Serious doubts after visit with surgeon (long)

[M2G 1,836]

Well, my particular surgeon was fairly new to the sleeve (I think he said he only had done about 15 prior to my sleeve) but I had 100% confidence in him as a surgeon. He has been around a LONG time and been not only a surgeon for a very long time but the speciality of bariatric surgery for a long time. While he has done literally thousands of Bands and RNY's he never missed a beat when I switched from the band to the sleeve (never tried to talk me out of it, never ONCE pushed one surgery over another) so my confidence in his ability to operate on me was 100%.

Honestly if I had your surgeon I would probably be getting a second opinion based on what you have mentioned about what he said and his feelings about the sleeve. I'm sure thsi is not an easy decision for you, and best of luck with whatever you decide to do.

I couldn't be happier with the sleeve and you couldn't pay me a million bucks to try yet another lousy "diet".

[educationrulz 18]

Mythreechildren,

I'm curious as to why YOU never mentioned going to another doctor - at least for an opinion. That's an obvious reaction just based on the follow up posts alone. What's the attachment to this doctor who all but said "choose a different surgery or go somewhere else"? I don't know of any modern day insurance that doesn't pay for second opinions or the option to switch docs. So, even if there isn't another bariatric surgeon in the state who could do the surgery, your insurance should also allow you to go out of state.

I can't wait to hear what you decided to do mythreechildren...Please give us an update.

[pumpkin07 32]

My thought was this. A salesman sells what he has in stock. He has skills as a surgeon to do other surgeries, not this one. It is anyone's nature to stick with what they are comfortable with, and to sell what they have.

I could understand his opinion if he had some data, but why does he ignor long term data suggesting that with GB so many people are ill long term and also many regaining like crazy. I mean, why do doctors keep doing lap band when they break and slip and create scar tissue on your stomach? These are all questions I have for surgeons.

I mean, no one would do a sleeve on a thin person, because they don't need it, right? But I'm the same age as you. I've been a guinea pig for WW, Optifast, etc. Where did that get me? They were happy to take my money even though long term the data that I would be successful on their program was not supportive.

Bottom line is you have to look at this with a viewpoint of protecting yourself AND getting results. I am not super worried long term. But I was more worried long term when I was 70+ lbs heavier with developing....high lipids, Type II diabetes lurking around the corner, sleep apnea on the way, etc. I have none of those problems today. The only problem I have is well, just the worry that there will be long term complications. But being overweight also has long term complications. But so far, so good/great/terrific.

Hang in there. Don't stress. The answers will come.

My PCP told me I had made the biggest mistake. He explained the long term possible nutrient deficiencies of the sleeve with certain Vitamins. He said some people cannot STOP losing weight, which hasn't happened here and I really think he was speaking of a specific patient. So okay, he worried me. So I asked him what surgery he would have recommended? The lap band, which common sense ruled out for me for all the reasons mentioned above. I could understand his concern if he had a good alternative, but the LAP BAND? Please!

Maybe you should look into the sleeve plication. I think it is reversible. That is an advantage if you are worried about long term. I mean if someone has an alternative, at least let it be something that makes sense. I would have considered plication.

[Stacy160 201]

Oh, that sucks. I agree that you should see someone else... maybe someone who's not only a little more competent with the sleeve, but a little more informed? I mean, he thinks the DS is safer, with all the extra cutting, sewing, re-routing, and malnutrition?? Wow. Sounds like he's resistant to change and afraid of anything affecting his "status" as such a great surgeon.

Here's something else to keep in mind: He'll get paid quite a bit more for doing RNY or a DS than he will with a sleeve, which is really very simple.

[mythreechildren2001 7]

Thanks again for everyone's input. This whole thing really threw me for a loop. I was just unprepared because it didn't go down exactly like I was expecting. I thought I knew exactly how it would play out. I have been reading everything I could on these boards and other sources. I did talk to him about seeing another dr in their group, because I know the other dr is a huge fan of the sleeve because he performed it on a friend of mine. I was just not expecting the head of the dept of one of the most prestigious hospitals in the world to have doubts about the long-term safety of the sleeve. I just felt that if HE had questions, I certainly should. I'm not attached to this dr in any way. This was the first and only time I've met him, but I did get the feeling that he was genuine in his reluctance and again, I don't doubt his skill as a surgeon. He has performed thousands of WLS successfully. He said he would do whatever surgery I chose between the 3 they perform, lap band, sleeve, and gastric bypass. He said I was a good candidate for any of them. He just really REALLY favors gastric bypass, and I am NOT having that done not matter what.

I've also learned through a lot of tough experiences (infertility) that drs don't know everything, and that a lot of time I actually do know better. If I had listened to some of the drs I've been to, I wouldn't have my two youngest children. I BIG TIME bucked the system to deal with my infertility, so I don't know, maybe I wasn't as mentally prepared for this as I thought. I really don't know. I'm also not saying that I'm giving up on it forever. I'm just going to hold off for a little while, and give it one more try on my own. I need knee surgery because I have 2 torn meniscus in my knee. I was planning to have WLS first and then do my knee this summer when school is out. I think I'll do my knee first, and go from there. I'm not giving up on my Quest for good health and freedom from obesity. I will never give up on that. Thanks so much for your support and input. I'm extremely appreciative of everyone's comments and thoughts.

[juliarh 35]

I think if you have serious reservations about WLS, you shouldn't do it. To have WLS, you must prepare for a lifetime change. The change includes what you eat, how you eat, your physical activity, everything. I think it's wise to hold off if you're not prepared both mentally and physically to do what is required. And I'm not saying that you're not prepared to change, but maybe you're not at the stage of realization that another diet is not going to work like many of us have already realized.

Please don't get me wrong -- I really really think you're wise to hold off -- it's better to hold off and then be sure than to jump into it and not be mentally and physically ready.

Good luck and I hope that with time you'll figure out what you need to do

[seniorsleever 17]

One more thing---feel free to stay with us here even if you haven't decided yet. Maybe reading the forums will help you get your thoughts clear. And let us know when and if you decide to proceed!

[klus263 9]

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.

I am in AL and live close to UAB but had my surgery with another office and hospital that is a bariatric center of Excellence. There are insurance companies in AL that do cover the sleeve. I attend monthly support groups and I am seeing more sleevers attending that they are considering splitting the support group (it meets also with bypass patients at this time) and sleevers have their own meeting time. If you have done your reseach and feel that the sleeve is what you want, get a second opinion with another office. I love my sleeve and am glad that my doctor suggested it over having the band.

[renniemommie 8]

FIRST go to a different Dr, maybe two. THEN decide if you want to give up this path right now! Don't let one bad visit throw you when you don't really know enough yet to make informed choice!

I've had knee surgery (ACL), I may have re-torn in (waiting on MRI). If I need surgery again, it will be Weight Loss Surgery first, then knee surgery. The extra pounds make it hard to move around afterwards. Trust me. It was hell the first time. I didn't have strength to go to RR, so I got dehydrated and ended up in ER.

Read here, talk to Dr. then make choices (I snore a bit too, it wasn't till I gained, though a sleep study isn't that bad either, though I did NOT need one in the end). Remember the Sleeve has been around as the first part of a two part surgery for 20 years. So long term stuff is out there on it (in a round about way)...

Wait, he suggested Gastic Bypass instead? hell no. I am still debating GS, have thought about plication, too new, but it is a thought.

Good luck

[Keys Pirate 70]

I just think it's interesting that this doc states that the world might be viewing the sleeve - mistakenly - as the "be all end all to WLS". None of the procedures are. As we've heard time and time and time again; they fix our stomachs, not our heads. The sleeve has been my little miracle and I don't use the word miracle very often when it comes to describing my life! I, like you, would never have done bypass for all the reasons mentioned above. The sleeve is the closest thing to "natural" as I see it when it comes to our anatomy. I hope you go forward with it, you won't regret it. But do find a different doc. Trust your gut. ooo, bad pun.

[PlannerGirl 3]

Just my two cents of it's ok. I would do the WLS prior to the knee surgery. Being lighter will make the rehab for the knee so much easier.

As for the sleeve as a WLS choice. When I started thinking about WLS I talked to a friend of mine who is a urologist. She is also obese. She had been considering WLS and told me after what she had done her researched she would only do the sleeve. She referred to it as the new "gold standard." I especially trust her opinion as she is a physician and understands the information, but has no biases.

[Brian66 85]

You have been put in a tough position, but I think the first step is definitely to find a new surgeon who believes in the VSG. In addition to the philosophy, I think you want someone who has more technical I went to my surgeon thinking I would have gastric bypass (I knew I did not want the band) and it was my surgeon who suggested the VSG. I am a single father of three young children, having lost my wife to cancer several years ago, so safety and the risk of complications were my main concern. I felt that I was having the surgery as much for them as I was for me. As I said, I was willing to have the bypass, but I wasn't crazy about someone re-routing my intestines. Once I learned that there was a viable alternative with much lower complication rates, I was sold. Having had the surgery in July and lost just over 110 lbs to date, I am thrilled with the results. It has not been a walk in the park and I have had to get used to a whole new way of handling food in my life, but at least I have not had to deal with dumping and some of the other issues inherent in gastric bypass.

If you truly believe that VSG is the right procedure for you (as it has been for so many of us), you need to find a doctor who believes in it just as much, if not more, than you do. You deserve nothing less.

Good luck to you.

Brian

[mythreechildren2001 7]

I'm still very appreciative of everyone's input. It is very helpful to me and I'm really contemplating what everyone has said. I agree about having the WLS before the knee surgery although my husband is really pushing me to have the knee surgery. I think I will get a second opinion with the other dr in that practice that is a big proponent of the sleeve in a few weeks, and see how I feel after I've met with him.

Thanks again

[Bryn Dawson 9]

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.

My surgeon is kind of the same way. He put a negative-ish (not totally negative, but not really positive) spin on his opinion of VSG vs RNY. He likes to point out that RNY has been around for years, has over 40 years worth of post-op data, will make you lose more weight, etc. But I am very afraid of dumping syndrome and having the intestinal reroute done - it just seems like too much to me. I want the VSG because I know it's right for me - it will help me to get close to where I want to be (which is bigger than the stupid BMI says I should be anyway - BMI says I should weigh 144, I want to be around 175.) When I told him that he really pushed me to do RNY - he says I'll only get down to around 200 with VSG. I just can't see that as being true when so many people here have said they got down to their goal weight. Surely an extra 25 lbs isn't an impossibility.

I think if you are set on VSG then either you need to find another surgeon who is more of a proponent of it, or decide that your surgeon's personal opinion (not professional opinion) doesn't make a difference in your decision. It hasn't in mine - his professional opinion is that it's a good surgery, just kind of an unknown in the long term.

[w2ben 3]

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.