New here, looking for advice and recommendations...

[Mspotatoblsm]

Hello, New here... Had an AGB back in 2005, lost 65 pounds then it slipped. Had it removed in 2008 and after 9 years I gained the weight back plus more. I am now at my heaviest and have had a bunch of other health issues that joined the party. I have been mentioning WLS again to my PCP for almost a year and finally took the step to make an appointment just to discuss my weight. To my delight he was very positive and is writing me a referral to the local Weight Loss center. I am beyond thrilled. I am positive this time will be different. I have a better support structure and know better what to expect. I would like to have a DS but unfortunately I don't believe it is offered in Maine. Looking for advice and recommendations about how to get the best surgery for myself if it isn't offered in my local area?

 

[galaxygrrl]

So, I don't have any great advice, but people travel for the DS. I would climb a mountain to get the DS. I went to MX for it. If you have Diabetes, there is no better choice. I think there are Drs in NYC that do it.

Others will know more.

Good luck

 

[Clematis]

You've been at this before so know the weight loss center is not going to do much for you, right? Especially long term. It will be an exercise in disappointment. Focus your money and efforts on getting a DS -- and the proper DS with two anastomoses and limb lengths based on the Hess Method. I went to Esquerra in Mexicali (and I thought people who went to MX were of limited cognitive ability -- haha BEST thing I ever did). Look into Gagner in Canada (Montreal? Toronto?) @harrietvane can tell you more.

 

[Larra]

You've already had one failed bariatric surgery - and I hope you understand that you didn't fail, the operation failed you. Lap band has the highest rate of failure of any bariatric surgery, and nowadays more health care dollars are being spent on removing them than on placing them.
But yes, why set yourself up for another failure? Get the operation with the best statistics of any bariatric surgery for percentage excess weight loss, for MAINTAINING that weight loss (by now you understand how important that is) and for permanent resolution of almost all comorbidities. Lots of people travel to get the DS, and most DS surgeons are used to working with people from out of town, out of state, out of country. Dr. Gagner is in Montreal, which isn't that far from you. There are DS surgeons in NYC, you just have to make sure you are getting the real, standard of care DS and NOT the experimental operation with a whole bunch of different names (SIPS, SADI, loop DS and maybe others) that does not have proven long term results.
And Mexico really is an option if you know where to go, which people here have already advised you about.
This is something that is intended to last you and help you for the rest of your life. Travel is a temporary inconvenience.

 

[hilary1617]

Hi and welcome @Mspotatoblsm! My recommendation is that you find the best procedure for you, then find the best surgeon and travel to see him/her. It will be worth it.

 

[Spiky Bugger]

When we can't find a good (legit*) DS surgeon close to home...and almost nobody does...we travel! All over the planet. Like from Alaska to Brazil...or from Oregon to Spain.

I'm in Southern California. When I got the stupid band, it was new. My nearest "experienced" surgeon had done 30. Not good enough for me. I traveled 1500+ miles, each way, to someone who had done 1500.

For my revision, there were 2-3 in Northern California, one in the center of the state and two in L.A. I met with middle-of-the-state-guy and the L.A guys...felt that the middle-of-the-state-guy was best for me, even if it meant hotels and 3.5 hours of driving each way for follow up visits. He has since wised up and moved to L.A.

This decision is HUGE. So...
-why did you need a referral? HMO thing?
-is your insurance going to cover a second bariatric surgery? Many exclude that.
-is there some reason you need to have surgery in Maine?


*surgeon doing REAL DS, not SADI or any other unproven thing.


ETA...look for the best procedure, then the best surgeon for you. The rest of your life may well depend on your deciding that those decisions are more important than location.

 

[Mspotatoblsm]

Thank you for your reply. My first surgery was done 2 hours from my home as the local surgeon hadn't done many bands. She wanted me to go there for all fills and was a terror! She had an awful "bed side manner" and when I tried to go to a center 30 minutes from my home she wrote a letter to that Dr and told him I was non-compliant. It was a horrible experience. I was able to talk the Dr in Lewiston (which is closer to my home) to take on my case and he ended up taking the band out as it had slipped. After the surgery he told me it had been inserted incorrectly ( by that terror of a Dr in Bangor) and it took them an extra 1.5 hours to take it out as it was imbedded in my stomach. I was going to have him do a bypass at the time but my father got very sick and I had to focus on him and my mom at the time. So now that I am ready to get back to taking care of my health I am a little jumpy about being able to find a Dr that I can go to for follow ups. How does it work if you have a surgery in another state... who do you follow up with? Do most DS patients pay out of pocket? My insurance and the local WLS does require a referral. Also my insurance does cover wls so I want to obviously try that route first. But I don't want to compromise on the type of surgery because of insurance either... looking for helpful advice and recommendations of Drs within a reasonable distance.

 

[southernlady]

Welcome @Mspotatoblsm
Pick your surgery then pick your surgeon.

Closest to you:
Dr. Gagner in Canada
Dr. Pomp and Dankin in NYC at NY Presbyterian Weill Cornell

 

[harrietvane]

Like @Clematis said, I was a band to DS with Gagner in Montreal. Was $22K Canadian, from memory. I travelled from Singapore, stayed in Montreal for five days then took the Amtrak down to NYC to kill the other five days till the airline would let me fly long haul home.

Montreal was one night in the clinic, then one night with a private nurse in the hotel. I stayed on at the hotel with a discounted rate.

Happy to answer any questions!

 

[Munchkin]

Welcome and best of luck!

 

[Clematis]

If you want to try to use insurance, Step #1: get a copy of your Evidence of Coverage. It will be 100 pages or more. This has the details of your policy. Read it very carefully. Trust that document, not what any agent tells you over the phone. Many policies exclude WLS, many more exclude a SECOND WLS and this is your second. They will make you jump through endless hoops (psychiatric evaluations, mandated year long diets) which have no medical necessity but are only designed to frustrate you to the point where you decide not to have WLS and save the insurance company a lot of money.

One of the reasons I went with Esquerra in Mexicali (and I would recommend no other in Mexico) is that you don't have to do this BS.

Regarding follow-up... I didn't need any! All you need is a PCP to order your comprehensive lab work which you will need to have done twice a year so you can adjust your vitamins and nutrients. (Actually, if you can't find a PCP to do that, there are resources for getting your own lab work done.) Your PCP will know NOTHING about the DS -- even in big cities where the DS is done, the PCPs know nothing, and you live where they are not done at all. You have to chart your own lab results and follow trends in order to meet your vitamin needs.

 

[Spiky Bugger]

I see where you're coming from. This is not like the band, where you need a willing, nearby doctor with a Huber needle and fluoroscopy.

Follow up for the DS is, for me anyway, regular labwork. So you need someone...and if your PCP won't cooperate, you can find legal online resources, to order labs. (Also, if the labs show you deficient in anything, then your "reluctant" PCP better get off his/her high horse before you have gathered enough evidence to show that he/she is not providing even basic care.) The distance to your surgeon is not an issue.

Once every nine months or so, my labs show that my iron is low. Then I need a hematologist, for iron infusions. Again, distance to surgeon is not an issue. If I were in an HMO and my PCP refused a referral, I'd say something like, "Well, I don't know how to do this! Do I have to file some kind of formal appeal to get a second opinion?"

[Beware...Sue Story follows: my diabetic mom's left leg slowly became completely numb. I went with her to her asshole PCP and asked for a referral to a neurologist. PCP said, "You don't need a neurologist! I can diagnose diabetes-related peripheral neuropathy!" Smart Ass Sue said, "We KNOW you can diagnose it. We just want to see if a neurologist agrees. Whom do we see to request an appeal?" He write the referral. Yes, he CAN diagnose peripheral neuropathy, even when it's not there! Neurologist said, "Diabetic neuropathies are generally bilateral...not so unilateral as this." He ordered imaging. Mom had spinal stenosis. On the gurney coming out of recovery after her surgery, I grabbed her left foot where she had had no feeling for several years, and she yelled, "Hey!" This is why we request, and then DEMAND, the services that we pay for and are entitled to.]

This is very different from band follow-up, more portable, and less demanding on your presence in a certain place at a certain time.

 

[Mspotatoblsm]

You've already had one failed bariatric surgery - and I hope you understand that you didn't fail, the operation failed you. Lap band has the highest rate of failure of any bariatric surgery, and nowadays more health care dollars are being spent on removing them than on placing them.
But yes, why set yourself up for another failure? Get the operation with the best statistics of any bariatric surgery for percentage excess weight loss, for MAINTAINING that weight loss (by now you understand how important that is) and for permanent resolution of almost all comorbidities. Lots of people travel to get the DS, and most DS surgeons are used to working with people from out of town, out of state, out of country. Dr. Gagner is in Montreal, which isn't that far from you. There are DS surgeons in NYC, you just have to make sure you are getting the real, standard of care DS and NOT the experimental operation with a whole bunch of different names (SIPS, SADI, loop DS and maybe others) that does not have proven long term results.
And Mexico really is an option if you know where to go, which people here have already advised you about.
This is something that is intended to last you and help you for the rest of your life. Travel is a temporary inconvenience.

Thank you for your reply and for saying that the band failed me! That was huge for me to see... I am just now realizing that a part of me did think it was my fault for all these years. I truly appreciate your words from the bottom of my heart. It was a bad experience and I am just starting to prep for a good one, the final one! I am very glad to have been told about this forum.

 

[Babette]

Hello, New here... Had an AGB back in 2005, lost 65 pounds then it slipped. Had it removed in 2008 and after 9 years I gained the weight back plus more. I am now at my heaviest and have had a bunch of other health issues that joined the party. I have been mentioning WLS again to my PCP for almost a year and finally took the step to make an appointment just to discuss my weight. To my delight he was very positive and is writing me a referral to the local Weight Loss center. I am beyond thrilled. I am positive this time will be different. I have a better support structure and know better what to expect. I would like to have a DS but unfortunately I don't believe it is offered in Maine. Looking for advice and recommendations about how to get the best surgery for myself if it isn't offered in my local area?

I know of 2 fantastic WL Centers near Boston. Google David Brams, Lahey Weight Loss.

Also, my surgeon, Sheila Partridge is at Newton-Wellesley hospital. I had my VSG there and will having my DS with her as well. Their website does not yet reflect that they offer the DS, but they do.

Best of luck!

 

[Mspotatoblsm]

I know of 2 fantastic WL Centers near Boston. Google David Brams, Lahey Weight Loss.

Also, my surgeon, Sheila Partridge is at Newton-Wellesley hospital. I had my VSG there and will having my DS with her as well. Their website does not yet reflect that they offer the DS, but they do.

Best of luck!

Oh wow! MA would be awesome! I will definitely check it out. Best of luck with your surgery.