First meeting with the surgeon
I have my first appointment with the surgeon on the 14th. I was just wondering, are there any questions that I should be asking when I go in? What can I expect? I already have all the office paper work filled out. Luckily the surgeon that is (hopefully) going to do my surgery gives that paperwork when you go to the informational seminar. I'm still on the fence as to whether I want to have the RNY or LAP. Does anyone know the success rate of either of these?
Sorry for all the questions, its just that now that I have my appointment coming up in 5 days, this is actually becoming very real to me :o)
I am getting excited, but am trying not to get TOO excited because if I am denied for some reason I don't want to have a huge let down...I'm sure ya all know what I am feeling right now...
Thanks in advance for any input ya'll can give :o)
Sorry for all the questions, its just that now that I have my appointment coming up in 5 days, this is actually becoming very real to me :o)
I am getting excited, but am trying not to get TOO excited because if I am denied for some reason I don't want to have a huge let down...I'm sure ya all know what I am feeling right now...
Thanks in advance for any input ya'll can give :o)
A few questions for you...
How much do you have to loose? The general rule of thumb my surgeon had was 50-100 pounds = lap band, 100+ pounds = RNY.
You can ask about things like post op diet (how long on liquids etc), recovery time - how long out of work etc.
I had my RNY almost 3 years ago and I am down 140 pounds and about 15 pounds from goal.
Have a great appt and keep us posted!
How much do you have to loose? The general rule of thumb my surgeon had was 50-100 pounds = lap band, 100+ pounds = RNY.
You can ask about things like post op diet (how long on liquids etc), recovery time - how long out of work etc.
I had my RNY almost 3 years ago and I am down 140 pounds and about 15 pounds from goal.
Have a great appt and keep us posted!
I am currently at 250 (according to my doctors scales) 245 (according to my scales at home)
Either way I do have at least 100 to lose if not more. I would really like to get down to my ideal weight, which on the high end is I think 135. I thought about asking him what he suggests on which would be the most successful. Do you think that is a good idea?
Either way I do have at least 100 to lose if not more. I would really like to get down to my ideal weight, which on the high end is I think 135. I thought about asking him what he suggests on which would be the most successful. Do you think that is a good idea?
I'd ask...
How do you get in touch with the dr. post op in the event of questions or issues?
What is the post op follow up care plan?
How often will you see the dr. for post op visits?
Does your surgeon handle your post op lab work or does he turn that over to your primary care dr?
What is the most frequent complication he deals with?
What is his rate of complications?
How long does it take to schedule your surgery after insurance approval?
What pre op procedures would you be expected to follow (diet? lab work? sleep study?)
How does his office handle insurance billing?
Are there support groups locally that you can take advantage of?
My dr. only works with RNY, so that is my only 'view' on which surgery. However, the OH home page gives a good summary of various types of surgeries. After talking with your dr. you may find that he has a more clear recommendation for you.
Pretty much the perfect set of questions! (Dr. Pupkova aced all of them, which is why i went with her, too - LOVE the woman!)
I would really probe on the issue of followup and ongoing support and support groups that work closely with the doctor. If you think about it - the surgery is only the very beginning of the process. The REAL work comes afterward, with middle-of-the-night questions, nutritional "challenges," psychological and mood challenges, and the whole reworking of your lifestyle around making healthy choices. Your support groups, information network, and online resources like this will quickly become a true LIFEline for you. Make sure the doc you choose is tapped into that and is a strong supporter of it.
Good luck - it is a very exciting time!
Karen
I would really probe on the issue of followup and ongoing support and support groups that work closely with the doctor. If you think about it - the surgery is only the very beginning of the process. The REAL work comes afterward, with middle-of-the-night questions, nutritional "challenges," psychological and mood challenges, and the whole reworking of your lifestyle around making healthy choices. Your support groups, information network, and online resources like this will quickly become a true LIFEline for you. Make sure the doc you choose is tapped into that and is a strong supporter of it.
Good luck - it is a very exciting time!
Karen
I was 248 pre-op. I had lap RNY. I got to 132 and remained there for many years. I am currently 147 since having my son in April. I am working on getting back to my goal weight. I am 5 years out, feel good and have maintained quite nicely.
You know.....I had 2 questions for my surgeon.
1) Do you take phone calls in the OR?
He said absolutely not. But I personally know some surgeons who do, so I was curious.
2) Do you listen to music the the OR?
He laughed so hard. And said yes. I said well make sure you are playing your favorite or whatever keeps you motivated and doing what what you do.
But I am a wierd patient. LOL. I requested a specific Anesthesiologist, and 3 specific OR techs. My surgeon asked if I wanted fries with that? I said only if I am allowed fries pre-op, cause post op, no way. He said, good girl.....you will do just fine.
Anyways, I digress. the surgeon should be able to look at your BMI, past medical history, current co morbidities, and suggest the right surgery for you. However the final decision is yours. I am happy with my RNY, but I have friends who are just as happy with the lap band. So you have to choose which is best for you.
Good Luck!
You know.....I had 2 questions for my surgeon.
1) Do you take phone calls in the OR?
He said absolutely not. But I personally know some surgeons who do, so I was curious.
2) Do you listen to music the the OR?
He laughed so hard. And said yes. I said well make sure you are playing your favorite or whatever keeps you motivated and doing what what you do.
But I am a wierd patient. LOL. I requested a specific Anesthesiologist, and 3 specific OR techs. My surgeon asked if I wanted fries with that? I said only if I am allowed fries pre-op, cause post op, no way. He said, good girl.....you will do just fine.
Anyways, I digress. the surgeon should be able to look at your BMI, past medical history, current co morbidities, and suggest the right surgery for you. However the final decision is yours. I am happy with my RNY, but I have friends who are just as happy with the lap band. So you have to choose which is best for you.
Good Luck!
When life hands you lemons, ask for tequila & salt and give me a call!
1st, Jojo your posts are amazing, love 'em.
2nd, in addition to the other questions listed...
I'm planning to ask my surgeon what sort of VTE prophylaxis he uses and how I can set up an autologous unit of blood, in case I need it.
Elizabeth
2nd, in addition to the other questions listed...
I'm planning to ask my surgeon what sort of VTE prophylaxis he uses and how I can set up an autologous unit of blood, in case I need it.
Elizabeth
Surgery Weight (1/25/10) 265 - Current Weight - 184 1/1/12 - Goal ????
Oh - i also meant to address the RNY vs Lap band question you asked.
I think for most people it comes down to personal choice and comfort.
With Lap band, you can eat anything, just in small quantities, well chewed. There's no dumping on sugar or high fat foods, for example. I was told lap banders generally lose about 75% of their excess weight in the first 2 years.
With RNY, the majority of people dump when they eat the wrong things - sugar, high fat foods. The fear of dumping (which makes you feel completely miserable) helps keep you honest. RNYers generally lose up to 90% of their excess weight in the first year.
I chose RNY because I knew I didn't have the self-discipline to stay off of sugar and high carb foods. Those foods are addictive substances for me and I needed an external "control" that would simply prevent me eating them. I also didn't want the potential complication of band slippage (where the band moves out of the place it was put) and just personally didn't like the idea of a foreign object inside me. But the primary reason was removing the choice.
When I started the process, I was at 270. Today, 7 months later, I'm at 178 and am happy as a clam. I would like to get into the 150s, I think, but we'll see. I'm also 5'9".
I know a bunch of highly successful people who are Lap banders - and a bunch of highly successful people who are RNYers. It all comes down to the choice YOU are comfortable with and can happily live with for the rest of your very long and much healthier life.
Does that help?
Karen
I think for most people it comes down to personal choice and comfort.
With Lap band, you can eat anything, just in small quantities, well chewed. There's no dumping on sugar or high fat foods, for example. I was told lap banders generally lose about 75% of their excess weight in the first 2 years.
With RNY, the majority of people dump when they eat the wrong things - sugar, high fat foods. The fear of dumping (which makes you feel completely miserable) helps keep you honest. RNYers generally lose up to 90% of their excess weight in the first year.
I chose RNY because I knew I didn't have the self-discipline to stay off of sugar and high carb foods. Those foods are addictive substances for me and I needed an external "control" that would simply prevent me eating them. I also didn't want the potential complication of band slippage (where the band moves out of the place it was put) and just personally didn't like the idea of a foreign object inside me. But the primary reason was removing the choice.
When I started the process, I was at 270. Today, 7 months later, I'm at 178 and am happy as a clam. I would like to get into the 150s, I think, but we'll see. I'm also 5'9".
I know a bunch of highly successful people who are Lap banders - and a bunch of highly successful people who are RNYers. It all comes down to the choice YOU are comfortable with and can happily live with for the rest of your very long and much healthier life.
Does that help?
Karen
Just wanted to pitch my 2 cents in!
I started exploring the surgery in Jan. of 09. Insurance wouldn't cover it - so never met with a surgeon to go any further. Had an OBGYN Appt. in June about the possibility of conceiving... well he was an ass to say the least - but he said he wouldn't talk to me about it until I lost at least 150 pounds. (Will never go back to that doc to save my life). I switched jobs 2 weeks later and new insurance did cover it if i was approved. Called the first week of July to set up appointments with my surgeon, he was so booked out - I got in on August 14th.
My surgeon is great, but he's very direct and to the point. I asked about all the technicalities with starting a family in the future and what that would be like. I asked if he thought I'd have trouble getting approved because I'm much younger than most people doing it (27) and currently don't have any co-morbidities (give me a couple years and I'd be there). He quizzed me in a way - which I appreciated. He wanted to make sure I knew what I was talking about and that I had done my end of the bargain by looking into everything before meeting with him. He asked what I preferred and I said RNY.
For me there were a couple reasons: 1) Once I have something with sugar or that's high in fat, I want it all! If I stay away from it all together, I do much better. 2) A foreign object in me with the lap-band was something that freaked me out. For some reason the RNY surgery and that alteration did not 3) At the time I was 341 and needed to get down to at least 180 to start thinking about carrying a child safely and in a healthy way. We'd like to get going on that process in about 2 years, so RNY fit that success rate and time frame the best. 4) I wanted this to be a LIFELONG change, not something where I could have it removed in 3 years. Knowing what complications people have with the lap-band 3-5 years out with slippage and other complications, made me think I would say just take it out one of those times - which then brings me back to my big old over used stomach!
I started the process of a supervised diet right away with the nutritionist and with my family doctor for insurance purposes. Dr. B makes us lose at last 10 pounds during a 12 weeks supervised period. Another great thing that he does is once you weigh in, you can't go back up. That was a huge motivator for me! Taught me from the get go that I'd have to lose the weight pre-op in a smart way, not a fast way. I've lost 10-15 pounds before no problem, but can put 15-20 back on in 2 weeks. That 10 pound requirement as well as all of the other behavioral changes they ask you to make really helped me with the reality of what was happening.
One thing I'd look for in a surgeon that was important to me is that you feel good about the team around them. For example, I met with the nutritionist regularly, there are 2 exercise people that I meet with, I wanted the front desk staff to be nice and considerate of me and always helpful when I called and I was pleasantly surprised to find out my surgeon has staff that is specifically there to deal with insurance companies - so nice that I didn't have to do any of that. I'd also recommend a strong support group system, it really has helped me (and my husband) learn about all the changes that are coming, not just the technical - but also the emotional and psychological.
My insurance required a 3 month supervised diet, but a lot of them require 6 months - so prepare yourself for that. Then once you pass your 3-6 month requirement, your paperwork is sent in for approval. At that point, if you're approved, you're usually scheduled out 4-8 weeks for surgery (assuming no other problems arise). That might help you envision what your particular time line would look like. Again, that can all be different for each of us - but when someone explained that all to me - it really helped me look ahead and know what to expect. I told myself that if I did everything they asked of me and insurance approved, I should be good to go with a surgery date of Jan. or Feb. after my August 14th meeting with my surgeon. I'm now scheduled for surgery on Jan. 5th - but again, my process was quick compared to most because my insurance approved right away and I only had a 3 month supervised period.
Feel free to ask any other questions and good luck at your first appointment!
Melissa
I started exploring the surgery in Jan. of 09. Insurance wouldn't cover it - so never met with a surgeon to go any further. Had an OBGYN Appt. in June about the possibility of conceiving... well he was an ass to say the least - but he said he wouldn't talk to me about it until I lost at least 150 pounds. (Will never go back to that doc to save my life). I switched jobs 2 weeks later and new insurance did cover it if i was approved. Called the first week of July to set up appointments with my surgeon, he was so booked out - I got in on August 14th.
My surgeon is great, but he's very direct and to the point. I asked about all the technicalities with starting a family in the future and what that would be like. I asked if he thought I'd have trouble getting approved because I'm much younger than most people doing it (27) and currently don't have any co-morbidities (give me a couple years and I'd be there). He quizzed me in a way - which I appreciated. He wanted to make sure I knew what I was talking about and that I had done my end of the bargain by looking into everything before meeting with him. He asked what I preferred and I said RNY.
For me there were a couple reasons: 1) Once I have something with sugar or that's high in fat, I want it all! If I stay away from it all together, I do much better. 2) A foreign object in me with the lap-band was something that freaked me out. For some reason the RNY surgery and that alteration did not 3) At the time I was 341 and needed to get down to at least 180 to start thinking about carrying a child safely and in a healthy way. We'd like to get going on that process in about 2 years, so RNY fit that success rate and time frame the best. 4) I wanted this to be a LIFELONG change, not something where I could have it removed in 3 years. Knowing what complications people have with the lap-band 3-5 years out with slippage and other complications, made me think I would say just take it out one of those times - which then brings me back to my big old over used stomach!
I started the process of a supervised diet right away with the nutritionist and with my family doctor for insurance purposes. Dr. B makes us lose at last 10 pounds during a 12 weeks supervised period. Another great thing that he does is once you weigh in, you can't go back up. That was a huge motivator for me! Taught me from the get go that I'd have to lose the weight pre-op in a smart way, not a fast way. I've lost 10-15 pounds before no problem, but can put 15-20 back on in 2 weeks. That 10 pound requirement as well as all of the other behavioral changes they ask you to make really helped me with the reality of what was happening.
One thing I'd look for in a surgeon that was important to me is that you feel good about the team around them. For example, I met with the nutritionist regularly, there are 2 exercise people that I meet with, I wanted the front desk staff to be nice and considerate of me and always helpful when I called and I was pleasantly surprised to find out my surgeon has staff that is specifically there to deal with insurance companies - so nice that I didn't have to do any of that. I'd also recommend a strong support group system, it really has helped me (and my husband) learn about all the changes that are coming, not just the technical - but also the emotional and psychological.
My insurance required a 3 month supervised diet, but a lot of them require 6 months - so prepare yourself for that. Then once you pass your 3-6 month requirement, your paperwork is sent in for approval. At that point, if you're approved, you're usually scheduled out 4-8 weeks for surgery (assuming no other problems arise). That might help you envision what your particular time line would look like. Again, that can all be different for each of us - but when someone explained that all to me - it really helped me look ahead and know what to expect. I told myself that if I did everything they asked of me and insurance approved, I should be good to go with a surgery date of Jan. or Feb. after my August 14th meeting with my surgeon. I'm now scheduled for surgery on Jan. 5th - but again, my process was quick compared to most because my insurance approved right away and I only had a 3 month supervised period.
Feel free to ask any other questions and good luck at your first appointment!
Melissa
High Wt/Consult Wt/Surgery Wt/Current Wt
347 341 328 170
1st Goal Wt: 225 (met 9/13/10) / 2nd Goal Wt: 200 (met 12/13/10) / 3rd Goal Wt: 190 (met 1/30/2011) / 4th Goal Wt: 180 (met 4/25/11) / After baby: 170 and holding for 8 months!
Total Weight Lost: 177!
http://wlstrusttheprocess.blogspot.com/
Trust the process....
Melissa
347 341 328 170
1st Goal Wt: 225 (met 9/13/10) / 2nd Goal Wt: 200 (met 12/13/10) / 3rd Goal Wt: 190 (met 1/30/2011) / 4th Goal Wt: 180 (met 4/25/11) / After baby: 170 and holding for 8 months!
Total Weight Lost: 177!
http://wlstrusttheprocess.blogspot.com/
Trust the process....
Melissa
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