Hello! Big story here.

[weaura]

I'm new to this site. I've also joined the ObesityHelp site, and from there was told about this site.
I'm an unusual case. I had a gastroplasty in 1984 (HW 258-LW 179). Got maried in 1984, had 3 children - gained back all the lost weight. No follow up at all with the doctor/clinic from that surgery. In 2004 I had the biliopancreatic duodenal switch or BPDS (HW 306 - LW 118). I was loving it, was wearing size 2 . Then I started having extreme hypoglycemic episodes. The belief was that I had an insulinoma, but the tests to locate it's location in my pancreas were inconclusive. Therefore they revised my BPDS in July 2007, told me gain weight, hoping that would take care of the issue. It didn't, so in Dec 2007 the reversed the gastroplasty, and what they could of the DS, told me to gain more weight. This was so my body could handle the insulin my pancreas was over producing. I gained about 125 lbs and that seemed to work. The in Oct 2011 my BS started crashing again. This time the location of the insulinoma was more certain so in Dec 2011 I had a partial pancreatectomy, and they also had toremove my spleen. Now I weigh 270, and I want to have back the complete DS and get my stomach made smaller, because I'm sure it's stretched again.
All of these surgeries were open. I went back to the OHSU Bariatric Clinic, and they refuse to do ANY surgery on me. The doctors I worked with in 2004, and 2007 have since retired, or left this speciality within the organization. The OHSU Bariatric Clinic does not do the DS anymore.
Because of that I have sent inquiries to Dr Keshishian in the LA area, and Dr Rabkin in the SF area, and have heard back from both of them. . Is it wrong to be reaching out to both places? Should I share with each of them that I have contacted the other?
Is there anyone here, or anyone that you know of that has had multiple surgeries, and was succesfully given a DS?

 

[DianaCox]

I would avoid OHSU like the plague. The DSs they did back 10+ years ago were subpar, to say the least.

Either Rabkin or Keshishian would be excellent - and you don't need to tell either about the other if you don't want to - or you can tell them if that makes you feel better. If you do, I would say something like "Of course I'm getting a second opinion - and I know I'd be safe with either of you - it's going to come down to which program will work best for me, and in case I get different approaches from each of you, I'd like to understand your reasons why."

 

[southernlady]

Welcome, @weaura
If anyone can help it's the two surgeons you already contacted. And as long as each knows that you are seeking options...I don't see why contacting both would be an issue. As Diana just said, you don't have to explain who else you are seeing.

 

[newanatomy]

Welcome and hello!

 

[aaa]

Welcome.

 

[Larra]

Well, here you are!
I see no harm in letting these fine surgeons know that you are in touch with both of them. The DS community is a small world and they know each other well. I have never heard of any animosity between them. they are both good people. And lots of people seek more than one opinion, esp in such a complicated situation as yours.
Your situation is even more complicated than I realized, in that I thought you have a full DS but now it sounds like maybe you have a "switch" type small intestine configuration added onto a gastroplasty stomach configuration, rather than having your gastroplasty converted to a sleeve, which we have with the DS. Your operative notes will tell the story and become even more important.
I am really looking forward to hearing what you learn from Drs. Rabkin and Keshishian and I hope they will be able to help you.

 

[hilary1617]

Hello @weaura

I am a fellow zebra with a history of a functional Pancreatic Neuroendocrine Tumor (glucagonoma) in my case. I have also had a distal pancreatectomy.

If you haven't done so already, before considering further bariatric surgery, please go directly to carcinoid.org (do not pass go) and read as much as you can and also get in touch with a NET specialist and see what is going on with your PNET. If you are NED, then Dr. K and Dr. Rabkin are excellent choices for revisions.

For PNET I see Drs Woltering (oncologist/endocrinologist) and Boudreaux (surgeon) in New Orleans (though I live in Chicagoland, the travel is well worth it).

Kind regards,
Hilary

 

[DSRIGGS]

I don't have much to add to what has been said other Dr K is an incredible guy.

Good luck

 

[weaura]

Thank you. I am scheduled for a video conference with Dr K next Thursday afternoon. I'm looking forward to talking to him. I'm glad he's willing to consider taking on my crazy situation.
I've submitted my info to Dr Rabkin's office too.
I'm encouraged by all the wonderful things I've heard/read about each of them.
Thank you to everyone that has responded!!

 

[Whit]

Hello,
I revised from RNY to DS in 2012. I consulted with both Rabkin and Dr. K. in person. Both were wonderful. Ultimately Dr. K preformed my revision. Why he took my insurance and I just knew he was right for me. But again both are top notch.

 

[DSRIGGS]

Thank you. I am scheduled for a video conference with Dr K next Thursday afternoon. I'm looking forward to talking to him. I'm glad he's willing to consider taking on my crazy situation.
I've submitted my info to Dr Rabkin's office too.
I'm encouraged by all the wonderful things I've heard/read about each of them.
Thank you to everyone that has responded!!

Dr k will love talking to you and so will you. He will be intrigued by your case and will want to do what he can to help(and if there is anyone who can help he is the person who can).

I have met Dr Rabkin but I hear he is wonderfully skilled as well so you are talking to the tops in the field.

I fly out from Illinois tomorrow morning for a revision on Tuesday with Dr K, if that tells you what I think of him.... And we are not lacking for skilled surgeons in my area. He simply follows a scientific methodology for his procedures that works and his technical/art/craft skills along with personality are all awesome.

Good luck... I hope one of these two csn help you.. If your health challenges and system csn withstand the DS they will take care of you.

FYI my revision is not typical. I am malnourished because I don't absorb enough and need pancreatic enzyme to help. He is going lengthen my plumbing to alleviate the issue. This is much less intense than a RnY to GA revision so it is a few hours versus a much longer procedure for typical revision.

 

[weaura]

Thank you all,
Hilary1617. I looked into the site you referenced. I don't think I fall into this category since my insulinoma was removed in Dec 2011. Since then my blood sugar has been normal, although I do inject 10 units of Lantus each night. Plus I do a shot of Bydureon 1/week.
If you think I'm wrong about this please let me know.
When I was going through all of this back in 2007 - when I spent 56 days in the hospital - I felt a little bit like a zoo exhibit. So many doctors came in to basically say "We've heard about this, but have never seen a patient that has it." That was how I ended up at OHSU in Portland. I had checked into St Vincent Hospital and for a week they wondered what to do with me. Finally said they wanted me to go to the Mayo Clinic in Rochester MN. I said NO, so then they reached out to OHSU who claimed they had experience with this (I think they had experience with gastric bypass patients with nesidioblastosis - not insulinomas).
No one ever talked to me about PNET or carcinoids, so your comments are in unfamiliar territory for me. My tumor was benign, which was expected.

 

[weaura]

I would avoid OHSU like the plague. The DSs they did back 10+ years ago were subpar, to say the least.

Either Rabkin or Keshishian would be excellent - and you don't need to tell either about the other if you don't want to - or you can tell them if that makes you feel better. If you do, I would say something like "Of course I'm getting a second opinion - and I know I'd be safe with either of you - it's going to come down to which program will work best for me, and in case I get different approaches from each of you, I'd like to understand your reasons why."

Why would you avoid OHSU? I'm not too happy with them right now for sure! Just curious.
I have not told Dr K, or Dr Rabkin about reaching out to both of them, not sure why that seems to stress me out. LOL

 

[Charris]

I don't think your wrong. Your purchasing a service you want the one who is a best for you. I don't think they would care to be honest from what I know of Dr K is not about the $$$$ it's about helping people.

 

[Jen-2]

Hello and welcome to the board. Good luck in your pursuit of a DS. I hope Dr. Rabkin or Dr. K can help you!