Pre-Op Clearances?

[lunadreams 22]

I'm doing my surgery at one hospital, which requires bloodwork, endoscopy, psych assessment, nutritionist visits, and six months of visits. Because it's not super-convenient for me to get to, I decided to do my endoscopy with a doctor that is in the hospital's network, but closer to where I live. She was really surprised that I didn't need a sleep study, pulmonologist clearance, stress test, and cardiology clearance (and, oddly, repeatedly asked ME why all of this wasn't required, even though I am definitely not the one deciding on what the program's requirements are or knowing what their rationale is?). I imagine, they'll do whatever clearance they need at the pre-op testing once the surgery date is set, like I've had done for other surgeries. But I'm curious if others have had to do sleep studies, go see a pulmonologist, and a cardiologist, prior to the hospital's regular pre-op testing?

She did tell me, after questioning why I was having the surgery because my BMI is borderine (I have other health issues) that I would have to have the endoscopy at the hospital (a different one from where I'm having the surgery) instead of as an outpatient because I'm "pre-bariatric," though someone else I know who saw a different doctor with similar BMI within the same network who was not "pre-bariatric" was able to get it done in the their outpatient center. She told me it was a liability issue. Have others found the same?

[Rhapsody43 8]

I’m in the preop clearance stage as well. My surgeon ordered a pulmonologist consult and an EKG. Since I already have sleep apnea and am on a CPAP my pulmonologist cleared me for surgery. Still need to get the ekg.

[catwoman7 10,867]

it depends on the surgeon. Mine did require a sleep study for everyone, but only required a cardiac stress test for people who were over age 50 and/or people who'd had cardiac issues in the past.

sleep apnea is common in obese people, but maybe your surgeon felt that since your BMI is borderline, that it might not be an issue for you? Not sure.

[jmarie26 9]

I only needed an EGD, EKG, and chest x-ray pre-op. I did have a sleep study done a few years ago, though.

When I started this process (end of 2019), my surgeon was splitting his time between two hospitals (same hospital network). I knew then that I could do all of my appointments locally, but I would have to have my actual surgery at the other hospital. Their program was more established, so my insurance required it. Same doctor/program, same hospital network, same/comparable equipment, but I still would have had to have surgery at the other hospital. So I guess it would not be that strange for different doctors within the same hospital network to have completely different programs.

Thanks to COVID, my surgeon consolidated his offices and is back to only one- the one far away. Thankfully he had so many patients in my local area that he came a few more times to do EGDs. But it sucks that I have to drive so far for all of my appointments.

[newyorklady20 97]

I had an EKG and sleep study done, and my cardiologist did not order a stress test because I’m young, had no heart issues and can walk up stairs without stopping, etc. The doctor that did my endoscopy was concerned about that and also asked questions about why I hadn’t had one. At the end of the day she trusted the advice of the cardiologist.