My doctor wants me to have an A1c just prior to surgery. My primary care physician just had me take an A1c and it was 10. Could the high A1c keep me from being able to have my surgery on May 9?

On 4/14/2018 at 11:42 PM, charismatic said:

Sometimes some of the stuff I see on this board sounds like some surgeons only want perfect patients. That’s their choice but being perfect did not get most of us here and to make the choice to have WLS. I’m glad some surgeons do higher risk cases or a lot of people that really need this tool would be SOL.

It's not about perfect patients, it's about keeping the chances of short-term and long-term complications low. My dad's A1c hovered around 10 for years, and that was with numerous medications and insulin injections several times a day. When he had to have knee surgery, he had all kinds of issues with the wound healing properly. He had to see a wound specialist and go on several different kinds of antibiotics before the situation resolved itself (and it took months). Why a surgeon would want to risk that, I can't say.

There are risks to surgery no matter what. So don't give me that crap about your father staying at 10 Ac1 for years and that it affected his knee surgery and applying that logic to sleeve surgery. I have never heard from my health care providers yet about my A1c. Can you tell me why not? But what I am concerned about is that I could be denied sleeve surgery if my A1c is too high. Why not tell me that early on? Why wait a week until my surgery to tell me? Thats unethical. Maybe going to an attorney may be the route to go.

High A1c means your diabetes is not controlled, which means there's a higher chance of complications related to healing. You can't argue with statistics or handwave them with "well, there are risks no matter what." There are risks to crossing the street, but it's riskier if you've been huffing paint before you do it.

Personally speaking, my checklist of items that needed to be completed before my surgeon would attempt to obtain authorization from my insurance company included "get your A1c below 7." It was right there, in big bold letters. Since mine was a little over 6 at the time, it was a moot point.

Frankly, I'm not sure why you've spent 3 days freaking out on here when you could've called your surgeon and had your answer by now.

53 minutes ago, apositivelife4me said:

There are risks to surgery no matter what. So don't give me that crap about your father staying at 10 Ac1 for years and that it affected his knee surgery and applying that logic to sleeve surgery. I have never heard from my health care providers yet about my A1c. Can you tell me why not? But what I am concerned about is that I could be denied sleeve surgery if my A1c is too high. Why not tell me that early on? Why wait a week until my surgery to tell me? Thats unethical. Maybe going to an attorney may be the route to go.

Please just go ahead and call your surgeon's office and ask for their guidelines and what they would be willing to do to work with you if they have an A1c threshold for surgery. When I had my consult back in September, my A1c was over 11. My surgeon told me to work with my endocrinologist to get it under 8 (his threshold) in order to avoid complications, but that if I wasn't able to do that, he would speak with my endocrinologist, and we would find a way to do the surgery if possible, knowing that I may have difficulty with infections and wound healing. I have been fortunate to be able to get my A1c down to 6.0 and feel much better about having limited my risk for complications. It makes most sense to speak with your surgeon and determine the best course of action for you.

Edited April 16, 20188 yr by brightfaith

12 minutes ago, brightfaith said:

Please just go ahead and call your surgeon's office and ask for their guidelines and what they would be willing to do to work with you if they have an A1c threshold for surgery. When I had my consult back in September, my A1c was over 11. My surgeon told me to work with my endocrinologist to get it under 8 (his threshold) in order to avoid complications, but that if I wasn't able to do that, he would speak with my endocrinologist, and we would find a way to do the surgery if possible, knowing that I may have difficulty with infections and wound healing. I have been fortunate to be able to get my A1c down to 6.0 and feel much better about having limited my risk for complications. It makes most sense to speak with your surgeon and determine the best course of action for you.

Ok thank you.

I am the first one in here to bring up the topic of A1c so it must not be that big of a deal. My thing is I have waited 8 months for my surgery and no one on my health care team has ever mentioned to me anything about my A1c. That is what I am concerned about. And my question is why haven't they?

There are worse things than having an A1c of 10.

1. eating and drinking things like pizza, huge meals, drinking alcohol days after the weight loss surgery.

2. Binge eating and drinking right after surgery.

These things can keep a person from healing properly too. We hear a lot about these things but not about A1c.

21 minutes ago, apositivelife4me said:

I am the first one in here to bring up the topic of A1c so it must not be that big of a deal. My thing is I have waited 8 months for my surgery and no one on my health care team has ever mentioned to me anything about my A1c. That is what I am concerned about. And my question is why haven't they?

I think your surgeon's office is the only one that can answer this for you. Giving them a call will help resolve this.

my surgeon, while I have a surgery date now, wants my A1C down about a 1/2 point and said we'll do a test about 2 weeks before surgery. the reason is because the higher your A1C, the higher chance of infection afterwards. He did say that if it was too high, he would 'give me more time to get it down'. meaning I could have my date pushed back. so i'm working HARD to get there and not have any delays.

1 hour ago, apositivelife4me said:

There are worse things than having an A1c of 10.

1. eating and drinking things like pizza, huge meals, drinking alcohol days after the weight loss surgery.

2. Binge eating and drinking right after surgery.

These things can keep a person from healing properly too. We hear a lot about these things but not about A1c.

Yes there's also worse things than delaying or canceling a surgery. Like getting hit by an Asteroid.

The fact is if you have a documented record of your a1c on paper and anything bad happens it's a clear cut case of negligent behavior by the surgical team, and opens the door to liability and lawsuits by the hospital and surgical team as well as them eating the cost of any complications. Why they would proceed without during their due diligence is beyond me.

And you've made it blatantly clear that you haven't cleaned up your diet at all so that your BMI still qualifies.

You can eat lots of calories without eating garbage allowing your blood sugar to go all over the place. Complex carbohydrates, nuts fats less lean meats coconut/dairy cream are all high in calories allowing you to maintain your weight without spiking your blood sugar up and down.

But it sounds like that's not the answer you want to hear.

Why your surgical team hasn't addressed it is beyond me. It's possible they don't give a ****, it's possible they're unorganized, it's possible they didn't look at it because your PCP did the lab work, or it's possible that it's something they won't address until the last minute.

You have two choices. Address the issue, or continue to try to convince people on the internet that it's not a big deal and roll the dice with whatever happens

Edited April 16, 20188 yr by Mhy12784

7 minutes ago, Mhy12784 said:

Yes there's also worse things than delaying or canceling a surgery. Like getting hit by an Asteroid.

The fact is if you have a documented record of your a1c on paper and anything bad happens it's a clear cut case of negligent behavior by the surgical team, and opens the door to liability and lawsuits by the hospital and surgical team as well as them eating the cost of any complications. Why they would proceed without during their due diligence is beyond me.

And you've made it blatantly clear that you haven't cleaned up your diet at all so that your BMI still qualifies.

You can eat lots of calories without eating garbage allowing your blood sugar to go all over the place. Complex carbohydrates, nuts fats less lean meats coconut/dairy cream are all high in calories allowing you to maintain your weight without spiking your blood sugar up and down.

But it sounds like that's not the answer you want to hear.

Why your surgical team hasn't addressed it is beyond me. It's possible they don't give a ****, it's possible they're unorganized, it's possible they didn't look at it because your PCP did the lab work, or it's possible that it's something they won't address until the last minute.

You have two choices. Address the issue, or continue to try to convince people on the internet that it's not a big deal and roll the dice with whatever happens

Thank you for your kind reply.