My Primary Doctor was PISSED

[pumpkin07 32]

I finally, after 5 mos. had to go back to my PCP b/c I was out of my thyroid meds. I hadn't told him b/c I have concerns about ever being able to get private insurance, should I need it. I'm self employed. But lying isn't good either, so I decided to fess up.

He was pissed. Said that he has patients (I believe he was referring to 1) that got the sleeve and could not stop loosing weight. He tried to keep his composure, but obviously he was mad that I didn't ask his opinion. He recommends the lap band b/c it is 'temporary' and can be reversed and seems to hate this surgery b/c of its permanency and says that I'll have trouble getting enough Calcium, B Vitamins, and D Vitamins b/c once the stomach is cut off they become harder to absorb.

I thought that is why I didn't get the bypass, b/c this surgery didn't have those issues. I thought once I could eat more that those problems would be more manageable.

I didn't really argue points with him about lap band b/c he didn't seem to have the time. He did help me figure which vitamins to take with which, but wondered what you all thought.

He is a nice guy, and I understand. But he was obviously caught off guard and not happy with me.

[Jane_J 117]

He's a nice guy and he is also wrong.

Jane x

[Tiffykins 673]

I agree with Jane 100%. pumpkin, I'm over a year out, and all my Vitamin counts are perfect, and guess what I'm not exactly perfect with my multi. I mean I rarely miss, but when I do it might be 2-3 days in a row. I can eat such a varied diet now that honestly, I don't see how I could get deficient in anything.

Also, the only one I've seen sleeve patients report getting low on is Vit D, D3, and Iron. Some of those patients had deficiencies before surgery, or other medical issues that can contribute to deficiencies.

I'm not trying to bash your doctor, but maybe he should read up on the stats of the band, and see just how horrible the complications can be. The sheer fact that 1 out of 4 patients he refers to the band will need another (if not multiple) surgeries to either replace, remove, revise, reposition the band should make him reconsider his pro-band opinion. Those stats are from the band manufacturer, it's not like people are out there making this stuff up.

By the way, it's my understanding that 90-95% of our Vitamin absorption occurs in the intestines, not the stomach. So, I'm not really sure what missing 80%+ of our stomach has to do with vitamin absorption. Could it happen, yes, but the fact is most sleeve and band patients do not experience vitamin or nutrient issues because there is zero malabsorption.

[Jaffa 5]

He is pissed, because he wanted to recommend you and get a kick back. PCP's get a really nice kick back from weight loss surgery referrel.

Don't kid yourself, don't be a fool, its all about the money!!!!!!

[TexasT 99]

It's amazing to me how biased these docs can be, and also how uninformed! My internist (who was my primary care) was against ANY type of WLS. When I got the band, he pretty much dissed it. Then he misdiagnosed my gall bladder symptoms last year, so I have quit going back to him. I didn't even want to get an earful about the VSG from him!

I just had my yearly gyno exam, and asked this doc to please run my blood work post-op. She was happy to do so, remarked about how great I looked with my weight loss, and was very positive.

My only deficiency was in Vitamin D, so I am now on a once weekly dose for 12 wks to get caught back up. As a hysterectomy patient, I'm considered post-menopausal, which has a lot to do with this - and is not completely due to the VSG.

And as for not being able to stop losing weight with the sleeve - I think there are plenty of us here that DON'T have that problem!

[breezy 8]

What a bummer to have your doctor react like that! It makes me feel even happier that my PCP was supportive (she found out after the fact also).

Kind of stupid of him to berate you when you've already had the surgery. I could understand the reaction if he felt he had to be so hard on you to keep you from having it, but after it's done, it's his job to help you stay healthy. Losing weight will make you healthier, so it just seems wrong of him to have that reaction.

Some doctors are really insensitive though. You may want to consider changing doctors if it keeps up.

[delawaregal 2]

I don't necessarily think her doctor was insensitive or worried about a kick back. I was married to a PCP and most of them work long hours and are genuinely interested in their patients' welfare. If they were really out just for money they wouldn't be a GP they would be a specialist.

His opinion is only based on his experience and information and he was probably more annoyed that as your PCP you did not discuss this major medical decision with him and get his feedback. It sounds like your doc is worried about your health and nutrition. The research I have read does find that VSG patients are at risk for Vitamin D, Vitamin A, folate, and B-12 deficiencies.

I gave my PCP information on the procedure when I went to talk to him about it. Even though he does not like WLS in general he has been supportive.

When you see him next time I would give him some studies (docs like science) to read and tell him you will work with him to make sure your nutritional profile looks good.

[Oregondaisy 2,021]

My doctor was thrilled . He said I had the cadilac of wls and it's going to replace all the other wls.

I was deficient in Iron and D3 but I am fine now. I take 50,000 of D3 per week and Iron with Vit C for better absorption. I got it from Vitalady.

[vkgirl 0]

I'm lucky in the fact that my PCP is the MD in charge of the weight loss program for my area (Kaiser) and all of the WLS patients need to see him as part of the process. He just happens to be the PCP I picked and I've always liked him and his honesty. When I finally went to him to talk about the VSG, it was really easy. He was also very upfront with the hard reality of keeping the weight off long term.

At the end of my appointment, I asked him if he liked being the MD for WLS, and he said it has been very gratifying. It really makes him happy to have patients come back to him and tell him how much their lives have changed.

The other reality is that not all MD's know everything about these procedures. My sister is an oncologist and had suggested that my mom get the lap band. She wasn't aware of complications, the normal life of productive burping, vomiting, finding the right fill amount, etc. But, she was coming from the same place I did when I first started thinking about the band, it would just help cut down on the amount of food we eat, simple as that. Unfortunately, my mom is the WRONG person for really any of these surgeries, she would never be compliant. My PCP is her PCP and he said the same things. Her head issues are too big for these tools to be a success.

[pumpkin07 32]

Thanks for your responses. Honestly his feedback has made my week hard and it did cause some worry in my head. Because I do trust him somewhat as a doctor, and I'd like to keep getting my thyroid meds from him. What he said exactly was Vitamin D deficiencies, B12 deficienies, Iron deficiencies - similar to what someone just said a couple threads up. He did totally understand the procedure and drew it out for me - like I didn't know the surgery. But he is totally oversimplifying the lap band in my opinion - calling it a temporary surgery. I don't consider it temporary when it grows to your stomach. He made it sound like a hair barrette.

I think you can't have any alteration from the body and not expect a downside. So since he is my doctor I'll respect his opinion and be more careful on my Vitamins. I really didn't do well with my Vitamins for a long time b/c I kept getting sick on them. But now that I can eat more I seem to be able to tolerate them better.

What I would say, however, is that he seems to not understand what it is like to be overweight your whole life, basically, and not be able to find a solution that is workable. I mean, even weight loss drugs that make you leak grease out of your ass? Pleaseeeeeee......no thank you. I gave up a long time ago on weight loss - after trying every diet I could stomach. This has given me hope again.

Also, if I should find myself in a situation where I can't stop losing, I think I'm at an advantage b/c my mind and my body are really good at working together to gain weight. In fact, I am losing so slowly now. I would say gaining weight is a strength I have, easier for me than losing. lol

Even if it true what he is saying, I don't think those comments alone would have kept me from having the sleeve over the band for many reasons, but certainly because of financial reasons. The band was not workable for me b/c it seemed like a constant expense of maintaining/replacing, etc. No thank you. This was a whopping $14k, but I won't have to keep spending that same money over and over again, or even more for revision surgeries. Also the bypass seemed like something that might have to be operated on again later as well, as I read about people that are having those reversed b/c of nutritional deficiencies.

I also don't really understand why Vitamin absorbtion is an issue since we didn't alter our intestines. So while I'm confused about that, I'll assume there is some reason I don't quite get.

My Iron was low on my bloodwork, and my Vitamin D. They were both barely low, but low. But I'm always a little anemic so I was not surprised. What did surprise me is my cholesterol did not go down and my bad cholesterol went up. Perhaps my next bloodwork will make more sense. My diet is getting more varied with more fruits and veggies worked in, so perhaps that will help. My triglycerides went wayyyyy down. And I'm taking my vitamins more faithfully now.

[Ellisa 6]

Thanks for your responses. Honestly his feedback has made my week hard and it did cause some worry in my head. Because I do trust him somewhat as a doctor, and I'd like to keep getting my thyroid meds from him. What he said exactly was Vitamin D deficiencies, B12 deficienies, Iron deficiencies - similar to what someone just said a couple threads up. He did totally understand the procedure and drew it out for me - like I didn't know the surgery. But he is totally oversimplifying the lap band in my opinion - calling it a temporary surgery. I don't consider it temporary when it grows to your stomach. He made it sound like a hair barrette.

I think you can't have any alteration from the body and not expect a downside. So since he is my doctor I'll respect his opinion and be more careful on my Vitamins. I really didn't do well with my Vitamins for a long time b/c I kept getting sick on them. But now that I can eat more I seem to be able to tolerate them better.

What I would say, however, is that he seems to not understand what it is like to be overweight your whole life, basically, and not be able to find a solution that is workable. I mean, even weight loss drugs that make you leak grease out of your ass? Pleaseeeeeee......no thank you. I gave up a long time ago on weight loss - after trying every diet I could stomach. This has given me hope again.

Also, if I should find myself in a situation where I can't stop losing, I think I'm at an advantage b/c my mind and my body are really good at working together to gain weight. In fact, I am losing so slowly now. I would say gaining weight is a strength I have, easier for me than losing. lol

Even if it true what he is saying, I don't think those comments alone would have kept me from having the sleeve over the band for many reasons, but certainly because of financial reasons. The band was not workable for me b/c it seemed like a constant expense of maintaining/replacing, etc. No thank you. This was a whopping $14k, but I won't have to keep spending that same money over and over again, or even more for revision surgeries. Also the bypass seemed like something that might have to be operated on again later as well, as I read about people that are having those reversed b/c of nutritional deficiencies.

I also don't really understand why Vitamin absorbtion is an issue since we didn't alter our intestines. So while I'm confused about that, I'll assume there is some reason I don't quite get.

My Iron was low on my bloodwork, and my Vitamin D. They were both barely low, but low. But I'm always a little anemic so I was not surprised. What did surprise me is my cholesterol did not go down and my bad cholesterol went up. Perhaps my next bloodwork will make more sense. My diet is getting more varied with more fruits and veggies worked in, so perhaps that will help. My triglycerides went wayyyyy down. And I'm taking my vitamins more faithfully now.

Love the "hair barrette!"

I didn't hate my band, but when it had to be removed, I opted for the sleeve, I didn't know at the time there was a reduction in absorbtion, but that wouldn't have changed my mind. I haven't talked to my PCP yet. Yikes. I was so busy with appointments with my OBGYN (unrelated) and surgeon to deal with the GERD/hiatal hernia, I just didn't take the time. I'm sure he'll understand...

My surgeon does require a Multivitamin, Iron, Ferrous Fumerate or Ferrous Gluconate, Calcium Citrate, Subl-lingual B-12 (weekly) for his sleeve patients. That's going to be a tough one for me because I've never taken my vitamins like I was supposed to. That's why I loved my band, I could eat enough vitamins.

My guess is that if you are a successful sleeve person whose health improves your PCP will be recommending it before long. Be the poster child!

[wannalise 16]

Hey just a side note, our bodies will never become deficient in Calcium because it has a set point it always has to be and if you aren't consuming enough it will leach calcium from bones and teeth. So....often when we present with Vitamin d deficiency it also means we are low on calcium.

I think that it is important to help educate your doctor, not in a confrontational way, but to help him understand why you made the choice you did. My doctor's reaction was more positive, but she was very unfamiliar with how the sleeve works. (but we all know it does) Results may be the thing that sells your doc on the procedure.

[stcyt 15]

I just take the chewable Bariatric Advantage daily. I have to suck on it real slow so as not to barf. Iron has always made this barfing problem with vitamines worse. What I'm reading though is I should add some iron and D and maybe B???

[Ellisa 6]

Hey just a side note, our bodies will never become deficient in Calcium because it has a set point it always has to be and if you aren't consuming enough it will leach calcium from bones and teeth. So....often when we present with Vitamin d deficiency it also means we are low on calcium.

I think that it is important to help educate your doctor, not in a confrontational way, but to help him understand why you made the choice you did. My doctor's reaction was more positive, but she was very unfamiliar with how the sleeve works. (but we all know it does) Results may be the thing that sells your doc on the procedure.

Exactly why I need to take the Calcium. I want to keep my teeth and strong bones. I'm at the age where that's a concern. LOL

[lmmore 0]

Thanks for your responses. Honestly his feedback has made my week hard and it did cause some worry in my head. Because I do trust him somewhat as a doctor, and I'd like to keep getting my thyroid meds from him. What he said exactly was Vitamin D deficiencies, B12 deficienies, Iron deficiencies - similar to what someone just said a couple threads up. He did totally understand the procedure and drew it out for me - like I didn't know the surgery. But he is totally oversimplifying the lap band in my opinion - calling it a temporary surgery. I don't consider it temporary when it grows to your stomach. He made it sound like a hair barrette.

I think you can't have any alteration from the body and not expect a downside. So since he is my doctor I'll respect his opinion and be more careful on my Vitamins. I really didn't do well with my Vitamins for a long time b/c I kept getting sick on them. But now that I can eat more I seem to be able to tolerate them better.

What I would say, however, is that he seems to not understand what it is like to be overweight your whole life, basically, and not be able to find a solution that is workable. I mean, even weight loss drugs that make you leak grease out of your ass? Pleaseeeeeee......no thank you. I gave up a long time ago on weight loss - after trying every diet I could stomach. This has given me hope again.

Also, if I should find myself in a situation where I can't stop losing, I think I'm at an advantage b/c my mind and my body are really good at working together to gain weight. In fact, I am losing so slowly now. I would say gaining weight is a strength I have, easier for me than losing. lol

Even if it true what he is saying, I don't think those comments alone would have kept me from having the sleeve over the band for many reasons, but certainly because of financial reasons. The band was not workable for me b/c it seemed like a constant expense of maintaining/replacing, etc. No thank you. This was a whopping $14k, but I won't have to keep spending that same money over and over again, or even more for revision surgeries. Also the bypass seemed like something that might have to be operated on again later as well, as I read about people that are having those reversed b/c of nutritional deficiencies.

I also don't really understand why Vitamin absorbtion is an issue since we didn't alter our intestines. So while I'm confused about that, I'll assume there is some reason I don't quite get.

My Iron was low on my bloodwork, and my Vitamin D. They were both barely low, but low. But I'm always a little anemic so I was not surprised. What did surprise me is my cholesterol did not go down and my bad cholesterol went up. Perhaps my next bloodwork will make more sense. My diet is getting more varied with more fruits and veggies worked in, so perhaps that will help. My triglycerides went wayyyyy down. And I'm taking my vitamins more faithfully now.

Your doctor is not as informed on the sleeve as he should be. Tiff is correct, malaborbtion is not an issue with this procedure. With regards to your cholesterol. This surgery does not help that. It helps with pre-diabetes and blood pressure,etc. but not cholesterol. If anything, our need to eat more Protein doesn't help. You may need to take a cholesterol medication. My triglycerides also went way down, but not my LDL. My HDL, the happy kind went up, which is great. But it's the LDL that cause most problems. I take Lopid for cholesterol, and they have also put me on Fenofirate recently. They want my LDL under a 100 (it's a 114 now). My cholesterol is great for most people, but I had 5X bypass, so that want it under a 100. Good luck.