Question:
Anyone denied because the Dr felt you would not comply post-op?
— kenhwilson (posted on December 7, 2003)
December 7, 2003
My doctor is Dr. Jamshid Nazarian. He is listed on this website. He deals
with patients all over the world. And has conducted over 2000+ surgeries
with no complications. He is an EXCELLENT surgeon and provides the best bed
side manner. He is extremely thorough. He is in Beverly Hills, CA and works
through Liv-lite out of Temple Hospital. Getting into see him isn't
difficult. I would suggest you contact his office or the Liv-Lite office
for help. But please understand, that you MUST do everything that the
doctor and nutritionalist tell you. The doctor cannot lose weight for you.
The surgery doesn't lose weight for you, all doctors will deny you if they
feel you will not comply post-op. Please see this surgery is just as major
as person with a heart or liver transplant. You have to maintain a health
lifestyle. Good luck to you.
— keishax
December 7, 2003
Why does your doctor think you won't comply? Did you do a psych eval and
perhaps something came up on it? Do you have a primary care physician who
may support you, and perhaps write to your surgeon that you would be a good
candidate? Don't give up...surely there are other surgeons in your area.
Perhaps your surgeon doesn't feel confident about doing your surgery and
rather than being honest about it and giving you a referral to another
surgeon, s/he is taking the cowardly way out...
— Le P.
December 7, 2003
My surgeon does debny active drug or alcohoil abusers because they self
destruct after surgery. If you dont mind me asking why? Just recently I
think my surgeon is requiring smokers to quit. Any of this apply to you?
— bob-haller
December 7, 2003
Hi Kenneth- I read your profile and saw that you will be self-pay for your
surgery. If your Dr says no, because you are self-pay, you're not limited
to only him/her :o) But I think you're doing the right thing by asking
your surgeon why he/she thinks you won't comply. If you and the surgeon
can't work it out, I would definitely start looking into other surgeons.
Good Luck, Mea :o)
— Mea A.
December 8, 2003
Our program has "pended" patients because we were concerned they
would not be compliant after surgery. You don't say why there's a problem.
Within our program there are several indicators of compliance. One, of
course, is the psych eval. There are also other smaller indicators. For
example - we ask all patients to lose 15 pounds in order to shrink the size
of the liver. This makes the procedure easier for the surgeon thereby
making it easier on the patient. Occasionally we have a patient who says
they can't or won't do it. We all know that at 275+ pounds, losing 15
pounds isn't that difficult and if a potential patient won't do it then
we're concerned about how compliant they will be after surgery. We require
that our patients attend a support group meeting prior to surgery. If they
won't or don't attend we will pend them. If a person can't take 2 hours
out of their life to satisfy a preoperative requirement than how can we
expect lifelong compliance? Our program advocates protein supplements and
if we have a patient that says they can't find a single one they like then
we worry about compliance. There are hundreds of products available and
literally thousands when you consider all the protein recipes so there's
really no reason a person can't find at least one they can tolerate. We
also have serious concerns about patients with previous alcohol or drug
addictions. And there are many other compliance indicators. We rarely
have to completely cancel or deny a patient. We generally pend them and
may approve them when they've demonstrated sufficient preoperative
compliance or they've resolved the issues that caused the concern to begin
with. Surgeons WANT to perform this surgery. It's how they make their
livelihood. So, if you were denied then the surgeon must have felt there
was sufficient cause and rather than just shopping for a doctor who will
perform the procedure I'd try to work through the issues that initially
caused the concern and stick with the surgeon who knows you. Best wishes
to you.
— ronascott
December 8, 2003
Hi Kenneth. I would do as you suggested and ask your doctor why he thinks
you would not be in compliance. It is so very important that post-ops
remain in compliance and committed to the program. You could shop around,
since you are a self-pay, but it sounds like this doctor may be a caring
professional with some legitimate concerns that could be worked out. I
know many surgeons that have "postponed" surgery dates while
their patients worked out their issues with a psych first. It will be
worth it in the long run..good luck to you.
— Cindy R.
December 15, 2003
If you have been denied why not go out of the country for surgery? It is
much cheaper for a self pay. I suggest you check out the
www.duodenalswitch.com site. At your super morbid obese BMI, the
duodenalswitch is your best chance to get to a near normal wt, the RNY is
not the surgery for that. There are great surgeons in Spain and Brazil that
do WLS and many patients that have gone to them and had wonderful
experiences. There are docs in this country that will take on self pays and
have caps worked out at the hospitals they practice at so you have a set
price no matter the compications or lack there of. Dr Elerany in Va and Dr
K, I'll butcher his name if i try and spell it, a surgeon out of Delano CA,
they have caps worked out, it is like 20 to 30,000 depending on the doc. Go
to the duodenal site and check it out and then check out the Yahoo site for
the duodenal and ask questions, you'll learn a lot.
As far as what you say to doctors, whether it is the surgeon or the shrinks
for the psych eval, remember, they want to know that you will be compliant
as a post op. You do not need to tell them every detail of your life, you
just need to be the model of the compliant pt. Be smart, you need this
surgery, play whatever mind game they want out of you to get the life
saving surgery that you need. Esp. with the duodenal switch, it is the
surgery that requires the least amount of effort as far as only eating a
teaspoon of food, screw that. Get the surgery that will enable you to lead
as near normal of a life as you can
good luck
— Deborah M.
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