Serious doubts after visit with surgeon (long)

[mythreechildren2001 7]

I met with the surgeon, insurance specialist, nutritionist, etc. I went to the appointment with everything (I thought) and was ready to get my approval and get the process going! If they had told me they could take me that day, I would have RUN to the operating room. After meeting with the surgeon, I was so disheartened that I don't think I'm even going to pursue this anymore.

First of all let me say that I was given the opportunity to have insurance that covered the surgery through my employer which covers WLS. I jumped on it, even though I have to pay a penalty of $130/month for 2 years because I didn't take the insurance when I first hired on 21 years ago (teacher) or during a major life change (birth of my children). When you're a teacher (in Tennessee anyway) you can't add on to the state insurance policy unless you're getting married, divorce, have a child, or spouse loses insurance. TN did an open enrollment for the first time EVER so I JUMPED on it...knowing I would be paying a penalty. The insurance took effect Jan 1. I knew what they required so I had been preparing for months prior to that. I completed the 6 month medically supervised visit Jan 3 and met with the bariatric surgeon, etc on the 6th.

The surgeon was very nice and compassionate BUT he is not a huge fan of the sleeve and has only done 2. He said he would completely understand if I wanted to switch surgeons, but he thinks the sleeve is being prematurely dubbed the be all end all. He said that even though the procedure was done along with duodenal switch, you can't compare the two in terms of long term safety, results, etc. He thinks there is nowhere near enough data for this surgery in regards long term results/complications. He really favors gastric bypass...REALLY favors it. This surgeon is the head of a MAJOR university hospital...world renowned hospital. He did say that the sleeve is by far a less complex surgery than the gastric bypass..he repeated how 'simple' it is in terms of complexity of the procedure itself.

This completely threw me for a loop, and I left completely disheartened and devastated. He wants me to do a sleep study because I told him that I sometimes SOMETIMES snore when I'm congested. He wants me to have an endoscopy done because I have felt reflux at times (when I've been pregnant and when I've really overeaten) and even though my insurance doesn't require a psychological eval, he wants me to have one. He tried to reassure me and told me I was the perfect candidate for surgery, and he would gladly perform whichever one I chose (lap band, sleeve, gastric bypass).

I was so disheartened when I left, that I REJOINED weight watchers for the 500th time. I am not interested in having my intestines rerouted (no offense to anyone who has had this. I have just not even considered it for me) BUT I do have high blood pressure, diabetes waiting to happen, have horrible knee pain, just plain miserable, and I certainly look horrible. I'm 47 years old and I'm at my all time high of 270 lbs.

I'm still numb from the experience because I really thought I good to go, and now I don't think I will even go forward.

[TijuanaPlication 87]

I'm so sorry to hear that. If your surgeon is anti VSG, then I personally wouldn't want a VSG with him. I didn't want the mal-absorption and bowel stricture/rotation issues that come with having your bowels re-sected. I don't really understand how a duodenal switch is meant to be safer than a VSG, when VSG is halfway to DS!

Have you considered self-pay? When you consider $130/month for almost 20 years until you retire, self-pay looks pretty cheap. In the US do they offer credit cards with introductory interest free periods? That's how I financed my surgery. If you self-pay then the world's your oyster!

[thinoneday 445]

I met with the surgeon, insurance specialist, nutritionist, etc. I went to the appointment with everything (I thought) and was ready to get my approval and get the process going! If they had told me they could take me that day, I would have RUN to the operating room. After meeting with the surgeon, I was so disheartened that I don't think I'm even going to pursue this anymore.

First of all let me say that I was given the opportunity to have insurance that covered the surgery through my employer which covers WLS. I jumped on it, even though I have to pay a penalty of $130/month for 2 years because I didn't take the insurance when I first hired on 21 years ago (teacher) or during a major life change (birth of my children). When you're a teacher (in Tennessee anyway) you can't add on to the state insurance policy unless you're getting married, divorce, have a child, or spouse loses insurance. TN did an open enrollment for the first time EVER so I JUMPED on it...knowing I would be paying a penalty. The insurance took effect Jan 1. I knew what they required so I had been preparing for months prior to that. I completed the 6 month medically supervised visit Jan 3 and met with the bariatric surgeon, etc on the 6th.

The surgeon was very nice and compassionate BUT he is not a huge fan of the sleeve and has only done 2. He said he would completely understand if I wanted to switch surgeons, but he thinks the sleeve is being prematurely dubbed the be all end all. He said that even though the procedure was done along with duodenal switch, you can't compare the two in terms of long term safety, results, etc. He thinks there is nowhere near enough data for this surgery in regards long term results/complications. He really favors gastric bypass...REALLY favors it. This surgeon is the head of a MAJOR university hospital...world renowned hospital. He did say that the sleeve is by far a less complex surgery than the gastric bypass..he repeated how 'simple' it is in terms of complexity of the procedure itself.

This completely threw me for a loop, and I left completely disheartened and devastated. He wants me to do a sleep study because I told him that I sometimes SOMETIMES snore when I'm congested. He wants me to have an endoscopy done because I have felt reflux at times (when I've been pregnant and when I've really overeaten) and even though my insurance doesn't require a psychological eval, he wants me to have one. He tried to reassure me and told me I was the perfect candidate for surgery, and he would gladly perform whichever one I chose (lap band, sleeve, gastric bypass).

I was so disheartened when I left, that I REJOINED weight watchers for the 500th time. I am not interested in having my intestines rerouted (no offense to anyone who has had this. I have just not even considered it for me) BUT I do have high blood pressure, diabetes waiting to happen, have horrible knee pain, just plain miserable, and I certainly look horrible. I'm 47 years old and I'm at my all time high of 270 lbs.

I'm still numb from the experience because I really thought I good to go, and now I don't think I will even go forward.

Wow, your physician is really unsure of himself huh? I'm glad he won't be doing your surgery cause he himself knows he is incompetent with doing the sleeve. . . find you another surgeon ESPECIALLY since you are fortunate enough to have it covered by insurance. . . you have been given a blessing and "someone" is telling you to NOT take that doctor cause he could screw up big time. . . go elsewhere honey, don't let him be your only choice. . . WW is good but as you say it's your 500th time, so it hasn't worked has it? Good luck and you'll do what you have to in order to help yourself.

[mythreechildren2001 7]

I'm so sorry to hear that. If your surgeon is anti VSG, then I personally wouldn't want a VSG with him. I didn't want the mal-absorption and bowel stricture/rotation issues that come with having your bowels re-sected. I don't really understand how a duodenal switch is meant to be safer than a VSG, when VSG is halfway to DS!

Have you considered self-pay? When you consider $130/month for almost 20 years until you retire, self-pay looks pretty cheap. In the US do they offer credit cards with introductory interest free periods? That's how I financed my surgery. If you self-pay then the world's your oyster!

Thanks for your reply. Let me clarify a few things. It's not that he's anti vsg (which is how I guess I made it sound), it's just that he thinks it's too early to hail it as the 'be all, end all' in WLS. His reference to the DS was meant to say that even though it has been done as a part of the DS, you can't look at the same studies and apply them to the sleeve. He is concerned about the long-term ramifications of this surgery that we just don't know about yet because it's relatively new as a stand alone procedure.

As far as the $130, that is a 2 year penalty and after that I won't pay anything.

Thanks again for your support and input. I really appreciate it.

[sleevesearch 14]

Your doctor isn't God, and he provided you his opinion. You don't have to agree with his opinion. You've done your own research and should form your own conclusions.

I happen to think he is wrong and that VSG will be the #1 WLS at some point in the future.

Get a new surgeon, and do what is right for you!

[mythreechildren2001 7]

Wow, your physician is really unsure of himself huh? I'm glad he won't be doing your surgery cause he himself knows he is incompetent with doing the sleeve. . . find you another surgeon ESPECIALLY since you are fortunate enough to have it covered by insurance. . . you have been given a blessing and "someone" is telling you to NOT take that doctor cause he could screw up big time. . . go elsewhere honey, don't let him be your only choice. . . WW is good but as you say it's your 500th time, so it hasn't worked has it? Good luck and you'll do what you have to in order to help yourself.

I do believe this surgeon is a competent surgeon. He has done thousands of WLS in his time. I'm sorry that I didn't add more detail. I was afraid people would get tired of reading and move on! lol The reason he has only done 2 sleeves is because he came from UAB. He said that no insurance in the state of Alabama will cover the sleeve, so they just didn't do it there. Now that he has moved to TN, it's a different story. He was extremely supportive and compassionate. I don't even think he realized the doubts he put in my head! I really don't doubt his skill as a surgeon, and I did ask him if there were other drs in the group that would be available should a complication arise. He said absolutely, and that he loves that aspect of his group/practice.

Thanks so much for your input. I really appreciate it.

[TijuanaPlication 87]

Oh, OK then according to the figures I've seen DS is the most effective WLS, so he's correct in what he says. I believe it's fallen out of favor tho due severe mal-absorption (and frequent diarrea). I can understand why people go for it as the average Excessive Weight Loss (EWL) is 80%, whereas other WLS is around 70%.

This youtube clip scared me away from surgery to do with bowels

It's a longish clip, but keep with it - Amelia's a sweetie and I think I've seen all her clips even tho she's an RNYer (BTW she was quite a long way out from surgery when this happened).

Just keep reading and researching, so you can make the most informed decision you can.

[mythreechildren2001 7]

Oh, OK then according to the figures I've seen DS is the most effective WLS, so he's correct in what he says. I believe it's fallen out of favor tho due severe mal-absorption (and frequent diarrea). I can understand why people go for it as the average Excessive Weight Loss (EWL) is 80%, whereas other WLS is around 70%.

This youtube clip scared me away from surgery to do with bowels

It's a longish clip, but keep with it - Amelia's a sweetie and I think I've seen all her clips even tho she's an RNYer (BTW she was quite a long way out from surgery when this happened).

Just keep reading and researching, so you can make the most informed decision you can.

Thanks for the link. This whole thing scares me so much. I have 3 children. I want to be healthy for them. I want to be a good example for them. But most of all, I want to be here to raise them. I just don't know what to do.

[feedyoureye 3,087]

If your not sure, then its OK to wait for a while. Do some research, in a year or two there will be more information on the sleeve. Perhaps you will feel better about it then, or not. You have your insurance now, just keep it up, so you can have the surgery in the future if you decide to.

I am 57, and don't want to wait any longer for weight loss. I am willing to be a bit of a Guinea pig with the sleeve... even though there is 5 years of study, and many more years of examples of people who have lost parts of their stomachs and lived excellent lives for many years without them in my favor. Heck, I even think there will be some miracle cure some day for obesity... but I'm not willing to wait around any longer for it.

Good luck with whatever decision you make, don't get yourself all stressed out, don't forget to relax and enjoy your life!

[Tiffykins 672]

Second opinions are always fabulous. In no way would allow a surgeon that wasn't confident in a surgery type to operate on me. Funny thing is that the stats that are out, can not and do not lie. The stats and long term research information on gastrectomies for stomach cancer and ulcers are all conclusive with showing minimal long term complications. While DS is the most effective long term, it's also a very extensive surgery with a whole slew of long term complications, and insane Vitamin and fat intake requirement. But, the sleeve is and has been showing long term results, it's the reason it became a stand along procedure to begin with.

I know you are frustrated and disheartened, but if you really want surgery, then pursue it with another surgeon that is more confident in his skill level and existing patient results.

[dawnvsg 2]

I would suggest you go to another surgeon who has done many VSG's. Surgeons will always push for what they are most comfortable with doing, and obviously he isn't familiar enough with the sleeve. I was scared of having surgery also. I am married, with 3 boys. I had the sleeve 4-16-2010..and have went from 354 lbs to 227 lbs currently..and feel fantastic! It's a scary decision to make at first, but one that has changed my life already. Best of luck in your decision..but don't let ONE surgeon be the voice for all.

[myrori 55]

I second all who have told you to get another opinion,, as a matter of fact I would say RUN don't walk to another doctor! This is just one bump in the road to a better life! Anything worth doing in life always has a few obstacles to overcome. I thought I would never get done with the the insurance companies requests.

Most everyone getting sleeved in the states completes the following with out fail: Psych eval, sleep study, nut counseling, 6 months diet, lung doctor visit, pre testing, ultrasound of abdomen.

It is all meant for your own good and success with the sleeve. You wouldn't want to go through this and end up with a major complication that could have been prevented.

Doctors are mearly people who give opinions based on their experience.

[BlackBerryJuice 349]

RNY is a scary surgery, the long-term consequences are very unpredictable. One of my friends is a resident doctor and she had to take care of a woman who had the RNY and, 20 years after her surgery, ended up a complete wreck with major electrolyte abnormalities that made it almost impossible for her to function outside the hospital. Every time they'd discharge her, she'd be back within days! To top it all off, you can't even say "well, at least she wasn't obese for 20 years so she didn't die of a heart attack a decade ago," because she was still obese! Granted, my friend didn't know how big she was before (maybe she was 500 lbs before her surgery), but talk about a crappy deal.

[Susanne 32]

To the OP - do it, just do it. I don't know you but I am sure you won't be sorry. Check with another surgeon though.

I personally was sleeved on 11/2 and I have not regretted it even for a second since then. I think I am happier than I have ever been in my adult life.

As for Myrori, I didn't have the sleep study, the 6 month diet, the lung doc visit or the ultrasound of abdomen. It really seems to depend on surgeon and/or insurance, what you get and what they do. But I certainly wholeheartedly agree - the times where we were sheep and followed whatever a doctor said are over. Thanks to the internet, we can get a lot of information and "second opinions" to make informed decisions.

[former_vbg 198]

Thanks for the link. This whole thing scares me so much. I have 3 children. I want to be healthy for them. I want to be a good example for them. But most of all, I want to be here to raise them. I just don't know what to do.

I have to say your surgeon has my respect for being honest with you that he had only done 2 sleeves. I don't get the impression he was trying to "sell" you something else, just being honest with you where his expertise was at.

You have time, don't rush it, but do get a second opinion, not so much which surgery to have but just learn as much as you can so that whatever you end up choosing you have researched things as best as you could.

Best of luck to you, only you can make the decision that is best for you and your family.