Hello, Revision to DS here in AZ

[Beckmo]

Hello There,
I had a RNY in December of 2007 and lost 175 lbs. (half my body). I had weight creep up and felt most of it was due to physical activity dropping off due to new back issues, fibromyalgia flaring and then shoulder surgeries (both). I decided to make sure all was well with the RNY and had an UGI. The UGI showed that the stoma was OPEN and NO retention in the pouch. After fighting for this surgery, I am finally going to have the Revision Lap. Duodenal Switch on July 28th and am super excitedly nervous about the whole new experience. I just need to Breathe and read advice and comments and soak it in.

 

[southernlady]

Welcome @Beckmo

 

[brooklyngirl]

Welcome and best of luck! Who's your surgeon?

 

[Beckmo]

Welcome and best of luck! Who's your surgeon?

Dr. Hilario Juarez with Bridges Weight Loss Center in Phoenix

 

[DianaCox]

There is no RNY to DS surgeon in AZ ANY of us would recommend - in fact, there is no DS surgeon in AZ the vast majority of us would recommend. And of any of the surgeons in AZ, Juarez would be near the bottom of the list (or not on it at all). From what I have heard of him, I would run far far away. In fact, you should be running to Glendale CA to see Dr. Keshishian.

Do your research on Juarez here. I'll give you a first link: http://bariatricfacts.org/search/1577214/?q=juarez&o=date - Start reading.

 

[Elizabeth N.]

RUN LIKE HELL.

 

[Charris]

I had juarez in 2000 -for ERNY. He was supposed to do my revision in Sep.2013' until I got information that he was not an optimal choice.. He's not the dr he used to be -in 2000. He was one of 3 back then and HAD best outcomes. I WENT to dr Keshishian after Juarez told me he would never give me a ds and when he revised me to a sleeve I probably would not loose any weight. Wtf? Every 6 months I take a 5 hr drive to see Dr. K no biggie. Most people don't go that often but I do cause im.special. lol the problem child. Lol

 

[Charris]

Oh yea also when dr. J did my ugi he said my stoma and pouch were stretched which I thought was strange because I couldn't eat more than 2 bites..well.when dr.k went in for my revision dr. K said my pouch was miniscule it never stretched and thats why I couldn't eat solids or more than a bite or two. Im just saying I don't know what happened that it went from stretched out of place to still in tact.

 

[Larra]

Welcome!
RNY to DS revision is an extremely complex, challenging, and high risk operation. It requires taking apart your RNY completely, totally restoring everything to the original anatomy, and THEN doing the DS. There are only a handful of DS surgeons with the skill and willingness to do this operation. As you are seeing already, the surgeon you have chosen (or who was chosen for you by your insurer) is not someone the group here feels has the experience and quality to do this.
I realize that it's very difficult and stressful to hear this kind of feedback and consider cancelling plans for a long awaited revision and start fresh with another surgeon. I also realize that not everyone has the same options with insurance, finances, etc etc. So you are in a tough spot. However, this is the kind of surgery where serious complications can happen, and not only do you need a surgeon who can minimize your risk of these complications, you need someone who can deal with complications should they occur and who will see them through as long as needed - potentially for weeks/months post-op. It's that kind of surgery.
At the very, very least (and I really mean LEAST) you should ask your surgeon how many of this specific revision he has done. NOT how many bariatric operations, not even how many DS though that's also a good question, and not even how many revisions (which could mean all sorts of things), but how many RNY to DS revisions. And what his mortality rate and complication rates are for this specific operation. Only you can decide if the answers you get are acceptable to you.
Personally, I would hit the road and go to Dr. Keshishian in Los Angeles, and consider myself lucky that I don't have further to travel, as many people do, and that I dodged a big bullet.

 

[Beckmo]

There is no RNY to DS surgeon in AZ ANY of us would recommend - in fact, there is no DS surgeon in AZ the vast majority of us would recommend. And of any of the surgeons in AZ, Juarez would be near the bottom of the list (or not on it at all). From what I have heard of him, I would run far far away. In fact, you should be running to Glendale CA to see Dr. Keshishian.

Do your research on Juarez here. I'll give you a first link: http://bariatricfacts.org/search/1577214/?q=juarez&o=date - Start reading.

Thank you for your concerns.

 

[Beckmo]

I appreciate your concern. I have decided to have the lap. DS by Dr Juarez on July 28. I know others that dr Juarez did their revision from bypass to DS and all went well and they like him. I know you are voicing out of my welfare. My decision is made here. So, I guess if this is not a place where I can receive the support for my decision, I can delete my account.
As to having an "Angel" I guess I don't know anyone here and who has spoken out most do not support my decision.
I know it is concern that you speak out. Does Dr K own or run this website?

 

[southernlady]

Does Dr K own or run this website?

No, he does not. Several members here own it and staff run it.

 

[southernlady]

I appreciate your concern. I have decided to have the lap. DS by Dr Juarez on July 28. I know others that dr Juarez did their revision from bypass to DS and all went well and they like him. I know you are voicing out of my welfare. My decision is made here. So, I guess if this is not a place where I can receive the support for my decision, I can delete my account.

He may have come a long way but his first solo did not end well: http://bariatricfacts.org/threads/old-thread-2011-with-summaries-links-about-bad-surgeons.2184/ In fact she passed away ON the table. He was not suppose to be solo.

What you can do is ask for this information and post here:
1) How many DS's has he done now...not surgeries but DS in particular.
2) We typically ask who proctored him but in his case we know already.
3) What is his complication and morbidity rate?
4) Since you tell us he is doing RNY to DS revisions, ask how many of that particular surgery has he done and who taught him?

It would be nice to know that he can be added to the DS surgeon list. Instead of one we need to warn people about.

 

[Larra]

@Beckmo I hope you will not delete your account. This group has so much valuable knowledge that you will need post-op. Yes, we are concerned about you, but what is the point of interacting with others if real and sincerely held concerns are not voiced?
If you need an angel, I will volunteer. You could have your family member communicate with me on your surgery day and thereafter until you are able to post for yourself. The group here will want to know that you are alright. I promise I will not say anything negative about your surgeon or your decision to your family.

 

[DianaCox]

You are spitting in the faces of people who are trying to help you. I'm assuming you have NOT read the posts about him, including about Stephanie's death.

No, Dr. Keshishian does not own or run this website. He is not a member here, and in fact, doesn't agree with everything we post here (we still have some disagreements about post-op nutrition, for example, and he does not approve of the lack of moderation of certain people on this board). He wasn't my surgeon, nor Larra's (he eventually was Charris' surgeon - he fixed the MESS Juarez made of her innards). But we know him, have communicated him, and I have even met him. I would put my life in his hands in an instant (as well as Rabkin's of course).

You go right ahead and have the most complicated bariatric revision from someone who has been known to screw up a straightforward DS and then of course Stephanie died from his revision of her band - who knows, maybe he's one that has adopted doing (and not disclosing) the SADI, so maybe you'll get a double whammy.

By the way, did you review the lawsuits against him (https://www.superiorcourt.maricopa.gov/docket/CivilCourtCases/caseInfo.asp?caseNumber=CV2012-092663 (Juarez must have an attorney on his payroll: https://www.superiorcourt.maricopa.gov/docket/CivilCourtCases/caseInfo.asp?caseNumber=CV2012-092663))? The disciplinary actions against him, which including serious ethical violations (http://www.azmd.gov/glsuiteweb/clie...e.aspx?entID=1615427&licID=316424&licType=1)?
oard Actions
08/14/2002 Letter of Reprimand - Letter of Reprimand-Unprofessional Conduct ( writing improper prescriptions, improper medical records, making false statements to the Board. ) You can go to that site and click on the links to read about what he did - and keep in mind that only FINAL adjudications are posted - if you compare the number of cases on the docket in Maricopa County Superior Court with his Medical License posting, you might appreciate how many more complaints were probably filed and not posted.
05/08/2008 Letter of Reprimand - Letter of Reprimand and Probation - Unprofessional Conduct for failure to perform a timely and adequate history and physical, inadequate documentation of an operative procedure and inaccurate documentation. Probation; shall obtain 17 hrs. CME within 6 months. CME completed. Probation terminated 5/28/08.

Good luck to you - we think you'll need it.