Expert: Diminishing Dawn - 5/24/2010

Question
Hi Dawn,

I was very close to having my RNY in the US but then OHIP changes came and my hope seems to be evaporating. I know that the surgery is not a silver bullet, I have had several friends and acquaintances that have had the RNY and I've been very sympathetic of their struggles. My husband and would like to have the surgery at the same time so we can support each other on this journey. I have a couple of questions regarding applying in Canada now.

For example: Would St. Joseph's in Hamilton, Guelph and Windsor all have the same criteria for acceptance for surgery?

I noticed in the Windsor paperwork that you can put down as a medical problem depression, yet later I read that if you suffer from depression due to your obesity that it will disqualify you from the surgery. Is this true?

Also, it says you are disqualified if you have had bariatric surgery before. I was part of an experimental group for stomach banding in 1985. It was successful but then I got pregnant and my vomiting got so severe in my first trimester I was hospitalized to keep hydrated and get enough nutrition for the baby. The doctors wanted to wait to see if the vomiting would ease after the first trimester. It didn't. My choice was to stay on intravenous for the next two trimesters till term - which would mean I would lose my job. I had surgery to remove the banding in 1986 - we had a healthy baby boy. So would I be disqualified from surgery now do you think?

In your other questions you said you need to be diet compliant - what does that mean?

Thanks,
Cate

Answer
They do have the same general criteria although of course different doctors might have different preferences (E.G. Dr. Hong is more open to doing VSG, other surgeons/doctors might reject doing a VSG on someone).  Hamilton does surgery only if your bmi is under 50. There are some slight differences as you can tell, qualifications though are pretty much the same - bmi of 40 and over or 35 with significant comorbidity.

Depression can disqualify you if they think that you are not mentally stable. That's why there is usually a psych kind of clearance -- I believe they use social workers.

If you had surgery, I wouldn't mention it til you had the surgeon. They don't want to be knee deep in revisions and that's why they put that qualifier in there. You should be fine if all is removed.

They will have a nutritionist. The nutritionist will give you a diet to follow according to your own needs. You have to do what the nutritionist says in order to be cleared by her. It may be a simple case of eating the proper number of meals a day if you don't or following a medically surprised diet.
Dawn