Initial Consult Slightly Disappointing

[soxaholic 0]

I have to admit, I’m a little bummed and somewhat discouraged after my initial consult with the surgeon. I knew going in that they were going to give it to me straight and prepare me for the risks, but I also expected them to pump the surgery up a little – tell me I’m a great candidate; that so many people are happy after the surgery; if I exercise and eat right, I’ll have a better chance for success, and so on. Maybe I was being naïve.

The nurse who first met with me was generally positive, but definitely harped upon the complications. The Doctor, however, kept hinting at the fact that he thought Gastric Bypass would be a better option for me (especially for being in my 20s and concerned about social situations). Further, he said that people with lower BMIs do better with Gastric. He did insist he wasn’t anti-band, but it sure seemed that way to me. He spoke at length about how most people only lose half of their excess body weight and that despite all of my efforts, I might not have success. I know these things are all true, but he almost made me feel as if I should expect this to happen (even though statistically it’s not very common).

So – I’m wondering if this is normal. Did anyone else experience this? Do they have to cover their behinds for post-ops who don’t have the results they had hoped for? I was SO excited for this surgery and now I can’t get it out of my mind that there’s a good chance I’ll have to sacrifice a lot for a little. Maybe, without any support from home, I was just hoping for someone to tell me this was a good idea.

I don’t know – maybe since the band varies so much from person-to-person (what you can eat, how many fills you need, how much you lose), they have to really try to prepare you for the worst.

Any similar (or different) initial consult stories would be great appreciated!

[RestlessMonkey 7]

I think it would be dangerous, during an initial consultation without knowing anything about you, for your doctor to "pump the surgery" for you. Seriously, it is smart of him to lay it all out so you can test your resolve. However if you are uncomfortable, go to a different surgeon. My surgeon had us go to a seminar first before any meeting, when the pros and cons were all laid out. After that if we still wanted to proceed, he'd meet with us and start getting blood, paperwork, other tests, etc. Mine also said in the USA people lose only an average of 50% on the lap band. He DID say that in Australia they lose up to 80%, so it CAN be lost, just isn't in the USA. He didn't try to steer me to one type or surgery or another.

I've NEVER heard of a surgeon recommending bypass (which is what I assume you mean when you say "gastric") for patients with less to lose. I HAVE heard of it for patients with very high BMI's.

His point is valid if you are nervous about social settings; nerves can exacerbate restriction.

I can't speak for him; don't know him or anything about him. But it sounds like while his "bedside manner" may be lacking, he was pretty straightforward with you.

It will be up to you if you want to go forward, find another doc, or go "back to the drawing board". At least this one seems honest with you, if more negative than you might wish.

[gentylwind 1]

Get a second opinion. It does not sound right to me. Chances are he is more experienced with bypass.

[SeattleSweetie 5]

Yeah, I agree, it doesn't sound quite right. Like Restless said, the doctor shouldn't be "pumping you up" for a surgery, but they shouldn't be trying to nudge you toward one that's more dangerous, a far bigger change to your system, and has a much higher risk of complications, if that's not what you went there for.

I agree it sounds like he's got a bias toward GB for some reason. If it's that he's more experienced or feels more comfortable with that surgery, you'd probably be better off finding a doctor who's comfortable and supportive of the surgery you want to have. I would hate to chance going into surgery with someone who doesn't really want to do that particular surgery, and having their mindset lead to some sort of problem...

[schatje01 0]

I also has a similar situation happen to me. I felt the nurse practioner was pushing gastric bypass on me instead of the lap band that I wanted.

I changed surgeons (after jumping through MANY hoops with insurance). I figured that this is such an emotional process to go through that I needed a team that would be behind me 100% and support me. I didn't want to second guess my decision through this process.

Remember - your gut feeling is always the best aspect to trust. If you are not comfortable - go somewhere else!

:thumbup:

[MistyD65 1]

What exactly are your "concerns about social situations?" That phrase intrigued me. I initially thought you were referring to having to eat so much less, until Restless Monkey mentioned the possibility of nerves causing more restriction. I'd like to know what your concerns are.

[luluc 6]

Further, he said that people with lower BMIs do better with Gastric. !

not necessarily true - you may be a slow loser having a lower BMI, but that would be true of all weight loss surgeries for the most part.

if your not sure what surgery to have - go to a seminar where the surgeons do all types of WLS. i personally had no desire for anything other than the band, so i went to a Dr. who only does lap bands.

you will want a surgical team that provides excellent post op care....if the surgeon you selected is more "pro" another type surgery from the onset; you might be best to shop around.

[Band_Groupie 3]

I I figured that this is such an emotional process to go through that I needed a team that would be behind me 100% and support me. I didn't want to second guess my decision through this process.

Remember - your gut feeling is always the best aspect to trust. If you are not comfortable - go somewhere else! :thumbup:

My feelings exactly...I went to 3 hospital seminars in my area. First was totally Gastric Bypass biased...I felt like I was going to have to give him my first-born to convince him to give me LB (he even said "if you've got diabetes you're going to have a hard time convincing me to give you a LB." I don't have diabetes, but I was outta there.). Second gave me both choices and the third one was very pro-LB...he said the only people that need G.Bypass are the sickest ones....ones that need to loose very quickly because they might not live another 5 years (5 yrs.-the point at which the LB patients and the GBypass weights end up about the same). If you have a reason to need to lose quickly and are OK with the additional risk, then go for it. If not, and you've got options, shop around! I think it's a very personal important choice...don't let someone else make it for you.

Edited December 6, 2008 by Band_Groupie
spelling

[neverB4 2]

I was BMI of 40 and my doc said LB was a very good option for me...and so far, a great success!!

[soxaholic 0]

Everyone - Thank you so much for responding; it's really nice to hear all of the different points of view. To answer all of the questions and/or clarify some of the points (warning: long!)…

As for the surgeon I selected – He absolutely has performed a ton of band procedures (hundreds in fact). He is the Director of Bariatric Surgery at a top Boston (Center for Excellence) Hospital, so I am not concerned about that at all. I did go to a number of information sessions, so I could hear, and speak to, multiple surgeons before I made my decision. I decided to go with this doctor because of his experience, patient reviews, referrals from other doctors, and also the fact that he was the only one to talk about the human/emotional side of obesity. At the info session, he spoke, at length, about improving the quality of life (feeling normal at restaurants, playing with grandchildren, etc.). I loved that – the other surgeons spoke about it from a medical perspective, and that was pretty much it.

As for the band vs. bypass – I’m sure, naturally, that doctors who perform both have a preference. They see all of the aftercare, hear the complaints, and so on. However, I think he thought my individual case might be more suited for bypass. I was a little shocked because I have a BMI of 38, I’m in my twenties, and have not had children yet – sounds like a perfect LB candidate if you ask me (and the PA agreed).

I think his opinion came from my concerns - I kept expressing that my biggest concern with the band was the unpredictability – how much will be lost, which foods can and cannot be tolerated, restriction levels, success, and so on. My other concerns, which I referred to in my first post as the “social side” – was being 25 and still having an active social life; having a job where I have to travel a lot, attend events frequently, and wine and dine clients on a regular basis; further, I am not planning on telling anyone outside of my immediate family – would I be able to get away with it, or would it be obvious at said social situations? Let me clarify that I know things must change in my life or I'll get the same results, even with the band...I just want be able to lead a somewhat similar life.

With that said, I think with those two concerns of mine, he thought bypass would be easier for me – I would definitely lose a lot of weight, I would have more flexibility with what I could eat in social settings (not how much, but what). I also have PCOS, which makes it more difficult to lose weight. I would have to do the research myself, but he said, surprisingly, those with low BMIs (<40) do better with the bypass.

He definitely didn’t seem to push it, he just seemed slightly partial…stating the best way to evaluate both is looking at the band to bypass conversions (he said most people were happier with the bypass after-the-fact). But, like I said to him, the more you're willing to risk/give up, the more you get - he agreed. As a medical professional, I understand that it’s his job to lay out both options. He did say my point to not want to re-route my insides was totally common and completely valid. I guess it just bummed me out because I went in not even really considering the bypass – I'm still not - but it made me question whether or not the band would work for me. It certainly wasn’t a tragic experience; I just thought it might be more positive. You know how after you meet with a plastic surgeon and they go over all of the risks, they say something like, “I think you’ll love your results.” I just expected a little something like that. I’ll give his bedside manners a bit of a pass because he was running two hours late because he had a family emergency. Then again, I never think Doctors are as personable as I would like, so I try to focus on their skills!

I guess, ultimately, I came out of it more afraid – that even with compliance and exercise, I might not get the results I want (75%+ of excess weight). I see so many people doing cartwheels leading up to surgery, and I’m wondering why I don’t feel quite the same. I’m SO excited to NOT live in this body anymore, but I am terrified of the uncertainty of the results – did anyone else feel this way?

Thanks for listening! J

[TQUAD64 9]

My doctor gave me the same talk regarding the complications, which I wanted to hear. I need to know everything, the good and the bad. How else can I make an informed decision unless, I know as much as possible.

Additionally, we discussed the difference results between the two procedures.

I did a lot of research and I don't mean reviewing the threads on this forum. I utlized the e-library at the university I attend and down loaded medical journal reports on gastric badning and the By-pass procedure.

Together, my doctor and I decided that the band would be best for me. It is less evasive, slower weight loss, quicker recovery, and my portions would be less because of the fills.