Feeling Let down

[lightnhealthy 0]

Today was my consultation and introduction to my surgeon and his practice. I am completely feeling let down!

First he refuses to operate unless I lose 50 lbs, he prefers 100. I understand the thoughts I guess. I have an extremely high BMI. (68) Also, I understand that the higher the BMI at surgery time the less effective the lapband is. That I can learn to live with.

But then he suggested that I have the bypass (after telling him I did not want it) I smiled and stood my ground. I listened and didn't close off to the idea but I want the least amount of evasive procedure and side effects and the lapband has proven to have those.

The center got my business because they were offering a flat rate price for 2 years of aftercare. (fills) Then to come to find out to be a center of excellence they can't operate on anyone above 55 BMI and in that case I don't qualify for the 2 years of aftercare. What a waste of my consultation fees!

But it didn't stop there! After meeting with the nurse, the doctor, the insurance lady, they had me meet the nutritionist. Apparently I can only follow their diet for not 1, 2, 3 weeks pre-op but 4! A cost of over 500 dollars! I just shilled out the money out of my pocket for the consultation fees. I'm frustrated, broke, and just feeling let down.

Don't get me wrong. I did like the surgeon. He seems to know about the lapband and has done many many hundreds and has a fantastic track record. I'm just wondering why it has to be so difficult and expensive! I am on such a tight budget and yet my life is at risk. Sigh. I just wanted to vent.

[elcee 3,341]

Sorry you are feeling let down.

However I am sure that the surgeon has your best interests at heart. Surgery is dangerous and the higher your BMI the more dangerous it is . A BMI of 68 is extremely high.Far better to lose the weight prior to surgery than to die from complications on the table.

It is also normal in the US to have to undergo a 6 month supervised diet prior to undergoing surgery . This proves to the insurance company that you are serious and have tried your best and are not just looking for a quick fix.

you are not the first person i have heard of that has to do a 4 week preop diet. The purpose of this part of the process is to help shrink the liver. When you are obese the liver is enlarged and fatty. If it is not reduced in size prior to surgery you run the risk of having to have open as opposed to laparoscopic surgery or of it getting damaged during surgery which is highly dangerous.

If your Dr suggested a bypass you need to find out why do not just dismiss his suggestion out of hand.Yes there are some Dr's that push bypass because it is their preferred surgery but your Dr may feel that a band would not suit you. With weight loss surgery there is no one size fits all - different surgeries suit different people depending on their types of eating.Bands are generally recommended for people that eat large quantities but do not have as much of an issue with sweets. bypasses are recommended where it is felt that malabsorption is also required. There is another option - the sleeve.I have even heard of people having a bypass and a band combined.

Price should not be your deciding factor when choosing a surgeon. I understand that it is important but it is more important to choose an experienced surgeon that has done lots of the procedure that you choose and that has a good track record. Their are countless horror stories of things going wrong when using a cheap or inexperienced surgeon. That is not to say that all surgeons offering cheap surgery are bad but you do need to be careful.

This board is a great place for you to vent, get support and do research.Read some of the threads from people that had revisions from lapband to bypass to help you with your decision as well.

Wishing you all the best.

[abandnewday 0]

I agree with the prior post. I would also suggest if possible to get a second opinion. As evident on these boards no 2 doctors seem to be on the same page about pre-post diets, rules for after care etc. You may have a doctor that has biases one way or another. Do your research and don't give up. Even if you were banded tomorrow you still need to put in the work to get the desired results. You are worth the investment in yourself. Worst case scenerio you keep the same surgeon and lose the 50 lbs prior to surgery, this is weight that you would need to lose anyway. You will be ahead of the game. Good luck.

[BetsyB 9]

I'm sorry you're feeling let down, but it's really not unusual for a doctor to recommend significant loss prior to surgery with a patient whose BMI is as high as yours. It's not really related to success rate of the band--it's related to getting you through the surgery alive.

You've asked another person to put his reputation and license on the line for your benefit. You have to do YOUR part.

Many doctors do recommend bypass for patients with more to lose. There are valid reasons for this. But that does not mean that the band won't work. It means that you have to discuss, with the doctor, his rationale for his recommendations, and then make the most EDUCATED choice you can make.

As for the program fee: it's not unusual for surgeons to have program fees that cover the nutrition and exercise counseling that are so, so important to success.

That said, it sounds like you're not comfortable with your doctor. And, in fact, that you may have chosen him for the wrong reasons (lower cost). It would be a good idea for you to get a second opinion. Even attending a handful of (free) surgeon seminars can help you get a good feel for a practice. You'll find out, right away, whether there's a program fee---and you'll learn a lot about how each doctor approaches things.