Finally scheduled 1st appt. w/ PCP - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

cnvh · 02-13-2006, 11:23 AM

Well, after having made up my mind over a month ago that I am going to pursue this surgery, I finally worked up the nerve to schedule my first appointment with my PCP. (This Friday morning, woohoo.)

And NOW I'm nervous.

Not so much that I'll be turned down (my BMI is 58, so I'm WAY over any reasonable limits, although aside from my weight I'm still reasonably healthy), but I am NOT looking forward to this meeting with my PCP. I posted a few weeks ago and mentioned her; she is one of these "diet and exercise cures everything"-types, and I have a gut feeling that she's going to resort to that tactic again. (I went to see her a year and a half ago, wanting to try Zenical for a short period-- I was planning my upcoming wedding and was completely stressed out, with a dress to have to fit into and the whole bit-- and I practically had to BEG. She only agreed to prescribe it after consulting with the other doctors in the practice, and only with our mutual agreement that she was prescribing ONLY 2 months' worth. And at that time, my BMI was around 45, so I was way overboard even at THAT point.)

So I've done my homework, at least as much as I can think to do... I've contacted my insurance and made sure it is a covered benefit; I've written down my complete diet history, including dates, weight lost/gained, and why I failed; I've written a list of all the physical, social, and emotional consequences of my weight; I've also written out a complete family history of all the obesity-related diseases that are in my family tree (and there's a bunch-- no one in my family is thin). I've also been researching this procedure like crazy (no small thanks to everyone here; you are all a wealth of help, information, and support!), so I can discuss with her the pros and cons ad nausaeum.

But what I don't want to have happen-- but what I'm pretty sure is GOING to happen-- is that she is not going to be supportive, and I'm going to end up losing it in her office. You know, I can be as practical as the day is long, but if I have to actually EXPLAIN to someone how hard it is to put on a seatbelt, or fit into a chair, or find clothes to wear when I've maxed out Lane Bryant, or the hygeine issues... If I have to "go there," it will not be pretty and I'm sure I'll be bawling. The fact that saomeone's opinion can have so much of an emotional effect on me just pisses me off, because I am normally a very proud person and I couldn't care less what someone else thinks of me... but with this, it seems harder for some reason.

Anyway, my fingers are crossed... if she is how I'm guessing she will be, I will of course be changing PCP's... but since she has all my records, I want to keep this as simple as possible, IF that's possible.

Short of what I've already done, is there anything else I should do before my appointment on Friday?

Bypassingme619 · 02-13-2006, 11:40 AM

Well I am rooting for you. Go in there with a stern mind, don't back down from your decision. Like you said if she doesn't agree there is always a PCP out there that will support you. That is what you want anyways walking into this journey is a very supposrtive PCP, not one will be looking for you to fail so they can have a reason to down your decision. You know what is right for you and if she can not agree then she is doing you a favor by inforcing your decision to seek a new PCP. Good luck.

coptergirl · 02-13-2006, 11:42 AM

Bawl away!!! You have done your homework, you have stats to give her, you have your history - you have prepared and though about this. Any blind idiot would have to see that you really want and need this. If it tales additional bawling, then do it - whatever it takes. You know whats right in your heart,you know that nothing has worked for you, you know how uncomfortable you are - SO BAWL - hit her...do whatever you need to (I am kidding about the violence

). If she says no, ask to speak with her medical director or superior - if that doesn;t work - change PCPs!! If I was in her shoes, though, and I saw all of the information you have, I would lean toward saying yes.

I wish you all the best, my dear. Please please let us know what happens - you will be in my prayers!

cnvh · 02-13-2006, 11:48 AM

I'm filling out the Bariatric Surgery Screening Form (required for the WLS program at my hospital) as we speak; hopefully that will be one MORE thing in my favor.

The strange thing is, my PCP is with the outpatient physician group of the hospital where I would want to have the surgery-- and it's a huge university hospital, with a renowned WLS program. I mentioned this to a friend who also had the surgery at this same hospital, and she was amazed that my PCP, being directly affiliated with this hospital, would be like this.

But I have never flat-out told her that I was at the end of my rope, or directly asked about WLS... so I will give her the benefit of the doubt and hope I will be proved wrong...

DreamCatcher06 · 02-13-2006, 09:30 PM

Hang in there! When the PCP isn't behind you, it makes it so much more difficult (but not impossible). Let us know how it went. I have my fingers crossed for you.

aesidwell · 02-14-2006, 01:18 AM

I was really nervous about my PCP as well. She is also one of those, "you know, you really need to exercise more and lose weight" without any kind of help or back up beyond that. So I circumvented her. I went directly to the hospital and got involved with the program, made all of the pre-op appointments coordinating only with the surgeon's office, and when they requested a letter from my PCP, I called her up and said point blank, "I am having this surgery and here is what I need from you." I kept on her every day to make sure there wasn't ANYTHING she could do to hold me up. She did act strange and very standoffish when I had to see her; her weirdest comment was, "Now I suppose I won't see you again now that I've done what you wanted." Well, I was already ready to drop her before this process and now that she's moving to Torrance, it's all that much easier!

ANYWAY, to make a long and rambling story short, TAKE CHARGE girl! If there is any way you can get into a surgical/hospital program WITHOUT having to be referred by a PCP, DO IT!! (not sure where you are located, but I went through the Center for Minimally Invasive surgery at Cedars Sinai and I cannot sing their praises loud or often enough!!!

)

Good luck! I'll be rooting for you!

brookscn · 02-14-2006, 11:32 AM

Tell her if she won't help you, you'll find a physician who will (someone who listens to their patients instead of dolling out stock advice to everyone). And if she's affiliated with a hospital with a WLS program, she should be supportive.

Only do this if you are with a PPO and can switch doctors easily.....I'm not sure what area you are in, but if you are in the San Diego area, I'm sure that someone could send you a PM with a PCP recommendation.

Good luck - stand your ground!

amazonbeauty · 02-14-2006, 04:30 PM

I too worried about what the PCP would say. Mine sells his own diet loss stuff and has his own whole thing going. I thought he'd try to sell me on his weight loss program. I was just pretty firm about wanting the surgery; and it helped that my fiancee had him also and he had sent him for his referral without problems.

I agree that, no matter what, you can change primary care doctors. You have that right! I don't know where you are (location), but I'm sure there is someone out there that knows a doctor in your area that is more supportive of this decision.

You deserve this new lease on life and don't let anyone, not even a doctor, stand in your way.

cnvh · 02-14-2006, 06:07 PM

I plan to approach this by telling her that I am seriously considering WLS, and that I know that, in preparation for this, I will most likely need to be on a medically supervised diet. So I intend to ask her to put me on said "medically supervised diet," whatever that may be, and we'll go from there.

But what happens if I go on this "diet" and, lo and behold, I lose weight! I will be the first to admit, I do great on diets in the short-term... so what happens if I lose weight, and my PCP says "great, just keep doing this instead!"

THEN what?!?!

brookscn · 02-14-2006, 07:51 PM

Well, if you lose the weight and put it back on again, it's still considered "medically supervised". Your doctor keep track of you for 6 months, you make that milestone, and when (and if you put the weight back on), you've already done that hurdle.

Even though I wasn't on a doctor "medically supervised" diet, every time I went in for an appointment - she weighed me and kept track of that. That is considered a medically supervised diet. During that 12 years, I was on Weight Watchers 3 times, Jenny Craig once, the Atkins, etc - she was there the entire time, with her chart and her pen, keeping track of me. Your doctor may have done the same.