Bad First Appt. With Surgeon!

[kat72 0]

OK, this one is gonna be a bit long...I have been so depressed and discouraged that I have not logged on to the site since Wednesday evening. I had my appt. with the surgeon Thurs. and everything was going wrong. There was a bad accident on the freeway, so I was running late. To make matters worse, after hustling to be on time for my appt., I finally get there and they tell me that the doctor is away visiting his father (who happens to be VERY ill), so, of course, I feel terrible about being upset that he's not available. In walks his 'assistant' who was about 4'9 and weighed about 98 pounds. I had a feeling that she was not going to 'understand' my 'situation', and, boy, didn't she!!!! She was the most negative and discouraging person I have ever met. For starters, she had ABSOLUTELY nothing positive to say about the band. She praised the RNY and went on and on about how its better because you lose weight 3 different ways opposed to only losing 1 way with the band; she demonstrated this by drawing 2 different diagrams on the white butcher paper that is on the little beds. Isn't that soooo sweet of her? She stressed (over and over again) that I would have to wait 6 whole months before surgery. I asked what would happen if I lost about 60 pounds by then since I would no longer qualify? Would I have to wait until I regained all my wait back (and then some) and start the whole process over again? She was not happy with my sarcasm, so I explained to her that I have lost that much weight several times before and regained it. She told me to look on the bright side- at least I would be thinner and healthier. I guess my question just went right over her pretty little head, because she had NO CLUE!!!!! Furthermore, she was not able to answer most of my questions (that you all provided for me, thank goodness). And the ones that she DID answer were not really answered. She also answered those questions as if I would be getting an RNY. I was SO offended and frustrated, and I am sure that she could sense it. Believe it or not, the appt. actually lasted for close to an hour. I needed answers, so I kept trying to get them. I asked her when the papers would be turned in to my insurance co., and she could not help but tell me that it would be "a really long way down the road, seeing as how you just started the whole process in the beginning of August". I'm not DUMB! I know that they are not going to be turned in now, but I wanted to know if I could get an approximation, to encourage me to keep goin' strong. What a waste of MY time. I finally told her that I would just make another appt. with the ORIGINAL surgeon, and, hopefully, he could answer my questions better than she had. She told me to make the appt. for a month from our meeting. Of, course, I ignored her and asked for the receptionist to make the appt. for 2 weeks from that meeting. So, if all is well with the surgeon and his father, I will be seeing the surgeon on the 6th of next month. I've actually spoken with the surgeon, and he seemed really positive about the band. I left the office feeling dissatisfied and sooooooo let down. All I wanted to do was cry and throw in the towel. My therapist tried explaining that the teams' job is to try to 'hand pick' the people that 'they' feel will really succeed with weight loss surgery. I can understand that, but I cannot understand her being soooo negative. Thanx to every one for allowing me a vent session. I actually feel a whole lot better

[giveyouthemoon 4]

My surgeon's office is also really down on the band. All of them except my actual surgeon. I go to monthly support groups and they ALWAYS talk down the band. It's mostly because they haven't seen enough experience with it. Stay strong. If this is what you want then stick to your guns. Yes, make an appointment with the actual surgeon. And when you meet with them, say with *such* surprise "you know, it seems like your assistant is very against the band, is there some specific reason?" and find out his take on the band.

And if the surgeon is also down on the band, then find a new doctor.

I'm sorry this had to happen to you. I had a weird first encounter with my surgeon as well but I researched him heavily and found that he's a great surgeon just not great with the bedside manner.

Stay strong!

[Tropicana 0]

My surgeon's office is also really down on the band. All of them except my actual surgeon. I go to monthly support groups and they ALWAYS talk down the band.

What do they say is bad about it?

[Bensmum1109 0]

I have the same surgeon as Karen and she is right. In fact my surgeon (Dr Feng, Karen) talked me out of the band and into a Vertical Gastrectomy, but after a few weeks of anxiety, research, and discussion with DH I decided to go back to the band, and am I ever glad I did!!

You need to tell your surgeon how his assistant made you feel so that it doesn't happen to other patients. It definitely sounds like she is clueless, and don't let the skinny little b*%$# affect your decision to go ahead with this process! She may not understand our struggle but she no doubt has issues of her own.

And if you need to be pushy or aggressive to get your process moved along in the system or your questions answered, don't be afraid to do it! Don't let anybody push you around!!

Good luck. You have a wonderful support system on this board, truly a bunch of great people. They have helped me immensely!

[giveyouthemoon 4]

What do they say is bad about it?

They emphasize HOW HARD you have to work if you have a band vs HOW EASY it is with the RNY. They talk about how MUCH weight you lose with RNY and HOW LITTLE you will with the band. They really put a sell job on on new people who are coming for information and I see them change a lot of people's minds in an evening. It makes me frustrated.

I have the same surgeon as Karen and she is right. In fact my surgeon (Dr Feng, Karen) talked me out of the band and into a Vertical Gastrectomy

Yeah, Dr Feng seems to be ESPECIALLY down on the band. He alternates the monthly meetings with Dr. Cirangle.

For some reason Dr. Feng is really high on the vertical gastrectomy. I mean they REALLY are into that procedure. No thank you.

I'm glad you stuck to your guns and got the band!! There is one other lady in the suppport meetings who, along with me, is trying to counteract the bad vibes that Dr Feng puts down on the band. He will say something great about the RNY or VG and we'll go "Yeah but with the band..." He doesn't like it but I think he's not giving the band a fair shake.

To his credit, my surgeon (Dr Cirangle) didn't try to talk me out of the band. He seems to "get" it. He is, however, an arrogant man and can be downright rude. His bedside manner was TERRIBLE. He's not a warm man, but all my research indicates he's a good surgeon and so that was enough for me.

So kat72 don't let that bad first impression ruin it for you. If you want this and you KNOW in your soul it is right, then keep strong.

[Time to love me 0]

Kat,

I'm sorry to hear about your bad experience, I hope your next visit is 110% better. I have to tell you that when I went for my meeting with the Dr.'s team they, too, pushed the RNY more than the band. I asked why the RNY was talked about more than the band through out the day, we were told it was preferred by the doctors (maybe the Dr's get paid more to do them). At the same time, we were told that it was OUR choice and we would be respected for it. The only time the Dr's team would try to convince you to get the RNY over the band is when they feel, medically, that it is the best choice for you. The team meets and discusses your BMI, medical history and everything else that is done in the day long appts. and then figures out what is best for you. BUT you still make the final decision. Believe it or not there are many medical issues that could make you an unlikely candidate for the band, so you would have to have the RNY. I'd have to look them up again, but I was shocked to see so many things listed.

I also asked the Dr. the same question you did. What if I lost a lot of weight, will the insurance company still approve it? The answer is yes. What happens is the doctor submits the paper work with your old weight and BMI on it and then notes that you need to lose 15 pounds before surgery (in my case) to help shrink the liver. I hope this helps you relax a little bit and not worry so much before you next appt.

Good luck and Take Care

[DrHekier 0]

(I should be posting anonymously, because some doctors might be offended, but I hope not.)

In my personal opinion, there are a number of bariatric surgeons in the US who fit in the category as 'bait and switch.' They have you come to a seminar about the Lap Band, get you interested in their program, but then try to sell another surgery to you.

Let's take a look (perhaps a cynical look) at the disadvantages of the Lap Band:

1) After the Lap Band, the surgeon may have to see the patient every 6 weeks for the first year. For the gastric bypass or VBG, you are often seen only once or twice posoperatively and then never again. Much easier for the surgeon if you never have to follow up with them.

2) Weight loss is more gradual with the Lap Band, (although after 2 - 3 years several studies indicate equivalent weight loss when compared with the gastric bypass) and as a result more patience and long term follow up is required with the Lap Band. (see #1)

3) The Laparoscopic gastric bypass is a surgical tour-de-force with a fairly high degree of complexity. In all honestly after a few dozen Lap Bands, it's a fairly straight forward procedure. I believe there is some intellectual snobbery against Lap Band surgeons, since it is a procedure more accessible to more surgeons outside of major centers, where many, but not all, bypass surgeons are. Ironically, since the risks are so much lower with Lap Band when compared with the bypass, I feel that some bariatric surgeons look down on the Band as a 'less elite' procedure. Who is cooler and more macho, the guy shot out of a cannon through a ring of fire across the street, or the one that uses a crosswalk when the light is green to cross the street? The guy shot out of a cannon might be cooler, but guess what, both guys cross the street, and one with much less risk.

I know I would never perform any obesity surgery other than the Lap Band, given the options available now. I remember reading articles and interviews with Dr. Paul O'Brien. As many of you know he is (or used to be) the #1 Lap Band surgeon in the world, having put in nearly 3000 bands last I heard. He used to do all types of obesity surgery but has switched to an essentially Lap Band exclusive practice. He would always be presented different patient scenarios and what his choice for surgery would be, and it was almost always a Lap Band. As he told me over dinner at one of the courses; 'why would you choose to mutiliate the GI tract [his explanation of a gastric bypass], when you can perform a safe, reversible procedure for the same results.?'

I agree.

Thus endeth the sermon.

[youknowit 11]

Thank you for the sermon... I hate to say this, but I seriously think the reason a lot of docs are using the "bait and switch" to bypass is money. I know my friends mom who got bypass paid over $30,000. Clearly, the band does not cost (and thus make) this much money. True enough, the band patient does have to come in again and again... but let's face it, when we hear of the bypass patients who restretch their pouch (and regain most, all or more weight) this might be something that could be monitored and/or avoided by having to see the Doc.

Just my two cents... Hang in there KAT72... if you don't feel comfortable with your current drs. office... find another. You don't owe them anything. Take care...

[kat72 0]

You guys never cease to amaze me with your support!!! I REALLY appreciate all of the advice that you all offer. I do not know what I'd do if I did not have this support group. I also LOVE the fact that DrHekier is a member and offers great advice and encouragement. Thanx soooo much for the info. as well as the words of encouragement. I really need all of the support that I can get at this time.

[ReneBean 3]

I hate to say this, but I seriously think the reason a lot of docs are using the "bait and switch" to bypass is money. I know my friends mom who got bypass paid over $30,000. Clearly, the band does not cost (and thus make) this much money.

It could also be because the insurance companies are still *&^*#$@ around about how the Lap Band is still "Investigational". I got that one from Blue Cross of CA today. It's just plain easier for them to get paid if they push the "insurance company approved" bypass.

I guess you can't blame them for wanting to get paid - but I find it hard to accept that ANY doctor would refer a patient to such a dangerous alternative when a safer one is available. Whatever happened to Do No Harm?

Thanks Dr. Hekier. We really do appreciate your comments.

[giveyouthemoon 4]

'why would you choose to mutiliate the GI tract [his explanation of a gastric bypass], when you can perform a safe, reversible procedure for the same results.?'

I agree.

I cannot TELL YOU how glad I am to hear a medical professional say that. That has always been my impression of RNY and in fact, I expressed this at a support group meeting and was scoffed at for not being "committed" to the weight loss approach. Hunh? As tho the band is disposable.

Thank you Dr Hekier!!!!!

[DrHekier 0]

I cannot TELL YOU how glad I am to hear a medical professional say that. That has always been my impression of RNY and in fact, I expressed this at a support group meeting and was scoffed at for not being "committed" to the weight loss approach. Hunh? As tho the band is disposable.

Thank you Dr Hekier!!!!!

Firstly, the quote above is Dr. O'Brien's so he deserves the credit.

Secondly, I personally think that the Lap Band requires a greater commitment and interaction from the patient than other WLS options. You have to work with your diet to find what works and what doesn't; you have to get a sweet spot on fills with your health care provider; you have to seperate liquids from solids, and on and on and on.

I think if you are going the Lap Band route you are as committed, if not more, than people that go another route for weight loss.

[youknowit 11]

ReneBean -- you are right about the "investigational" or "experimental" thing... that's what I was told by my insurance. They don't like to cover the bypass either, but they figure if they offer that, enough people will be scared s-less of it, to say "nevermind"... and move on. My Dr. told me this is common. Sorry you got the No on the band... I hope they will change their minds. They won't here... Maybe in the future.

[MerryHearted 20]

Kat72, are there other surgeons in your area that do banding? I personally chose a center that does ONLY lapbands. Pretty much everyone on staff there has a band, and so they all know the info firsthand. I am finding it to be a very supportive environment.

Even if you have to drive a couple hours to get to another surgeon, it'd be worth it if the office staff were more familiar with and supportive of the band.