Wayyyyy OT, but I would like your opinions ladies

Okay, so as most of you know, I have been on a PICC line with TPN since Memorial Day weekend due to complications from a distal RNY.  Last week I developed an infection in my blood due to the PICC line, so the PICC line was pulled and I had to go in and have IV antibiotics every day.  So, here is my dilemma.  I have been seeing 2 different surgeons for my issues.  Up until this point, they agreed on how to treat me.  Now they have very different opinions, and I do not know which one to go with.  I am going to give you both docs opinions..and if anyone has any thoughts or advice, I would so greatly like to hear it!

Surgeon 1:  Prescribed the PICC line and did my revision surgery in January that failed...wants to get me on the table immediately, do an open procedure, and switch me from an RNY to a sleeve gastrectomy.  I am not sure what the urgency is all of a sudden since I have not heard from him since Memorial Day, and I feel I would not have heard from him yet if I had not had to call to let them know my PICC had been removed. 

Surgeon 2:  Feels that we should take a wait and see approach.  He thinks we should leave the PICC out and see if I can maintain on my own.  If I drop down to 95 pounds, or start feeling poorly, then he wants me in immediately to restart the PICC and TPN and do surgery as soon as I hit 100 pounds.   He feels if we do surgery that I need a complete reversal, not just switching me to a different WLS procedure.  

I am more inclined to take the more conservative approach and see if I can do it on my own, but the flip side to that is...I am healthy now, so is it better for me to have a major procedure done now?  I just don't know what to do.  Any thoughts, ideas?   I would love to hear them, as I am really at an impass on what to do. 

Thanks to all :)

Laura

230/102/115
Preop/Current/Goal  

I guess I agree with a little of both...I would be more apt to go with surgeon 2 recommendation to try and maintain on your own in order to avoid major surgery in light of your recent infection and other issues. Than IF not working maybe surgery but not a total reversal but maybe the switch as surgeon 1 recommended. That is me...

I would say wait and see is what I would do but I am not in your situation and know how you feel. I dont see why it would be such an emergency either if you have waited this long. I say if you are feeling a little better that should be a good sign and maybe it will get even better. If not you always have the other option available to you. Its a kind of hard situation though. I am always a wait a little bit kind of person though. Not jump and have surgery unless its life or death.
I sure hope you can figure out what is best for you. Thats a hard one for sure!! Let us know what you decide to do!!

Again- I am not a medical professional..so this is just my thoughts.  Only you know how long it took to regain your strength and become healthy after TPN was started.  My thoughts are if it didnt take too long- I would wait, I would be scared to death to have a 3rd surgery. I would see if you can get it back on track on your own with monitoring, etc.  I guess they are both telling you  that you need more stomach surgery, is it possible to get a third medical opinion- that way you have someone else..hey it's like majority rules?!  I personally remember being so sick and not eating I was begging for them never to make me insert food into my mouth again.  I told them I was A okay give me a feeding tube and call it done. But once I healed from the ulcer, peterson's hernia, adhesions, and bad gallbladder..I was on the right road.  I was able to sustain myself and have done so a little to well.  Good luck Laura and I hope you get lots of great guidance. 

I would go with the 2nd one and not have any more surgery until it is looking like you are losing too much again.

Or maybe have the Picc line put in at 100 pounds if you go below that. I know you hate having one but you do feel so much better so it has to be what you feel you can handle.

Good luck whatever you choose!!

Just an opinion here- I would either go with Surgeon #2 or if possible seek a 3rd opinion. Get a fresh pair of eyes looking at your case. I would have a hard time going with surgeron #1 since he hasn't contacted you in 3 months.... and the first time he does he wants to cut you open.

I'd most likely wait it out while seeking another opinion. Good Luck!! 

I think you should call your PCP. When you call, tell the girls to schedule you for a "complex" appt so you are sure they allot you more time in his schedule than an acute visit.

Then go over it all with your PCP. He/she knows you overall. And they will have a medical understanding and a valid medical opinion about your best option. And one of those options may be that they send you for another opinion with another surgeon.

I know what I would do. But my opinion has alot to do about my personal feelings and not just medical necessity, so I don't feel it's fair to express it.

Please check with another health care provider who IS NOT one of these individuals. We get situations all the time at our office and the patients ask our docs for thier opinion. Do the same! Good Luck and please keep us posted on how things are going and which decision you made.

well.... this is what i think.. waiting and seeing isnt going to help.. but neither is getting into the or faster then yesterday..... maybe a " if dont  get to 100 lbs in x amount of days then we need to do a reversal" switching to another wls procedure i dont think is the answer... and being on tpn for life isnt the answer

Haven't you had lots of problems with your RNY?
Honestly if it were me I would lean towards the sleeve. They can still 'reverse' what is left of the intestinal part, I am assuming? The sleeve will still give you some restriction so you won't fear gaining weight back.

I'd hesitate to rush into another surgery myself, for various reasons.  I also agree w/getting another opinion and talk extensively with all the drs and see WHY they have the opinions they do.  WHY does dr #1 suddenly want to do the surgery when he's been OK with you as is w/the PICC for the last three months?  WHY does #2 think you should have a complete reversal rather than just a revision?  Personally...that option would scare me, because I know myself and that I'd be scared to re-gain all my weight.

Remember...you're the customer...make them explain their reasoning behind why they feel their treatment is the best option, then get a third opinion, and talk them all over w/your PCP to help you make the best decision for your health.

Good luck...I hope you get some answers that help.