Please Help

Hello,

I'm glad I found this place. I'm in a pickle. I've been looking at surgery for years.

Was going to get surgery 7 years ago and my marriage imploded. Brutal divorce, false accusations of abuse, married to a Borderline and didn't know about BPD until she destroyed my life.

Was just starting to get my life together when I was in a bad car accident. Hip permanently injured. Constant back pain. Weight skyrocketed. All the progress I'd made gone, debt. Lost everything of value. Dog died.

My insurance company just settled. I lost my shirt but I'm grateful that chapter is done. Now I have a little money in the bank and can relocate anywhere in the US.

My health is deteriorating. I need to get this surgery to save my life. So I'm asking for your support. I need to know who the top three surgeons are in the country. BMI is 70. constant back pain. Terrible sleep apnea and I can't sleep with those damn machines.

so can you guys help me know where to go? Who to talk to?

thanks

these surgeries have become so widespread and routine that it's really not necessary to find one of the top three in the country (unlike plastic surgery - where that WOULD be a consideration since it's a far more complicated surgery - with cosmetic results that you can actually see...). At any rate, I don't think I've ever seen any posts re: the top bariatric surgeons in the country. That may have been the case back in the 60s and 70s when it was a risky surgery and there weren't a lot of people doing them, but I don't think that's the case anymore.

Find out if any are in your insurance network and then check for reviews on them. Or ask your PCP for recommendations. You'll most likely need his/her referral anyway, depending on your insurance policy.

Sorry to hear of all of your troubles - you've been through a lot! Welcome to the club here.

With your high BMI and pain issues that inhibit your activity levels, I would suggest that you look seriously at the duodenal switch (DS) procedure, as that would give you the best chance to attain and maintain a healthy weight. It is a more technically challenging procedure to perform, so relatively few surgeons offer it. But that means that those who do generally come from the top of the class. A very incomplete list of DS surgeons can be found here: https://www.dsfacts.com/duodenal-switch-surgeons.php

Docs that I am familiar with, there is Dr, Ara Keshisian in the LA area, John Rabkin and Greg Jossart in the SF, Mitchell Roslin, Alfons Pomp and Daniel Herron in NYC and David Greenbaum in NJ. These are all in fairly high cost of living areas, but there should be others on the above list in other areas. The good news is that since DS surgeons are fairly few and far between, most are set up to work with non-local patients and routinely deal with patients from all over the country, so that shouldn't limit where you choose to live. My wife and I both deal with Dr. Rabkin though he is about 400 miles away - fax, email and phone work just fine for routine follow up.

The DS is a bit fussier on supplements and compliance with them than the RNY (and a lot more than the VSG) but that is the trade off to consider to get its' better performance on weight loss and maintenance.

Good luck in this new chapter...

yes - this poster is correct. I should have clarified my response. Getting a top surgeon IS a consideration if you're considering the DS. It's a rarer and more complicated surgery than the RNY and the VSG, so you want to go with one of the top people.

Yes, I'm looking at DS

Been told for my size it's appropriate. I'm in Washington but looking at moving to AZ or TX. Really looking for any new objective sources as far as data on number of surgeries done, percentage of complications, hard data if available. Any ideas are helpful. Thanks for sharing.

If you're looking at AZ regardless, I had a good experience at the Mayo. Great pre program requirement to work on the head stuff, very strong support during the process and I've been pleased with the post op support as well. They met my insurance requirement as a bariatric center of excellence as well. Good luck!

Good luck in your journey. What type of surgery you get may determine how well long term you would do.

Another option, besides a surgeon in US is a great surgeon outside US, and I believe they're few to consider.

With back injury and the high obesity you may qualify for disability and medical insurance that may help you. Not sure if money in your bank account would prevent you from getting that. Probably.

I had RNY, and ideal with some health issues related to that. One of the issues I deal with is not being able to take NSAIDs. Orally or by any other way, as IV or topical, in rubs or patches. NSAIDs are not recommended to take after any WLS, but with RNY, we have remnant stomach, not accessible orally, and any even small amount of NSAIDs can cause internal bleeding in that stomach, that can only be deal with surgically.

The VSG, sleeves or DS - I know bunch of people who still take some NSAIDs to help them deal with pain. They take other meds to protect their sleeve, and can manage pains like arthritis better than I do.

You have to think of that aspects of your long term medical treatment when considering WLS.

Slleve is the least invasive, but also comes with it's own limitations.

With a 70 BMI you might want to consider a two-step surgery as it's a lot less risky - a sleeve first that will help you lose about 200 lbs and get mobile fast ... and then revision to a DS which will give you permanent malabsorption. Hugs good luck hun

Sorry to hear about all you have been going through. Seems like now it's time to take care of YOU! I am not sure who the top three surgeons would be but wish you well in your search. Most of the surgeons have patient reviews that I found to be helpful.

Hi Mr. Darling,

I tried to find where your from, but since you say you can move anywhere now my surgeon is Dr. Douglas Ewing with the Laparoscopic Associates in New Jersey..201-646-1121. He did all 3 of my surgeries last being January 30, 2020, one month ago..look up his website, look up reviews and I know he and his team does all of the surgeries. in my opinion (TOP IN THE WORLD)lol..

Good Luck in your Journey!