Thursday, March 25, 2010

Pre operative testing

At the very minimum, a Bariatric surgeon should have routine medical testing, psychological testing, blood work, and clearances from cardiologists, pulmonologists and your general practitioner/primary care physician.

I was required to have general blood work drawn and an urinalysis. Basic tests are usually CBC (complete blood count), CMP (complete metabolic panel), PT/PTT (blood clotting), Thyroid function tests, lipid panel (cholesterol), glucose (sugar) panel. For RNY gastric bypass surgery, a H. Pylori blood test is also necessary to make sure this bacteria isn't present in your digestive tract. If so, they do a basic run of antibiotics to clear it up pre-op.



Pre-operative psychological counseling and evaluation are a requirement of all surgeons. I had to complete a Minnesota Multiphasic Personality Inventory (MMPI, which is a really long test that asks tons of questions, and many of the questions are asked multiple times in different ways to determine if the tester is fudging some of the results. I had my MMPI about three weeks after my first internship, so the psychologist was a little worried about me and some of my answers, needless to say I was stressed and depressed. She still cleared me for surgery as long as I continued to follow up with my psychiatrist to get my depression under control.

The other tests I needed were a respiratory exam and a cardiovascular exam. Since I am rather young for a RNY patient and didn't have co-morbidities contributing to my obesity, these tests were rather simple. My respiratory exam consisted of a chest radiograph (X-ray) and my cardio exam consisted of an EKG. Some people have to have more tests, such as cardiovascular stress tests (either on the treadmill or chemical) and pulmonary exam determines the volume of air your lungs can breath in and out.

A clearance from your primary care physician (PCP), or general practitioner (GP), is also required for surgery. My doctor wrote a letter of medical necessity to assist with my insurance clearance in the beginning, so he was totally on board with my getting surgery and there were no issues with clearances on that front.

So anyhow, these are the things that my surgeon required prior to surgery.

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