Anyone been told they might get half of the DS first?

GenJones

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May 22, 2017
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Location
Streamwood, IL
Just had my follow up with the surgeon (my surgery is December 26) and he said that it's possible he would have to do an initial sleeve and then wait a year until I lose "a lot of weight" so there would be more room in my abdominal cavity and therefore he'd have more room to maneuver (and complete the second half of the operation).

Has anyone else been told this? Anyone gone through it? Feeling a little unsettled right now. :unsure:
 
Geez, girl, I can imagine you're disappointed. I'm sorry. In the old days the DS was often done as a two step procedure as your physician has suggested, and also it was more likely done only on the SMO. Then the research showed there was a synergistic effect in doing the whole magilla in one operation.

I don't know if your surgeon merely does not have the experience to perform the switch of the DS on someone SMO or if there is truly a medical reason for the delay. Someone with more knowledge than I will chime in.

I do know that people with quite high BMIs had the DS surgery all at once and post here.
 
Dr. Rabkin has done single stage DSs on 800 lb people. I'm sure Keshishian has too. Kane is not as experienced at the DS. I would immediately begin looking elsewhere for a more experienced surgeon. The fact that he feels you would have to wait a YEAR is even more concerning to me - you will lose most of the synergy of the sleeve and switch done at the same time. A BMI of 62 is high, but hardly unusual for experienced DS surgeons.
 
It's 62. Hence, the DS.
I had the DS because it was the best. Even tho I am a lightweight in the bariatric world.

I was asking cause I can see their concern at maybe an 80 BMI but a 62, I'd be shopping for a new surgeon ASAP. BTW, I had to shop for a new surgeon cause my original surgeon said I was too small for a DS. That I would lose TOO much weight. Yeah, right, NOT!!!!
 
That's not too high to do a full DS. Plenty of people here have had a full DS at that BMI. I looked back through your posts. Haven't others suggested that your surgeon is not known for performing DS? He does not have the experience to perform a DS if there is even a slightest challenge, such as a BMI of 62. Really makes me wonder if he even does a real DS with a common channel of about 100cm or Hess Method (well WHEN he gets around to completing the surgery). You want a one and done surgery @GenJones

You may also want to check your insurance as many only cover ONE bariatric procedure per LIFETIME. Will it cover the switch in a year?

And OMG a YEAR??? Why? You'll have lost a ton of weight in 6 months. And you'll miss the weight loss synergy of having the procedures done at the same time. He does not know what he is doing.

I echo the others: find another surgeon. I know you're thinking you can't do that as your surgery is scheduled for the end of December and you've jumped through all these insurance hoops and in your mind you're thinking it's better to do SOMETHING than NOTHING. It's really hard to stand up to a surgeon. But you can do it and we're here to help.

This is YOUR body. YOUR life. Get this done RIGHT the first time! There's a place on the loser's bench waiting for you.
 
I haven't reread all your posts, but enough to see you were seeing a "less experienced" surgeon, when Alverdy and Prachand are right there.

Have you consulted with either of them?

This is a HUGE step...more complicated to undo than getting married or buying a house.

And, even if your insurance will pay for a two-step DS now, it doesn't mean that they will agree to do so later. And, even if they do, it probably won't be soon. They will need to see that this part "failed." And then they will likely want another six-month supervised diet.

Bag of worms.

See the more experienced surgeons.
 
OK, let me translate this for you. Your doc is right out front telling you he may not be skilled enough to do the whole surgery. So why would you want this person to operate on you? First and best option, get a new surgeon. Option 2, tell him you want the whole DS even if he has to open you up or get a second surgeon to help him. Why should you go through 2 separate surgeries because of his skill level? And @Clematis is right, you would not be the first one to find out that surgery down the road is NOT covered by insurance.

Years ago I met a man at my surgeon's office who had the whole DS at over 800lbs. In the DS world, a BMI of 60 is NOT that high.

When someone you are allowing to slice and dice you tells you they don't have the skills, LISTEN!!!!!
 
Btw...we "old timers" ain't makin' this shit up. Most of what we are warning you about are things we have seen others have to deal with.

My BMI was "only" in the mid-50s. But I was 59 years old and it was a revision from the lap band, which occasionally, can be daunting depending on how much damage the band has done. My surgeon never even suggested a two-step. He KNEW he was capable.

So...what @Munchkin said.
 
What everyone else has said...and we did have another patient of this surgeon awhile back, and she was given the same warning you are now getting, which scared the crap out of her (same as you, I suspect) and had her consulting another DS surgeon and waffling between the two for ages. I doubt that the surgeon has any idea what emotional trauma this type of hedging causes.
Either see another surgeon, or tell this guy that you want your full DS EVEN IF he has to go open. There is nothing wrong with doing the operation open - that's how surgeons did everything for years. The work on the inside is the same, and that's the important part.
 
I haven't reread all your posts, but enough to see you were seeing a "less experienced" surgeon, when Alverdy and Prachand are right there.

I sent an email to Prachand - and he got back to me within about 2 hours! (impressed) But he did say, "I have been doing totally laparoscopic DS since 2002 here at University of Chicago (DS makes up about 20% of our bariatric practice), and I have done so in patients with BMI as high as 86 as a single stage procedure. Having said that, there are times that, in the interest of patient safety, I elect to stop after either the sleeve gastrectomy or the loop DS portions of the procedures -- that decision is based on anatomy (prior surgery, size of liver, thickness of abdominal wall, etc.), underlying medical conditions, and how the patient is doing under anesthesia." (emphasis mine)

Does this mean he only does the LOOP DS? Has any one ever had a DS with Prachand?
 
what the vets said - there are very good reasons to get the full DS in one surgery.

ETA: I love the quote in your siggy
 
I sent an email to Prachand - and he got back to me within about 2 hours! (impressed) But he did say, "I have been doing totally laparoscopic DS since 2002 here at University of Chicago (DS makes up about 20% of our bariatric practice), and I have done so in patients with BMI as high as 86 as a single stage procedure. Having said that, there are times that, in the interest of patient safety, I elect to stop after either the sleeve gastrectomy or the loop DS portions of the procedures -- that decision is based on anatomy (prior surgery, size of liver, thickness of abdominal wall, etc.), underlying medical conditions, and how the patient is doing under anesthesia." (emphasis mine)

Does this mean he only does the LOOP DS? Has any one ever had a DS with Prachand?
He also does the REAL DS. Make sure he knows that is what you want and specify the CC you want too.
 

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