Esg Consult scheduled for 12/7

[hope4momof4 162]

Hello out there to the endosleevers or future endosleevers. I’ve finally taken my first step to getting this procedure done. I am scheduled for a consult on Dec. 7 with the only NJ doctor who performs this procedure, Dr. Sadek. I’ve read reviews about him and most have given him a good review. His office has told me he has done over 200 endosleeves. (However, the girls who scheduled me did not sound like they were 100% sure) I actually messaged a woman who had the esg done with him and she was very pleased with the procedure but lukewarm about him as a surgeon. Nevertheless, he is the closest surgeon to me and even he is one hour and a half drive. It’s finally starting to feel real to me. I hope I remember to ask all the important questions I’ve told you all to ask during your own consultations, lol. I’m nervous but ready I think. My procedure probably won’t be for another two months which will give me enough time to prepare. Please remind me of the important questions to ask. Thanks all. 🤞🏻🤞🏻🤞🏻

[BubblesCT 83]

Congratulations hope4momof4 on your consult date. I'm here to support you and share my experience.

[hope4momof4 162]

Thank you so much Bubbles. Your help and support will most definitely be needed. We should be getting our procedure around the same time. We can be esg buddies. 😊😊

[Tex Slim 66 94]

So cool hope4momof4!! Good luck on Dec 7, for ESG that is a large number of procedures for one Dr at this point in this relatively new technique. Don't get too stressed by the office workers, be prepped with your personal history and questions for Dr. and I found a much better response from the head nurse and Doctor in my consult. I will check back on my notes and share some of the key questions for me, you already have a good start. Keep asking if there are questions, we're here to help!

[hope4momof4 162]

Thanks Tex Slim. I’m depending on all of you pioneers—so to speak to help me with this. You have all been my guides thus far so I’m counting on you! Yes please help me prepare the right questions to ask. From what I’ve been told, this particular doctor gives you the one consult where you set your procedure date and then your procedure. You only go back to him one week and then one month after the procedure. This consult will be my one and only chance to ask any questions I have. Butterflies starting to build. 🦋🦋

[Melesg 112]

That's so exciting hope4momof4 . What a big step you have taken . Onwards and upwards!!

[hope4momof4 162]

Thanks Mel! Just like I asked Tex Slim, please remind me of the important questions to ask.

[Melesg 112]

Thanks Mel! Just like I asked Tex Slim, please remind me of the important questions to ask.

Definately ask what your Dr's patients average weight loss is and follow up support with a dietician. I have similar Dr follow up to you buts it's the rest of his team that you will deal with more frequently after the procedure.

Also, don't be shy in discussing all your fears about the procedure, such as revision rates and post op care. The only way to move forward is to feel very reassured that you will get where you need to be. Even if his bedside manner isn't fantastic, it's so important to know that as a clinician - his work is impeccable. There are no silly questions and nothing you should be concerned about asking.

You have fantastic insight and have done your homework so the time will come to make your decision and then it's time to research less and get your head in the "this is happening" game. I also double read every study I could get my hands on but then knew I had to stop and trust my team and my decision. Otherwise I would have found some information that made me question my decision and escalated my anxiety about having the procedure.

You've got this

[hope4momof4 162]

Yes, Mel you are absolutely right. I’m not researching this procedure anymore (I’ve researched it to death). It is what I’ve chosen and I’m confident enough in my decision that it would only take my doctor at the consult to say I can’t go forward to convince me otherwise. I will ask those questions you reminded me of. They have been added to the list. I think that by the time I finish my consult my surgeon will be happy when I leave, lol. It’s actually starting to come together and starting to be real. 😬😊😬😊

[Tex Slim 66 94]

hope4momof4, what a great note by melesg on what to ask during initial consult! Amazing how similar her list was to mine. Weight loss experience, time to lose weight, complication rate and what were they were all the key questions for me in the initial consult.

One thing I covered in addition to ESG was to find out from my doctor how many other bariatric procedures he had done. I asked this as ESG was still quite new here. Apparently there's a similar suturing method (Overstitch) and instrument used in ESG as VSG. My doctor was very familiar with this technique and made me more confident. In the end we agreed ESG was a better fit for me than VSG (less recovery time due to no incision and less invasive technique (not removing part of stomach) was a big factor in my decision for ESG).

I also asked about ESG reversal and my Dr. was quite clear ESG is permanent procedure, in the initial weeks as new tissue builds up around your smaller stomach.

The diet plan they shared with me during the dietician consultation later, covered a lot of post procedure eating questions.

Think you're in a good place to be ready for this one!

Good luck and let us know if there's anything else we can share to help!

[hope4momof4 162]

Thanks so much Tex Slim. I do feel ready for this. This forum and in particular, all of us in the esg group, have made me feel ready. In all honesty I’m hoping that I don’t overdo it with the questions next Thursday or the other extreme which is get cold feet and forget to ask anything, lol. But I won’t do that and I’m taking Mel’s advice that no question is too silly. I’m paying good $ for this and I’m entitled.

Thanks Tex Slim. I’m adding those questions to my list. I’m such a nerd. 🤓🤓

[Melesg 112]

Let us know how your consult went, thinking of you x Mel

[hope4momof4 162]

Thank you for asking Melesg. You and everyone on this forum have been amazingly supportive. Well here is how my consultation today went—- I got there about 15 minutes before my appointment time and filled out some forms, very few because most I had filled out online which were more specific and asked about my medical conditions and medications etc.

I was called back shortly after to consult with Dr. Sadek. I had a list prepared of questions to ask and here they are with his responses:

1- How many esg procedures have you performed? (I added that I knew it was a very new procedure so I wanted to know his experience) He told me about 40 and that he and Dr. Sharaiha were the only doctors in the northeast that do this.

2- Has any of your patients needed a revision and why? His answer was extremely interesting to me. He told me that only one patient needed a revision and the reason was that he, Dr. Sadek, needed to change his technique. He told me that initially he would suture the fundus of the stomach (I think that is what he called it) in a straight stitch but he found that doing that allowed for a greater possibility for the stomach to stretch because the sutures were not holding well this way. He now sews it up on a diagnol to ensure the best hold of the stomach. He believes this is the reason that some may need revisions to this procedure or why some sutures come undone. He also said scar tissue is good to form around the suture because it holds it well in place and increases the strength. 🤷‍♀️

3- What happens to the actual stitches or sutures in your stomach? Do they dissolve or stay? He said the sutures are permanent and are not meant to dissolve or be removed. They are supposed to hold your stomach indefinitely.

4- So why then is it possible to gain back some weight? The sutures hold the lower part of the stomach so the upper part can stretch over time if one eats the wrong foods.

5- Any long term data further than 2 years? He said even though it has been performed in other countries for longer than 2 years ago, there is not a big enough group study to give us accurate info for more than 2 years.

6- is this procedure reversible? He explained that the sutures should stay in place but if the procedure does not yield enough weight loss or there is regain you can then go in laparoscopicly and cut the sutures and remove them and then proceed to a laparoscopic gastric sleeve. You can also after years if needed convert it to a laparoscopic gastric plication which is the same as the esg but done with incisions.

I was told that the procedure would probably take one hour- one hour and a half to perform and he believes that if he starts at around 7:30 that by 10:30-11 I would be going home.

He told me I didn’t need any clearances or blood work because I had no comorbidities. The only medicine I am taking is phentermine which he agreed because I was taking it for so long is no longer effective at all.

He gave me a pamphlet with my preop diet of liquid only for one week prior or at the very least 3-4 days prior. Nothing after midnight the night before and nothing the day of. Post op diet is clear liquid for 3-4 days then liquid for two weeks. Then another two weeks of purée. Then one month post op is smaller portions but I will be into see him one week post op to go over that in more detail.

He believes I should lose between 25-40% of my excess weight which he estimated should be 30-40 pounds. (I can only hope🙏)

Finally, I booked a procedure date for FEBRUARY 6, 2018

I’m on my way guys!!😬😬

[Tex Slim 66 94]

WOO HOO!! So cool you had a great consult and got your date!! Sounded like a really good dialogue, I received similar info on scar tissue supporting keeping the sutures in place. Also heard from my doc the gas pains just after surgery don't "damage" the new stitches, the one activity to avoid to protect the stitches is not to get your stomach so upset that you vomit. I was never close to this after my procedure.

Stay calm and get the ESG done! you will do great! Happy for you!!

[hope4momof4 162]

32 minutes ago, Tex Slim 66 said:

WOO HOO!! So cool you had a great consult and got your date!! Sounded like a really good dialogue, I received similar info on scar tissue supporting keeping the sutures in place. Also heard from my doc the gas pains just after surgery don't "damage" the new stitches, the one activity to avoid to protect the stitches is not to get your stomach so upset that you vomit. I was never close to this after my procedure.

Stay calm and get the ESG done! you will do great! Happy for you!!

Thanks Tex. It’s good to hear that other surgeons had the same idea with the sutures. You are right about only damaging them if you vomit too much right after the procedure. This is why my surgeon prescribes the nausea meds before hand and has us taking them from a day before. I felt a lot more confident in my decision after today’s consultation. The main theme of course was that this is only a tool and you have to do your part to ensure success.

I’m getting anxious hearing about others’ success.