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Doctor John MD
Doctor John MD, Board Certified MD
Category: Medical
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Experience:  Medical Physician
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What do I need to know to prepare for my upcoming work up to

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what do I need to know to prepare for my upcoming work up to if I am a good choice for surgery. I am currently on four diabetic medications with a a1c still 11.4.
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: Byduraeon, metformin, glimepiride, januvia all at maximum doses per by doctor.
JA: Anything else in your medical history you think the doctor should know?
Customer: sleep apena, and high cholesterol under control.

This is Dr. John and I will be helping you today.

I will be reviewing your question and will respond shortly.

I may need to ask a few more questions in order to best serve you.

Thank you for your patience.

Answers here are for education and information only.

I have a few more questions to ask, is that ok?

Customer: replied 1 month ago.

what type of surgery is planned?

has your doctor talked about starting you on daily insulin?

Customer: replied 1 month ago.
I just want advice about having informed answers to possible questions I will be asked during my upcoming work for bariatric surgery at Mayo clinic.

ok, let me type up some information....

Customer: replied 1 month ago.
age 65, weight 210, height 5'1" A1c 11.5 down from 12.5 3 months earlier after addition of Bydureaon.

Bariatric surgery has some specific guidelines, so the surgeon will look at your BMI (body mass index) as well as other medical conditions such as your diabetes. For many people undergoing gastric bypass, they have other medical problems such as high blood pressure, diabetes and sleep apnea.

They will also run a bunch of blood work and other tests such as EKG and chest X-ray. They may want an ultrasound of the heart called an echocardiogram.

They will often also have you meet with other specialists such as a psychiatrist, who will evaluate your reason for the surgery and motivation to keep weight off after the surgery. You may also meet with a pulmonologist because of the sleep apnea and an endocrinologist because of the diabetes.

Are you having gastric banding or are they doing a more involved surgery?

Customer: replied 1 month ago.
to insulin but I am not interested in insulin due to expected weight gain..I have already lost 65 lbs since 2005 gradually over time and have a fairly restrictive eating plan
Not banding..I am hoping to lower my A1c and banding isn't as effective. Are there any specific questions I can expect to be prepared for?

Depends on the surgeon, but they will ask why you want to have the surgery done, if you understand what the surgery entails, if you understand what the recovery is like and that it means a big lifestyle change.

There is about a 1% complication rate - ie. wound infections, etc with the surgery, so they will make sure that you understand that as well

Customer: replied 1 month ago.
Ok I appreciate your time. I am mostly worried about my A1c. Weight loss will be a nice bonus but is not my primary driver.

Ok, your A1C and diabetes will usually improve after the surgery.

Doctor John MD and 5 other Medical Specialists are ready to help you

The weight loss helps, but there may also be some change in how your body responds to insulin, which helps with control of your blood sugar

The Mayo Clinic website has this information for patients about gastric bypass surgery as well.

http://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/how-you-prepare/prc-20019138

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