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Old 05-17-2018, 05:25 AM
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RivkahChaya RivkahChaya is offline
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Anyone been a support person for someone having weight loss surgery?

I just started a thread on this, and then had a cat walk across the keyboard, and the first thread disappeared, so if there is another, incomplete, duplicate thread floating around somewhere (I searched all over and couldn't find it), mods, please delete it.

Anyway, here's my situation. I have a very dear friend who is almost 300lbs (at 5'3). She has weighed around 250(US)lbs most of the 15 years I have known her, and has gone up to about 290 in the last few years. She has tried diets, including one one phentermine, which helped her lose a lot, but her blood pressure went way up.

She has trouble exercising, because she has knee and back pain. She is now borderline diabetic, and her blood pressure is in the orange range. She is on BP medication.

So she has been thinking about bariatric surgery. She has been on the diet she needs to be on for three months prior, and has a month to go. She was required to lose 10 lbs over three months, and lost 15 already, so she's a very compliant patient. She eve skipped cake on her birthday.

Here's where I come in: she needs a support person to go to the pre-surgery seminar with her, and to drive her to, and pick her up from the hospital, to stay with her for the first 12 hours after surgery, and help her with things like running errands while she is on pain medicine (maybe three days). Also, to check to make sure she is 1) eating; 2) eating according to what she is allowed to have following surgery; 3) taking her vitamins; and 4) getting 64 ounces of fluid a day.

If I do this, I have to sign a piece of paper promising that I will. I'm not sure if this sets me up for liability, or if it's just a hoop she needs to jump through, getting someone signed up.

I am thinking I will do it; she's a good friend, and I'd like to see her be healthier (diabetes, HBP and back pain aren't a matter of cosmetics), plus, it's something she really wants. However, I don't know much about this, and I really don't know what I'm getting myself into. I asked the doctor if I could make an appointment to come in an talk about it, but I can't do that without paying OOP for a whole appointment. I think he was trying to discourage me on purpose, because of HIPAA, even though I tried to make it clear I didn't want to know anything specific about my friend, just about expectations for the support person.

Has anyone here ever done this? Has anyone ever been a support person to someone having weight loss surgery? Or, has anyone here had weight loss surgery, and is willing to talk about it? How much did you depend of the support person? Did you need to make a lot of demands? If you have been one, was it easy? Very hard? something in between? was it worth it, even if it was hard, or did you regret it?

Everyone seems to be stressing that this is a big commitment, and I'm not sure if that's because it always is, or simply because of the possibility that it could be, and they want you to be prepared.

FWIW: she is divorced, and her ex has agreed to keep their kids for a week after her surgery (more if needed)-- they have a pretty amicable divorce-- but he has a live-in girlfriend, and can't be her support person himself. She has no family locally. Her only sister works full-time, her father is dead, and her mother is not well enough to care for her, plus, she lives in Oregon. She has other friends. I don't honestly know if she asked me first, or if she asked several people, and is waiting to see who gets back first. Nonetheless, I'd like to do it. She has helped me out a lot in the past.

Please share any and all stories. I have about 10 days to make a decision.

TL;DR: anyone know what it's like to be a support person for someone having bariatric surgery?
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Old 05-17-2018, 06:47 AM
Joey P Joey P is offline
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Both of my (now ex) in laws had it. It was fun to watch them both go from probably 300 pounds down to 100ish very rapidly...like every single time I saw them (at least once a week), they were noticeably smaller. This was probably 15+ years ago and sometimes when I see them I still think they look like miniature or photoshopped versions of themselves.
I'm sure a lot of it, for them anyway, was made easier because of their general disposition. They're pretty fucking cheerful people.

Overall, the most difficult thing really seemed to be portion control, but they both learned very quickly that if they attempted to eat too much the food/drink would literally back up and sometimes come out. That, at least to me, is really what this surgery is about. You make your stomach smaller so that it's really hard too eat too much. It's like sewing your mouth shut so you can't smoke anymore.

I'm sure they were each others support person, but ISTM, other than general post-op stuff, the biggest thing was helping each other deal with the portion control. Making sure that what they ate wasn't just oreos and jello and like helping someone quit smoking, helping them get past the 'cravings'.

You seem to be most worried about this contract, that's something I don't know anything about. Maybe you could call the office and ask to get a copy emailed to you. If it's just general post-op stuff (which I've seen for other surgeries, don't let them drive, buy a house, make a big decision etc for the next 24 hours), you probably don't need to be concerned, but personally, I wouldn't want to be legally on the hook if they put the weight back on.

In other words, if it's just general support type stuff, go for it, if it's a legal contract and you can be held responsible for something, I'd probably back off. Maybe tell her that you'll do it, but ask her if someone else can sign it. Personally, I'm guessing is not a real contract, more like the office trying to get the patient to feel responsible to more than just themselves.
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Old 05-17-2018, 11:10 AM
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panache45 panache45 is offline
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Quote:
Originally Posted by RivkahChaya View Post
She has trouble exercising, because she has knee and back pain.
Slight hijack:

Has she tried water therapy? I also have severe back and knee pain, and I work out two hours a day at a nearby aquatic therapy facility. While I'm in the water, I feel no pain, even with strenuous exercise. And your friend would not be out of place due to her weight. Is there such a place near her?
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Old 05-17-2018, 11:41 AM
Shodan Shodan is offline
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Quote:
Also, to check to make sure she is 1) eating; 2) eating according to what she is allowed to have following surgery; 3) taking her vitamins; and 4) getting 64 ounces of fluid a day.
I think I would ask your friend what she wants/expects you to do to fulfill the above. Just ask? That's one thing. Keeping watch so she drinks enough, etc.? That's something different.

Al-Anon says you can't stop an alcoholic from drinking. I don't know if that also applies to other addictions, like over-eating, and maybe the surgery will prevent her from over-eating and she will find that out as Joey P says. As long as you/the doctors/anyone else doesn't blame you if it doesn't work, I wouldn't have any problem being generally supportive, including 'did you take your vitamins' as often as seems appropriate.

It's very kind of you to consider doing this.

Regards,
Shodan
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Old 05-17-2018, 11:53 AM
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wonky wonky is offline
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Quote:
Originally Posted by RivkahChaya View Post
If I do this, I have to sign a piece of paper promising that I will. I'm not sure if this sets me up for liability, or if it's just a hoop she needs to jump through, getting someone signed up.

...

I think he was trying to discourage me on purpose, because of HIPAA, even though I tried to make it clear I didn't want to know anything specific about my friend, just about expectations for the support person.
I do not know anything about bariatric surgery. But to address these two issues:

I'm pretty sure the first is just to ensure that she isn't saying "Oh, I'm fine! I've got all these supports!" when she doesn't actually have anyone who can check on her at all. People lie. Dressing it up as a document that someone is signing is likely an attempt to get around that.

As for HIPAA, patients are allowed to have caregivers in on their appointments and can designate people to receive information about their specific care. These designations are usually informal--you go to the appointment with the person and the practice assumes you have their consent to be there. But a doctor should not hide behind HIPAA when it comes to your access to information the patient wants you to have. If you feel they are, tell your friend to make it clear that you are the caregiver in this circumstance and that she wants you to have the relevant information. HIPAA should keep the practice from revealing anything irrelevant to the specific care/treatment that you are supporting.
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Old 06-12-2018, 03:54 AM
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RivkahChaya RivkahChaya is offline
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UPDATE:

I agreed to be her support person. Her surgery is this coming Monday. It's called a gastric sleeve reduction, or what is referred to as stomach stapling. It's what is commonly used with less obese people, which at 275lbs. now (thanks to the weight she was required to lose for the surgery), she is, relative to other people having this surgery. Seriously, at the seminar for patients and support people, I think she was the smallest patient there. There were people who probably weight close to 600lbs-- granted, one huge guy was close to 6' tall. Still.

Anyway, it turns out that aside from considerations of helping her watch her diet and making sure she takes all her vitamins, it's not uncommon to require support people for a lot of surgeries now, because so many people get discharged the same day or after just 24hrs. Surgeries are done laproscopically, and infections control is so good, that most of the complications have been all but eliminated.

However, you still have a person on heavy pain meds being discharged. Before 21st century surgery techniques, people were kept for days after surgery, and were discharged sometimes no longer on narcotics, or just on very light narcotics. But now people are discharged heavily drugged.

She is going to have something interesting, though-- an external pump with a tube going into her abdomen, that administers a local anesthetic constantly for several days. Which is another reason to be careful-- she could do some damage and not know it-- but it reduced the need for narcotics by about 75%, and eliminated them in some people. She might get discharged needing nothing but Tylenol.

Now for the hijack:

It got me wondering about the current "opioid abuse epidemic." I wonder if the revolving door surgeries have contributed to it. It used to be that people got discharged with little or no need for strong pain medication. They had narcotics as an in-patient, but by the time of discharge, didn't need them. Now, with people getting surgery as out-patients, or 24hr patients, they are getting discharged with a lot more narcotics. And until new laws were passed, oftentimes, narcotics with a refill on the prescription.

In 2010, I had ankle surgery as an out-patient, and got Percoset with a refill. I didn't refill it, because hydrocodone gives me migraines after about the 3rd day on it, so I was on plain Tylenol as soon as possible. [/hijack]

Yes, I realize I just tossed my thread into IMHO territory. Mods can split the thread and move the hijack, or just move the thread. I have all my answers for the original question.
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Old 06-12-2018, 07:34 AM
Joey P Joey P is offline
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Quote:
Originally Posted by RivkahChaya View Post
Now for the hijack:

It got me wondering about the current "opioid abuse epidemic." I wonder if the revolving door surgeries have contributed to it. It used to be that people got discharged with little or no need for strong pain medication. They had narcotics as an in-patient, but by the time of discharge, didn't need them. Now, with people getting surgery as out-patients, or 24hr patients, they are getting discharged with a lot more narcotics. And until new laws were passed, oftentimes, narcotics with a refill on the prescription.
You hear stuff like that all the time in relation to this. I think, at least in part, that's the docs trying to get around the system. For example, you mentioned all the Percocet you got for your ankle, including a refill. That's (at least here, but I think it's federal) not allowed anymore. The doc can prescribe a month at a time, no refills and new scripts have to be picked up in person (no faxing or e-prescribing). So, back in the day, I could tell the doc my ankle hurts, get some Vicodin and a few weeks later call him up and tell him it's getting better but still bothers me and he could fax a new script over, no bid deal. (Not a perfect example, just something for the logistics).
Now, however, with no refills and the person having to come in, they may prescribe way more than needed just to avoid complications for the patient as well as any legal headaches on their side. For example, when I had shoulder surgery, I walked out of the hospital with a script for 90 Percocets and 30 Oxycodone. Honestly, 10% of that would have been enough. If I was careful, I easily could have gotten away with 1 or two percocets for the first few days and probably 1 oxy each night for 5 or 6 days.


Having said all that: I know people talk about this being the reason for the big (current) problem, but I'm curious what the actual statistics are. How many people have died or become addicted had, at some point, an actual legitimate prescription for real, even if overstated, pain that they can point to and say 'it was because of that'? OTOH, how many of those people became addicted or died, but started taking them because they liked them? I'm quite sure there's plenty of people in both groups, but I always got the feeling the majority of these people are buying them illegally not being over prescribed. Granted, the pills may be available on the street because they're being over prescribed, but in that case, the doctors may be less at fault than we suggest.

To kind of bring all that back around, what, if anything, would change if a doc could give you a script for a week of pain meds (say, 10-15 pills), but could call in refills? That might avoid them saying 'wow, that's quite a scratch, here's 90 pills'.
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