I May Not Get Approval For Surgery

Deb,

So sorry to hear about your news. This must be very hard for you. Wait to see what the cardiologist will say once they have all the test results back. Hopefully it'll be good news. I don't know about your centre, but I know in Ottawa they offered us a weight loss program prior to suggesting the surgery. The cost was very high but it may be something to look into. I know this is hard but try to keep positive. We are all here to support you.

Take care,

Ah, thanks Julie! I'm going to try to not stress too much over this. I can only wait to see what the tests show and go from there. If needed, I will look into possible joining a weight-loss program or I may just try to do it on my own - don't know yet. Believe me, having the support of all of you is making this whole situation a little bit easier to bear - I appreciate all of your responses so much!

Deb

Deb, I'm so sorry you have to deal with this, but I imagine once the surge of disappointment passes you will be very glad to be on the safe side because, as you noted, there is an alternative.  Just wanted to mention that I started a "trial run" presurgery of Atkins shakes, food diary, water, (no real exercise because it hurt too much), and vitamins.  I lost 30 lbs, and went into my surgery with real confidence that I would be able to adjust to the eating changes.  Good luck, and while it may not be the ideal, this options may work out fine for you - just slow you down for a while.  All the best, Claire

Thanks Claire & I do agree with you - I want to be safe, not a statistic! I have my family to think about & they are already worried about me having surgery of any kind, as most of our families are. That's amazing that you lost 30 lbs pre-surgery and that's without exercise! Good for you and thanks for telling me that. You're right - if it turns out that I can't have the surgery right away, well, it doesn't mean that I can't have it down the road - that's what I'm telling myself tonight. It was just such a disheartening thing to hear this afternoon that it just took the wind right out of my sails, you know? Besides, maybe the BNP test will have positive results, who knows?

Deb

Questions to ask your cardiologists.



If you don't think WLS is right- how do you suggest I lose the weight? Dieting doesn't work- tons of good medical evidence (forgive the pun) shows that dieting is not effective.



If I don't lose weight- the strain on my heart will continue- thus my heart will continue to be damaged and get worse over time. Increasing my risk of disability and early death.



With WLS, I will lose the weight.



Btw - can you provide evidence of the cardiac arrests in the literature? A review of the bariatric surgery literature fails to find any reference to 'lots of cardiac arrests"



A good surgeon and anethetist can manage someone with heart failure- witness all the very sick people who have heart surgery every day. Before the pt is put on cardiac bypass quite a bit of surgery has to happen- in that time- a good surgeon can do a VSG. A VSG can be done in a very short time- if your heart is bad, a shorter surgery is better.



In your place I would request a referral to a cardiologist working at Toronto General Hospital- they are connected with Toronto Western. These doctors work with the sickest people and are far more experienced than most community based cardiologists.

Edit- I see you are hoping to go to Guelph- it would be better if you went to Toronto Western or St Joes in Hamilton- both are University teaching hospitals- far more capable of handling complex pts.

Thanks, Louise - you've given me some good points to raise with my cardiologist when I see him next. I wish that I had thought of those things yesterday, but I will discuss those issues next week, as those are all very valid points. You're absolutely right - many people with faulty hearts have surgery every day - how am I different? After all, knowing of my heart issue, the medical staff could be forewarned of the possibility of a cardiac incident occurring. Perhaps you're right - maybe I should be looking at a VSG instead of RNY for those reasons. You also raise a valid point about considering Toronto for my surgery.

For now, I will go for my BNP blood test, which, by the way, is not covered by OHIP (!) & is costing me $125, and see what that shows. Maybe the levels of BNP in my blood are acceptable and I can simply proceed as planned. If not, then I will discuss with my cardiologist the points you've made and see what results from that discussion.  Thanks again Louise - I really appreciate you giving me those suggestions & I intend to use them!

Deb

I'd be surprised if he changed his advice. Sounds like he is anti-wls. In your shoes, I'd be asking my GP for a consult with a cardiologist at either St. Joes or Toronto General. Maybe you could check out each hospital's web site to get a few names or someone here might know someone.

Louise, I don't really think that he is anti-WLS. He told me before that he thinks that it can be an excellent solution for people who are very obese and haven't been able to lose weight using other methods. We first started discussing it last year and he was fine with it. Then, the internist at the bariatric center sent me to see my cardiologist in March to get his approval for the surgery. The internist wanted it because I'd had heart issues off & on in the past few years - nothing major. We talked about it and my cardiologist said that he just wanted me to make sure that I understood what was involved in the surgery and I told him that I did. All he said then was that he knew of some patients who had had problems with their hearts after the surgery, and the restrictions afterwards, but he wasn't acting like an "alarmist" about it & he gave me his approval to go ahead. That was before my latest Xray showed this latest enlargement of my heart. His concern now stems from the fact that my heart has become more enlarged than it was before and, since he is aware of it, he's hesitant about the surgery, which is why he wants the BNP blood test. If the levels are acceptable, then he will give me the go ahead, so that's the next step. I'm taking this one step at a time. If he feels that it's too risky, then I'll have to see about a consult with a Toronto cardiologist. That's an excellent suggestion - I will definitely start checking the websites of St. Joe's & Toronto General. Once again, thanks for another great lead, Louise. Gee, can I hire you to serve as my personal advocate????? LOL!

Deb

Dear Deb
I'll be keeping my fingers crossed for you and your test results.  All the best!
Claire

Thanks Claire, for your support! It's very much appreciated!

Deb