Need Advice, Consent Form….

[southernlady]

"Ongoing future?" "Future" will do it.

And "ensure," as opposed to "insure."
http://www.quickanddirtytips.com/education/grammar/assure-versus-ensure-versus-insure


ETA...I'm sorry...Catholic schools in the 1950s.

LOL, that's okay...I SHOULD have caught those...Catholic school in the late 60's early 70's.

 

[robs477]

Robs,

No offense, Sweetie, but is there some particular critical information that Hilary's letter omitted and that you felt a need to add? If there is, I can't find it.

Keep in mind that Hil is one of those Way-Off-the-Charts, VERY well-educated types and it is almost impossible to improve on what she writes.

Not to mention that the ass-kissing isn't needed, but that's just my humble opinion. It doesn't accomplish much at all, unless the surgeon is horribly insecure and, in that case, I'd want to know why.

Spiky, I just went back to compare her version to the one I just added and you're right. I started off to put the changes in there adding dates to make it apply to this and wound up getting long winded again which made it loose focus. When I went back to just compare, I was about ready to write you back telling you I didn't change much, but to my surprise, I did. I will lean it back out again, thxs for the constructive criticism. I really must be some kind of a latent closet "Serial Filler" or something!

 

[Spiky Bugger]

LOL, that's okay...I SHOULD have caught those...Catholic school in the late 60's early 70's.

Lol!

Did the nuns still have rubber-tipped pointers they slapped against everything?

 

[robs477]

Spiky, I just went back to compare her version to the one I just added and you're right. I started off to put the changes in there adding dates to make it apply to this and wound up getting long winded again which made it loose focus. When I went back to just compare, I was about ready to write you back telling you I didn't change much, but to my surprise, I did. I will lean it back out again, thxs for the constructive criticism. I really must be some kind of "Serial Filler" or something!

I also like what SL, Liz re-wrote and am re-doing that.

 

[robs477]

Ok...I officially hate this thread now!!!....here it is back like what Hilary wrote.... and a few of SL ideas and mine SL and my add ons in (in red)!

I am scheduled to meet with you on 1/27/15 for our final pre-surgery visit. I thought I'd take a moment to write down my thoughts as it is critical to me that our expectations are aligned for the intended surgical approach and contingency plans if concerns arise during the procedure.

It is clear that the DS is the only bariatric surgery that I would benefit from long term and therefore is the only surgery which is acceptable to me. Based on my personal metabolic challenges, and as confirmed by the collective opinion of several other medical professionals, counselors, and long term bariatric patients, it is an absolute necessity for me to have the malabsorptive component of the DS for successful long term weight loss as well as for my comorbidities, especially my type II diabetes.

Further, that DS must be performed in a single procedure, unless medically precluded due to unforeseen intraoperative circumstances. A two stage surgery is not an option as my insurance will NOT cover a second weight loss procedure post VSG.

I am seeking your guidance as to how best to go about adding the following language to my surgical consent form, to ensure awareness and mutual agreement. To that end, I want to add the following to my consent/surgical release form:

CONSENT/SURGICAL RELEASE FORM ADDENDUM
Consent is granted strictly for a Full Duodenal Switch Surgery intended to be completed fully in a single laparascopic procedure. If it is determined during the procedure that the full Duodenal Switch surgery cannot be accomplished laparoscopically, consent is further granted for the full Duodenal Switch surgery to be performed as a single open procedure. Should any unexpected situation occur intraoperatively which, in the best medical judgment of the surgical team, requires that the procedure be stopped, I will expect full documentation be provided to me of the rationale for not undertaking the switch part of the surgery which shall be provided to me upon request.

I know you will, of course, exercise your best professional judgment during surgery, but I want it to be clear on what approaches are acceptable to me. The DS surgery is the only chance I have, and it truly is my last hope to force some semblance of a metabolic course correction to increase and extend the quality of my life. I am very grateful to be in the hands of such a highly skilled surgeon as you and would appreciate if you could advise how best to proceed.

 

[Spiky Bugger]

Ok...I officially hate this thread now!!!....here it is back like what Hilary wrote.... and a few of SL ideas and mine SL and my add ons in (in red)!

I am scheduled to meet with you on 1/27/15 for our final pre-surgery visit. I thought I'd take a moment to write down my thoughts as it is critical to me that our expectations are aligned for the intended surgical approach and contingency plans if concerns arise during the procedure.

It is clear that the DS is the only bariatric surgery that I would benefit from long term and therefore is the only surgery which is acceptable to me. Based on my personal metabolic challenges, and as confirmed by the collective opinion of several other medical professionals, counselors, and long term bariatric patients, it is an absolute necessity for me to have the malabsorptive component of the DS for successful long term weight loss as well as for my comorbidities, especially my type II diabetes.

Further, that DS must be performed in a single procedure, unless medically precluded due to unforeseen intraoperative circumstances. A two stage surgery is not an option as my insurance will NOT cover a second weight loss procedure post VSG.

I am seeking your guidance as to how best to go about adding the following language to my surgical consent form, to ensure awareness and mutual agreement. To that end, I want to add the following to my consent/surgical release form:

CONSENT/SURGICAL RELEASE FORM ADDENDUM
Consent is granted strictly for a Full Duodenal Switch Surgery intended to be completed fully in a single laparascopic procedure. If it is determined during the procedure that the full Duodenal Switch surgery cannot be accomplished laparoscopically, consent is further granted for the full Duodenal Switch surgery to be performed as a single open procedure. Should any unexpected situation occur intraoperatively which, in the best medical judgment of the surgical team, requires that the procedure be stopped, I will expect full documentation be provided to me of the rationale for not undertaking the switch part of the surgery which shall be provided to me upon request.

I know you will, of course, exercise your best professional judgment during surgery, but I want it to be clear on what approaches are acceptable to me. The DS surgery is the only chance I have, and it truly is my last hope to force some semblance of a metabolic course correction to increase and extend the quality of my life. I am very grateful to be in the hands of such a highly skilled surgeon as you and would appreciate if you could advise how best to proceed.

Rather like hating labor but loving the baby...lol

 

[southernlady]

Lol!

Did the nuns still have rubber-tipped pointers they slapped against everything?

No, the order that taught us didn't. And to avoid derailing this thread with off topic, I'll put this one in a new thread.

 

[robs477]

Rather like hating labor but loving the baby...lol

Thxs Spiky for the reality check! No one can do it like you!

 

[hilary1617]

Rob, At the end of the day, any version will be fine. That said, extraneous detail may obscure more than it conveys... Unadorned is my personal preference. Best wishes, Hil

 

[robs477]

Rob, At the end of the day, any version will be fine. That said, extraneous detail may obscure more than it conveys... Unadorned is my personal preference. Best wishes, Hil

Thxs Hil, I’m done and am NOT going to beat this up anymore. My brains turned in to gristle just thinking, actually OVER thinking about it and I agree with the Spiky B!! I’ve always been a self-confessed windbag, but didn’t realize until today the extent that I keep striving for perfection only to wind up in worse shape from too much info. Yup…as of today, I coined a new phrase and am a self-diagnosed, out of the closet recovering “Serial Filler”.

 

[Elizabeth N.]

@robs477, I would delete "upon request." All the blahblah stuff shall be provided to me as soon as it is available, period.

 

[Jen-2]

Rob - I know I'm late to the game - and I say this with all due respect bc I adore you- but are you ABSOLUTELY SURE Dr. Wilson is your guy? You have insurance approval. You've jumped through all the hoops and done all the testing. Could you forward your file and tests to another doc you TRUST? I know it would mean you have to travel but it doesn't sound like you really trust this guy to give you what you know you NEED. You're worried about him doing this in 2 stages, doing a different procedure or not giving you the CC length that will help you be successful long term. I'd hate to see you settle for the "least offensive" option of the 5 or 6 docs you met with just bc he's local and come out of this with something other than the DS you wanted.

I changed docs in December and within 5 weeks of that change I'll have my surgery. Would Keshishian, Rabkin or Greenbaum take your insurance? We know for sure all three of them would do a one step traditional DS w the right CC length. I'm sure there are others too.

The fact you feel you have to go to such lengths with your consent form, cover letter and final appt and you're still only HOPING he gives you what you need - it freaks me out on your behalf.

Please just think about changing docs. I know you're a thorough and thoughtful guy and I hope I didn't offend you with this post - but something about your doc just doesn't pass the smell test. I guess it's bc he doesn't seem to be on the same page with you. You've struggled for 30+ years. You want to make sure you're in the absolute right hands.

BTW- if you decide to change and if you'd choose Greenbaum - I'm only 2 hours away and will happily make myself available to help you in the week you'd be here.

 

[robs477]

Rob - I know I'm late to the game - and I say this with all due respect bc I adore you- but are you ABSOLUTELY SURE Dr. Wilson is your guy? You have insurance approval. You've jumped through all the hoops and done all the testing. Could you forward your file and tests to another doc you TRUST? I know it would mean you have to travel but it doesn't sound like you really trust this guy to give you what you know you NEED. You're worried about him doing this in 2 stages, doing a different procedure or not giving you the CC length that will help you be successful long term. I'd hate to see you settle for the "least offensive" option of the 5 or 6 docs you met with just bc he's local and come out of this with something other than the DS you wanted.

I changed docs in December and within 5 weeks of that change I'll have my surgery. Would Keshishian, Rabkin or Greenbaum take your insurance? We know for sure all three of them would do a one step traditional DS w the right CC length. I'm sure there are others too.

The fact you feel you have to go to such lengths with your consent form, cover letter and final appt and you're still only HOPING he gives you what you need - it freaks me out on your behalf.

Please just think about changing docs. I know you're a thorough and thoughtful guy and I hope I didn't offend you with this post - but something about your doc just doesn't pass the smell test. I guess it's bc he doesn't seem to be on the same page with you. You've struggled for 30+ years. You want to make sure you're in the absolute right hands.

BTW- if you decide to change and if you'd choose Greenbaum - I'm only 2 hours away and will happily make myself available to help you in the week you'd be here.

That is the sweetest thing anyone has said or done for me in a very long time. You are most assuredly a VERY observant, smart and perceptive young Lady…and I agree with your “assessment” 100%. And, so does, Diana, Spiky and many others. I don’t wanna start picking on that scab again...lol, but, this was all cussed and discussed way back in August. So, your perceptions are correct.

That being said, sometimes you have to go with your gut feeling, (pun intended)! Dr. Wilson for sure does not have a reputation as a “Bait and No-Switcher”. He does limit whom he does the DS on because of its hazards and due to the education level needed to maintain your health.

I have actually always been the one to bring up the two stage vs one stage aspect of it in our visits, not him and he may feel like I’m putting him on the ropes, thus the he leaves himself an exit if needed. I really think he will try to do the DS one stage, BUT it is my biggest fear, no doubt.

If he has a problem with the consent form, then I may have to make another decision?? But, again, I’m putting him on the ropes with that too. Thank you though for your thoughts, observations and concerns. That and a million other things are all twirling around in my brain right now…lol

 

[robs477]

OK, here is the final re-write, (not longer)...I actually substituted just a few re-wordings that @southernlady suggested and EN as well. I sent it off about ten minutes ago, so no re-writes Spiky! Done deal, let’s see what happens.

Since I am scheduled to meet with you on the 28th of Jan for our final pre-surgery visit, I thought I'd take a moment to write down some final questions I have prior to my surgery so that you can read them prior to our meeting.

It is clear that the DS is the only bariatric surgery that I would benefit from long term and therefore is the only surgery which is acceptable to me. Based on my personal metabolic challenges, and as confirmed by the collective opinion of several other medical professionals, counselors, and long term bariatric patients, it is an absolute necessity for me to have the malabsorptive component of the DS for successful long term weight loss and mitigation of my comorbidities, in particular, my type II diabetes.

Further, that DS surgery must be performed in a single procedure, unless medically precluded due to unforeseen intraoperative circumstances. A two stage surgery is not an option as my insurance will NOT cover a second weight loss procedure post VSG.

I know you will, of course, exercise your best professional judgment during surgery, but I want to be clear on what approaches are acceptable to me. The DS surgery is the only chance I have, and it truly is my last hope to force some semblance of a metabolic course correction to increase and extend the quality of my life. To that end, I want to add the following to my consent/surgical release form:

CONSENT/SURGICAL RELEASE FORM ADDENDUM
Consent is granted strictly for a Full Duodenal Switch Surgery intended to be completed fully in a single laparascopic procedure. If it is determined during the procedure that the full Duodenal Switch surgery cannot be accomplished laparoscopically, consent is further granted for the full Duodenal Switch surgery to be performed as a single open procedure. Should any unexpected situation occur intraoperatively which, in the best medical judgment of the surgical team, requires that the procedure be stopped, I will expect all full documentation be provided to me explaining the rationale for not undertaking the switch part of the surgery. To best insure for my continuity of care with any physician I may see in the future, I also request all medical records and documentation be provided as soon as they are available.

I am so grateful to be in the hands of such a highly skilled surgeon and am really looking forward to my scheduled surgery date and finally getting the help I need to be able to move forward with my new life!

 

[Larra]

@robs477 I think your final final version covers what you need to say. It is collaborative rather than confrontational, which is the tone you want, but makes your desires very clear.
And to my mind, this approach is not kissing up. You and the surgeon and everyone else involved should be a team. You and the surgeon are the two most important members of the team. You are on the same side, it's just a matter of good communication in both directions.