bmi of 50.6 and considering surgery. what to ask my pcp

I'm going in to see my pcp for the first time in 2 years on May 2nd.  I've been struggling to lose weight for years. At one point 6 years ago I was down to 215 but I got stuck and then I started regaining and now I can't even lose a pound. I've tried so many diets and failed to even lose a pound. Instead I kept gaining.  I got pregnant in July 2009. I was up to 263 at the time.  I only gained 14 pounds while pregnant but I didn't lose it and my weight kept going up.  I'm now 295 pounds at 5'4 and 31 years old. I have polycystic ovarian syndrome and am suffering secondary infertility now. I haven't had a menstrual  I had preeclampsia while pregnant and suspect my blood pressure may be high again from how dizzy and tired I am. I feel worn out all the time.  I normally enjoy taking my little boy for walks in his stroller but now I am too tired.  My stomach hurts all the time and I am constantly in the bathroom.  I am scared I will keep gaining and die.  I am depressed.

I know that my insurance requires a six month supervised diet before they will even think about approving surgery and this is what I want to bring up with my doctor but I am not sure of even the right questions to bring up to let my doctor know that I am thinking about surgery.  I am scared he will tell me I don't need surgery or not offer any help although he has been great about writing referalls for my two year old who has speech issues due to fluid in his ears and is going to be having tube surgery soon. I am so worried he will think I am trying to ask for the easy way out.  

I also want to go to one of the weight loss surgery seminars that the hospital that performs weight loss surgery offers but of course they are all on monday nights and my work will not give me the time off. I wor****il 9:30 and am only available wednesdays or thursdays. :(

What did you ask your doctor?  How do you bring it up?

 I had actually never met my PCP before, and I scheduled a physical. So, I went, did all the normal stuff, and she was really non-judgmental about my weight and before I left, I just asked for a referral to bariatrics. She didnt have anything to do with the process other than that, so it was easier I guess. 

Usually when you see your doctor, especially if you go in for a general physical or something, issue of weight usually comes up. You can be proactive and bring it up first and let her know youve tried everything and you are ready for a major life style change but need help. Doctors really have no business judging your decision for WLS as the easy way out because if they know anything about the process, they should know its not the easy way out - nothing about my life post WLS has been easy. If they dont approve, move on to another doctor who will support you 100%. 

 I would agree with acb, if your doctor is judgemental, I would ask to see a different doctor. I made an appointment to see my doctor for a general check up and while there I informed her that I wanted a referral to bariatrics and she did it right away, she was very supportive and never judged me at all. Doctors know that you cannot simple get a referral and have surgery next day, they know the process and know it is not an easy one nor is it an easy decision. The doctors and nurses and dieticians that work in the bariatric department are the ones who will get you ready and help you decide if surgery is, ultimately the right decision for you. Good luck with your doctor and remember, this is your body and your health and your life, do not let anyone prevent you from getting all the information to make the right decision for you!! 

First of all Congrats for considering this life-changing option. I know for many of us here, this is one of the best decisions we've ever made.

Secondly, when I asked my PCP if I could get a referral for Bariatrics, he told me "No, just eat less" uh okay thanks for nothing buddy- buh bye- is what I said to him. I switched docs and found one that said, "Sure no problem"!

I reccommend that you take this time to research all 4 surgeries, Lap Band, RNY, VSG, and the DS to find the right surgery for your body and eating style. That way when you go in, you will have some information to back you up.

As for how to bring it up, just tell him that you have tried everything, but nothing is working and as your last resort to get your life back you are considering weight loss surgery and would like a referral for the Bariatrics department. Easy peasy!

I hope you can find a seminar that meets on a different night, or get some time off work!

Good Luck,

When I was first considering wls I had an appt with a new PCP I asked him his opinion about wls surgery and he told me it was dangerous and unnecessary. That didn't bother me because mentally I still wasn't "there" yet so his did not have an effect on me. I never saw him again but not because of his feelings about wls I just didn't like him and he happened to be about 1,000 years old LOL.

Fast forward about 4mths I went to a wls surgery seminar. I was still unsure if I actually "needed" surgery but I scheduled a consult with a surgeon. I was required to get a referral from my pcp that I didn't have so I picked random dr from insurance company directory and made an appt. He asked why I was there that day, I told him I wanted a referral to bariatric surgeon and the rest shall we say is history. I am just shy of 6 months post-op from lap rny.

Thank you for the advice that helps a lot.  I'm hoping my doctor is supportive and knows some about insurance approval as well. My biggest concern is my insurance needing a 6 month supervised diet and I want to get started on that asap. I also want to make sure it's done right so my insurance doesn't deny me because of it.  Maybe seeing a dietician would help me understand more what I can and can't eat.

I'm leaning towards either Duodenal Switch or RNY. I think the DS would be my first choice.  This is my insurance company's preferred hospital for wls: http://www.stfrancisweightforlife.org

Congrats on the journey!  I want to say its different for everyone but it was the BEST decision I had made in my life.  I think it gave me a second chance to live the way I always wanted to! 

My insurance I had to do the 6 month diet and I went to my original PCP and he WOULD NOT agree to support me so I found one that would.  The best news is the day you go to your doctor starts month 1 (it did for me anyway) so while I found a new PCP that did support me I didnt lose the time.  I was so glad with the 6 month diet and took full advantage of it losing weight before hand and started to cut out the things I knew I couldnt have any longer right after surgery.

If your doctor doesnt support you call PCP's around and ask the quetion .. Im thinking of getting weight loss surgery what are your thoughts before you waste your time... Doing a serach on this board as well is helpful!

Good Luck and I bet it will not be nearly as bad as you think.....

 

Well I saw my doctor today. I did discuss weight loss surgery with him but he is concerned I have hypothyroidism based on the symptoms I have as well as insulin resistance.  It's not that he is opposed to referring me but he said right now he wants to run all the bloodwork for hypothyroid, insulin resistance and cholesterol.  He said they do have a nutritionist in their office and did talk about referring me to the nutritionist but his biggest concern is getting my other health issues treated.   My blood pressure is normal strangely enough but he thinks the tired and dizzy feeling I have constantly is my thyroid. He wants to run my blood work and get me on any needed medication first before referring me to the nutritionist is pretty much what it comes down to.

Thank goodness your blood pressure is okay. Getting checked out, medicated etc. can only help. I lost 60 pounds in my preop year.

Hope you'll stick around and learn about the different surgeries. I was strongly leaning towards DS but decided I couldn't live with the postop vitamin regimen. It's a great surgery though.