Common Channel and Roux Limb?
You really need to ask how many DS's he's done, now.
As for the common channel, my surgeon discussed it with me at my surgical consult. He said he usually does 100cc, but that since my BMI is lower, he may want to do a 125cc to help with better absorb vitamins. He said we'd discuss it more the day of surgery, I'm leaning toward the 125, since I already had deficiencies when I first got my labs done back in December.
As for the common channel, my surgeon discussed it with me at my surgical consult. He said he usually does 100cc, but that since my BMI is lower, he may want to do a 125cc to help with better absorb vitamins. He said we'd discuss it more the day of surgery, I'm leaning toward the 125, since I already had deficiencies when I first got my labs done back in December.
5'5" -- HW 275/SW 246/GW 130/CW 157
jenflock posted it before I could. You NEED to grow those balls NOW. Having WLS (especially the DS) means becoming our own health advocate. If you can't work up the courage to as him about his stats how are you going to fight him or your PCP to order blood work they find unnecessary?
You can probably find awesome information about his stats from other patients on here but you need to be able to ask him.
As for the lengths? I have a 75cm common channel. My surgeon uses the Hess Method which customizes the length for each individual patient. I preferred this method and it's one of the reasons I chose him.
This is your life, take control of it.
You can probably find awesome information about his stats from other patients on here but you need to be able to ask him.
As for the lengths? I have a 75cm common channel. My surgeon uses the Hess Method which customizes the length for each individual patient. I preferred this method and it's one of the reasons I chose him.
This is your life, take control of it.
As I said in my post to her, this isn't the same as a civilian doc that I would normally be paying or an insurance company would be paying....NO MONEY will exchange hands.........I won't be fighting him for anything because 2 weeks after my surgery he will release me to travel back to Texas and I won't see him again!
My PCP will either order what I need, or I will get a new PCP. I'm not afraid to question civilian docs......but a freakin COLONEL in the US ARMY......yep as an army wife with NO RANK at all......I'll admit I am intimidated by him and do NOT want to offend him..........he has been very good about answering the questions I have already asked, so as I already posted above.....I'll figure out a way to ask what his "numbers" are!! THANKS!!
My PCP will either order what I need, or I will get a new PCP. I'm not afraid to question civilian docs......but a freakin COLONEL in the US ARMY......yep as an army wife with NO RANK at all......I'll admit I am intimidated by him and do NOT want to offend him..........he has been very good about answering the questions I have already asked, so as I already posted above.....I'll figure out a way to ask what his "numbers" are!! THANKS!!
Hon you need to wipe out that military rank thing from your brain. IT IS MEANINGLESS, TOTALLY MEANINGLESS. He is a physician to whom you have access through your husband's workforce insurance, no more, no less. He DOES work for you.
Military rank has no place in the workings of a relationship with a civilian, and you are a civilian.
The workings of the social world of officer versus NCO *only* apply, to the extent that they do apply, when it's about your husband's direct workplace, or if you are a civilian employee or contractor in a military setting.
You're building up the "he's a *gasp* COLONEL" thing in a way that does not apply to ANYTHING. And I promise you that if he were to hear from you that you are intimidated by rank, he would say exactly the same thing. (He'd be breaking some large military rules if he tried to suggest or act otherwise. They don't get to pull rank or use it in any other way for any kind of benefit when civilians are involved.)
^^^ Um, that's a very awkward sentence and I apologize to current and former military officers. I don't intend it to sound like there's ever an "okay" time to pull rank or use it for one's benefit. But I can't formulate a better way to say it just does not figure into this equation.
Military rank has no place in the workings of a relationship with a civilian, and you are a civilian.
The workings of the social world of officer versus NCO *only* apply, to the extent that they do apply, when it's about your husband's direct workplace, or if you are a civilian employee or contractor in a military setting.
You're building up the "he's a *gasp* COLONEL" thing in a way that does not apply to ANYTHING. And I promise you that if he were to hear from you that you are intimidated by rank, he would say exactly the same thing. (He'd be breaking some large military rules if he tried to suggest or act otherwise. They don't get to pull rank or use it in any other way for any kind of benefit when civilians are involved.)
^^^ Um, that's a very awkward sentence and I apologize to current and former military officers. I don't intend it to sound like there's ever an "okay" time to pull rank or use it for one's benefit. But I can't formulate a better way to say it just does not figure into this equation.
To offer a different perspective, I am a medical professional and I'm a civilian. I worked for several months at a well known Air Force base as a civilian contractor, and the surgeons I worked under, were officers. One was a lieutenant colonel, the rest were younger and were majors. I also interacted less frequently with many other physicians of various ranks, even colonel, and met with the doctor running the hospital, who was a General.
As a civilian, I started out less intimidated by all of this than someone enlisted would have, I'm sure... BUT, all of those doctors treated all of their patients like PATIENTS, not underlings. Many of their patients were spouses and children of enlisted, and of officers. And, many patients were retired military (not just air force) and still receiving military health care. All were treated with equal respect. All had their questions answered. The patients who were belligerent or had self-inflicted injuries fom fighting.... those were the ones *****ceived less respect.
I'm sure it's a bit scary to ask him, but you have the right to ask him, and I'll bet he won't even mind. Good doctors like to have educated intelligent patients. Good luck!
Karen
As a civilian, I started out less intimidated by all of this than someone enlisted would have, I'm sure... BUT, all of those doctors treated all of their patients like PATIENTS, not underlings. Many of their patients were spouses and children of enlisted, and of officers. And, many patients were retired military (not just air force) and still receiving military health care. All were treated with equal respect. All had their questions answered. The patients who were belligerent or had self-inflicted injuries fom fighting.... those were the ones *****ceived less respect.
I'm sure it's a bit scary to ask him, but you have the right to ask him, and I'll bet he won't even mind. Good doctors like to have educated intelligent patients. Good luck!
Karen
NoMore B.
on 8/16/11 10:41 am, edited 8/16/11 10:42 am
on 8/16/11 10:41 am, edited 8/16/11 10:42 am
A few thoughs -
It really doesnt matter how many credentials your surgeon has in other types of surgeries, you need to know specifically how many DS's he's done. That's just a start. Then you should ask about the outcomes of those surgeries - complication rates, people who make it to goal, etc. Lots of people have the "surgeon as God" complex, but it's just not valid. You are the consumer and he is providing a service. Think of it like that.
My surgeon and I were talking about surgical difficulty of the DS once, and he said that on a scale of 1-10, the difficulty of putting in a LapBand is a 3, a RNY is a 5, and the DS is a 9.9. I asked him how the level of difficulty of the DS compared to other surgeries like a heart or kidney transplant, and he said those are different types of complicated, but he thought the DS was the same, if not more complicated.
Now about the common channel question. A 100CM common channel and 150CM alimentary limb is a pretty standard DS. There is one thing to consider, though, which is that every surgeon might have a different method to measure. Dr Keshishian has a good explanation on his website where he makes a comparison to a phone cord. Some will measure it pulled more tightly than others. I also talked to my surgeon about this and he said there's variation in those numbers by surgeon. For example what one surgeon measures as 100 might be someone else's measurement of 85, or someone else's 125. I doubt there's a great deal of variation, but the potential exists. That's why it's important to ask your surgeon about his outcomes, too.
It really doesnt matter how many credentials your surgeon has in other types of surgeries, you need to know specifically how many DS's he's done. That's just a start. Then you should ask about the outcomes of those surgeries - complication rates, people who make it to goal, etc. Lots of people have the "surgeon as God" complex, but it's just not valid. You are the consumer and he is providing a service. Think of it like that.
My surgeon and I were talking about surgical difficulty of the DS once, and he said that on a scale of 1-10, the difficulty of putting in a LapBand is a 3, a RNY is a 5, and the DS is a 9.9. I asked him how the level of difficulty of the DS compared to other surgeries like a heart or kidney transplant, and he said those are different types of complicated, but he thought the DS was the same, if not more complicated.
Now about the common channel question. A 100CM common channel and 150CM alimentary limb is a pretty standard DS. There is one thing to consider, though, which is that every surgeon might have a different method to measure. Dr Keshishian has a good explanation on his website where he makes a comparison to a phone cord. Some will measure it pulled more tightly than others. I also talked to my surgeon about this and he said there's variation in those numbers by surgeon. For example what one surgeon measures as 100 might be someone else's measurement of 85, or someone else's 125. I doubt there's a great deal of variation, but the potential exists. That's why it's important to ask your surgeon about his outcomes, too.
Kristi,
I do not like his wording " usually " ... he is using standard textbook terms here. Does he know what the Hess Method is for the DS ? Do YOU know what the Hess method is for the DS ? I know you have been here for awhile and trying to figure out how to get this done.
BUT, A free surgery, is not worth your life if he has never really done the DS. How many has he done ? Does he really do the DS ? Or does he say he does because that is what he wants you to think ? I have seen the bait and switch with military docs in the past. I realize the surgery is free to you, but your life is worth having this done properly. Also, what size does he make the stomach ? What size bougie does he use in surgery ?
You NEED these answers. I do not care what rank he is, that means diddly when it's your life. I would also want to talk to other patients he has switched as well and know how they have done, complications, weight loss, long term results. If that is not provided you are wise to go elsewhere, even if you have to pay out of pocket.
Just my opinion. From what I have read in this thread I would not let him touch me.
I do not like his wording " usually " ... he is using standard textbook terms here. Does he know what the Hess Method is for the DS ? Do YOU know what the Hess method is for the DS ? I know you have been here for awhile and trying to figure out how to get this done.
BUT, A free surgery, is not worth your life if he has never really done the DS. How many has he done ? Does he really do the DS ? Or does he say he does because that is what he wants you to think ? I have seen the bait and switch with military docs in the past. I realize the surgery is free to you, but your life is worth having this done properly. Also, what size does he make the stomach ? What size bougie does he use in surgery ?
You NEED these answers. I do not care what rank he is, that means diddly when it's your life. I would also want to talk to other patients he has switched as well and know how they have done, complications, weight loss, long term results. If that is not provided you are wise to go elsewhere, even if you have to pay out of pocket.
Just my opinion. From what I have read in this thread I would not let him touch me.
Ginger<><
Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire 5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm 
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