Pre-op requirements?

I just posed this question on another thread, but figured if I started it under a new topic, I might get some informed answers. My operation was 10 years ago, and I see that the pre-op requirements are very different. For pre-op I had to undergo lots of medical testing, a psych evaluation, and loose 5 lbs just before surgery(liver shrinker). I don't understand why these requirements have changed, required pre-op weight loss is more, there's a pre-op diet of clear liquids? I can fully understand why they might add group sessions and counseling to the pre-op requirements, these are things I wish I had, but why the other changes? 

Different surgeons have different requirements.  I imagine that was the case ten years ago, too.  For instance, my surgeon did not require any pre-op weight loss.  I had to do a full liquid diet for one week pre-op, but not clear liquids.  The reason different surgeons have different requirements seems to be based on their personal preferences and their professional experience.

Looking back at it, I think I would have preferred a clear liquid diet over the laxative, that was very harsh, (my brother and i had taken bets on which one of us would be running to the bathroom first, I lost) although, it kept me very occupied for the 10 hours before surgery so I didn't have time to get any jitters

See, I don't understand why some docs recommend a laxative.  Many don't.  And since they are operating on our stomach and the upper part of our small intestine, and not doing anything to our large intestine (or bowel), I don't know why the laxative would be helpful.

It did the job, as unpleasant as it was. But I do see very comical now. It was me and my brother, with heavy laxatives, and we were staying in a hotel room 5 miles from the hospital, and at the last minute, my grandpa showed up and insisted that we get 2 rooms that were joined( I don't think he knew about the laxative but it was the best thing that could have happened). Me and my brother were in those bathrooms so long, that our support team(my grandpa and my mother) had to go down to the lobby bathrooms when they had to go. I'm still not sure why the hotel wouldn't let us put a tv in the bathroom.

I appreciate  your humor.  2 years ago I had a 3 to 4 1/2 month low carb diet ( lost 35 lbs) and a 2 day liquid diet...no laxative.  I also had extensive exams and tests.  I didn't know the difference at the time but do feel it was the best way to start off this trip.

I originally set a goal to lose 140 pounds but lost 125 and have stayed here for several months.  I'm happy and think it is probably more realistic.   As for your question, I don't know why the difference but it is probably the medical school that they attended and the different observations of the dept/ heads.  It is an interesting question.

As embarrassing as it was at the time I find humor with what happened at a lot of my testing. One of my tests was an MRI of my heart, however the local hospitals machine had a max limit of 350 lbs. Did that stop the technician? No! Only when it was trying to lift my large weight into place and there was smoke coming from the motor did the test get canceled. The treadmill for the stress test had a limit of 300 lbs, the answer, crank it up to full speed before I get on and it should keep going. As soon as it received my weight, it bogged down and tripped the breaker to the outlet. Fortunately the hospital where my surgery was performed at was well equipped to handle a guy of my proportion.

I don't really think that the pre-op requirements have changed over the years; I think you are just seeing differences from surgeon to surgeon.  There have been a number of discussions here about the pre-op diet requirements that different surgeons require, and it is all over the spectrum.  Some people have none and others at the other extreme have 4 weeks of liquids!  I think it appears that many more people are doing liquid diets because the people who DO have to do one often have questions or struggle with it, so they post about it.  The people who have no pre-op diet don't have any reason to post.

I had my RNY 6 years ago, had to have a psych eval, had the prior evening laxative, but had no weight loss requirement or liquid diet (except the usual day before surgery requirement.  The other surgeon I considered using, though, (who, ironically, mentored my surgeon) required people to lose a certain amount of weight and do a 2 week liquid diet (not clear liquids, though).  He also required a week of liquids post-op and then soft foods (no puréed stage) whereas my surgeon allowed us to start soft foods on Day Three.

I also had a bunch of tests done, and I think almost everyone has to undergo those for safety's sake and to see what condition the gallbladder is in (if it has stones, best to take it out at the same time as the RNY).  I am not aware of any surgeons *****quire group counseling sessions (just the pre-op class to giver post-op instructions) and the only people who are required to do individual counseling are those who "fail" the psych eval.

Lora

My surgeon asked that I lose 15 lbs pre-op (I imagine this was to show my commitment) and I was on a pre-op diet of protein shakes in order to make my liver all floppy and pliable. They also did blood work. I found the whole thing really helpful, honestly. Prepared me, at least a little, for what was to come. :)

My mom and I were just talking about this a few days ago. She had her RNY in 2004. Her requirements were different from mine although we both have the same surgeon. She had to go to a seminar, I had to do mine online. Mine was just a video explaining about the procedure which to me was a waste because I already knew about how the surgery worked. Her seminar was obvious with the doctor and other people so there was the option to ask questions, talk to others,etc. Personally I feel that everyone should physically have to do a group seminar that way you can ask questions, etc. Though during my first appointment my surgeon explained all of the surgeries, why or why not I would be successful with the RNY, sleeve, bands,etc.

We both had to do a full panel of blood work-vitamin levels, TSH, lipids, AST,ALT,etc. An EKG, if the EKG was abnormal, then see a cardiologist which both of us didn't.

We both had/have to keep a food/exercise log.

We both had to see a NUT, have a psych. eval--which both did the same exact thing. We both had to do a 5 day ketosis diet. I was under the impression it was just to purely lose weight but the NUT explained to me that they want to see how honest you were, if you were going to stick with the diet requirements by seeing if you had a high level ketones in your urine. 

My mom had to do an endoscopy, I don't. I'm not sure if it's due to insurance reasons or the surgeon. My insurance states that it's not necessary but I get it done if the surgeon requests it.

My mom had to go to a support group, I don't have to though I am choosing to post op to stay on track.

My pre op requirements are very simple. I have to have a BMI of 40 or higher, or 35 with co morbid diseases like high blood pressure, sleep apnea, diabetes mellitus, etc. I have to have a NUT/psych evaluation. I also need to have a mental understanding of what I am getting myself into. I also have to have a referral from my surgeon that I have taken all measurements to attempt to lose weight in the past, I have to have post op care and THAT'S IT. I was under the impression that I had to wait 6 months  to do weigh ins but apparently I don't have to, I was reading the wrong surgery requirements( I have CBA Blue which is a subsidiary of BCBS, I was reading theres WHOOPS!) 

My mom didn't have to do medifast or optifast, no liquid diets pre op. I don't think I do but I am going to do a very "clean", protein rich diet a few days before my surgery due to my liver enzymes being elevated.