Okay, Wow, Didn't Expect to be Taken in Circles??????? *LONG*

I apologize in advance for the chaos that this post will probably be but I am lost. Maybe I don't know what I'm supposed to be doing, what kind of questions to ask, maybe I'm really not ready for WLS. I don't know. But I'm having a very difficult time right now and I need someone to show me the light.

I went to meet with Dr. H today and I don't know how I feel about the meeting. I don't even know where to begin in explaining this because it's kind of all over the place. My impression of him was that he didn't care about what the patient thought and he was just gonna talk, talk, talk. I don't know, maybe that's just me being crazy and over analytical but this is just like, whoa. I felt like he looked at my age and automatically assumed I'm stupid or something just because I'm 19. God, I don't know, but I guess you guys don't want to hear about that. I don't know. He didn't really have an opinion on which surgery I should have. One minute he was pushing the Lap-Band for my age, the next he was pushing the RNY or DS because of my BMI but then he went back to the Lap-Band because of my age. Which is what I have been doing for the past year. When I mentioned to him that I was pushing for the sleeve he was like "Oh, well, the leak risk is really high, about 3 - 6%. I used to be pro-sleeve but not so much anymore." He proceeded to tell me about 2 out of his 100 sleeve's he's performed that have had some pretty serious leakage problems. About how one lady got to the point of having to be fed through an IV because she couldn't eat or drink normally. And I mean, maybe this should scare me, but just because TWO our of 100 have a problem you want me to back down? It seems like a pretty insignificant number to me. But then he started pushing for the RNY and my mom (I wanted her there because she's a nurse) asked him what the leak risk is with the sleeve vs. rny. And I wish I could remember EXACTLY what he said but he said something like they'd be able to tell immediately with the RNY if there was a leak where as with the sleeve, you could leak 2 - 3 weeks out. He said something like if the RNY doesn't leak in the days immediately after surgery then the risk of a leak in a few weeks in pretty much zero. I think that's what he said. I don't know, but that doesn't make a whole lot of sense to me. So if anyone could confirm or deny that, I'd appreciate it.

All he could say to me at the end was that it was my decision and I know me best. Which is true, I do know me the best. Better than he would anyway, because before today we were complete strangers. But shouldn't your surgeon want to get to know more about your eating habits and things like that and then together decide on your surgery? I mean, god, I don't know, I feel like it was a complete waste. He sat there and went over every complication and blah blah blah of the 4 procedures, most of which I already know and then told me it was up to me. I don't know, maybe that's my fault for not asking a million questions and being a better informed patient but I've never done anything like this before. I don't know how this is supposed to go.

I honestly thought that I would get in there and we would talk and decide upon a surgery, which I hoped would be the sleeve, and he would say "okay, well I'll work on a letter for your insurance to try and persuade them." Idk what he's gotta do to have insurance possibly pay for it but I just wasnt at all expecting the answer I got. Do you know what he said to me when I told him I wanted the sleeve and I wanted to try to have insurance cover it? He IMMEDIATELY just said "Nope. They won't cover it. No way." And that was it. He said the only way was to take it up with HR at my work but I DONT work. We've cobra'd my insurance. WTH? Am I missing something? Have I totally been misinformed? I thought the surgeons were supposed to help you get insurance to cover this.

I don't know. Maybe this is all my fault. Maybe I didn't prepare enough. Maybe I haven't done my research. I don't know WHAT is going on anymore. Someone said to me in the first post I made here that they would hate to see someone settle for a surgery they didn't really want just because it was free (insurance paying for it). And I know it's not free, you still have to pay but that's what the guy said to me. I don't know. I AM SO LOST AND CONFUSED. I don't know what to think anymore.

Am I the only person that felt this way when trying to decide on a surgery?

I am sorry you felt so confused and overwhelmed. I hope that you will continue to research and decide what is best for you.
He is right, you know your self better than anyone and based on the information you have researched, you can make a good decision. I knew the band wouldn't work for me because it was too easy to cheat. I know how I am so I decided to choose RNY. The sleeve was and is very new. My insurance felt it was experimental and wouldn't pay for it and I thought it seemed extreme. But those are MY feelings.
Your surgeon has nothing to do with getting your insurance to cover a procedure. His office staff will help get all the paper work together and he will sign whatever he needs to, but it is not their job to get it approved. It is yours. You have to do whatever your insurer says you need to do. He is right, lots of insurers do not cover all of the WLS available. You need to check your policy. Find out what they cover and what they don't cover, find out everything you need to do to get your chosen surgery covered. That is really all on you.
Continue to research and PRAY. Also, ask you mom to help you too.
Good luck, it will all work out the way it is supposed to.

Thank you for your opinion. Now that I've calmed down (because believe me, I was stressed and upset when I wrote the original post), I understand exactly what you're saying. I have the knowledge to decide which surgery is right for me. And talking to him DID infact help, just not in the way I expected. And I know it's not his job to get me approved. I'm aware of the requirements my insurance asks of me-- I've completed them and have been approved for the surgeries they cover (Lap-Band and RNY). But I want the Sleeve, and they dont cover that. And it was my understanding that the surgeon and his staff would help me fight to have the sleeve covered. SO when he said "No they won't" I kind of flipped out. I was like "WHHHAAAAAT???" But we're working on getting this craziness sorted out. Thanks again, though.

You said he kept going over complications blah blah blah.  The "blah blah blah" part makes it sound as if you don't care about anything other than just having someone hand it to you on a platter and make it easy.  People say surgery is the easy way out...  but nope.  It's a hard way in, its a hard way through...  and the thing is, there is no end.  It's for a lifetime.  This is serious business.

The information he gave you is enough for you to think and ponder on.  Then, you have to come to a conclusion based on what the differences are in the surgeries.  For example, if you don't want to be re-routed, cut on, etc., you may opt for the lapband since there is no cutting of the stomach.  Also,  it can be removed, unlike the other procedures.  If you want dumping and the ability to only eat a little, you might want the RNY.  I can't speak for the benefits or disadvantages of the other surgeries (DS or Sleeve) because I dont know enough about them.  John and Tammy can help in those 2 areas... but, what are you willing to live with?  What do you need to be successful?

As for the doc not asking about your eating...  He isn't concerned about that because at this point, you should understand that eating as you know it right now...  will be changed dramatically after wls!  Are you ready for those changes?

There's a couple reasons I wrote "blah blah blah". One, I was too lazy to type out EVERYTHING he said. Two, it was just the basics. The pros, the cons, the risks, the surgeries themselves. I mean, it was stuff I already knew. He did not tell me anything that I did not already know. He just refreshed my memory. I don't expect anyone to hand it to me on a platter but I did expect my surgeon to HELP me and I left the consultation more confused than I was before I went in.

I can understand now what I need to do to make up my mind. I realize NOW that my surgeon CAN'T make up my mind for me, it is truly my preference. But I didn't expect him to decide my destiny for me. I expected him to help guide me to the best possible choice and all that happened was he verbalized what has been going on in my brain for the past 9 -10 months.

What I realize about the eating is that it doesn't matter because it's not a choice of restrictive vs. malabsorption. Because REGARDLESS of what surgery you have, it's gonna be hard work.

Which only leaves me with how I feel about myself and will I be able to handle the different scenarios that each surgery will present to me.

And I am MORE than ready to make those changes. 

Thanks for your input!

I know you feel lost and confused right now, but to me I feel like you were expecting all quick, easy and ready to go answers. The Dr was just trying to inform you of every surgery, procedure and what the risks are, thats part of his job, even if you do think you know all about it. Honestly I dont feel like you do know enough right now. As far as you thinking the Dr is trying to scare you out of a procedure, no he just wants you to understand and be prepared. Its not simple at all none of it! As far as him to get the insurance to approve you its not his job, he can sign some papers stating that you meet the requirements needed to be a candidate for the surgery, but you also have to make sure that you meet all of the other guidelines through your insurance before they will approve, which may mean a  6 month Dr supervised program or a 3 month program. You need to call your insurance and see whats required from you to get approved for any WLS, and then you need to see what your insurance covers of the surgeries. Once you have this information go from there.

I was expecting quick and easy answers. But I had no idea what else to expect, you know what I mean? I haven't seen many posts on consultations with surgeons and I don't know if that's because every hospital is different or maybe I just didn't do enough research. But I expected him to have some sort of opinion on the right surgery for me. I guess I didn't realize how difficult it is, especially for a surgeon, to have to help a nineteen year old make such a huge decision. He said it himself that if I were forty and at my weight, he would suggest the DS and be done. But the fact that I'm nineteen makes things that much more complicated. He doesn't want to push for the lifetime of malabsorption and care that the DS requires on a NINETEEN year old. That being said, I was wrong. He DOES care about his patients. He even said to me, "I'm trying to think what I would do if you were my daughter." And I'll admit it. When I wrote my post, I felt lost. I only heard what I wanted to hear and focused on that. But when I sat back and looked at it with a calmer approach, I see now what I didn't see then.

And again, I have already been approved for WLS. My policy only covers Lap-Band and the RNY. But I want the Sleeve and I KNOW my insurance considers it "investigational". So I did some reading on how to possibly get insurance to pay for it. And from what I understood, the surgeon and his staff was supposed to help me with that. Because, after all, you need a letter from your surgeon explaining WHY it's a better surgery for you over the ones they cover. At least, that was my understanding from what I read. So when he told me "Nope. There's no way." And that was the end of that discussion I was crushed because we've been cobraing my insurance JUST BECAUSE we're keeping hope alive that I won't have to fork over the $21,000 to have the Sleeve. THAT is why I was upset. But like I said, I've calmed down and I see things with a much clearer outlook now.

Thanks so much for your input!

Dr. Houston is a surgeon and a very good one. The eating and all the insurance things are left mostly up to you and his staff. You need to see what your insurance will approve , and then you need to decide what kind or if you want to have surgery. When I went to see him , I had researched every surgery and I knew exactly what kind of surgery I wanted, and exactly how big I wanted my stomach and common channel. No doubt, this is a HUGE decision. and it ii is YOUR decision. Read and read and then read some more. 

I realize that now. Thank you.

Your insurance will not cover a sleeve - not as a one time procedure and not as the first part of a staged duodenal switch. I was 95% sure of this before Dr. Houston asked us to check again, we verified it on the policy. That is why he was so quick to tell you they wouldn't cover it. If we send a request for a procedure they do not cover, it delays the process tremendously as they deny it. If you have any specific questions about the insurance portion, please call our office at 615-342-1231 and ask to speak to the financial counselor. Have you attended a support group yet? If not, go to a few and ask why they chose the procedure they did and if they had it to do over, would they make the same choice?

Good luck and hope to see you soon!