Frustrated....it's a little long, sorry!

I'm feeling very frustrated-my master plan is falling apart....I have surgery scheduled on December 19th in India with an experienced DS surgeon, Dr. Lakdawala (same surgeon that BearMom used) at an International Bariatric Center of Excellence and had planned to get follow up care in South Africa where I will be living, with another Center of Excellence which I have visited before and liked. I just got an email from them reneging their offer to provide me post-op care because they are upset that I'm not doing the surgery with them (it's literally twice the price and actually my surgeon in India has done many more DS'es and revisions than the SA surgeon AND the SA surgeon refused to do a DS on me because my BMI is under  50...and I will NOT be getting RNY).....so I'm disappointed about the loss of a good place to get follow up care.

I know that many of you have done much of your follow up care with your PCPs and hematologists that you have found on your own....can I get some words of encouragement that losing this resource for followup care isn't the end of the world? I know I will be able to find a good PCP there, I will just need to ask around. There are other bariatric surgeons in SA of course but not many who have experience with DS so I'm nervous if there are any post-op surgically-related complications I'm going to be up the creek without a paddle....I'm staying in India for 2 weeks and some change after my surgery just in case, I think most leaks are caught in this amount of time, how about strictures?

 FWIW,  I am 11.5 years post-op and I have never used a surgeon for care.

Strictures usually occur farther out but any decent GI can handle it. Print out the info on DSfacts.com twice and make 2 small binders. Find a good PCP and present it to him/her. Keep the other one for yourself to show other specialists should the need arise. You can also print out pertinent posts from here and add it to the binders. Include your surgeon's contact information just in case the doc needs to speak with him.   Make sure the binders contain the section that describes (and has pictures of) the DS from DSfacts.com so the doc totally gets it. It isn't a difficult surgery to understand once it is presented correctly. You may need to post here regarding things like vitamin and protein requirements, particularly when you have labs drawn early out because your PCP won't likely know what you will need at first. But the vets will and if you post your labs here, they will tell you where you need to tweak your vites.

Good for you for recognizing that you need a surgeon who has more experience. If the COE in SA does not want to deal with you because you are getting your sugery elsewhere, what does that say about their priorities? Certainly they are more concerned about profits than patient care so clearly your best option would be to train a willing PCP. You will improve the community by providing it with an alternative to the COE in your area so more than just you will benefit. Find an open minded and curious PCP who truly cares about the patient and is eager to learn about this wonderful surgery. It will give the PCP a competitive advantage over other docs in the area and it would be a wonderful way for you to pay it forward as the PCP will be able to confidently provide another option to obese patients AND provide follow up care. You GO!

Here's what I did for follow-up care:

1. Made sure my PCP was totally on board.

2. Got recommendations from my PCP for gastro docs. (in case of complications)

3. Interviewed 2 of them, the 1st one didn't seem interested in working with my surgeon via phone and / or fax.  The 2nd one was a hit, but I never needed him.

The only aftercare I have needed so far has been labs.  I have moved since my surgery but found another PCP that was willing to listen and learn.

You will do fine and I am glad that you are using an experienced surgeon, half your battle is won right there!

Michele

This is unfortunate, but really it will be ok. Almost everything can be handled by a good pcp and, if needed, a knowledgable gastro, and your surgeon will only be a phone call or email away. The world is a much smaller place these days.

Larra

Thanks everyone, I really appreciate your advice and words of encouragement. Starting my search for a great PCP now!