13th November 2018 The Pre-op

Feb 04, 2019

After establishing that I wanted to go through with, or at least take the tests to see how eligible I am for the operation, I had to take some tests.

So how does one go about it? I live in Belgium, but I think the overall principle is the same. In order to undertake an operation, you need to be cleared.

Belgium is an insurance based medical system. Fit the right criteria, the insurance will cover as much of the pay as they deem necessary, however, you have to pay a certain percentage. These tests were to tell the doctor I was up to it, but also to prove to the insurance that there was more than just a BMI index to say that this was necessary.

What did I have to do?

  • Blood tests
  • Abdominal ultrasounds
  • Endoscopy
  • Psychological interview
  • Overall check-up by a cardiologist
  • Blood tests

There were some administrative issues, but those are not for here, so I’ll leave you with a brief anecdote, the reason for the test, the results and the result they had on how I was to behave before my operation.

The Blood Test:

The blood tests confirmed my blood sugar levels and cholesterol levels. Despite doing a fair amount of sport over the years, my ‘good’ cholesterol has been under average and my ‘bad’ cholesterol has been high. My sugar was around 108.

The Abdominal Ultrasound:

The abdominal ultrasounds were odd. I was handled by a medical student (male) who was clearly doing his nursing training. The doctor was out, so I didn’t quite realised, but I felt sorry for the boy, who clearly got more than he bargained for when he entered the room to find a young, big woman with her shirt off waiting for him to go ahead. He tried to stifle his surprise, but it was obvious, and I felt both apologetic for what he was having to look at, as well as feeling very self-conscious. After being told repeatedly to breathe in and hold, an older woman came in and asked him how he was doing. Unlike the firm, if gentle, hand of the student, the master’s approach was to dig the scanner into my belly like a mad thing. I was not particularly pleased by this.

The point: to check the organs around the operated area for fat, lumps, and anything that could prove obstructive to the operation.

What was found: A non-lethal, not unexpected amount of fat around the liver which needs to be reduced, as the stomach is behind the liver and it will be easier to get behind a leaner liver than a fatty one.

Result: a ten day-protein based diet before the operation.

The Endoscopy:

The endoscopy was equally unpleasant. I was drugged, the effect of the drug was to basically make me drunk, in fast motion, to stop me from trying to swallow around the camera or vomit it up. On a screen on the wall, I could see the inside of my throat, the decent towards my stomach and the inside of the food sack itself.

The nurses and doctor were very kind, told me how well I was doing, while I was drugged on the table, a rubber hole gag on my mouth forcing me to keep it open in a small ‘o’ and a very uncomfortable, scratchy thing in my throat I kept reminding myself not to swallow. They pumped air into my stomach, telling me that I was doing great, and that this was nearly over. Then, the camera was pulled back out of my mouth, as scratchily as it went in until a sense of relief flooded through me, along with some serious hiccoughs. I removed my rubber ring gag and staggered out of the room, woozy and feeling awful. All of these tests needed me to be ‘fasted’, i.e. not to have eaten.

The point: to check for acid reflux scars which would be a serious repercussion after the operation, and to check for any foreign bacteria in the stomach.

What was found: my throat and stomach were completely clean. No worries and nothing to do to fix it.

Possible Result: should there have been bacteria in my stomach, I’d have been put on antibiotics for a few days to kill them off. If I’d had acid reflux scars, I would have been rejected for the surgery (I think, please check with your doctor and don’t take my word as gospel).

The Psychologist:

By the time I got to this point, I was tired, hungry, grumpy and miserable. The woman I saw was a non-English speaker, she was French speaking. I’m a fluent so it wasn’t much of a problem. However, trying to explain the deepest recesses of your mind and reasoning for undertaking this procedure when, in all honesty, I was using these tests as a way to check that it was possible and not to think of it as a certainty.

I was asked deep questions: had I ever been abused by a partner? Had I had problems at school? What was my opinion about my weight?

Straight talk: I don’t trust women who are like this particular psychologist. Thin, blonde, who come across as both clever and not clever enough, with high pitched voices that try to sound sympathetic, but really sound quite patronising. Belgium is full of these women and they tend to work as psychotherapists, in job centres and a lot of government-based civil servant positions. The kind of women who tend to use ‘okay?’ as a full stop, a full two octaves higher than the rest of the sentence, whose eyes show little warmth and no compassion. I’d rather sit with a Mediterranean who shouted at me to pull myself together and get my shit straight, I’d feel less bad about hitting them. These ladies annoy me to the point of wanting to pull my hair out.

The point: to establish whether or not I was mentally ready for all that the operation entailed.

What was found: I have a deep-seated anxiety that needs to be addressed and that I might be using my weight as a shield against the rest of humanity.

Result: Prescribed therapy following the operation. Having already been in therapy, I’m sceptical, but I’ll be happy to give it a go.

The Cardiologist:

I was probably not in the right frame of mind for this guy. He was blunt and had no real time for feelings. I felt sorry for his children. He took one look at the photo on my ID card, looked back to me and said ‘yep, you’ve gained weight.’

‘Thanks’ was my scathing response.

‘Well what? You have!’

He weighed and measured me, calculated my BMI, and checked my heart. All about as unsympathetically as a butcher that's weighing sausages for Mrs. McCreedy on Sunday. To the sausages that is. I'm sure Mrs. McCreedy was given full moral support in her buying of produce.

The point: to see if I’d pull through the op.

What was found: my BMI should satisfy the insurance that this is necessary, and my heart is just fine, if not great.


The results were given by the surgeon in another private consultation, and then I had to go and meet the anaesthesiologist a couple of weeks later due to the Christmas period. The operation was scheduled for 9 January 2019, and I would remain in hospital for 3 days.

4th January 2019: The Anaesthesiologist.

Technically, this was not the same series of tests, but belongs here, so I've added it for good measure.

This was merely to check for previous operations under anaesthesia, to check for allergies, and basically took on the form of a question and answer session.Luckily, I come from a good stock of non-allergic people, the main one in the family being a mild nut intolerance for my dad, and mild dust allergies for the rest of us.

Unlike the cardiologist, this guy clearly cared. He was also obviously stressed, his hair all over the place and it looked like he’d been sweating. He must have operated that morning.

I was told to ask any questions I had. While I realised that this man was not my doctor, I thought he may have some answers.

When could I go back to sports?

Did I need to take time off work?

As only French speakers can do, he launched into monologue after monologue about how I was to act, how to behave, that I should tell my trainer as he was someone who had to care about my health unless he was a dick. It is a strange thing when someone decides to take such a hands on look into your life that they can talk at you for about 20 minutes at a time, uninterrupted, about the fineties of how to behave about an operation like this.

I left, feeling condescended and patronised, similar to when I’d left the psychologist. But I was given the all-clear.


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Surgery Date
Feb 04, 2019
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