Need Advice, Consent Form….

[robs477]

Ok, so, yesterday I saw my Surgeon again, Dr. Wilson. He did the EGD on me which was the absolute last thing I needed prior to surgery. He said everything was good and we are ready for DS surgery and are just waiting on insurance to set a date. In the course of our conversation, he said “you’ve done a great job on loosing the weight I asked you to, just lose as much as you can so we don’t have to do it in two stages”….needless to say, I laid in to him, not rude or anything, but firm. I told him, we’ve had this discussion before and I told you that is NOT an option for me. IF you get in there and cant “move around” as he says, then open me up and do it. His response was, “recovery is a lot more difficult with an open surgery and chances of infection are greater” blah, blah, blah, blah. My reply was, well that’s what I want and a VSG only IS NOT an option. I also reiterated that I did what he asked and lost the twelve pounds he asked me too and I did it THROUGH THE F*@KIN HOLIDAYS!, which includes Thanksgiving. I had to just drink ONE protein drink a day, 100 calories in order to lose weight.

So, Consent form? How do I word it etc? AND, what else can I do?? Here is what I have prepared:

Consent Form: (proposed)
I only consent to a full one stage only Duodenal Switch Surgery, (DSS). I DO NOT consent to having this done in two different stages, two separate operations. This is NOT an option for me. If the surgical team gets inside of me and determines there is not enough room to operate, due to limited maneuverability, fatty liver or for any other reason, then I consent to having the full (DSS) performed in an Open Surgery procedure.

My consent only allows for the following three options:

1. Perform the full one stage only Duodenal Switch Surgery, (DSS) Laparoscopically, which is my 1st preference.
2. Perform the full one stage only Duodenal Switch Surgery, (DSS) in an Open Surgery if the procedure cannot be accomplished Laparoscopically. This is my 2nd and only other option for consent.
3. If the full one stage only Duodenal Switch Surgery, (DSS) cannot be accomplished Laparoscopically or in an in an Open Surgery, close me up and send me home.

Please give me your advice Ladies; I would be lying out my ass if I said I wasn’t really starting to get worried about this AGAIN!!

 

[newanatomy]

I am sure the smarties will be along soon with some great advice. I just want to let you know I understand your reservations. I lived in terror of the "bait and don't switch". I hounded the doctor's office, hospital, and medical records office after my surgery until I got a copy of my operative report stating, I had indeed gotten what I went in for, for my records.

Your doctor is just covering his ass, I am sure he will do everything in his power to complete your DS.

Deep breaths, you will be fine!

 

[DianaCox]

Understand that typically, the sleeve is done first. if for some reason, intraoperatively, he feels that your life is in danger after doing the sleeve and before he starts the switch, he is going to stop surgery and close you up anyway.

What I would add is:
While I understand that there could be some reason that occurs intraoperatively which requires that you, in your best medical judgment, must stop the procedure after doing the sleeve and before completing the switch part of the surgery, this is notice that, in that event, I will NOT be coming back to you for the switch portion of the procedure, but will find another surgeon to perform the switch.

Just my off-the-top-of-my-head thought.

 

[Elizabeth N.]

I'm no lawyer, so don't consider my word Gospel on this. I think the form is pretty clear, but Diana or someone else might have vocabulary/form suggestions .

I'd do something additional, though: I'd make sure that anyone who is any "danger" of having to make medical decisions for me while I'm not able to do so, knows that these are your wishes, so that there is no chance of having some jerk, I mean some surgeon, talk a loved one into doing something different.

 

[Elizabeth N.]

I think I'd also be asking questions about possible scenarios where he would think he'd want to do a "two stage" procedure....And I'd put in writing that if he pulls a fast one of any kind, there had better by God be serious shit EVIDENCE that a full DS was utterly impossible (or truly life threatening) OR ELSE.

At the minimum I'd add that if he pulled any dumb shit like the "two stage" claim, he would NOT be doing the second stage. (And I'd be looking for ways to force his ass to pay for the second stage *snarl*.)

 

[MyNewLife]

If you distrust his intent so much, why are you using him? Just wondering...

 

[robs477]

I'm no lawyer, so don't consider my word Gospel on this. I think the form is pretty clear, but Diana or someone else might have vocabulary/form suggestions .

I'd do something additional, though: I'd make sure that anyone who is any "danger" of having to make medical decisions for me while I'm not able to do so, knows that these are your wishes, so that there is no chance of having some jerk, I mean some surgeon, talk a loved one into doing something different.

I told my wife yesterday and she said “wait until I talk to him, he hasnt meet me yet, I will set him straight”! My wife is a HOT tempered Latina girl and I promise he doesn’t wanna scrap with her, so that’s covered at least! She more than anyone in the world knows how much I need this and I suffer because I can’t eat like other people.

 

[robs477]

If you distrust his intent so much, why are you using him? Just wondering...

I interviewed SIX different surgeons in the Houston area and Erik Wilson is only 1 of 3 with true DS experience, over 100. The other one is not in my plan and the other one has a ton of malpractice suits. This guy is an excellent surgeon and I like him a lot. He gave me re-assurance many times over that he would do the DS, BUT, it’s getting close and I’m just worried again and getting ready for the consent form. When he said what he said about me losing as much weight as I can, it sounded like he was just wanting us to just have our best chance for success, it didn’t sound intentionally deceptive at all, but, still worried. As far as "Trust" goes, I trust very few people, especially regarding something this serious.

 

[DianaCox]

"Trust, but verify,"
http://en.wikipedia.org/wiki/Trust,_but_verify

 

[Spiky Bugger]

Understand that typically, the sleeve is done first. if for some reason, intraoperatively, he feels that your life is in danger after doing the sleeve and before he starts the switch, he is going to stop surgery and close you up anyway.

What I would add is:
While I understand that there could be some reason that occurs intraoperatively which requires that you, in your best medical judgment, must stop the procedure after doing the sleeve and before completing the switch part of the surgery, this is notice that, in that event, I will NOT be coming back to you for the switch portion of the procedure, but will find another surgeon to perform the switch.

Just my off-the-top-of-my-head thought.

Diana probably used proper legal language, but I might try for something with the threat intact, but a tad more passively insulting. Because I'm a Latina bitch myself.

As in, "While I understand that there could be some reason that occurs intraoperatively which requires that you, in your best medical judgment, must stop the procedure after doing the sleeve and before completing the switch part of the surgery, this is notice that, in that event, I will need to have thorough documentation, with photos if possible, of what you have encountered so that when I present to a surgeon with more experience with this particular type of difficult case, both s/he and I have all the details we need to proceed."

 

[DianaCox]

Spiky raises passive insulting to an art form - I like it.

 

[JackieOnLine]

Spiky raises passive insulting to an art form - I like it.

I know, right?

 

[Spiky Bugger]

I know, right?

 

[robs477]

Spiky raises passive insulting to an art form - I like it.

You guys never ever cease to amaze me. Each one of you has your own strengths to bring to the table, with some commonalities of course. BUT, when collectively brought together, the synergy of that collective energy and power from knowledge is what makes this site so unique. And yes, Our “Spiky B” is most definitely an “Oratory Ninja”. The thing is….I’d like to think of myself as a reasonably smart guy and I recognized all this right from the start!!

 

[robs477]

I know, right?

Yup!! a regular “Oratory Ninja”.