Surgeon shot down my plans!!

Hi, just finishing up moving - computer and internet are up finally!!!  Yes, he said he would not do an RNY either - many "lightweights" with a DS  have a lower BMI than I do.  Why isn't Dr. C recommended?  Both he and Jossart have lots of experience and are considered experts, from what I have read anyway.  Just wondering.  Dr. K charges $4,000 'program fee' and I already paid $3,500 program fee when I had the lapband put in . . . I think those charges are bogus, IMHO.  When six months had passed, my LB surgeon started billing my insurance for visits/fills so I don't get what the program fee is for.

Off subject - sorry, I would like your opinion about whether since I only lost around 30 lbs, some of that pre-op, if a VSG would be a success since there is no absorbtion portion.  I'm really afraid to go through another surgery  then need a revision to a DS anyway when I went through three for the LB (LB, port rev and LB removal).

So on one end is losing too much and the other end not losing enough . . . thanks for your input.

Wendy

Dr. C has a program fee too. It's for 2 years of follow up and other stuff. Jossart charged it when he was with LapSF. I don't know what he's doing now.

I think the concerns about losing too much weight are misplaced though. Losing too much is rare and it doesn't seem to be related to start weight. It just happens to some people either because they can't absorb enough nutrients or because they send up with a low set point and don't eat enough. If you use a surgeon who makes a smaller sleeve and longer common channel, the risks of issues due to malnutrition are lower and not eating enough can be overcome in a number of ways.

I don't know why Dr. C isn't on the recommended list and no one has ever given me a good reason. My personal opinion is that he pissed off the wrong person(s) in a certain DS clique. 

Marie, the only things I've heard that got him pulled was his bad attitude about the DS and his way of pushing his beloved VSG at every opportunity. Probably an over simplification but that's my take on it.

--gina
 

To me, "bad attitude about the DS" and "pushing his beloved VSG" is politics and a matter of opinion. He doesn't worship the DS and think everyone should at least one surgeon I know. Yes, he's big on the VSG, but so are tons of surgeons. It's becoming more popular every day and many surgeons are saying it's going to replace RnY, not just him. He actually pushes the DS for certain patients over the RnY and his attitude towards RnY is more in line with many DSers in that he doesn't see the reason to get it over a VSG (or DS if you need more oomph).

So is that a bad attitude about the DS? I don't think so. He certain won't say he does the DS and then talk people into RnY like a lot of docs do because they don't really do the DS. Is he telling people that they will weigh 70 pounds if they get a DS as a lightweight like Jossart told the OP? No, because it's not true. Does he say that malnutrition is a greater risk with DS than with VSG. Yes. But again, that's true.

The bottom line for me is that, rather than focusing on what they have in common with him and basing their recommendations on things like surgeon skills, they are trying to shut him out of the DS market for not toeing a certain philosophical approach. I think that does a disservice to the WLS community and I think it gets pretty silly when they recommended his (former) partner but not him when they were in the same practice with very similar approaches and attitudes towards the DS. That, to me, is very personal. Like *he* pissed someone off and Jossart didn't.

I don't know enough about Pomp to guess why he's not  on the list but, as far as I can tell, he's also an excellent surgeon and again it's a disservice to the community not to recommend him. Unless it turns out he's doing something bad to patients that I just don't know about, I think he should be on the list too. Anyone who has a certain complication rate (or lower) and doesn't do Bait & Switch should be on the list IMO.

Wendy, not EVERY DS surgeon has a program fee but it depends on travel time too...And while Dr. Alfons Pomp, my husband's surgeon is not on the DSFacts list NOW, he was. And he does revisions to a DS. He is one of the few with NO program fee.

My husband and I have tried to find out why Dr. Pomp was pulled from the list for sure but no one is answering...like Dr. C, I think he pissed off the wrong people as DSFacts IS run by an individual. It's a very good resource but not infalliable. My surgeon isn't even on the list and should be but he charges a program fee.

Now, the cost benefit of fee/no fee is can you afford to travel to see a surgeon who does not charge a fee? Traveling to NYC to see Dr. Pomp cost us almost as much as staying here and paying the fee for my surgeon. Only reason we had two different surgeons was that MY insurance company would approve the DS but only if I stayed IN my own state.

Good luck on your search...

Liz

Thanks for the info - politics sure plays a part everywhere!!  I really think if a surgeon is good then he/she should be on the list.  It is an ethical thing to me and a disservice to those looking for good information. Looking at this from another angle, there may possibly be a way to get ON the list even if someone isn't necessarily a great surgeon, it kind of sours the value of the purpose of the list in a way.

Dr. K charges a fee of 4000 and Dr. Cirangle charges 5750.  I paid a 3500 program fee when I had my lapband put in and I'm not interested in paying another one.

Dr. J said he would not charge me a fee for a sleeve - I am considering this but I am not really a volume eater, I really think all the years of yo-yo'ing dieting messed up my metabolism so I'm worried about that.  I may appeal to him with more of my background and eating habits but he sounded pretty set that he did not want to give me a RNY or a DS . . . we'll see.

I submitted my info to Dr. Rabkin's office so we'll see what costs are involved there - he is not a subscriber to my insurance and probably has a fee as well.

Would be nice to have surgery in 2011 since my deductible is paid and the family maximum has been fed into which would help the cost.

Thanks again!!!

Wendy

I'm not a volume eater either. I ate because I was hungry all the time but I ate a little at a time and ate constantly (and still do).

The VSG is a very metabolically active surgery. Not as active as the DS, but more active than RnY. It may be enough for you. OTOH, the fact that you lost only 30 pounds with the band is concerning. I would be asking myself and the surgeon.... why was that? Was it because you never got true hunger control with the  band? If so, then it's not a metabolic issue. But, if you followed the program and were eating 800 calories a day (or even 1200) and didn't lose, that's means there is a metabolic issue that needs to be addressed.

I never, ever had hunger control with the band.  I went back and forth, had a fill or unfill every month the entire time I had the band - never got to 'that sweet spot', if it even exists.  I threw up a lot, the tightness varied with the weather, my stress etc.  Very frustrating.  I lean toward the VSG but I have yo-yo dieted my whole life, since the 8th grade and over the years my 'fat weight' went from 140 to 200.  That is why I worry - luckily my insurance has not implemented a 'one per lifetime' yet, perhaps they all will go to that at some point so I feel like this may be it.

Thanks, the input helps!!