TWH bariatric team question

Was curious if someone *****ceives their follow-up care at the TWH program might be able to tell me if the various support team members would be knowledgeable when it comes to needs of DS patients?

Right now I am going off of rather conflicting information. I reached out to a contact directly at the MOHLTC after I never did hear back or get any action in follow-up care (I've only been making numerous requests/referrals for it over the past few years).

One email response said Dr. Anvari (who I believe is at the St. Joe's Hamilton program?) and a second email just said TWH.

When a manager at two of the programs tells you "Sorry, you are just an orphan..." it sort of makes you wonder what the heck is going over over there at the MOHLTC.

Sort of sad that at my heaviest (750lbs) I actually felt better (mentally and while sitting) than I do now. Since I was last around during the summer it has really only felt like a couple of weeks to me.

At any rate don't want to make this any longer than it already is. Just trying to figure things out prior to eventually getting whatever call I'm told to expect probably this coming week.

The proogram only follows for 5 years then you are discharged back to your GP. If you are thinking about revision then you need to go through the process again  especially if you have no surgeon. Have you had your labs done? When you go to twh website search the bariatric program and find their app. It will list the labs you need. Its a good place to start.

Good luck

I have not had proper labs done. While blood work has been order (infrequently) by my family physician the issue is that labs outside of a hospital setting do not cover a full panel. Both my surgeries were done outside of Ontario (VSG in Cleveland, OH in 2009, DS in Montreal, QC in 2012).

My understanding was that Dr. Hong at St. Joe's (or that centre anyway) would conduct my follow-up care as he was the one who approved my going to Montreal and that was what was stated to me.

I am over 6 years post-op from the VSG stage and over 3 years from the DS.

Not having any sound 'medical' advice on where I stand (not to mention the inability to fully afford the proper regimen for vitamins/supplements I should be on for the DS) are a couple reasons I've contemplated having that reversed. Not at all an easy decision.

Sadly no matter how hard I've tried explaining the situation to various government employees that vitamins/supplements are 'essential' for me the V-word will immediately get a "NOT COVERED!" response.

Seems the app you mentioned Leslie is not available to those not undergoing the surgery at TWH (I couldn't find it doing a couple of quick searches anyway).

However the key issue is whether the program or surgeon I end up seeing will be able to properly analyse any results considering TWH does not perform the DS so my concern was just whether they even have the resources.

Granted at the end of the day anything is better than nothing, even if it is 6 years late. I appreciate your thoughts on the matter.

Here is the link www.twhbari-care.org

For the lab work recommended it can be done at life lab. Have mine done there. For vitamin D they just have to tic off OHIP insured. In the comment section add gastric bypass malabsorption. Have never had to pay.

Getting labs done is a good place to start. Unfortunately vitamins are not covered. Even private insurance don't cover.

Yeah, I know at least under ODB it used to be covered many years ago, but people took advantage of the system and then it screws everyone else.

My issue with how the government (provincial and federal) handle vitamins is that they do not take cir****tances for each individual person into account. Going in I was fully informed and aware of what was expected, however you can't predict life and what will be thrown your way and sadly when you live below the poverty line on a low/fixed income you are faced with the choice of putting food on the table or keeping a roof over your head and in this instance vitamins end up being the sacrifice.

Looking between what Dr. Gagner ordered at 3 months post-op and assuming it is not grouped into something listed on TWH the following is what was requested to be tested (and I am not sure of the importance they hold for a DS over an RNY for any additional tests not included for the TWH panel):

1. FSC/CBC
2. SMA-20 (complete biochemical profile which should include lipid panel, liver function tests, renal function, total protein and albumin, calcium and phosphorus, electrolytes, creatinine and BUN)
3. Fer/Serum Iron
4. Ferritine/Ferritin
5. Serum PTH
Selenium
7. Zimc
8. Vitamins A&D/Serum Vitamin A&D
9. Thiamine/Serum thiamine
10. Vitamine B12/Serum B12 and Serum Folic acid

I recall a lot of those having costs associated with them and not being OHIP covered. Not sure if the 'gastric bypass malabsorption' trick would have the fees waived or not. Worth a shot perhaps.

However having some results to take in for my first appointment with whomever it ends up being would save some time and actually give me some feedback on my health. It is over 3 years overdo for the blood work and while my family doctor is great, he simply is not versed in how to determine what any blood work results would mean for me.

Thanks again Leslie.