What to say to my doctor?

My journey starts here.

This first step has taken much longer than I wanted it to.  I had to quit smoking before I could make a Dr. apt and I had to get married before I was willing to quit smoking (too much stress till the wedding was over).  So here I am post wedding and I have been smoke free for a month on Monday.

Now it is time for me to make my first doctors appointment and beg for his referral.  I think I might have a hard time convincing my doctor to give me a referral.  He is a GREAT doctor but believes in just eating right and excercising. 

What did you all say to your doctors... 

I am armed with the family history of heart disease, diabetes, high blood pressure, all of which I do not have yet and would like to not get!  I am also armed with multiple failed weight loss attempts. 

I feel like this surgery is the best option for me to have a healthy future, but how do I convince my doctor that this is right for me?

Thank you for your help.

Jenn

You go in with the information you need... Understand the surgery, understand the risks.  Tell him you have thought long and hard about this and that you know it is the right decision for you.  Tell him about family history.  Don't take no for an answer, this is YOUR life, YOUR body, YOUR health and you meet the criteria for surgery...

If he says no find a Dr. who will say YES!!

You always have my support.

Julia

stand firm in your resolve to have this surgery. I had the same kind of doctor, i went again and again and again over a three year period, and he kept refusing to refer me, he always made me feel badly about not being able to manage it on my own.

Finally, i went to another doctor in the same office, and got the referral from him. No problem, no lecture.

you're pretty awesome for having quit smoking, btw.

Hi Jenn and welcome! :)

My best advice is to go in really prepared with not only your reasons for wanting the surgery but also with information on how to apply to the registry, knowledge about the process, an informed understanding of the surgery you want, and a firm stance that it is not up to a GP to decide whether you are a good candidate or not, it is up to the Bariatric Centre specialists.

Good luck!

BTW - your wedding photos were GORGEOUS!! Congratulations!

Honestly... I think my GP will **** bricks. From shock... more than anything else. YES... I said that. To the best of my knowledge my GP is absolutely unaware of where I am in the process.

I just burst out laughing over that by the way...

I got a referral from a Plastic Surgeon (breast reduction consult) into the program. I know I will be emailing my GP's to book in once a month for B12, etc. but at this point she's not relevant. I know that might seem harsh but... *shrug*

She'll support me though because that is her job. If your Dr chooses to not support you... Find one who will. Period.

If you are over a BMI of 40. They need NO justification. Tell them you would like to be referred to the registry so you can go through the orientation, and assessment if they start to question you going through the program. If they don't agree go to walk in clinics, etc.

*big hugs*

Your sister has it down pat I think...

Shell

Welcome aboard Johjen!

Congrats on your wedding and on your smoking cessation.  Sounds to me like you have already taken many steps to get ready for this journey start and on the road to a healthier you.  I am nearly 8 weeks post-op and doing great.  I think that many people including GP's have limited information and think that some people do not try hard enough.  There is enough information and testimonials on this site to arm yourself well and request the referral.  Hopefully you will be pleasantly surprised. Welcome to this wonderful forum and I hope to follow along on your successful journey.

Nancy

OK, I'll share a little psychological trick, I played a few times with docs and other ... busy people.

Switch their attention to technicalities, make this conversation a kind of "here is how to do it' instead of "please do it for me/let me...".

First of all - you start with " I've decided/believe/blah-blah .. to have wls because... and give your perspective very briefly, concise but persuasive - one to two sentences (statistically cures/prevents diabetes, heart desease..).and that you ask him to refer you for an ASSESSMENT!!!!! (very important, he doesn't have to make decision - just refer you to specialists), then, before the doc got his negativity out, or in response to it, you lay in front of him a list with detailed step by step instruction on how to refer you - all links, phones, STEPS! that he has to do, etc. and start the "how to do it part". Prefacing it with mentioning how simple the process it and that every one does it...for an ASSESSMENT!!!!

This way you remove a "responsibility for a decision" and answer to a question, that MOSTLY prevents your doc from referring you - the "how to do it". They often have no idea about the process, or what's worse have outdated information and are too busy or too ignorant to figure it out. You have to bring him a simple "manual from IKEA", and emphasize  that it is for assessment by specialists.

Good luck.

P.S. Unrelated to this referral, If I need anything from anyone in writing, I usually do all the work myself and ask to proofread it and modify the way they want... usually get it signed within seconds. Trick of doing the "feet work" by your self and let them just to "approve", is a well known tactic, I learned it in business school. works like a charm.

Great answer Nata!

Welcome JohJen! 

You TELL you doctor you want to be referred for this surgery.  It is your choice.  If he won't do it, get another doctor.

Before you see him/her you investigate the things bariatric surgery fixes, diabetes, etc.  It is on the bariatric website by gov't of Ontario.

You take to your doctor a written list, ALL the risk factors you have INCLUDING family history (ie my father had type 2 diabetes, obesity runs in my family, both grandparents died of heart attacks, both grandmothers & a grandfather had strokes, my uncle died of sudden cardiac death at age 60, osteo arthritis, etc etc).  Your doctor may not have taken notes on your family history.  The more organized you are, the better he can make your referral.

You ask them to do the online referral to be ASSESSED (as Nata said).  You tell them that is all they need to do, you can follow up yourself with the bariatric center to make sure the referral is received.  (SAY THAT OUT LOUD).  Politely.

If he says "diet & exercise" say "I have been researching this, and for a person of my weight, studies show that WLS is MUCH more effective than diet and exercise alone, but I know that diet and exercise is part of long term success of this surgery.  Also, WLS has significant benefits for diabetes & high blood pressure."  (or whatever your problem is/might be).

Really CHECK UP with the center in 6 weeks.

If your doctor can't or won't help you, then GET A NEW DOCTOR.

Stay NOT SMOKING.  They DO test for tobacco !

Try to get your other conditions UNDER CONTROL as bariatric surgery post op needs a lot of self-maintenance, and it is helpful if you demonstrate that you DO take care of yourself now.

OUT OF CONTROL conditions are contra-indications. 

As Nata says, all you need is a BMI of 40.  I may have slouched a bit on the height scale and drunk about 2L of fluid before my weigh in and worn my heavier jeans.

Good luck!

my family physician was ALWAYS of the mind "instead of eating two pork chops eat one"...mind you I never ate two pork chops even pre-surgery..but that was his philopsophy or way of thinking...you may have a harder time to convince a GP that has never seen the miracles that this surgery provides for obese patients. 

I would take the time to develop a folder with a lot of positive pictures, comments and information from people  and then if you have been a patient for years..simply tell your doctor you want him to be an advocate for you and this surgery.  If you have been bese for many years and your weight has kept on creeping up and there were NO programs such as TOPS or Weigh****chers etc that ever helped (we most don't work), then plead your case,

If you have a support group in your area go to the meetings, those individuals will help you navigate on how to change or encourage your doctor to help you.

IN the end I had my GP who knew nothing about gastric by-pass refer me to a local doctor that was quite versed in teh whole journey..that doctor remains my doctor to this day mostly to minor my blood levels and the fact that I am anemic..but never the less, stand your ground and if necessary show your true feelings of frustration and possibly sadness and make your doctor realize that you know that RBY or the sleeve isn't a walk in the park or EASY and that you are a part of this board and willing to do what it takes...he/she won't be dissapointed in what you could/can achieve you just need their help to kick it of fthe ground.

ON a side note three years ago our city invited the local physicians to attend a weekend event that had the bariatric unit from Duluth, MN come and present heir programs and provide information...sadly the turn out of local  GP's was VERY low...which I would have equated to non-interest at that point. 

 Since then we have a bariatric clinic that does the screening here locally as we don;t have a bariatric surgery team here...so there is more talk and more people are willing to share their experiences.

All the best and let us know how it goes...don't give up...if you have co-morbidities...you should also get some statistics that shows how those co-morbidities, like insulin, blood pressure medication etc are proven to be reduced or in SOME cases eliminated.

Stand up for yourself...if you have a spouse, perhaps if they are supportive you might want to bring them along to the appointment, sometimes it's more difficult for a doctor to say NO to two individuals than it is only one.