Advice needed on a delicate situation please

I need some advice. How would you handle this? My WLS surgeon (who did my RNY here) never approved me to have my abdominoplasty. He said I had to wait 2 years, and hold down the loss of 100 lbs first. I had lost 158 lbs as of this summer. I have BCBS/Comm Blue PPO and my PCP wrote the recommendation letter, it was approved by my insurance company and she approved it also. So I went ahead with it. And am I thrilled so far with the results!!!!!!!!!!!!! But, in a few short months, February 2007, I have a 6 month malabsorption/follow up appointment with my WLS surgeon here. He always wants to see the incision. It's gone. It's a pencil line from my Xyphoid down to the south of the border. His work is gone....from the outside that is. Do I tell him now? Do I write him a letter or just go to the appointment and say "by the way, I went ahead with the surgery for my abdominoplasty without your consent because this isn't your body, you aren't 47 and desperately in need of that skin removed because I have osteoporosis in 2 lumbar which the excess skin was causing strain on my lower back"....................... I'm not quite sure how to handle this because deep inside, I want to go to his office where he has one of those 'scales' that shows your bmi, fat mass, fat percentage, etc, and see what I weigh. Or, do I wait. Let me know what you would do in my position. I'm not really worried about hurting his feelings, his work is done, other than making sure my labs and malabsorption is going ok, he did his job and I'm just doing follow ups as he recommends. Any advice as to what I should do would be greatly appreciated. I say "don't sweat it" and when he wants to see the scar show him and tell him at the appointment. What is he going to do? Throw me out? Not see me anymore? My PCP could do the labs because she herself had WLS and lost over 200 pounds, so if it came down to it, I could go see her. Thanks for your advice Stacey W

just tell him when you get there.........i go with the no sweat philosophy! hug rae

Rae, yea, that's what I am thinking...but wanted a variety of opinions and advice to gather and then decide. hope you are doing well...I feel great and can't believe how I look.... isn't it cool?????????????? hugs to you 2! Stacey W

Stacey I too would just go and when the time comes, explain that you did what was best for YOU! I don't see why at 19 months he would still need to/want to look at your incision.... After all you are there for a malabsorption appointment, not a "scheduled RNY checkup". I say if he gives you any grief about not following his recommendation, go see your PCP! I am sure your surgeon doesn't follow EVERY recommendation given to him, so don't sweat it Hugs, Jennifer 355/229/150

I see no reason why you should have to "justify" the surgery to him. He's not a plastic surgeon and he's not your PCP --- and he's not the one to make that decision. That's like the plumber telling you that you can't paint the house. It's your body, you did what you felt was in the best interest of your health and you don't need his approval or blessing. Mention it as a part of your current medical history when he asks how you're doing --- but don't feel like you need to justify it to him. Good luck! Pam

Jennifer and Pam: Thank you for the advice. I needed to hear this and decide that what I was planning to do is the best choice for me. Not him. I'm still going with the "dont sweat it" attitude and let it go. *****ally cares? It is MY body!!!!! And it's looking hotter and hotter!!!! lol....went to Meijer today and some guys were watching me walk. FIRST TIME IN YEARS. FIRST TIME IN YEARS THAT'S HAPPENED AND I'M LIKE, DUDES, THIS BODY AINT UP FOR GRABS. IT'S IN LOVE WITH A HORSE. NOT A MAN!!! rotf. hugs to all and warm thanks Stacey W

Stacy, First, like has been said, he does not need to see the incision site except he may want to see his great work ,Some DRs are like that, if he does see the site and ASK then say you went to a great PLASTIC surgeon sugessted by your PCP, he should be happy for you, even though many WLS Drs do the TT etc he should be able to understand your need to see an actual Plastic surgeon whether you did or didn't, Diplomacy is the key here, Don't attack his policies or discuss your motivations you will be fine sounds like you are doing very well Marcia

Stacey, I love reading your posts.....who else uses "Xyphoid"? It's what makes you uniquely you I think you found your answer. Just act confident, people will form their opinions of you from your body language. If you sit up, shoulders back, look him in the eye and say.....(insert speech here) you'll come off as a woman that is in charge of what happens to her body. You look great btw! Brenda

Hiya Stacey, Like those before- tell him if he asks. The two things Dr's/ Surgeons want you to forget: 1) They are not God 2) They can be fired. Patients is a nice title- but in reality we are customers and they can be replaced. I had to shop to find a doctor that worked well for me (manner, information given, treatment options etc) but I finally did because I made sure he understood that it was my body and nothing would happen without me understanding it. You did what was good for you- it doesn't matter what he thinks. Jennifer

Stacey, I also agree with just telling it like it is. Shoulders back and head held high.... I made a great decision for me and couldn't be happier about it. (I use that line concerning my DS decision) When you are that confident people have very little if any thing to say. Good for you for taking the initiative to make the decision for plastics. I'd say that if the plastic surgeon thinks you are ready that is the ok you needed. Don't apologize you did nothing wrong. Please let us know what happens.