The First Steps

The first steps to planning for a gastric by-pass surgery are obvious.  You make an appointment and meet with the doctor.  Explore the different procedures available and choose the one that you and your doctor feel will fit your needs best.  What?  You say.  There’s more than one procedure? Yes, there are several.  I did not know this going in.  I thought there was just the gastric by-pass and the lap band.  Turns out there are several procedures.  Wiki has a great entry on gastric bypass procedures.

Once you have decided on a procedure, then the real work begins.  

Unless you are paying with cash or on credit, you are probably, like me, relying on your health insurance company to pick up the tab.  Most insurance companies have a few requirements you must meet.  You have to have a bmi over a certain limit.  This can vary depending on your insurance.  They also have a mandatory waiting period and nutrition counseling.  My insurance company requires six months of nutrition counseling.  A bit draconian?  I thought so until I realized what else is required.

The doctor and/or the insurance company may also require a sleep study to test for and treat sleep apnea, clearance from your primary care physician and possibly a heart doctor if you see one, a psychological review, tests done by an endocrinologists, and any other medical tests they feel are necessary based on the general health of the patient involved..

Seems like a lot, huh?  It is.  This is a big surgery.  A life altering surgery.  If the doctors and insurance companies do not make sure a patient can handle it, they would not be being fair to the patient.  The surgery also changes forever your relationship to food, your body shape, and can affect your self image.  You go into the surgery thinking this is exactly what you want.  The reality is, it can be much more of change than you are mentally prepared to handle.  Many patients suffer depression for months, sometimes years after the surgery.

So, where am I in this process? 

I have visited the sleep center three times already.  I have been doing the nutrition counseling.  Trust me, none of this is particularly easy.  I have not done the psychological evaluation yet, but that is next on my list.  I also had my yearly physical.  Once I have finished the nutrition counseling and complete the psychiatric evaluation, I have to contact the bariatric doctor’s office again and find out what else they want me to do.  It took me longer than I had planned to get started on some of these things, but I should be ready to start planning for the surgery by the end of the year.

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