How do they decide?

tmlf959
on 10/21/12 1:12 pm - Hamilton, Canada

Haven't seen the surgeon yet as I still have a few more appointments and tests to do. But was just wondering, how does the surgeon decide which procedure you will have? Rny, sleeve or ds? Do you get to choose?

(deactivated member)
on 10/21/12 1:21 pm - barrie, Canada

I believe it is based on medical history and medical conditions, the #1 go to procedure is RNY though.

ShallowGirl
on 10/21/12 1:51 pm - Richmond Hill, Canada

RNY on 06/22/12

It's your decision, the surgeon makes recommendations. You should ask them about what makes one surgery better or worse for you. You can decide then change your mind about what you want.

The future belongs to those who believe in the beauty of their dreams. ~ Eleanor Roosevelt

Onward and
Downward
on 10/21/12 9:33 pm, edited 10/21/12 9:34 pm - Canada

RNY on 11/07/12

I wish that had been true at TWH! My experience is that at TWH, you get the RNY unless there's some major medical reason why you have to have VSG, because VSG isn't covered by OHIP without a good reason. (And needing NSAIDS doesn't count for them, because they say you can't have them regularly with VSG either, and that you can have them on occasion for either surgery.) That's what I was told there.

I understand it's quite different in Hamilton, though. It would be nice if all centres would be a bit more consistent.

Referral to registry: Oct 21, 2011 Orientation (TWH): Feb 22, 2012 Surgery: Nov 7, 2012

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Monica M.
on 10/21/12 9:43 pm - Penetanguishene, Canada

RNY on 03/02/11

it's not your decision. The go to surgery is RNY, unless you have medical conditions that make one of the others better.

nata
on 10/21/12 11:39 pm - Ottawa, Canada

DS on 10/30/08

that's the HRRH policy, it is Dr. Hagen's opinion, which affects hundreds of people's lives. He was very vocal about it at Baritric Event, I believe in Mississauga. He also "reviewed" a few appeals for my friends about three years ago. He doesn't "see effectiveness or advantage in any other surgery", hence RnY for every one, period. Being the lead of Bariatric program in Humber, he made it official policy.

Dr. Anvary, leading same program in Hamilton was quite open to various options and in his reviews recommended DS RATHER than RnY for BMI over 60 and VSG for some cases as well (there were two "expert reviews" per appeal, copies were sent to the patients, so I actually read their "opinion" myself).
No wonder, the only DS surgeon joined Hamilton program. Dr. Hong by the way wasn't here forever, he is a quite recent but very valuable "acquisition".

So they do decide... depending on our location.

Nata, a very happy DSer!
Starting BMI - 62, current BMI - NORMAL!!!!!.

204 pounds lost!!!!

OKNEE FE + 3
on 10/22/12 2:11 am

VSG on 09/17/09

Dr Hagen recommended and did my VSG, just saying

Oknee's just gotta dance
Weight at the start of Optifast 378 T-1 OR Weight 352
Broke the 300 pound Barrier 13-Dec-2009 291.2lbs 01-APR-11 "onederland"
HGBA1C 5.2 d/c from the care of my Endocrinolgist 09-JUL-10 "diabetes resolved"
10-MAR-11 Extreme Sleep Apnea (dx 2007) resolved-"b-bye CPAP won't miss ya"
HAVE A QUESTION ABOUT IRON AND/OR http://theironmaiden.ca/

nata
on 10/22/12 8:59 am - Ottawa, Canada

DS on 10/30/08

Don't you have severe case of IBS? it wasn't a choice but necessity.He denied patients choice. His expert opinion costed one of my friends 30K (she had selfpaid DS in France and about another one 8K -she paid for VSG in Mexico).

The discussion was about influence of patien's opinion. Hagen doesn't take it into consideration, Anvary does, Dent. Their staff do as their leader's policy require. So again, our right to choose depends on our location.

Nata, a very happy DSer!
Starting BMI - 62, current BMI - NORMAL!!!!!.

204 pounds lost!!!!

OKNEE FE + 3
on 10/22/12 12:05 pm

VSG on 09/17/09

his is true Nata, but your post read like Dr. Hagen is single handedly responsible for RNY being the only procedure available, and this simply is not true. Granted there is no patient "choice". There is specific criteria which some centres apply more loosely than others. . .this is not Dr. Hagen's fault as much as it is the Ministry of Health and Long Term Care for imposing criteria for procedures other than RNY instead of leaving it to the surgeons discretion in consultation with his/her patient.

Here is hoping that the province doesn't crack down again like it did in the fall of 2010, making access to VSG tfor even those for whom there was no other option almost impossible.

I agree there should be a choice but please do not hang the fact that there is not around Dr. Hagen's neck for applying criteria set by the province

Oknee's just gotta dance
Weight at the start of Optifast 378 T-1 OR Weight 352
Broke the 300 pound Barrier 13-Dec-2009 291.2lbs 01-APR-11 "onederland"
HGBA1C 5.2 d/c from the care of my Endocrinolgist 09-JUL-10 "diabetes resolved"
10-MAR-11 Extreme Sleep Apnea (dx 2007) resolved-"b-bye CPAP won't miss ya"
HAVE A QUESTION ABOUT IRON AND/OR http://theironmaiden.ca/

Heidi S.
on 10/21/12 2:08 pm - Sault Ste. Marie, Canada

Yes, it is part your decision and part the surgeon ... it does depend on your medical conditions past and present .... it also depends if you have any abdominal scar tissue, if so how bad it is .... sometimes they don't know what you will get until they have you on the table and can see inside you. You can do a search and see hwo people have been "surprised" with a sleeve. I went in expectign either and ended up with the RNY. Wishing you all the best and keep us posted

Sometimes you just put one foot in front of the other, even if you don't know where you're going.

Surgery Aug. 29, 2012 with the Wonderful Dr. Aarts at TEGH

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