I’m just going to send it to Dr.'s bariatric coordinator with a brief explanation that I want that verbiage in my consent form and we can just take care of it at my last pre-surgery visit and discuss then one last time in person as Diana said. That’s about all I can do. If the hospital has something different…well, whatever. All I can do is all I can do and the deal is with my surgeon not the hospital, that’s about all I can think to do.
OK, here is what I'm going to send to the bariatric coordinator, for all to review, especially the Dr., and then discuss one more time on my pre-op visit. A cover letter is first, explaining what, when, why I need to add this to the consent form and then the actual "consent statement" that everyone helped me author, especially Hilary. It is under the "cover letter".
COVER LETTER:
Prior to our pre-surgery consultation on ????, I wanted to compile and reiterate what I need to achieve most from this surgery and convey to you the severity level of my crashed metabolism.
I have spent well over a year and hundreds of hours researching what Bariatric surgery would benefit me the most. As I have stated previously, because I have a severe case of
Metabolic syndrome(due to insulin resistance etc, limits my body’s ability to use sugar and convert for energy), and everything I eat gets turned into fat first, and stored as fat cells and not burned real-time for energy as “normal” people. Because I eat fewer than 800-1000 calories a day and am in the starvation mode 24/7, this syndrome is self perpetuating and with age and time has spiraled down to my present condition of non-functionality and is no longer sustainable. Therefore, because it as an absolute necessity for me to have the malabsorptive component of the DS, it is
the only bariatric surgery that I would benefit from long term and is the only surgery I will consent to or consider.
Based on my personal metabolic challenges and on the collective advice of several other medical professionals, counselors, and long term bariatric patients and veterans’ of the DS that I have consulted with, I have been strongly advised that I need to add that to my surgical consent form, (see below).
In pursuit of seeking a DS Surgeon, I have met with and consulted SIX different Bariatric Surgeons over the last year. I specifically chose you to do my surgery because you have a reputation as an experienced DS surgeon, and have said you could perform this procedure on me. I am 56 years old and I/we need to do our absolute best to get this maximum benefit from the full DS surgery the first time.
In addition, the surgery cannot be done in two stages because my insurance will NOT cover a second weight loss surgery, especially if my BMI drops from the short term weight loss I may achieve with the VSG portion of the surgery, so, a two stage DS is surgery is cannot be an option for me.
Please understand, I’ve been riding this metabolic roller coaster for over 35+ years, and either way, I am done. I can’t go on living on 800 calories a day. From a more personal perspective; my wife and I are raising our Granddaughter and she is 12 years old now and we are the only parents she has known since she was 10. I have to be here for her and am trying to buy myself another 15-20 years or so. 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, and those are my primary motivations.
CONSENT/SURGICAL RELEASE FORM
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, it is expected that photographic evidence and all full documentation of the rationale for not undertaking the switch part of the surgery shall be provided to fully ensure continuity of care for the subsequent completion of the procedure.
