My Dr. won't sign a clearance because he doesn't "believe" in WLS? Help.

Like most of you I have spent months (and for some of you it has been years) jumping through hoops to get my surgery done. It's been exhausting to say the very least. I FINALLY have a surgery date of April 15, 2005. However, I still have a handful of appointments and such that I need to have taken care of within the next month. Additionally I am a self-pay patient and had to do some serious financial juggling to make this happen. I need a letter of clearance for surgery from both my PCP and gastro specialist. The gastro office contacted me today and told me that my doctor will not give me the clearance I am requesting. Not because of any medical concerns but "BECAUSE HE DOESN'T BELIEVE IN THE SURGERY". I couldn't believe my ears. If he will not sign a clearance for me he could singlehandedly cancel or at the very least seriously postpone my surgery. I don't want to have to change gastro doctors but if I have to to get an approval I will. I am really upset and surprisingly hurt, that the very doctor who has consistantly given me the most amount of grief about my weight won't approve my surgery. His reaction spoke volumes to me about his possible reasoning. Like if I just tried harder I could lose the weight? I've been trying for 30 years and am exhausted. This surgery is not a miracle; it's a tool to help me lose the weight and keep it off for good. I did not make this decision lightly. My surgeon has already discussed the surgery with him to no avail. I made an appointment to discuss this with him on Wednesday. I am hoping to get him to at least sign a note stating that although he does not approve, there is no medical reason why I cannot have the surgery. My concern is that if he tries hard enough I'm sure he could come up with a medical reason. Does anyone have any experience with this kind of situation? Any suggestions and/or supportive words would be appreciated. Thanks.

Donna, After I read that I got angry, right there with ya! Sounds like your doctor is extremely ignorant. My surgeon right out told me that so many doctors are REALLY behind on the latest technology/studies. And he said you sure can't tell a doctor what to do! Anyway, is it your surgeon who wants the letter from him? Would your surgeon accept the alternative letter that you mentioned above (saying he doesn't agree, but that there is no medical reason why you can't). Seems to me that he HAS to sign a letter like that! It is not his decision if you get this surgery or not. Seems to me that all he is obligated to do is CLEAR you for surgery, NOT "OK" IT! He has no right to make that sort of decision for you. I hope you get the letter you need from him. I pray that his eyes are opened! Elizabeth

I was just recently banded. I have only one kidney and diabetes. I spoke with my kidney doctor about the lap band and he said," That would be the best thing you ever do for yourself." Wow, I was really glad to hear that. I was concerned about having the band because of my only having one kidney. I got my approval letter from my gynocologist. He is the one that discovered my tumor in my kidney and also the diabetes. I wish you well, I am sure you will find a way to get your letter. I am pulling for you doll. Laura

Ask for his Malpractice Insurance Company and see if he flinches. If your gastro appts are paid by insurance you could request a review of him via your insurance company, or lastly-the state medical board. Pritty radical-but if you tell him-he might write the letter instead of writing oodles of letters to defend his position! On the more subtle side-I would ask your WLS doctor for him to recommend a gastro doc for you-and see that doc for the clearance. Best of luck-Joan F.

The only way around this situation is to get a different PCP who is more WLS-friendly, unfortunately. Nancy

Both my PCP and Cardologist "don't believe" in the surgery. But they clear me because I was healthy enough to have the surgery. That is what he is clearing you for anyway...not his personal opinion of the way you decide to lose weight. So I suggest that you ask for a medicial reason why he is not signing off on the surgery? My cardologist made me wait a year before he signed. I had a history of blood clots and he want to make sure my arteries were "good and heal up" before I went under. So good luck!!! Cole 359/345/170's

A personal question...why are you seeing a gastro? Do you have a condition/disease?? Why I ask is that my gastro doc was a very leery of me having the band because I have Crohn's Disease. After he and my surgeon talked he felt more comfortable. CD is a contrindication for the band and I had it done...doing beautiful!! Personally I think my band has put my CD into remission. Can't explain anything else..I'm on the same meds the only thing different is my banding. You may have to change gastro docs if needed...Lili

Wow! Thank you for all of the responses! I can't begin to tell you how helpful it is to hear all of your suggestions and support. Lili, I have had ulcerative colitis for about 10 years. I take daily maintenance meds and fortunately have been in remission for several years now. I chose the lap band procedure in great part because of the UC issue. It seemed the most accomodating of my medical condition and because it is reversible if needed. The only medical reason I think my gastro would be able to find is that I tend to run very anemic. However, I have prescribed vitamin and iron tablets that I have been taking without fail and hope to have all of my bloodwork results come back positively. I would hate to change gastro docs because I have a long and positive history with him, which is part of the reason I was so disappointed with his reaction. I guess it just didn't occur to me that he wouldn't be supportive. However, I will change Doctors if I have to. It is frustrating to realize that he doesn't understand what a struggle this is. Once again, thank you all for your responses. I'll post again on Wednesday with the results of my meeting with him.

Donna, I'm so sorry to hear about your UC. That explains it all now. All I can say is that with my CD my band has helped me. Since being banded, I have spent only just 3 days in the hospital. That's considerably down from 25-30 days. I am anemic also but I try to stay on my b12 injections. Last month I couldn't get in to get my shot and I developed some glossitis but it's okay since my shot. I can tell you I was taking 16 tabs of Pentasa and I'm off those since banding. The only thing I am taking is 4 tabs of Imuran (immunosuppressor) and the dose is probably going to be lowered because my weight loss. I know it's a long shot but if your gi doc wants to talk to me...I'll be more than happy to speak with him...or if he wants to talk to my GI doc I know he'd be more than happy to talk to him also. I can so understand you don't want to change GI docs. I love my GI doc and have been a patient of his for years. He's a kind and understanding man. I had come to the conclusion that he knew what was best for me and if he didn't want me to be banded I wasn't going to do it. He stated he didn't know too much about the band but wanted to find out more. The thing that really concerned him was the slippage of the band and the erosion but he knew how important this was to me and proceeded with an open mind. In the end he gave me his okay. I really didn't want to go through this without him. He's seen how much better I have been doing. My movements have gone from 30-35+ per day to maybe once every-other-day. My white blood count is starting to decrease..it's always been high and meds have never been able to get the count down. I have my life back...truly. I was becoming a prisoner in my own house and the band has freed me from this terror. I no longer "scope-out" bathrooms nor do I panic after I eat. The terror and worry of that is behind me. Infact, it never enters my mind. If you want to talk more please let me know. There's also another gal on the boards who has UC but she's not on too much anymore. I can give you her name and maybe she can help you more. I know she was a huge help to me. Feel free to email me and please don't give up...this was the best thing I ever did for myself and the weight loss is nothing but a bonus. Lili

Sweetie, what this idiot doctor fails to realize is that you pay him, so in a sense, he works for you. And if he refuses to do something that you have requested that is both LEGAL and ETHICAL, then FIRE HIS A** and find a doctor who will. Don't waste time with him. Good luck. Tammy