Question:
Undiagnosed Co-Morbidities, especially CHF

I have only recently gotten insurance through my husband's employer. I've not seen a doctor in four years. I am I pretty sure I have congestive heart failure, edema, and apnea. These conditions have not been diagnosed or treated. I currently do not have a family doctor. Will this put my surgery back further? Will I have to go on medications before surgery and what kinds of testing should I make sure I get before surgery? Should I go in for a consultation with the surgeon before seeing other doctors? Or should I get a recommendation from the surgeon?    — Ms.Fausey (posted on June 5, 2005)

June 5, 2005
Fausey, My first thing if you haven't been to a doctor in 4 years and you know you have CHF, you need to see a cardiologist first. That is dangerous left untreated. You should do that anyway, due to you will more than likely will need a cardiac clearence. A cardiologist should say if your heart is able to go through a 2 hour surgery. I don't know your insurance, but most you got to get a referral to go to a surgeon. If not go to a bariatric surgeon. He will also tell you if he will do it or not. Don't play around with CHF. Good luck! Kevin
   — Kevin R.

June 5, 2005
Hello, Please get to a doctor immediately. YOu will need to have several tests done before your new insurance company will consider paying for a surgery. Mainly, the heart issue needs to be addressed, then the sleep apnes can be tested by a sleep center at your new doctor's recommendation. Your doctor needs to put yo on a supervised diet immediately, as most insurances require at least 6 months -1 year of a doctor monitored diet. Get all your conditions addressed. My gastric bypass was 4 hours long, and if your heart is weak, it may not be strong enough to survive that surgery. Now that you have insurance, get yourself to a doctor! Best wishes on your journey. Kathy A in MA
   — Kathy A C.

June 5, 2005
Yes, these conditions will likely set your surgery back further, to be blunt. No surgeon will touch you with those conditions untreated. Morbidly obese people are high risk to begin with, so having serious co-morbid conditions that have been untreated makes you even higher risk. Seek out a primary care doctor covered by your insurance. He will refer you to a cardiologist if need be, and the caridologist will order the tests and medications you might need to treat your suspected CHF (and it could be something else altogether). No one on this board can tell you what tests need to be done - that is for the doctors to do. Your primary care doctor is one who you need to rely on after your WLS to monitor your other conditions and perhaps he will even adjust your medications as you lose weight. The surgeon is the past person you should see about these issues. Save yourself a lot of time and backtracking by starting at the beginning and working you way through to get your health problems under control before you even think about having surgery. I know it's hard to wait any longer, but if you do have untreated CHF, this is very serious and untreated for as long as you say, it can damage your heart permanently. You want to be int he best condition possible before you have WLS, so that your recovery is as uncomplicated as possible. Good luck and be patient on your journey!(FYI- I started my process in March of 2002, didn't have surgery until late October that same year - and I had no co-morbid conditions!)
   — koogy

June 6, 2005
Hi,, I have vtach, dialated cardiomyopathy and heart failure.(Im a 43yr old female) Before I was diagnosed I never would of thought I had heart failure, I never heard of anyone thinking they may have it,, if you feel badly, you need to get to a doc and be checked out,, its easy for them to see if you have HF. I found out about the DCM and HF when I was in hospital recovering from my WLS (which was in Nov 02). Also this past september I had a triple hernia repair with an abdominal plasty, so depending on how well your heart problems are managed you may or may not be able to have the surgery... being an elective surgery its really the surgeons call. Having HF isnt the end,, Ive lost 155 pounds work out cardio an hour 5 days a week, weights 3 days a week,, I dont let it interfer with my life. I also try to take good care of my heart, Its been almost 4yrs since I quit smoking, I see my heart doc as sceduled and take my meds,,, Good Luck to you, and if you feel that strongly about your health, dont wait, get to a doc SOON,,, Amy
   — Amy Hoffman

June 12, 2005
Hello! First of all welcome to the group and congratulations for taking the first step to making yourself the best "you" that you can be. My first question would have to be: what would make you suspect that you have CFH? Have you had this diagnosis prior to the 4 years that you were not able to get medical care? Is there a strong family history? I have seen many patients come in and recieve the initial of CFH and they were blown away. Never one time have I seen a patient that came in and said "doc, I suspect that I have CFH". Anywho, Please let the group know what your doctor saud about your conditions. We are all pulling for you and are very curious. Best of luck in your journey into a lighter you. Christy Riederer R.N.-B.S.N.s 4-8-04 Open RNY 265lbs. June 12-05 129 lbs@goal (-136 lbs gone forever!)
   — Tiny Pixie

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