Anaesthesia Specialist nearly did not take me on...:( 50/50 chance.

Sindylou wrote:

benbelle wrote:

I was in a HDU for 2 nights, it is normal for my Dr to put you in at least one night. I am an ex-smoker and an asthmatic. My knock-out dr virtually said the same to me, I had central lines put in my arm as well as in my neck, it is part and parcel of the size that we are. I would prefer all this than the alternative :-)

Hi,

What are central lines please?

Hi Sindylou,

central Lines are IV lines that go straight into your arterial veins, fastest way to get medication to your heart etc.

Asimov wrote:

Hi Sindylou,

I'm really sorry if I scared you - that wasn't my intention! Trust me, I have seen people who weigh more than you come through surgery safe and sound! It is really a good idea to try to cut back smoking or stop altogether if you can - it's a hard thing to do, but your lungs will thank you for it on the day of your surgery, especially considering your asthma.

Everyone is entitled to get a second opinion - you don't have to though. You're the one paying for the anaesthetist's services and if you're not comfortable with him/her, you have the right to look elsewhere. I agree with Emily about informed risk and the need for caution. There's a legal obligation for the risks to be disclosed to you prior to proceeding - that doesn't mean it's not scary though.

We're all doing the same thing as you - trying to make a better life for ourselves and the people who love us. All you can do is prepare your body as well as you can for your surgery.

Cheers, Asimov

Thankyou Asimov,I really appreciate your information ...

benbelle wrote:

I was in a HDU for 2 nights, it is normal for my Dr to put you in at least one night. I am an ex-smoker and an asthmatic. My knock-out dr virtually said the same to me, I had central lines put in my arm as well as in my neck, it is part and parcel of the size that we are. I would prefer all this than the alternative :-)

Hi,

What are central lines please?

I was in a HDU for 2 nights, it is normal for my Dr to put you in at least one night. I am an ex-smoker and an asthmatic. My knock-out dr virtually said the same to me, I had central lines put in my arm as well as in my neck, it is part and parcel of the size that we are. I would prefer all this than the alternative :-)

Emily wrote:

I'm not sure why people are suggesting a second opinion, it sounds like the physician told you the exact correct information - you have a much higher risk of operative and anesthetic complications at very high BMI, and they would not be doing their job if they did not ensure you were aware of it. It's called "informed consent" and it's their responsibility to make sure you know what you're getting in to. You definitely have a higher risk of needing breathing support for longer postop, and you want to know that now rather than when you wake up with a breathing tube in, if that happens.

Emily the reason I suggested a second opinion was NOT because Sindylou was given incorrect information, and most definately she should be 100% informed. The reason I suggested it was because Sindylou said

"Whom wasnt sure if he would take me on for my operation in two weeks due to my BMI and sleep apneore (not sure how you spell that)...".

Basically she has been given the information, it should be up to her, after discussing with her family, if she wants to take that risk. If that particular aneathetist is reluctant to go ahead, but the INFORMED patient is, she should find one who will do it.

Also, having trust in the people who will be doing the op is so important. A patient should NEVER be advised against a second opinion if there is doubt, questions, fear, anything that doesn't sit right.

Hi Sindylou,

I'm really sorry if I scared you - that wasn't my intention! Trust me, I have seen people who weigh more than you come through surgery safe and sound! It is really a good idea to try to cut back smoking or stop altogether if you can - it's a hard thing to do, but your lungs will thank you for it on the day of your surgery, especially considering your asthma.

Everyone is entitled to get a second opinion - you don't have to though. You're the one paying for the anaesthetist's services and if you're not comfortable with him/her, you have the right to look elsewhere. I agree with Emily about informed risk and the need for caution. There's a legal obligation for the risks to be disclosed to you prior to proceeding - that doesn't mean it's not scary though.

We're all doing the same thing as you - trying to make a better life for ourselves and the people who love us. All you can do is prepare your body as well as you can for your surgery.

Cheers, Asimov

Sindylou wrote:

I have just been to see the Anaesthesia ( Not sure if thats the right spelling) Whom

wasnt sure if he would take me on for my operation in two weeks due to my BMI and sleep apneore (not sure how you spell that)...

He has told me that after my operation I will be transfered to the Public hospital to Intensive care.He has given me a 50 percent chance of breathing on my own at the end of the operation.

However he has decided to take me on and has suggested that I prepare my family for complications.

I am in tears and so scared...I am on the road to know where as I am 170kgs!

My BMI is 69?....I dont remember them doing a test on my BMI so I am unsure how they came up with that number .

I am all my kids have left...

So confused! How does one let themselves go!:(

What have I done and what will I do?

Has anyone been in my boat?

Thankyou to everyone who has replied and offered good wishes and support!

I appreciate it more than you know!

Asimov wrote:

Hi Sindylou,

Aside from the sleep apnoea and the high BMI, do you have any other health issues which may affect your anaesthetic? That is, do you smoke? Do you have diabetes? Are you asthmatic? Do you have false or loose teeth? Have you had previous surgery where there was an adverse outcome from the surgery or the anaesthetic? These are a few of the issues which will affect your anaesthetist's decisions. His concern will likely be your lung function and lung capacity during the surgery as well as how your body is managing the anaesthetic. During a laprascopic procedure (keyhole surgery) the surgical team pump gas into your abdomen which is what lifts your abdominal wall/tummy away from your organs and your intestine in order for the surgical team to be able to see what they're doing - pumping the gas can also put pressure on your lungs. Also, the bigger we are, the more anaesthetic we require, and the longer it takes us to recover. (Fatty tissue loves to suck up anaesthetic agents).

If this anaesthetist is unsure, it is in your best interests to seek a second opinion! Try to find an anaesthetist who regularly works in bariatrics - you'll be in safer hands.

If you smoke - do your best to stop now! It really affects your oxygen levels during and after your surgery and it will also affect your recovery.

All the best, Asimov (former anaesthetic nurse)

Hello Asimov,

Firstly Thankyou for your information...I stopped smoking today as I am so scared.Athsma I do have .Everything else is fine.

I have never been asked by anyone if I smoked.I havent had one today and I will not have another!

I dont think I have time to get a second opinon but will ring my sugeon tomorrow..

Thankyou

I'm not sure why people are suggesting a second opinion, it sounds like the physician told you the exact correct information - you have a much higher risk of operative and anesthetic complications at very high BMI, and they would not be doing their job if they did not ensure you were aware of it. It's called "informed consent" and it's their responsibility to make sure you know what you're getting in to. You definitely have a higher risk of needing breathing support for longer postop, and you want to know that now rather than when you wake up with a breathing tube in, if that happens.

My BMI was 41 and my surgeon sent me to the ICU postop just because he's the cautious type, so I wouldn't worry about going to the ICU itself; it just lets them monitor you more carefully which is good!

Do your best to lose whatever weight you can preop as every little bit helps. Hopefully you'll do just fine like most people, and this will soon be a distant memory.

I was sleeved on the 26th september. my starting weight before optifast was 179kgs, i lost 9kgs before operation. I will be honest and tell you my operation wasn't a good one, 5.5hours in surgery, 3 bags of blood BUT I wouldn't change it, I would go through it all again.

All I can stress to you is lose as much weight as you can before the operation using the optifast/optislim, it does help, my liver was still enlarged, and made it a difficult operation. I am now 2 weeks post-op and down 15.7kgs all up.

Hi Sindylou,

Aside from the sleep apnoea and the high BMI, do you have any other health issues which may affect your anaesthetic? That is, do you smoke? Do you have diabetes? Are you asthmatic? Do you have false or loose teeth? Have you had previous surgery where there was an adverse outcome from the surgery or the anaesthetic? These are a few of the issues which will affect your anaesthetist's decisions. His concern will likely be your lung function and lung capacity during the surgery as well as how your body is managing the anaesthetic. During a laprascopic procedure (keyhole surgery) the surgical team pump gas into your abdomen which is what lifts your abdominal wall/tummy away from your organs and your intestine in order for the surgical team to be able to see what they're doing - pumping the gas can also put pressure on your lungs. Also, the bigger we are, the more anaesthetic we require, and the longer it takes us to recover. (Fatty tissue loves to suck up anaesthetic agents).

If this anaesthetist is unsure, it is in your best interests to seek a second opinion! Try to find an anaesthetist who regularly works in bariatrics - you'll be in safer hands.

If you smoke - do your best to stop now! It really affects your oxygen levels during and after your surgery and it will also affect your recovery.

All the best, Asimov (former anaesthetic nurse)

I agree with the others, sounds like your anaesthetist is out of his comfort zone. I started at 174kgs and my BMI was very high too. I didn't have sleep apnea though, but I do know that I was at a higher risk with the general.
Good luck with whatever you decide.

So sorry about this Sindylou,

Your BMI of 69 is out of your anaesthetists comfort zone...thats all.

I would ring your surgeon and tell him what youve been advised, and ask your surgeon for an anaesthetic referral to someone that they know is comfortable and confident with high BMI cases, so you can not only get a second opinion but can feel more confident with your decision to proceed too!! Your surgeon needs to know!!

Dont worry about ICU at a public hospital...thats often routine in many places with high BMI cases. Being ventilated for a bit post op is no big deal either, and the ICU doctors will do whatevers best for you at the time. Can be very scary for your family to see though...hence the advice to warn them about this. You should be blissfully unaware of any of the drama however, as you'll be sedated and in LaLa land.

Some doctors like to hit you with 'worst case scenario's', so that at least you are aware of them (ie youre giving informed consent)..but also because it legally covers their butts too..

You are 37, which is a really good thing as you are young...and even moreso if you dont smoke.

I think the way to look at this might be...that you are now the unhealthiest you'll ever be...it all gets better from here.

Call your surgeon and get a second opinion..or maybe even just a second explanation.

Deb

Sorry to hear that Sindylou. I would take stragazers advice, and get a second opinion. There are some doctors out there who will not do "higher risk" cases because it either stuffs up their "success rates" or insurance pushes them out. Maybe a longer period of optifast to take off a 5% loss (about 9kgs)? It has been proven just a 5% loss can make a dramatic difference. There have been lots of people on here who have done long opti stints. I did it for 3 weeks, but Luke (Jacko84) and some others did it for longer.

I was terrified having this op, but I looked at it that the chances of something bad happening to me because of my weight was so much higher than the risk of something going wrong with the op. Was I still scared- you bet. But I took a leap of faith, found a doctor and anaethetist that I trusted and jumped off that cliff. And guess what, I found my wings!!!!

Hope you find what you need.

I can't relate Sindylou but just wanted to offer my support. That must have been very confronting to hear, I would be in tears and scared too.

Your BMI is a calculation based on your weight and height.

Hopefully there are others that can give you an insight into their own similar stories ... but in the meantime, can you phone another Anesthetist (? spelling) and get their opinion/feedback.

hi sindylou, i was 231kgs i saw my anethethiist before my op and he said no problems, i have sleep apnea, and was put into icu for 24hrs post op, all went fine and i am 7 weeks post op.

I have just been to see the Anaesthesia ( Not sure if thats the right spelling) Whom

wasnt sure if he would take me on for my operation in two weeks due to my BMI and sleep apneore (not sure how you spell that)...

He has told me that after my operation I will be transfered to the Public hospital to Intensive care.He has given me a 50 percent chance of breathing on my own at the end of the operation.

However he has decided to take me on and has suggested that I prepare my family for complications.

I am in tears and so scared...I am on the road to know where as I am 170kgs!

My BMI is 69?....I dont remember them doing a test on my BMI so I am unsure how they came up with that number .

I am all my kids have left...

So confused! How does one let themselves go!:(

What have I done and what will I do?

Has anyone been in my boat?