VSG vs. DS (Sydney, Aus.)

I hope you will be able to put together a plan that will allow you to have surgery, get more healthy, and have a kid or two as well. Keep in mind that losing weight will improve your fertility, and also that more and more women these days have babies in their early forties. Not that that's ideal, and I totally get that you want to give yourself the best possible chances and that means younger is better, but at least the possibility is still there.

Regarding the bad experience your friend in Melbourne had, keep in mind 2 things: 1) complications are not uncommon with bariatric surgery, even in the best of hands - we are a high risk group, and 2) as far as how she was treated, you are hearing only one side of the story. I say this with all due respect to your friend, who is relating to you her honest perception of what happened. Obviously you can't ask the surgeon about this, but if you could, you might hear a very different story. Also don't forget that Kyal had a very good experience with the same surgeon.

Good luck with whatever you decide to do, and remember that we are here for you.
 
It seems to me like the universe is making your path clear: Have the VSG and be happy.

While I was in recovery from my ds, I jealously watched the VSG people bound back much, much faster. A large part of me wished I had tried a VSG only first. Yes, it might not have been enough, but what if it was? Yes, I would probably never reach "normal" ranges, but in the scheme of things, that is not so horrible as long as I was healthy enough.

When you lose 3/4 of your stomach, you reset a lot of systems. The physical limitation is obvious, but there are profound hormonal and mental changes as well. Since it seems to be your path, why not embrace the journey! See where it takes you. Let the future take care of itself. Life after the VSG will be very different and the problems you are sweating about not may not matter to you.

One random idea that is perhaps way too expensive to contemplate is that you could freeze some of your eggs. That would take some time pressure off. However, I have no idea what this entails.

I so admire that you had enough strength and faith to leave everything and bet on a better future. From an outside perspective, this jog in the path doesn't seem as daunting, however YMMV. I can't help but believe that you will find a way to make your destiny sparkle, even if it isn't what you thought it was going to be.
 
@DuodenalSwitchaRoo - I wish Dr. K were an option, but there's no way in hell we could come up with tens of thousands of dollars out of pocket, even if we wanted to. It's harder to get credit in Aus even with a higher income, neither of us can get that kind of credit in the US since we don't have a US income anymore, and even if we somehow could we'd literally be giving away thousands of dollars for nothing in terms of currency exchange right now since the US dollar is so much higher than the Aussie one. It's just not feasible.

Thanks @Larra - yes, I definitely understand that there are two sides to every story, and that's the reason (along with his skills) that I'm not letting her experience keep me from choosing him as a doctor. I'm hoping my experience will be far better.

@Brandy - if I were starting at 300ish pounds just getting the VSG might be a possibility, but at 500+ pounds there is simply no way I'll lose as much as I need to to make a significant change in my life. As Roo said, I'll be lucky to get down to the 300s at all.

I just don't know whether to try to use someone else for the VSG here in Sydney and make our lives a lot easier but risk irking Dr. N when I'll eventually need him to do the DS, or to just suck it up and do whatever it takes to use him for the VSG. I mean, he's the best cutter in Aus. It wouldn't exactly be bad to have him do the VSG. But all these trips are really going to add up and we're seriously financially hurting at the moment.
 
more2adore said:
I just don't know whether to try to use someone else for the VSG here in Sydney and make our lives a lot easier but risk irking Dr. N when I'll eventually need him to do the DS, or to just suck it up and do whatever it takes to use him for the VSG. I mean, he's the best cutter in Aus. It wouldn't exactly be bad to have him do the VSG. But all these trips are really going to add up and we're seriously financially hurting at the moment.
Click to expand...

I could really use opinions on this, if anyone has any to offer. I still am feeling very torn about what to do here. :(
 
This is a tough one. One option would be to just figure that at your bmi you are high risk even with just a VSG and maybe it would be best to put up with the hassle and cost of going with Dr. N. Another approach would be to either phone or email him about your concerns (I don't know the best way to contact him, hopefully you do), and ask for his opinion about having VSG closer to home, and would he still be ok with you coming to him later for the rest of the DS.
If you think that question might offend him, I would say that your actually having surgery with someone else would REALLY offend him, and would be another reason to stick with him. Since I don't know the guy I have no idea how he would react to either a question about having the VSG locally or to your doing so.

Sorry I can't be more helpful. You are in a tough spot, for sure, and I hope that your VSG will go well and help you to lose at least a substantial amount of weight and improve your health for now.
 
I'm not saying it would. I don't know one way or the other. But some surgeons prefer to do the whole job themselves, rather than work on someone else's prior work.
I would hope he would be open to the idea of a patient having a VSG close to home, esp with the distance being considerable, I just don't know.
 
Thanks, Larra, for the input. @Elizabeth N. - it's what my friend said his response to her was when she questioned something he told her that has me concerned about how he might react, as well as the general feeling I got from him when I met with him. I never thought reaching out for and getting help when I finally decided I was ready for it would be this stressful. I know... I need to just put my big girl panties on and deal with it. I just found out today that I didn't get a job I thought I had as well (I was one of the top two finalists) - so our finances aren't looking up, either. I think I just have to suck it up and use him. Hopefully I can convince hubby and he won't be too sad/anxious about the added expense. It's just far too risky to offend the only person in the country who can give me the surgery I want safely down the road.
 
Dr. Ungson actually just responded to my post on OH and said he agrees that a two-part surgery is the correct decision for someone with my BMI. Somehow that makes me feel a little better about it all. I'm going to suck it up (and convince hubby to do the same), we'll make all the trips down there necessary to get this done. I'll start getting the tests done ASAP, and see if we can get this surgery scheduled ASAP. Nottle is the best of the best here - having him do the VSG is probably the best decision given how high-risk I am at this size, anyway.
 
Good decision! Now that you've made your decision, it will be easier for you to keep taking the steps you need to take to keep the process moving forward.
 
I hope you guys don't mind me updating this thread even with the mundane progress I make on my surgery. :)

I called my private insurance company here and made sure they covered the VSG. They do. They also cover the DS, so when it's time for that a couple of years down the road it shouldn't be an issue. I asked about some kind of lifetime limit on the number of bariatric surgeries and if it might need to be coded differently, and the rep was really confused. If I was having surgery in the US I know @DianaCox could set me straight, but I have no idea how to verify what they're telling me here in Australia. I just would hate to either do something now that jeopardizes them covering the VSG, or NOT do something now that means they won't cover the DS later. Argh.

Hubby still keeps saying "IF you need the DS part in a couple of years...." He's an optimist, and thinks the world of my capabilities and thinks I will be the one outlier who manages to beat the odds and, even from this weight, lose all the weight I need to lose from the VSG, and poof, happily ever after with far less malabsorption to worry about. I love his sincere belief that I am superwoman, but I'm trying hard to manage what I feel might be unrealistic expectations on his part. He insists they're not "expectations" but hopes, lol. I'm trying to get him to understand that it's WHEN I need the DS, not if, at this size. If anyone knows studies of how much weight SMOs lose on VSGs, and the percent that go on to revise, please point me in the right direction. Though I'm not even sure that will convince him, lol.

I've worked today on getting a checklist going for all the things I need to do to make this surgery happen. 3 WEEKS OF OPTIFAST. FUN TIMES. :)

  • Determine how to fund it - (with hubby) Medical loans, or accessing retirement early?
    • Contact Medical Loan companies to see if transport is included, get interest rates, payment info, etc.
  • Determine timing – (with hubby) When can we afford (and hubby get time off for) second Melbourne trip to see hospital doc/nutritionist? When should we try to do the surgery so that we have time to financially recover from our move in Nov.? When can hubby get enough time off for surgery? Jan/Feb?
  • Make appointments – Make appointments to see nutritionist & Director of the Department of Intensive Care at hospital where I'll have my surgery.
  • Try to get surgery date from Dr. Nottle – need to see Director of Intensive care BEFORE booking surgery date?
  • See GP – referral to head of intensive care, try to find place to have abdominal CT
  • Blood Test/EKG - One week before second Melbourne visit – Fast 10 hours before test. Collect first urine of the morning and take with me to pathologist. Drink 2-3 glasses of water 1 hour before blood test.
  • Second Melbourne trip for meeting with Director of Intensive Care and Nutritionist.
  • Phone appointment with Dr. Nottle – when? During appt., find out who to use for follow-up in Syd, when to start fasting on surgery day.
  • Make post-op follow-up appointment with follow-up doc recommended by Dr. Nottle.
  • 3 weeks before surgery, start Optifast diet.
  • Complete hospital admission forms online AT LEAST 10 days before surgery (once we have an admission date)
  • Day before surgery, start fasting at ___ time.
 

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