OK, Call me a meanie.  Flame me if you want,  But I have to put this put there.

Do you think there needs to be a serious, and yes, I mean a serious exam that you must pass before you can have WLS's surgery pre app'ts?

There are so many things that people need to learn before surgery and I don't think people are learning them.  Every day we see questions about basic stuff like, supplements, protien, birth control, getting pregnant, what the surgeon did,  counting protien, fats, and calories, meds after surgery etc.

This exam would cover such topics as proper nutition, what is the hell the surgeon is doing to you, birth control, supplements, protien, carbs and fats and it's role in your body,  food choices, understanding labels on food products, undertanding what needs to go in your mouth, medications etc. and some sort of a critcal thinking test.  

Here is the mean part, I think if you don't pass the exam at 70% or more you should have to wait 6 months before you can try again. Fail three times and you can try again in 3-5 years.  Right now the wait lists are a year long?  If you can't use that year to make sure you understand life after WLS, then maybe you need some more prep time.  I am worried that in 5 years the government is going to cut WLS funding because of the deaths due to patient error (and laziness) and the skyrocketing revision rate.

They don't give people organ transplants without making sure that they really understand what they need to do.  We don't let people self prescibe medications.  Failure to understand post wls lead can kill you,  should just anyone be trusted?

Just a thought,
CNC

I understand where you're coming from but testing won't alleviate the problem of some people not understanding what they need to do post-op.

We're given a TON of info during the classes and countless opportunities to ask our team questions. All one has to do is read it and refer back to it when in doubt but people don't because often times it's just easier to ask a question here.

Even if someone scores 100% on a test, there is NO guarantee that he/she will follow the rules or even remember them post-op. IMO testing one's pre-surgery knowledge proves nothing and will not be a great measure of a person's future success with WLS.

What I would be in favor of is greater time delving into the cause of one's obesity & teaching patients how to overcome those barriers or obstacles. I think therapy should be mandatory.

 

Simona,

I think you make some excellent points here.
 
People are given a ton of info at sessions and then they get binders of info.  But do they take the time to synthesize that information? Any one can go to a session about a new subject and have alot of information thrown at them and remember and understand some of it.  But if after that session they are given that information in writing (given a binder)  and take the time to read it, question it and understand it. i don't think that is happening too often.  (there are a ton of people out there making sure they know there surgery frontward and backwards though, just like i did.)

Taking a test to show you have knowledge does not guarantee success by any means, it never will, but it does demonstrate that you have the knowledge to make an informed decision. That you understand that taking an NSAID's means you could get an ulcer, that using only the pill as birth control has a good chance of leading to a high risk pregnancy.   When I talk about a test, I think it is about making sure people have the information to make informed decisions. If they choose not to follow the rules, eat chocolate, take NSAIDs, use a straw that is their issue,  but if they say they never knew they couldn't take NSAID's or shouldn't use a straw that is another whole issue. We seem to be seeing more and more of the later issue.  There is one thing i want to clarify,  Everyone needs to ask questions, Esp. right after surgery,  your brain is clouded after surgery and remembering water/ protein/ meds/ issue xy&z etc. for the first few months is not easy.  I am by no means saying that people shouldn't ask questions, but the pre surgery education is dodgy in Ontario and some people aren't  being proactive to make sure they get info on their own.

I think you are right that therapy of some kind should be part of the program.  Understand our personal eating issue is majorly lacking in the system at this point.

Cheers,

CNC

This has been posted before, not too long ago.  I have actually worked with patients who have had transplants - they don't do any pre-op 'quiz', and a lot of them do fine, others, not so well.

There would be so many different points that would need to be considered.  We ALL know what we were doing pre-op that made us fat.  We could have given lectures on how to lose weight, what foods made us unhealthy .... doesn't mean we followed our own knowledge.  People may take the test and still have behaviours that will lead to health issues post-op. 

It is not as simple as just a test.

The most effective thing is health teaching both pre and post-op, with extensive follow-up.  Some people may do okay with their family docs, others with the clinic, and those who need more help should seek therapy etc.  There are also tons of learning disabilities that inhibit one from passing a test.  The government is sinking a lot of money into Bariatric Health, and having someone go through the process, only to stop again, and have to start all over again would use up valuable resources - resources that are already tapped.  Yes, you may say that the money would be spent later on trying to heal the person who did not do well post-op, but our health care doesn't look at it this way.  Their view is that we have the money now, so let's help the current people GET surgery, and see how they do.  Increasing the wait times (which will increase the cost) by people potentially going through the process two or three times won't happen. 

The clinics that deal with WLS are doing more and more for their patients compared to even five years ago.  BUT, they can only do so much, the rest is in our hands.  We need to be aggressive and make ourselves informed. 

We do not want the government deciding who qualifies for what surgery based on a test.  If this were to happen, people who have heart attacks after a life time of poor choices, or people who end up with lung cancer after smoking 2 packs a day for 20 years would not qualify for treatment ... nor would those who got Type II diabetes after becoming obese.  We are lucky we live in Canada with the access to health care.  No, it's not perfect, and money could be spent in a much more efficient way, but without it, we all would be subject to ****ty insurance plans and out of pocket WLS. 

  I agree with you Tammy. There are just some people who, no matter how much information you put in front of them and figuratively shove it down their throats, just never "get it". They could pass all the tests they needed, but just never "access" this information that has been blasted at them. How else can we explain the fact that people from the same program, going through the same process, taking the same classes, given the same literature, end up with different results?

 HI Karen,

" How else can we explain the fact that people from the same program, going through the same process, taking the same classes, given the same literature, end up with different results?"

There are a variety of factors in the answer to this question. Each as different as each person who has surgery.  But my point is that i bet some of that success comes from how the person deals with the information they are given after they leave the pre-op class.  Do they read it, question it, understand it?  or does it get stored away somewhere under the 2007 phoneboo****il they get "the call" from the hospital? 

You're right ,some people can have alot of information blasted at them, memorize it and then when it comes to apply it,  the connect isn't there.  That happens,  but are people taking the time to get the information on their own?   Like many people before and after me, I spent 1000's of  hours online reading about WLS and everything about it.  Not everyone wants to or needs to do that, I am a details person.

But why is it the duty of the hospital to educate patient everything about WLS surgery? But what about something like having everyone read "Weight Loss Surgeries for Dummies" and then have some knowledge checks (yes a test or exam) based on that book? It isn't a hard read, It isn't an expensive book but I bet it contains all the info needed to keep people safe.   Keeping them successful after WLS,  that is a whole other bucket of worms.

CNC

Well said Tammy

I don't think you are being a "meanie" Catnip, I just don't 100% agree. I had all these questions before I had my RNY (and some after) and I came here to have these questions answered. I also contacted my surgeon's office to get some of these answers. I was proactive. I know other people who had RNY with the same team as I and they had the same information given to them and they are just completely clueless.