Amazed

[Roo101769 742]

I am going to precursor this post with the fact that I do understand every surgeon/hospital/ practice has different requirements when it comes to WLS. But I am just stunned at HOW different sometimes!!! One of my very BFFs in the world ( since high school) was sleeved yesterday. His process has been entirely different than mine and it astounds me. He did not have all the extensive pre op testing before approval as I did, but he had to do several classes with NUT. ( I only saw NUT once. She was satisfied with my knowledge and my insurance didn't require anything but NUT approval) My friend didn't even have a scope done to check the esophagus down to stomach, just an upper GI. My upper GI missed a small hernia that was found via the scope. ( but was so small they didn't repair) His pre op diet included food ( two Lean Cuisines or the like a day for 7 days ) while mine was full liquids for ten days. He did not have to do any bowl prep pre op, although he had food up until the evening before surgery. ( I did no bowl prep due to liquid diet for 10 days) He does not have a drain tube and there was no catheter used during surgery. And he just told me he already was given custard this morning to eat!!!!!!!!!! Seriously? I could barely sip a few ounces of apple juice two days post op, let alone eating anything the next day. Now I know my body reacted much differently than his from anesthesia and so on, but wow. ( I had severe nausea and vomiting, he hasn't had any of that) And the other thing...I was in the hospital from 8am on Monday until about 4:30pm Wednesday. He said he is supposed to be released today. His whole process seems so rushed and weird to me. I wouldn't trade the experience I had for the world. I loved the hospital I used and the staff was awesome. I guess I am biased to it. I try hard to keep my opinions to myself because I do not want to "step on his moment" in any way. This is just as big of an event for him as it was for me so I do not want to be a negative Nelly. But I am certainly having opinions about how different things have been for him. I truly just want him to be healthy and happy.

[McButterpants 2,846]

I find it interesting, too! Pre-op diets, post-op diets and the actual surgery itself is so different from doc to doc.

My surgery was done on an outpatient basis - I was in admitting at 6:00 am and back at our condo by noon the same day. I didn't have a catheter or drain.

My doc approved applesauce, cottage cheese, scrambled egg and the like as soon as you could tolerate it in small amounts - 2 tablespoons per day. He said to start introducing foods when you can. My local doc is much more conservative - I an following the local doc's rules even though they are more conservative because she is providing my aftercare.

On a side note look at you and you're great weight loss!!!! I hope you're doing well!

[Arts137 1,811]

Yeppers, programs and surgeons are often very different. There are many roads to Rome.

[Roo101769 742]

Thanks McButterpants.. That weight is my total loss since I began my journey. ( I decided to have the sleeve in July and I started my own diet pre op Aug 1st) Since surgery I have lost 26lbs. ( It will be two months the 21st) I am working at it. Every day is a new day and a new struggle, but I am trying to keep it together and do the best I can!

I find it interesting, too! Pre-op diets, post-op diets and the actual surgery itself is so different from doc to doc.

My surgery was done on an outpatient basis - I was in admitting at 6:00 am and back at our condo by noon the same day. I didn't have a catheter or drain.

My doc approved applesauce, cottage cheese, scrambled egg and the like as soon as you could tolerate it in small amounts - 2 tablespoons per day. He said to start introducing foods when you can. My local doc is much more conservative - I an following the local doc's rules even though they are more conservative because she is providing my aftercare.

On a side note look at you and you're great weight loss!!!! I hope you're doing well!

[PdxMan 4,292]

McButterpants and I had the same surgeon, so, I, too, was outpatient. (My that was a lot of commas ... did I use them correctly?) In at 6:00 and back at the Golden Nugget taking a nap at noon. But that was our surgeon, not anybody else's.

Each surgeon is going to have a protocol they are familiar and comfortable with. I don't know about you, but I want my surgeon to be as comfortable as can be when they are working inside me. Just because one surgeon does it one way versus another doesn't necessarily make it better. They are going to make these decisions based on a number of things most of which we are not privy to.

So, as I'm sure you have read on these forums many times, comparing yourself to others does absolutely no good. Why were you on a 10 day liquid diet and your friend was able to enjoy lean cuisines? Because that is what each doctor has recommended before and it has sized the patient's liver to a size they are comfortable working with. Why do some people get a catheter and other's not, especially when the surgery is only supposed to be less than 45 minutes? Because that particular doctor knows that if the surgery should go longer, they don't want to take the time to catheterize you mid-process. They just want to eliminate the hassle by just doing it, while others are fine pausing for a catheter insertion, again, if needed. Why the drain for some and not for others? Because each has witnessed different results using them. There is a tipping point for using drains as there is also the belief that drains themselves can cause issues, so one has to way the risk/benefit of using them. It would appear laparoscopic VSG is one of those procedures that sits on the fence.

As far as how we react to anesthesia and surgery, well ... that is a highly individual thing. Two people can undergo the exact same process by the exact same surgeon and have two completely different outcomes. I couldn't drink hardly a thing afterwards, but I have always been a sweller. Meaning, that my body gets swollen easily by the least bit of trauma. I know this attributed to my inability to drink early on, but of course, I got past it.

You say you don't want to be a negative Nelly and want to truly be happy for your friend, then do just that.

** EDIT **

So, I just re-read this and I can see where it could be interpreted as coming off harsh, but my intent and tone is just the opposite. I just want you to be focused on your journey and make the decisions that are right for you. When we start to compare ourselves we often take the track of being "less than", and that, for me, is just one aspect of my destructive behavior.

Edited December 18, 2013 by PdxMan

[Roo101769 742]

PdxMan...I understand what you are saying, truly. And my post wasn't meant to sound as "comparative" as it did. I was just trying to impress upon how different it was. As I stated at the start I understand each practice / hospital is different. The only place I had any great concerns for my friend was the lack of testing he went through. It didn't seem they were getting a full and accurate picture of his anatomy pre op without the tests. ( such as the scope) But as you said, it is what the surgeon is comfortable doing. I just love my friend and worry a great deal about him. He is a Hodgkins Lymphoma survivor and I worry. He is 401lbs and has sleep apnea, high BP and other issues. I just want him to be healthy and HERE! I look forward to having this friend to help me with my journey, and me with his. Part of his decision making was based on ME deciding to go for it. We have spent years ( and do I mean YEARS) dieting together, going up and down and back up together. Can't tell you how many "before" pictures we have taken together. This is the first time we both have the chance at success. I truly don't mean to compare our journeys other than seeing what works and what does not for each of us. At the same time I have done a LOT of reading and research and spent hours on the boards seeing everyone's stories. (He has not) I guess I just meant my original post as a thought provoker, to encourage discussion. Because I for one am truly amazed at how different it all can be.

[PdxMan 4,292]

I hear you, Roo. Personally, I think a lot of those test pre-op are completely unnecessary. Myself, I did not have a scope at all. When I asked my surgeon about it, he said he would be looking at everything when the procedure started. If there was something extraordinary, he would stop, but he has done so many of these procedures, there really wasn't anything he couldn't deal with. He was going to get a better, more complete analysis with all the tools the procedure provided anyhow.

I also didn't have a leak test post, which, after his explanation made a lot of sense. The tissue is so swollen anyhow post surgery, it wouldn't reveal a leak if there was one. Having a leak test post op come back negative was no assurance that a leak would not develop, so why even do one? Made sense to me. I was self pay, so of course, my surgeon is looking to keep costs down, but when the insurance IS involved, just the opposite can occur. Somebody else is footing the bill, so LET'S ORDER EVERY TEST UNDER THE SUN!

At the end of the day, we have to research our surgeon and the procedure ourselves. Have done that, we then need to believe they are going to give us the best care, but of course, questioning anything that doesn't seem right. Everything you have described about your friend doesn't seem too far out of the ordinary which you will see as you continue to read similar threads on this site.

Good luck to you and your friend!

[mistysj 1,940]

I don't know if you have seen posts from GamerGirl on here, but she and her husband were sleeved the same day by the same doctor. They each had different pre-op diets and other requirements.

I didn't have to do a pre-op diet, have any pre-op tests, see a psychologist, do a bowel prep. I only had about a month between initial consult and surgery. My surgeon says you don't need a pre-op diet if you weigh under 100 kg and I was 98 at the initial consult. I didn't have drains or a catheter. Heck, I didn't have a catheter after my hysterectomy either, only my knee surgery. I was cleared to take non-chewable pills on the day of surgery and cleared to drink coffee in the hospital.

The sleeve surgery is not the same as it was 5 or 10 years ago when Sleevers and bypass patients had the same pre-op and post-op protocols. Surgical tools and techniques have evolved. Sleeve surgery is faster and safer than it has ever been. Surgeons have more data to draw on. Some surgeons will be more conservative in their methods than others.

With all of that, there is no point comparing your surgery to someone else's. You each chose your surgeon for a reason and each surgeon gave you a protocol for a reason.