"Super Doc"

Had my first private consultation w/ my surgeon after getting all of my evaluations, tests & letters in order. He immediatey started talking about lap gastric banding, which was my original choice but, as I told him, my insurance had informed me they would only approve Roux en Y laproscopy. (It had also been suggested that with a BMI of 56% I would do better w. RnY). He basically said not to worry he would get approval and that I shouldn't "settle", I should have the surgery I wanted AND in the worst case scenario there were "grants" available from the Lap Band manufacturer. Has anyone ever heard of such a thing? He went on to say that recent stats suggest lap-band actually has a better rate of permanent weight loss and that unlike stapling, you cant stretch the stomach...as well as the fact it is less time on the operating room and in recovery. Am I being sweet talked by a surgeon who is going to hit me with "out of network" charges down the road? He is a reputable guy, well known to my family docs and held in high-regard at the local hospital--I'm just suspicious of his cavalier attitude toward my ins. co. when it has always been my understanding that they are immovable.

hmmm, everything I've heard about the gastric banding is that it does NOT have the proven success that the rny does, both for amount of weight lost and and for "permanence". The lap band is just a restrictive operation, while the rny combines restriction with malabsorbtion, so it usually results in more weight loss. I would look for another surgeon, one who is a member of the ASBS. JMHO irene

he would get approval and that I shouldn't "settle", I should have the surgery I wanted AND in the worst case scenario there were "grants" available from the Lap Band manufacturer. Has anyone ever heard of such a thing? I had another thought -- Is HE getting grant money from the Band manufacturers to promote the band? irene

I originally started researching the band, but decided on lap rny because of my eatting habits. i've got a major sweet tooth and I knew that with the band I'd find a way to defeat it. With the rny, if I eat sugar, I know I'll be sick. Do what you feel comfortable doing, don't let him change your mind.

I appreciate everyone's thoughts--hope you all keep posting! Lap band was my original choice because it is less invasive & is reversible (mercury fillings in teeth were thought to be safe & effective for years, too--now people rush to have them removed! Thus my thinking is: cutting out part of the stomach and rerouting the intestines might have a backlash 15-20 years down the line). I don't know...being fat all my life (& weighing 348 now) losing even 100 lbs permantly would be a HUGE benefit--is it wrong not care about weighing 150 lbs? I would be so-o-o happy to be a size 20! I am in my 40's and just do not want to let any more of life pass me by--I also want to make this change (after years of yo-yo-ing) in the least dangerous way possible. Having said all that, I'm still concerned about Super Doc's cavalier attitude...it does go against everything we have all read. Wow, and I thought POST OP would be hard!

No - it's not wrong to not care about being 150. You may be ecstatic at 200. OTOH you could find that being 200 and feeling so much healthier and mobile inspires you to take off more, but find yourself unable to budge the scale. You may run into limitations with the surgery at some point in time. Have you checked with people that have the band? What are some of the complications they've experienced? What is the revision rate? Are you likely to be diet compliant? Are you willing/able to restrict your food and make good food choices? I know myself well enough to know that I would "eat around the band" by consuming things that are not good, like candy, ice cream and things that are sugary, high calorie foods. So for me, the added feature of negative reinforcement is useful. The RNY has been around for a long time, since it evolved from surgical treatment for things such as bleeding ulcers. Now, while one should only undertake rny with the idea that it is irreversible, in fact, since the transected, and bypassed parts are left in the body, it is in *some part* reversible. Of course it can never be restored to original uncut GI tract. The thing that disturbs me about cavalier doctor is that the information that he's giving you is the opposite of what's been documented by many other surgeons and professionals. This, to me, is a red flag. I really don't understand why (and this is my impression based on what you wrote) he seems to be pushing you to the band. Not that he should push you to the RNY, either. Maybe you also need to look into his qualifications/training in doing any wls procedure. I know that you really need to be careful in choosing your doctor. I heard of a doctor that learned how to do wls by *watching a procedure*!! Talk about being a guinea pig. Keep in touch and let us know what you decide. irene

Hi J.C. I don't know if your doctor is sweet talking you or not, but make sure that you get your approval in writing if at all possible. My insurance pre-approved me for the Lap RNY, but failed to cover the entire surgeon's fee, leaving me with a post-op balance of 4, 200. My insurance doesn't tell you ahead of time exactly what they will pay. There reasoning is that it depends on how the Dr. codes it. Something I took into consideration when I was choosing what type of procedure to have done. Banding requires the application of a foreign body. I don't believe there have been any studies to determine if people have experienced a negative or allergic reaction to the banding material. Whereas stapling uses titanium steel which is the same material used for artificial hips and rods and screws used for complex orthapaedic surgeries, which has been used for decades. I hope this info doesn't confuse you any more than you might already be. All in all, it was the best decision I ever made for myself, despite the out of pocket expense. Best of Luck to you. Kathy

Thanks, Kathy--very helpful advice!

I am scheduled for a lap RNY on 3/3/04. My surgeon is Dr. Andrei in New Brunswick at RWJ. We discussed both options and although I had researched WLS for 3 years or more, the newest lap procedure w/the saline fill was something I wanted to discuss. He explained that it's not that the success rate is better or worse for either surgery it's the patient who makes or breaks it. He said, "The lap band is only as good as the diet." So while it restricts your intake and is adjustable, etc. If you aren't disciplined enough to follow a the eating plan set before you, it's not for you. Does that help?