Hello everyone,

Where do I start? I am an American woman living in Saudi Arabia. A few years ago I had my gallbladder removed here. The surgeon has become a family friend. My dh saw him in the stroe a few months ago and was informed that the hospital he works at has him opening a WLS Clinic.

I did not think much of it because I have a 7 month old son who I am nursing. I have been eagerly awaiting him to turn 1yrs so that I could get back on the Atkins diet for the fifth time (it is ideal for me because I have had gestational diabeties in all 3 of my pregnancies and diabetes runs in my family. I nurse my children for a full 2 yrs but have done Atkins in the past with my other two children when they were over 18 months). However, I have been pregnant and/or nursing for 7 years now, so I am always losing and regaining.

I have recently learned about the LAP Band. I never ever thought I would be interested in any WLS because the GBS scares the heck out of me. So I called our family friend/surgeon and asked him which procedure does he do. He said to come in when his clinic is open in a month, that they do not do GBS that they put a 'ring' on you (he's arab and is use to refering to stuff in english in a way that he thinks most ppl can relate so I am assuming he means band). I asked him how much is the procedure and he said, "don't worry about it for you it's free!!!"

I will tell you the situation,here in Saudi. Since I have been researching I have found out that the military hospitals (treats the royals so they have top notch doctors) and the private hospitals have been doing LAP Band for years (I think they use the Swedish band). My doctor, however, works for the Government hospitals which are free for all Saudis and qualifying expats. I had my gallbladder removed there and a cesarean delivery (side bar: I had LOTS of adhesion/scar tissue removed I hope it has not come back and will be a problem for LAP BAND). This is a new clinic he is opening so I am assuming that I will be one of his first, if not his first patient. He is a great surgeon and has performed many laproscropic surgeories, I'm just not sure if he has ever done Lap band.

I guess the advice I am seeking here, is what would you do if you were in my shoes? I have no insurance at all, anywhere in the world, so America is not an option. It is fairly inexpenive here at the private institutes, but I still could not afford it without putting my dh in a bind and then it would take time for him to save for it. I prefer to do it now because I would like to have another bAby in a few years (ALL F MY KIDS ARE 2 1/2 YEARS A PART). What are the things that would make you turn down an opportunity to have this done FREE!!!???

What would be your concerns with being a docs first patient? I would be more comfortable if he was more established, but the clinic doesn't even open for another month. Of course I will inquire about his training when I go in for the consultation.

Please advise me like you would advise yourself. Give me the good, the bad, and the ugly!

Thank You

P.S I notice that after banding most people eat low carb. The reason I can't stick to Atkins when I am pregnant and/or nursing is because I need the ketosis to keep me in control of whatI eat. Without the ketosis I am back to my bad habits. However, it is not recommended to be in ketosis while pregnant and/or nursing. Due to the restiction of bandind I am assuming that you even get less carbs than on Atkins...are most bandsters in ketosis?

Wow...I'm in a hurry or I'd respond more fully...but just wanted to let you know that I'm pretty sure desertmom is in Saudi. I'll try to scare her up later if you don't find her.

I would find out exactly how long he's been banding and when/where he was trained to do it.

I haven't had a consultation yet. The clinic hasn't even opened yet, so honestly i doubt that he has done many if any. I'm thinking that I will be one of the clinics first patients. Would any of you ever consider being a first patient. Sounds kinda experimental. I so hyped about this and desaparate. i just came back from the beach hich is a 2block walk and it hurt my back so bad so sooner than I walked out the door. I don't have much energy to play with my kids and I had to hire someone to cook and clean for me because it too painful and exhausting for me.

I know that most people would say that they wouldn't do it if they were going to be the first. But in all honesty, if you know that he's an excellent surgeon, if he's got good credentials, is willing to give you good aftercare, and knows what he's doing (Has been proctered in the LapBand procedure, or will have some there who is proctered in it to show him how to do it.) then I would personally go for it.

I don't say to go for it just because it's free, I say to go for it only if the above guidelines are met. I wouldn't say to do it if he will be doing the surgery alone and is not familiar with the procedure, and I wouldn't say do it if he isn't going to be giving you aftercare either. You need to ensure that those things are going to be taking place and set up for you ahead of time, otherwise you may find that you'll regret going ahead with it.

I also advise you not to keep your body in ketosis, and no, we bandsters are not supposed to be eating that way either (with the exception of maybe a week or 2 right before surgery, to shrink the liver so that it doesn't get nicked during surgery). It can be very harmful to keep your body in that state for any extended amount of time.

Whatever your decision, I wish you the best of luck in all of this.

You can eat a very balanced diet when banded. And if you do find that you are unable to get in what you need during pregnancy, just have him take some of your fill out. That's the great thing about it being adjustable!

If there are problems with the band, will you be able to have followup surgeries for free? (removal, port revision, etc)?

And is he nearby enough that you will be able to get fills/unfills as needed?

Best wishes!!

thanks everyone. my main concern is that i read somewhere that the mortality rate in gbs was higher in patients in the easrly percentile of a surgeons/hospitals wls career. my doc is very experienced in laproscoptic surgery, but i won't know how many bands he has performed until sometime next month.

i think my main concern would be that he hasnt had much hands on experience. if you let him get a few bandings under your belt the chance for surgical error would go down (i would think) i would come up with an excuse of why you need to wait a few months, let him do a few bands and get some experience before you go to him.

i would spend the next month or 2 or 3 DOING MAJOR RESEARCH on the band. if you go in there and are able to ask him questions (like how he would handle worse case scenarios, complications) and get a satisfactory answer that lets you know that he *KNOWS* his stuff then i would go for it!

are you all gonna be in saudi long term? if you EVER have complications it would likely be an out of pocket expense so you NEED to have a plan as to where that $$$ would come from...just in case.

good luck!

Thanks Michelle, that is exactly what I am thinking of doing. I don't want to come right out and say, "O heck naw you are noy about to go experimenting on me!" Even though I don't think he would have even offered to do me if he did not feel confident that he would not do a good job, God Willing.

My last cesarean was done at his hospital. My OBGY opted to give me an emergency c-sec against the head surgeons advise (I found this out from my nurse after the fact), who wanted her to wait until the next day when he would be available to attend. I guess she thought it was no big deal, but once she opened me up she could not get the baby out because the opening of my uterus was stuck to the abdominal wall (too much scar tissue). An emergency team of surgeons had to be dispatched and the surgeon now in chargew of the WLS clinic new I was in surgery and rushed in to see if he could assist (I did not find this out until after the fact). So I'm confident that he has my best interest in mind. I will ask him at the consultation any and everything I can think of (he loves talking to me because most patients here are not informed at all about even the simplest matters so it's a switch to talk to me...his only American patient), if anyone else has a list of qustins that they would ask please post tem and I will be sure to inquire.

you should try doing a search (right beside the 'new posts' button above) on 'questions for dr' or something of that nature i am sure someone has posted a list like that before!