Getting Ready for Surgery - anyone know Dr. Blackstone?

trish4 · March 16, 2010

Hi all - I'm scheduled for surgery in 2 weeks - believe it or not I haven't decided if I'm having the bypass or the sleeve. I have about 75 pounds to lose. Anyone out there have the sleeve done by Dr. Blackstone in Arizona? THANKS!

LAN2k · March 16, 2010

I'm in NY so I can't say a thing about your surgeon. You don't have that much weight to lose. Are you aware that with the bypass their is malabsorption? I had the sleeve by 4.5 months I was down 70lbs. I am sort of at a plateau for the last month or so but that's because I have not been exercising at all. Best wishes what ever you decide.

trish4 · March 16, 2010

LAN2k: thanks for your reply. Yeah, I know about the malabsorption with the bypass. Congrats on your great loss thus far. I just keep thinking that the bypass has a really good track record and since I'm a self pay I don't want to have to go through 2 operations. And as I've mentioned in other posts - I get nervous about reflux with the sleeve. Just a million things to think/worry about before my surgery

NOPATIENCE · March 16, 2010

Hi TRISH4. I'm having my surgery on 4/5 and I too had a very difficult time over the VSG vs gastric bypass. I have acid reflux as it is and I'm hoping that with the med I currently take I can keep it in check after surgery. My HMO will not pay for a revision if I find that I do not loose enough weight from VSG, so that was also a consideration for me. But after thinking about it for several months, I've decided that I will do just as good with the VSG without the malabsortion problems. It is a very difficult decision to make, isn't it? However, I am at peace with my decision. Keep us posted.

Tiffykins · March 16, 2010

I'm not familiar with your surgeon, but I can tell you why I chose VSG over RNY for my revision.

1) No blind stomach left behind with VSG that can't be scoped, but can still get ulcers and cancer that is left with RNY.

2) Malabsorption of calories and fat only last 18-24 months for RNY patients, the intestines adjusts and villi is regrown but your intestines never regain the ability to absorb Vitamins and nutrients. So, I didn't see any sense in trading 2 years of malabsorption of calories and fats, for a lifetime of possible Vitamin deficiencies and nutritional issues.

3) Removal of the ghrelin hormone

4) Pouches and stomas are not normal. I had a pouch with the band, and it sucked.

5) Full functioning normal stomach left with the VSG

6) No food or med restrictions with VSG, RNY no NSAIDS, several food limitations with RNY

7) Dumping only occurs in 30% of RNY patients so it wasn't a guarantee that it would happen to me. Bad consequences over something I ate seemed a little self-destructive. If I want to eat a miniature Snickers, I want to eat one, and enjoy it.

8) Pouch and stoma stretching

9) The number of people seeking a revision after a few years with RNY because of regain, pouch stretching, stoma issues, and all of the other problems with RNY patients not just that I've read about on forums, but people I know in real life.

10) Long term complications with the VSG are minimal vs. long term complications with RNY.

Best wishes with your decision. Every surgery can be cheated, or eaten around, it's really more about changing your entire lifestyle and choices about food that will ultimately determine your success.

Best wishes in your research.

trish4 · March 16, 2010

Tiffykins - I noticed on a different thread that you said a surgeon needs about 300 sleeves under his/her belt to be considered experienced - can you tell me where you got this info? I asked my surgeon's office today and they said she has done "about 36" - and I'm scheduled for surgery in 14 days and I'm thinking "yikes!"

Tiffykins · March 16, 2010

In some of the research articles out there, it statistically shows that complications decrease after that many sleeves are performed, and technique is about practice makes perfect. No one should be a surgeon's guinea pig. My revision surgeon only had about 200 sleeves, but over 500 staple lines between VSG and RNY. I felt confident with his abilities and technique.

I can try to dig through some of the research articles I have, also Cajun has the info so I'll message her and she she has it bookmarked. We had to get a new laptop, and I lost a lot of my old research links but I'll find the articles at some point.

The surgeon may only have 36 sleeves, but you can also find out how many RNY staple lines, and/or DS procedures have been performed.

Technique is a big part of the equation for the sleeve. A surgeon can use a 32fr bougie, but not dissect the fundus completely, or leave the sleeve too big which can affect your overall success. I hope that makes sense.

trish4 · March 16, 2010

Tiffykins - thanks for responding so quickly. I'm getting very anxious over all of this. My surgeon is at a Briatric Center for Excellence and has done thousands of laps and bypass's - but with the sleeve being somewhat new I guess she's done only about 36 of those. Looks to me like the surgeon who has A LOT of experience in the sleeve is Dr. Aceves in Mexicali - and even though I'm a self-pay it makes me nervous to do it outside of the U.S. so here I am scheduled for this surgery on the 31st and the more I read the more confused/anxious I'm getting about how experienced the surgeon should be in the sleeve - so anything you can throw at me would be greatly appreciated.

3636millie · March 17, 2010

Trish4,

In response to one of your posts re: reflux: I was a revision from lapband to sleeve. Long story but the band almost killed me. I had severe reflux before the revision surgery. Would wake up at night with a mouth full of acid, coughing, gagging, etc. Since getting the sleeve, I only have occassional "burning" throughout the day. I have not had any night time reflux. Everyone is different though so I really can't tell you if it will affect you.

I live in AZ and haven't really heard of Dr. Blackstone. I did alot of research about the different weight loss surgeries and decided to go with the sleeve when I had the revision. I knew that when I did have the revision that it was gonna be "ugly" for the surgeon due to the issues I had been having. I had insurance that would have paid for me to get the sleeve in the U.S. I chose to go to Dr. Aceves for help and pay cash. I chose him because of his excellent reputation and his experience. He was a little more expensive than some but believe me, it was worth it. I had the best care I've ever had anywhere in the world. I have lived all over the world and worked with thousands of physicians. He is definately in the top 5 that I have ever came across. If you are looking for someone with experience, don't rule out Mexico/Dr. Aceves. I use to think that if it wasn't "American", it wasn't good. Bull Sh.t. There are good and bad everywhere. My "American" surgeons almost killed my ass because they wouldn't listen to me. Dr. Aceves literally saved my butt.

It is your health so you need to do what you are comfortable with. If you feel comfortable with Dr. Blackstone, then by all means, go with him/her. Just don't "settle" because of incorrect/false information re: experienced Mexican surgeons.

Well, I'm rambling. Sorry for poor grammer, spelling errors, etc. I just got off an ass kicking 14 hr day at work. Good luck in your decision. Keep us informed. Last but not least, don't just "settle".

Tiffykins - thanks for responding so quickly. I'm getting very anxious over all of this. My surgeon is at a Briatric Center for Excellence and has done thousands of laps and bypass's - but with the sleeve being somewhat new I guess she's done only about 36 of those. Looks to me like the surgeon who has A LOT of experience in the sleeve is Dr. Aceves in Mexicali - and even though I'm a self-pay it makes me nervous to do it outside of the U.S. so here I am scheduled for this surgery on the 31st and the more I read the more confused/anxious I'm getting about how experienced the surgeon should be in the sleeve - so anything you can throw at me would be greatly appreciated.

cwalck · March 18, 2010

I'm not familiar with your surgeon, but I can tell you why I chose VSG over RNY for my revision.
1) No blind stomach left behind with VSG that can't be scoped, but can still get ulcers and cancer that is left with RNY.

2) Malabsorption of calories and fat only last 18-24 months for RNY patients, the intestines adjusts and villi is regrown but your intestines never regain the ability to absorb Vitamins and nutrients. So, I didn't see any sense in trading 2 years of malabsorption of calories and fats, for a lifetime of possible Vitamin deficiencies and nutritional issues.

3) Removal of the ghrelin hormone

4) Pouches and stomas are not normal. I had a pouch with the band, and it sucked.

5) Full functioning normal stomach left with the VSG

6) No food or med restrictions with VSG, RNY no NSAIDS, several food limitations with RNY

7) Dumping only occurs in 30% of RNY patients so it wasn't a guarantee that it would happen to me. Bad consequences over something I ate seemed a little self-destructive. If I want to eat a miniature Snickers, I want to eat one, and enjoy it.

8) Pouch and stoma stretching

9) The number of people seeking a revision after a few years with RNY because of regain, pouch stretching, stoma issues, and all of the other problems with RNY patients not just that I've read about on forums, but people I know in real life.

10) Long term complications with the VSG are minimal vs. long term complications with RNY.

Best wishes with your decision. Every surgery can be cheated, or eaten around, it's really more about changing your entire lifestyle and choices about food that will ultimately determine your success.

Best wishes in your research.

I just love your answers and advice. I always read your stuff and so trust you and your judgment. Carol

trish4 · March 18, 2010

Boy, I am one confused woman. I THOUGHT I was ready for the sleeve - had even seriously considered changing to Dr. Aceves in Mexicali for it (because he seems to have the most experience) - so I get on his website and here's what is recommendation is if you have GERD: "the recommended surgery for obese patients with GERD or severe acid reflux is the Gastric Bypass. The bypass is the anti reflux surgery for weight loss. The sleeve can actually cause more reflux that may or may not be controlled with medication..." He goes on to say that if you have the sleeve and your reflux/GERD is not controlled with meds you will need to consider converting the sleeve into a bypass." And YES I do have GERD and Reflux and so does that mean it's the bypass for me?