got a call Dr. I recommend i would not qualify for DS.... Now what????
I am very heartbroken right now, i just can't even explain. Okay in 2010, i elected to have the the lap band surgery hoping i would be able to lose the access weight. That dream turn out to be a doozy, as i have since struggled with the band due in part to the uncomfortable feeling i constantly had during meals. I additionally found out i had reflux at night time and had to constantly sleep sitting up or deal with food coming up through my nose. I rest comfortably when i sleep on my stomach and the band port kept interfering with my sleep pattern. long story short, i went back to by Dr. and had all the fluid taken out. i gained all my weight back and more!!!...I begin exploring options for revision. At first, i decided on the option of a sleeve, but my nurse and social worker recommended that given my history of reflux due to the band, it would be preferable i do the bypass. I researched and researched and decided on the bypass , it would afford me more weight loss. This went well until i suddenly lost my insurance and had to move states due to employment issues. I currently have a great insurance, and went about seeking revision surgery that would afford me much more results and given my long history of dieting, my body would probably not succeed with the sleeve, and gastric bypass appear to have too much complications with high chances of weight regain. My friend suggested something called the DS. I did research and with every way i look at it, the DS appear to be a right fit for me. I tried to see whether Drs. in my state provided this procedures. That was a no, so i turned to this site for Drs. that would provide the procedure out of my state. That is when i came across Dr. Buchwald and his team. Recently, i have been told by the UM clinic staff that Dr. Buchwald will no longer perform DS surgery, he is only following prior patients. i settled on Dr. I. I drove out to his clinic , met with his nurse Donna, and was told it shouldn't be a problem about me getting the surgery. Now i received a call from the clinic pre-surgery nurse coordinator and she just told me that after looking over my medical record , Dr. I is stating that i would not be the right candidate for the DS as i am below 50 BMI, had prior surgery (thus increasing my risk of future complications) and he is suggesting that i do a surgery for removal of the band , wait 6 months , than perform a sleeve. THIS IS MADNESS!!! someone please advise.. i am feeling helpless. Can i switch Drs.? will i get the same with every Drs. in that clinic?
ok a few things wrong with this post:
Stay away from another restrictive procedure, that being a revision to a lap band, a conversion to RNY or conversion to VSG-as stand alone, you best chance at health is a DS
1st if you bmi is 40 per NIH you qualify for WLS, this is not a question of insurance denial but your surgeon, the 50 bmi for DS is a bunch of crap and they cant say what is good for the "sickest" patients is not good for others who qualify for the WLS. There is NO competenet medical advice via peer reviewed journals to suppor this. Because your dr said you dont qualify-YOU RUN FOR THE EXIT DOOR and find another surgeon.
The suggestion of a 2 part surgery is not madness and can be rooted in complicaitons. You did not state what complications you had with the band (endoscopy, UGI) if you do have erosion, NO DR should sleeve until you and you should have an immediate explant and have your stomach rest for at least 6 months. then you can have your DS. and depending on your band complications you cant just go to any tom dick or harry you have to go to an experienced revision surgeon, leaks along the G junction are very dangerous and not like RNY leaks.
I had to fly for my DS, many patients do, and BTW I am one of those patients that had to have my band explanted and wait due to erosion, yes I gained 100 lbs. Then I had the DS.
Yes.. During my last barium swallow, i was told there wasn't any erosion, but the issue was the ring in my esophagus that enabled proper swallowing showed a bit or irritation. I am assuming this might be the byproduct of the stuck feeling i use to get when i ate and the food sits in my chest and i had to force water down with it. i have had all my fluids out of the band and its been a year. Now the surgeon wants me to take the band out wait six months and get a sleeve. if i wanted a sleeve i would have stayed with my surgeon here. i dont know what i should do, at least if he could advised me that i had that option i would be open to his suggestions, but to go through the trouble of getting two surgeries for a sleeve, when i have dieted my entire life and currently sit at a weight of 280lbs, is fustrating.
I wrote you a long reply, which the internet decided not to send in time. So I'll keep this short and simple. Get a second opinion from another experienced DS surgeon. The failure rate for lap band is so high that surgeons are removing them and doing revisions to the DS all the time. of course sometimes when the surgeon gets inside he may find a big mess, but usually it's possible to take the band out and do the revision. Are your risks increased by having had prior surgery? Of course, but that would be true with either sleeve or DS.
Get a second opinion at the very least, with a DS surgeon somewhere else. Learn all you can and then make your decision. And the operative word is YOUR - this is your decision, no one else's.
Larra
I think Larra and Irbender are on point. A surgeon can have any personal guidelines they feel comfortable
with - it doesn't mean you will hear the same answer from other surgeons. It all depends on their own ability
and experience. Even though it is disheartening it is a great idea to get a 2nd or even third opinion from some
respected surgeons.
My incliniation would be to always try and get as much done in one operation as is safe.
Good luck on this I hope you find someone that can help or at least do what you want in stages.
Pete
Did you ask why? Please post all the reasons. Did you ask if they would remove the band and then do the whole DS in 6 months? That MAY be reasonable. You need to stress that you know a restrictive only procedure will not work for you. You have to be your own advocate.
Dr. Buchwald taught Dr. Ikramuddin the DS. I have met Dr. I but that's it. Is there someone else at U of M who does the DS now?
As Larra said, you meet the NIH guidelines for the DS. Get another opinion and fight for your choice. Don't settle for what someone who has seen you for 10 minutes, or not at all, tells you to do.
Thanks guys.. i was just about to give up, The doctor have never met me.. he has only seen my medical records and my weight chart from my recent appointment with Donna. Can i call up and ask to see whether Dr. Leslie will be of similiar opinion? I am being told by Barb the pre-op coordinator, that i should begin the pre surgical requirements and make an attempt to lose the weight before she can set me up to meet with Dr. I. Why should i go through all this process when all i am going to get is a sleeve??? I know my body, as a long time dieter, my body have mastered the ability to store fat as soon as i eat a bit and losing the weight is harder . The DS sounds better as i will still keep my digestive tract intact and get the benefit of malabsorbtion. If the Dr. had even made an attempt to request tests before coming to this conclusion i would have given it a second thought, but he is relying on tests conducted a year ago for a bypass surgery for which i was approved (did not get the surgery by the way) and is stating that i should get a sleeve after removing the band in six months. This is just unfair. i am thinking of switching to Dr. leslie, but i fear that Dr. Leslie will just go along with what his partner is saying. this means i have to start all over again in my quest to get the DS.
Thanks guys.. i was just about to give up, The doctor have never met me.. he has only seen my medical records and my weight chart from my recent appointment with Donna. Can i call up and ask to see whether Dr. Leslie will be of similiar opinion? I am being told by Barb the pre-op coordinator, that i should begin the pre surgical requirements and make an attempt to lose the weight before she can set me up to meet with Dr. I. Why should i go through all this process when all i am going to get is a sleeve??? I know my body, as a long time dieter, my body have mastered the ability to store fat as soon as i eat a bit and losing the weight is harder . The DS sounds better as i will still keep my digestive tract intact and get the benefit of malabsorbtion. If the Dr. had even made an attempt to request tests before coming to this conclusion i would have given it a second thought, but he is relying on tests conducted a year ago for a bypass surgery for which i was approved (did not get the surgery by the way) and is stating that i should get a sleeve after removing the band in six months. This is just unfair. i am thinking of switching to Dr. leslie, but i fear that Dr. Leslie will just go along with what his partner is saying. this means i have to start all over again in my quest to get the DS.
