New to Forum/Darmouth Hitch**** Experience?

Hello, I live in Waterbury Center VT and am working with Dartmouth Hitch**** I thought I'd post and see if it is okay for me to join this board. The Vermont State Board is really slow, as in nobody's posting on it. I am working with Dr.  Truss and his team to do a revision from lapband to RNY. My insurance denied his first request. He is trying to talk with one of their doctors to do a peer review, but three times Cigna's doctor hasn't called him at the scheduled time. I am really hoping that will get straightened out this week.

I had my origional surgery at Fletcher Allen but decided to look for a new doc because I had a bad experience with my first surgeon.

Andrea

I had rny at DHMC back in May.  I have never met Dr. Trus, but have only heard good things about him.  He actually was going to do my surgery, but due to scheduling I switched to get an earlier operation date.

DHMC is great, their program is very thorough.  Good luck in getting everything straightened out.

Thanks for the reply Trish. You've done great! What has your experience been like so far? Dr. Truss does have a great reputation and does the entire program/department. I've met with him three times so far and he is kind, thorough and knows what he's doing.  I hope to get things worked out! 

Dr. Adrales is great, but I will warn you that after surgery you don't really see your surgeon alot.  I have only seen Dr. Adrales twice, and once was because I had a rash at the incision site.  You will be dealing with Maureen (head nurse) and Dianne (nutritionist) for the most part. 

I think they are great, and really connect with them.  They also run the monthly support meetings so I would suggest after surgery attending those, as they will answer any questions you have.

I also found when I had surgery, the nurses I had didn't really force me to walk or really understand the surgery.  You will need to be proactive when you are in the hospital to make sure you need to do things Maureen has already mentioned.  This may be due to the size of the hospital, not just the nursing staff.

Hope this helps.

 Hi Trish, thanks for the further information, especially about the hospital stay. When are the support groups held? I think that information is in my booklet from them. I'll take a look.

This is a very complex surgery as it is a revision.  Has this doctor done any revisions?  You need a very experienced revision surgeon IMHO.
I had a revision last year from a lapband to the RNY done in Boston at the Brigham.  It was complicated due to adhesions and an unbilical hernia that needed to be taken care of.
My insurance originally denied my revision initially, Harvard Pilgrim HMO, then my surgeon sent in some more paperwork to them and they approved it.  It will usually be approved if the surgeon can prove "medical necessity".  I have heard from many people that Cigna can be "difficult" to deal with.
Good Luck!

 I am so glad to  have found someone who knows what I am dealing with. My doctor had done quite a few of these. However, I am taking my time to make the decision as I am a bit afraid. What does IMHO stand for. How experienced is the surgeron that did yours. Would you mind sharing with me what your experience with the lapband was like? If not that is perfectly fine,

I did well for awhile until my former doctor started bullying about my slow weight loss. I did lose 40lbs  and keep it off. My band is now turned. I've spent two years in therapy working out how I allowed his behavior to get in my way of weight loss. Now I feel I will be successful.

IMHO stands for in my humble opinion.  My surgeon is very experienced having done a lot of WLS (2,000+)as well as revisions.  He has done some patients from Dartmouth's program...people that already had their surgery and they ended up with severe problems after.  My surgeon Dr. Lautz has a good reputation as a surgeon who takes on difficult cases that other doctors won't touch as well as other doctors mistakes.  I am not trying to scare you but this is a very complicated surgery.  I spent five days in the hospital and felt like a mack truck ran me over.  I was in the OR for five hours. My daughter said my surgeon looked really stressed after my surgery was done probably because it was more involved that he probably anticipated. i had my right kidney out due to cancer and that was a open surgery which created massive adhesions that he had to remove first.It was really rough at first but I have been very successful with the RNY.  My weight loss has been very good and I can now eat like a normal person. 
My experience with the band was very bad.  I too initially lost 35 lbs. but then had trouble eating anything.  I had awful sliming, meat stuck that had to be removed at the ER, PB'ing know matter how I ate.  I did not tell my surgeon although he knew about the stuck meat episodes (3) but I was in denial for a very long time about the band.  I would not recommend it to anyone at all.  I eventually developed GERD really bad.  Dr. Lautz offered to do a conversion, that's what he calls a revision, so I went ahead and had it done.  I chose the lapband initially because I had kidney cancer in 2003 and wanted something "less invasive" so I can't fault my surgeon.
I took my time making my decision too!  He offered the revision in January 2008 and I gave him my decision in March 2008 and had it in June 2008.   The important thing is your doctor's surgical skill in doing revisions.  Some doctors will not even consider doing one due to their complexity.  You need to ask how many he has done and what the complication rate was.  This is very, very important.

 Again, I can't thank you enough. I honestly didn't realize it as so complex. Perhaps I am in denial about that due to my fear. I need to get over that and learn as much as I can. I'd like to get in touch with doc and have him review  my case. Your experience sounds very similar to mine. The sliming, food getting stuck, pbing etc. I now have GERD as well as a result. It has been a miserable two years.

My mistake is that I blamed myself for this. Beat myself up royally and stopped going to see my surgeon because I was a afraid of his reaction and blaming. It was complicated because it created the same dynamic between us I experience with my father. I was not as aware as I needed to be of what I was going through psychologically but I am now. 

Thanks for the reassurance and support. You've done wonderfully with your weight loss. You must be so pleased. I will be sure to ask the questions about how many revisions. He said a lot, but I need to get the numbers and info about complications and what kind of complications can arise. 

I see you are on the seacost of NH. I grew up in Newburyport and try to get down to that area at least once a year.

With gratitude!

You musn't blame yourself.  Many people do not do well with the lapband.  Some only lose 50 or 60 lbs. and never get to goal and can't get anymore fill as their stomach is too sensitive.  The GERD should be enough "medical necessity" to get your revision approval.
The surgery is complex as the doctor has to completey take down the lapband, remove the band, the port, adhesions, etc. Then he has to do the RNY.  Some doctors do this whole process in two surgeries instead of one.
You want to know the following:

# of Revisions
What type of revision?  band to RNY, band to sleeve, etc.
# of Leaks....revisions only
Blood Clots....revisions only
Postop Infections.....all his WLS surgeries

If I were you I would post your questions on OH's Revision Message Board. I grew up in Rye, NH. so not too far from Newburyport. I was in Vermont back in August for my job.  We have a BJ's in West Lebanon and I chose an Adopt-A-School for that club in White River Junction.  The club sits right on the Vermont border.
Please do your research carefully and ask questions!  Do not be intimidated by the doctor!  They don't always know everything.
ETA:  I had my band for a miserable two years too!