc in Mx.

It feels good to know real people understand me. A thin "friend" told me "It's ONLY 50 pounds, that's easy". Ever wanted to strangle someone so badly? lol

Tina

Hi-

My doctor wanted us to lose 10% of our weight before he would operate. Once he explained it to me I didn't think he was crazy at all. So, 10% for you would be 38 pounds which I guess I don't think is that unreasonable.

You said that you retain alot of fluid- would a diuretic for a short amt of time help you lose that Water weight so that you qualify for the surgery?

I also agree that a 2nd opinion is in order but I think that since he has your complete medical history and we don't that his reasoning of wanting you to wake up after surgery sounds valid and caring to me. Sadly, it sounds like he just didn't explain it in a caring tone.

Good luck to you- Most of us have had to do liquid diets and I bet that would help you drop the weight that you need to lose.

I am on so many diuretics it's not funny. I am on very high dosages of lasix (200 mg AM/160 mg PM), metolazone and spironalactone.

I think if you go to another doctor, they will still tell you to lose weight. It may not be so much, but it sounds as though more and more are requiring at least some weight loss before surgery.

Did your surgeon give you any ideas on how to lose this weight?

Please see someone else for a second opinion. I don't know your background but...

You said you are self-pay? If you have insurance please double-triple check that they might pay for it. I say that because it seems you have a great deal of medical problems that would be a slam dunk for them to pay.

If this doc and any others also agree that you have to lose-see if they can put you on some sort of regimented liquid diet like Optifast that is monitered. I take acception to the fact that this guy is leaving you out to dry without offering some sort of assistance in losing the weight. Also, back to the insurance thing-the insurance may cover the special food or liquid diet since you require it.

If you do not have insurance still find someone who will help you lose that weight, who offers counseling and solid support.

I wholehearterdly agree with the others who say find another doc. Please... I watched a show a few months ago where they gave a man who weighed 900 pounds a gastric bypass (and he's doing great)!!! So I think it's outrageous that your doc would require that you lose 50 pounds.

diva,

I am on medicaid which does cover all my doctor visits and medicines monthly, thankfully. They do cover gastric bypass (not lap-band) and I am already on the 2 year waiting list at the University of Wa which is the only place in the state that accepts Medicaid.

So basically I'm screwed unless I self pay because my kidneys wont last the 2 year wait and I dont want gastric bypass!! lol

My insurance will pay for dieticians which I've already seen. I'm already on a very strict low sodium diabetic diet for the last year. If I could lose another pound I would! Starvation seems like the only thing I haven't tried and for a food addict, that is torture. I passed a McDonalds 4times this morning and circled it like a vulture on my way back from the doctor's this morning. The only thing that stopped me was sudden stomach cramps which I took as a sign. I know some of you know what I'm talking about. It just feels like you are suffering when you are hungry. :Banane13:

Thanks for giving me a place to vent... you don't know how much I need it

Tina

Let's get down to what could be an issue here. With the high numbers of obese people in this country, the doctors have access to a very large pool of patients. IMHO, I believe there are some docs who just aren't too motivated to take on higher risk patients when they can make the same money and operate all day on patients that are less of a risk to them from a mortality and malpractice standpoint. We'd like to think they're only doing this type of surgery for altruistic reasons, but we have to realize thare are thinking about THEIR bottom line.

I think that *is* part of the issue. This doctor doesn't want to ruin his pristine record with a high risk patient as well. Plus he mentioned that it was mandatory I visit his seminar so that I can't sue him later by saying I didn't have enough information about the operation. His words, not mine.

I think he is a good and cautious doctor, but he lacks empathy or common sense. :Banane13:

Tina

Honey, I started at 350 and had to jump thru massive hoops to get insurance coverage because of my weight - but when I went in for surgery, the Anesthesiologist told me he had recently been part of the procedure on a gal who weighed over 450 and had not a single problem.

Definitely pop the extra dollars to see a 2nd doc for another opinion. I know it's expensive - but what is your life worth? If you drop from renal failure while you lose the weight for this doc - would it not have been worth the extra couple of hundred to see another doc?

I hope you find a good one. I know if you tell us where you are located, someone will probably be able to give you a recommendation.

Hugs and good luck!