VBG to DS Revision ?'s (Surgeon Decisions)

[Elizabeth N.]

We have a vet here....Can't think of her handle....who had an unalterable VBG and got the DS. She has done quite well, not at 100% EWL but doing damned fine .

 

[Whit]

Hi,
I am a Dr. K revision patient. His 4K fee was well deserved, I am 18 months out and still have his cell number. I traveled for surgery. When I went home he called me every couple of days. I have lost all of my excess weight and am happy and healthy. He is an awesome surgeon and genuine human being who really cares about his patients. I am happy to answer any questions you may have.
Best

 

[jillc]

It was @Mary_J.

@Whit. If only it were 4K for me. I'm self-pay, so his fee is too dear for me. Right now, I've got it narrowed down to two excellent surgeons, Marchesini or Greenbaum. I would love to have Dr K, as he is in California and my parents winter in California.
@Barb1 My VBG should be able to be taken down. I'm just finding out what my surgeon would do and/or agree to do if for some reason it can't.

 

[jillc]

Update - Well, I got an email back from Marchesini. I'm disappointed but I'm happy that I'm informed - I need to know everything up front. He said that he wouldn't accept me as a patient if I totally refused the RNY.

He made the argument that he was sure that the conversion was feasible, but if it wasn't - he wouldn't be willing to do the VBG + DS. He said it was too similar to the jejunoileal bypass (JIB). Which I don't agree with at all, but I'm not a bariatric surgeon. Any thoughts on that?

He asked me if the DS wasn't feasible then he wouldn't want his choices limited - he stated that surgeons need a degree of freedom to decide what is best for the patient. Which in theory, I understand.

He was very respectful and kind. So there's nothing to hold against him. We just don't agree. I wouldn't take him as a surgeon unless he agreed to rule out the RNY, so it's a stalemate.

I could tell him to close me back up again if it wasn't feasible. But, if I'm traveling all the way to Brazil, I wouldn't want to return without some surgery. But not the RNY or ERNY. Nope. Not happening. Notwithstanding the failure rates of the RNY, that video with Dr. Roslin about whether the procedure fails the patient or vice versa really made an impact on me. There were so many things that resonated with me in that video. AndI totally agree that the pyloric valve is very important.

So, I have a phone interview with Greenbaum on Friday. Let's hope that goes better. If he wants to close me up, I could accept that a bit better as Calgary to NJ is a long-ish flight but not 22-25 hours and over $2000 in flight fees.

 

[Larra]

I'm sorry that Dr. Marchesini isn't going to work out for you. However, I respect his opinion and that he was honest with you up front. You can't ask for more than that.
Good luck with Dr. Greenbaum!

 

[jillc]

Thanks @Larra - he sent me a lovely email back stating if I changed my mind he would be glad to serve me. I hope Greenbaum works out also!

 

[jillc]

This morning I had a phone consult with Dr Greenbaum. I was nervous as I'm not a patient person and had a panic moment wondering if I was supposed to call him instead of the opposite.
Call came in about 15 mins late - typical waiting time for a Dr's appt
He started off with many questions. I asked him several back (paraphrasing, not quoting):

• Common Channel - usually 100 cm unless he's confident that the patient will be compliant with the supplementation. He would consider shorter for me as he finds that most out of state/country patients have done more research and are usually more serious about it.
• He described to me upon my question how he will create a sleeve from my VBG. He said he wrote a paper about it, so I'm now looking for that paper as I'm very interested to read it.
• Stomach size - 3-4 ounces. Although he stated it could vary with a VBG revision due to the existing anatomy, which makes sense.
• He seemed confident that the conversion would be possible.
• He's sending me a prescription to get an upper GI barium series done. He wants me to mail the disc to him.
• Need to be cleared for surgery by a cardiologist and pulmonologist (called respirologist in Canada).
• Surgery needs to be booked 4-6 weeks in advance after all the testing is done.
• I've emailed his assistant to see what else I need to get done besides the blood panel.

I am relieved as I found him a knowledgeable surgeon who knows what he's doing. As he was my only option left, I was worried that I wouldn't get a good vibe off him and I did. So it looks like I'll be visiting NJ in the near future @Elizabeth N. Don't know when yet, might have to wait for spring breakup for the surgery (March/April, when the ground gets too soft and rigs can't be moved).

 

[babs71958]

Sounds great, Jill! I am so happy for you.
If I may ask...what is the price range and is it based on a per patient determination?

 

[jillc]

@babs71958 - Greenbaum quoted $15,000. This is for his services and hospital services for 4 nights, barring complications. He said he would not personally charge me more if I needed another surgery, but the hospital will charge $800/day, and that doesn't include possible extra costs for pathology, radiology and any specialist if there should be a problem.
This is for a revision surgery of a VBG (Vertical Banded Gastroplasty) to DS. It is an open surgery. I'm not sure what the cost for an RNY to DS would be as it's a totally different surgery. Both are complicated but in different ways. But you can call or email and ask. They got back to me with a quote in a day, I think.
From the looks of it, he's worked out a really good deal with the hospital for his patients - I found this listing of costs for in-patient per diem cost:

From a 2012 article based on 2010 information from http://www.beckershospitalreview.co...r-inpatient-day-across-50-states-in-2010.html
United States
• State/local government hospitals — $1,625
• Non-profit hospitals — $2,025
• For-profit hospitals — $1,629
Alabama
• State/local government hospitals — $1,377
• Non-profit hospitals — $1,479
• For-profit hospitals — $1,239
Alaska
• State/local government hospitals — $1,163
• Non-profit hospitals — $2,092
• For-profit hospitals — $3,170
Arizona
• State/local government hospitals — $1,163
• Non-profit hospitals — $2,092
• For-profit hospitals — $3,170
Arkansas
• State/local government hospitals — $1,275
• Non-profit hospitals — $1,560
• For-profit hospitals — $1,373
California
• State/local government hospitals — $2,590
• Non-profit hospitals — $2,676
• For-profit hospitals — $1,975
Colorado
• State/local government hospitals — $1,855
• Non-profit hospitals — $2,329
• For-profit hospitals — $2,283
Connecticut
• State/local government hospitals — $1,942
• Non-profit hospitals — $2,156
• For-profit hospitals — $2,516
Delaware
• State/local government hospitals — NA
• Non-profit hospitals — $2,233
• For-profit hospitals — $1,752
District of Columbia
• State/local government hospitals — $1,109
• Non-profit hospitals — $2,674
• For-profit hospitals — $1,594
Florida
• State/local government hospitals — $1,708
• Non-profit hospitals — $2,092
• For-profit hospitals — $1,492
Georgia
• State/local government hospitals — $840
• Non-profit hospitals — $1,602
• For-profit hospitals — $1,139
Hawaii
• State/local government hospitals — $929
• Non-profit hospitals — $2,073
• For-profit hospitals — NA
Idaho
• State/local government hospitals — $889
• Non-profit hospitals — $2,317
• For-profit hospitals — $1,969
Illinois
• State/local government hospitals — $1,581
• Non-profit hospitals — $2,049
• For-profit hospitals — $1,576
Indiana
• State/local government hospitals — $1,504
• Non-profit hospitals — $2,132
• For-profit hospitals — $1,843
Iowa
• State/local government hospitals — $1,190
• Non-profit hospitals — $1,344
• For-profit hospitals — $1,222
Kansas
• State/local government hospitals — $901
• Non-profit hospitals — $1,555
• For-profit hospitals — $1,755
Kentucky
• State/local government hospitals — $1,492
• Non-profit hospitals — $1,575
• For-profit hospitals — $1,352
Louisiana
• State/local government hospitals — $1,590
• Non-profit hospitals — $1,519
• For-profit hospitals — $1,618
Maine
• State/local government hospitals — $1,361
• Non-profit hospitals — $2,117
• For-profit hospitals — $764
Maryland
• State/local government hospitals — NA
• Non-profit hospitals — $2,348
• For-profit hospitals — $1,903
Massachusetts
• State/local government hospitals — $2,341
• Non-profit hospitals — $2,470
• For-profit hospitals — $1,701
Michigan
• State/local government hospitals — $1,228
• Non-profit hospitals — $2,020
• For-profit hospitals — $1,250
Minnesota
• State/local government hospitals — $936
• Non-profit hospitals — $1,929
• For-profit hospitals — $1,378
Mississippi
• State/local government hospitals — $988
• Non-profit hospitals — $1,292
• For-profit hospitals — $1,372
Missouri
• State/local government hospitals — $1,420
• Non-profit hospitals — $2,124
• For-profit hospitals — $1,938
Montana
• State/local government hospitals — $404
• Non-profit hospitals — $1,253
• For-profit hospitals — $2,543
Nebraska
• State/local government hospitals — $556
• Non-profit hospitals — $1,886
• For-profit hospitals — $1,755
Nevada
• State/local government hospitals — $2,281
• Non-profit hospitals — $2,198
• For-profit hospitals — $1,548
New Hampshire
• State/local government hospitals — NA
• Non-profit hospitals — $2,171
• For-profit hospitals — $2,090
New Jersey
• State/local government hospitals — $2,398
• Non-profit hospitals — $2,212
• For-profit hospitals — $1,193
New Mexico
• State/local government hospitals — $2,041
• Non-profit hospitals — $2,175
• For-profit hospitals — $1,895
New York
• State/local government hospitals — $1,780
• Non-profit hospitals — $1,906
• For-profit hospitals — NA
North Carolina
• State/local government hospitals — $1,677
• Non-profit hospitals — $1,616
• For-profit hospitals — $1,552
North Dakota
• State/local government hospitals — NA
• Non-profit hospitals — $1,341
• For-profit hospitals — $1,440
Ohio
• State/local government hospitals — $1,943
• Non-profit hospitals — $2,173
• For-profit hospitals — $1,972
Oklahoma
• State/local government hospitals — $1,204
• Non-profit hospitals — $1,597
• For-profit hospitals — $1,580
Oregon
• State/local government hospitals — $2,508
• Non-profit hospitals — $2,896
• For-profit hospitals — $2,533
Pennsylvania
• State/local government hospitals — $649
• Non-profit hospitals — $1,921
• For-profit hospitals — $1,776
Rhode Island
• State/local government hospitals — NA
• Non-profit hospitals — $2,325
• For-profit hospitals — NA
South Carolina
• State/local government hospitals — $1,778
• Non-profit hospitals — $1,961
• For-profit hospitals — $1,463
South Dakota
• State/local government hospitals — $379
• Non-profit hospitals — $1,113
• For-profit hospitals — $3,573
Tennessee
• State/local government hospitals — $939
• Non-profit hospitals — $1,710
• For-profit hospitals — $1,414
Texas
• State/local government hospitals — $2,126
• Non-profit hospitals — $2,062
• For-profit hospitals — $1,650
Utah
• State/local government hospitals — $2,625
• Non-profit hospitals — $2,219
• For-profit hospitals — $1,990
Vermont
• State/local government hospitals — NA
• Non-profit hospitals — $1,656
• For-profit hospitals — NA
Virginia
• State/local government hospitals — $2,584
• Non-profit hospitals — $1,630
• For-profit hospitals — $1,734
Washington
• State/local government hospitals — $2,429
• Non-profit hospitals — $2,972
• For-profit hospitals — $2,588
West Virginia
• State/local government hospitals — $622
• Non-profit hospitals — $1,444
• For-profit hospitals — $1,170
Wisconsin
• State/local government hospitals — $360
• Non-profit hospitals — $1,963
• For-profit hospitals — $2,389
Wyoming
• State/local government hospitals — $1,003
• Non-profit hospitals — $1,350
• For-profit hospitals — $1,697

Hope this helps.

 

[Barb1]

Jill I am so happy and excited for you! I know you will rock your DS!

 

[jillc]

Thanks @Barb1 - I'm excited too! Now I'm getting scheduled for the pre-op testing... Unfortunately I think I will have to wait until April to do the surgery. I don't have the type of job where I can take an extended time off. I'm basically the only full time employee they have, and they have a couple of casuals. Four weeks off may not be much of a problem, but 6 weeks? That will be an issue.

 

[Elizabeth N.]

Keep me posted, I'll look forward to meeting you when you get to NJ! (If I don't scare you too much that is lol....)

 

[Munchkin]

@Spiky Bugger I know Baltasar's prices include hospital and meds. Odd that Dr. B said no DS.... He did my H for diabetes and his BMI at the time was 27.

 

[jillc]

@Elizabeth N. So far I'm not scared But then again, I have no problem with people who don't mince words.

I lived in the UK, was married to a soldier, worked in a bar on the base, and now work in the oilfield (none of which are good for people who get offended/scared off easily). Look forward to meeting you too!

@Munchkin - he said no in the first instance, once I said I wanted it, he gave me a price.

 

[Larra]

Jill, this sounds very promising, and his self-pay deal is a steal for this kind of revision. Go for it!!

Though, I still wish we could have met up in Spain.