Dr. DeBarros describes the tests required before bariatric surgery that include a psychological evaluation.
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You know, bariatric surgery, as you know is, in a lot of cases, high risk. Bariatric patients have different types of problems including sometimes diabetes, high blood pressure, things that can predispose to heart disease. A lot of patients have severe sleep apnea. The statistics are that most bariatric patients have, about 90% of them have sleep apnea in some form, either mild moderate or severe. Those issues have to be dealt with as well. So the typical test, besides the normal routine test, some patients might require a heart test – heart test in terms of stress test or an angiogram, however the cardiologist wants to sort that out. Some patient may require a scope where we put a esophagogastroduodenoscopy where we put a scope actually inside the mouth and look at the stomach and see if they have any other gross abnormalities that will sort of preclude them. Depending on the type of surgery we find different things of patients are positive for bacteria called H. pylori that can lead to ulceration of the stomach and stress ulcers and things like that. So those types of issues should have to be dealt with, some patients need that. Other patients are over the age of 50 and if they have not had a colonic screening I think that that is very important because you don’t want to do an operation for somebody who potentially has a cancer. The other things are routine well woman screening. In our clinic we make sure that every patient, within a year’s time, 12 months from the time they have seen us at that first visit, before their surgery has a routine PAP smear, breast exam, and if age-appropriate, mammography. All of our patients undergo a thorough psychological evaluation. Psych is an integral part of the support groups, as I previously mentioned, psychologist, dietitian, and exercise, but every patient has to undergo a psychological evaluation, which is typically one-on-one with a psychologist or psychiatrist. In our program it is the psychologist.