Sean_B's Profile

Username: Sean_B
Location: Schenectady, NY, USA
Member Since: 9/3/2006
BMI: 21.8
Post Op
Surgery Type: Duodenal Switch (11/14/06)
Surgeon: Paresh Shah, M.D.

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me on a short hike today 10/19/08 Uploaded on 10/19/08 9:05 pm	preop - somewhere around 310-320 lbs Uploaded on 4/12/08 5:50 pm
Uploaded on 4/12/08 5:50 pm	preop - around 310-320 Uploaded on 4/12/08 5:50 pm
1 week postop - first day home Uploaded on 4/12/08 5:50 pm	preop - day of surgery Uploaded on 4/12/08 5:50 pm

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Friends

Sean_B has 73 Friends

SameButDifferent	Raelene C.	Kryst
Candle	Dreamy	The New & Still Impr Robin
Dixie Chick	Amy Williams	Tavia V

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Surgeon Testimonial

Paresh Shah, M.D.
very easy to speak to, makes things easy to understand....
and much taller than I had imagined him LOL.
office staff was SUPER friendly and helpful.

Latest Surgery Support Comments

Comment by Anna G. on 10/13/07 5:17 pm

Wow! You zipped right through that surgery! So glad it went well. Hope you have a swift and pain-free recovery!

Comment by LeaAnn on 10/13/07 1:40 pm

Enjoy those percocets my Renegade/Ds Brother! Glad your surgery went well!

Comment by Mis94 on 10/13/07 7:24 am

Hi Sean! Hoping your hernia repair is a breeze! Missy

Click here for the surgery support page

36 y/o, married 9 years and have a 5 y/o son
live in Schenectady NY.... a small city just a few minutes west of our state capital (Albany)
LOVE music... I sing in a local cover band (picture MeatLoaf on a bad day LOL... well, not "MeatLoaf" anymore... more like Steven Tyler hehe )
also play guitar... but not good enough to play it in the band.... no problem, I love singing.

last cigarette pre-op was on 9/13/06
first cigarette post-op was 7/23/07 (many stressful pile-ups on me, compounded by a dear friend's accidental death on 7/22/07)
don't give me a hard time... my smoking is MUCH less than it used to be, and I have no issues hiking, singing, exercising, etc. It's really the only "bad" thing I do, so give me that much OK? thanks

6'1" date of surgery - 323.6 LB 6 months post-op - 189.8
stable since August '07 (roughly 9 months post) - 160-165 lb

Sean_B's Blog

10/23/06 - do they really NEED to be famous?
on October 22, 2006 1:30 pm

well, I opened up my can-o-worms the other day by posting that someone was concerned that they've never heard of my surgeon. Does fame and/or popularity really make for a better ANYTHING? I personally know several guitarists who are many times more proficient than any famous guitarist you can think of (Van Halen, Page, Clapton, Vai, Malmsteen, etc) it's just that they aren't seeking fame. I could probably go on about different professions all day, but that's a quick way to get my point across.

Scopinaro and DeMeester gave us two procedures that Hess put together... many papers were written by the "Brothers Rabkin" LOL, Marceau, Baltasar, Anthone, Gagner and Keshishian. Gagner was the first to perform the DS laparascopically. Should we write off anyone else?

It's been mentioned that since I'm travelling 3 hours, why did I choose Shah when Gagner is right there too?

Dr Shah is relatively new to NYC.... he was recruited there in 2004. Before coming to NYC, he was at the Lahey Clinic in MA... where he started their bariatric program in 2000.... he was Director of the Minimal Access Surgery and Technology Center and also Director of The Center for Surgical Obesity.
I assure you that he has done WELL over 50.... more like 100+ DS procedures.
He was also just last year, appointed Director of Laparoscopic Services at Lennox Hill Hospital.

You can pretty much disregard anything you read here on OH as far as the surgeon listings... many of them are OLD... like 2003/2004. I don't know if they got them all in the cleanup, but there were MANY surgeons listed as performing the DS... yet, when you call their office, they tell you that they don't, or that they did for a short time, but gave it up due to the complexity. THAT part has supposedly been cleaned up according to a post made by Amy Williams recently.... but it seems they didn't do any updating, which I guess is understandable... can you imagine the undertaking that would be? contacting all the surgeons listed to get an updated tally for everything on their chart? I know I wouldn't want that job.

I'm fully aware of Dr Gagner and his contributions to the field, and this post should not be misinterpreted as an attack on his qualifications.... when it came down to selection, I narrowed it down to two groups... Dr Gagner's group at NYP/Cornell, and Dr Roslin's group at Lennox Hill (of which Dr Shah is a partner).... basically, the top two bariatric groups in NY. I had no problem going with either. Frankly, Gagner's group dropped the ball in not returning 2 e-mails and a couple phone calls, so I never even went in for a consultation.

I feel very comfortable with Dr Shah and his partners at Lennox Hill.

I am NOT very comfortable with my insurance company at this point though.

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10/20/06 - spoke too soon?
on October 20, 2006 9:18 pm

well I guess I had to be a dumb-ass and jinx myself with that last paragraph in yesterday's post. LOL

I called my insurance co today just to make sure they had all the paperwork they needed to make their determination. I was clear that I knew it has only been a week, that I wasn't calling to get an answer, but to make sure they had all they needed to make that answer, and if they had any estimate on how long these decisions usually take.

Then I was told something that, even now, I'm not 100% sure how to take. She said, well I see it was submitted... but here's something else I see submitted for pre-determination on 9/29, requesting approval for CPT 43845 (the DS billing code) and that the decision was denied due to being investigational or experimental (just what I was afraid of).....

then she said.... further information received on 10/13, claim determination still open.

that last part is a good thing, because it means I haven't been denied.... YET. I was going through some copies, and the only thing I can think of that initially started it was the letter I sent in... it basically was a letter giving my personal dealings, and why I was choosing the DS procedure.

The bad thing, is that now I know they MIGHT use the whole "experimental" thing to try and deny the claim. What pisses me off probably more than ANY of the process, is that they're (any insurance co.) basing the claim of "experimental" on an N.I.H. Concensus that is FIFTEEN YEARS OLD!!! Hell, the RNY was fairly new back then.... a lot has happened in 15 years. I just hope they can pull their heads out of their butts for long enough to see the current calendar, and see what's been going on in the world of medicine.
On the plus side (yeah, I know... back and forth) at least with the info (about 40 pages) that my surgeon sent in, they have it under determination. I KNOW that I qualify for WLS, even under THEIR criteria.... and I know I've met all other requirements. my biggest issue is for them to approve the PROCEDURE I want. Knowing that IF they deny me, it will be on the "experimental" claim.... I have all this time to collect info regarding the DS... any peer reviews, other insurance companies determinations for procedures, the recent medicare decision, any medical journal articles.... all sorts of "scholar" type articles written by surgeons, doctors and other medical professionals... anything that may give extra weight to the DS not being experimental... that there is enough documented literature and case studies to show efficacy and safety.

I'm already up to about 200 pages with NO REPEATS.... all nicely stapled and highlited to show relevant points.

like others have said.... I'll fight like hell for the DS, and won't accept any other procedure for me.

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10/19/06 - I now know the feeling
on October 19, 2006 6:49 pm

Well, my insurance company received all the paperwork last Friday... it is now Thursday. Yeah, I know, that's only like 4 business days.

I used to read posts and blogs of people who were anxious to find out, and would think to myself "Jeez, it's only been a week (or whatever time frame) relax and let them do their job." well, now I know the anticipation side of things.

I've been checking the website the last couple days to see if there's anything different posted under my account... something that looked odd or out of place.... but after thinking about it just earlier... I'm not even sure if they PUT pre-determination stuff on my account listing. Of course, I see all the claims and stuff.

hmm... maybe I'll just give them a quick call tomorrow... it will have been a week, and the least they should be able to do is give me an ETA on when I'll find out. I know my case by itself should be open and shut... but there's two possibilities I'm not sure of.... 1- do they have everything they need paperwork wise? 2- is there a problem approving the DS? there SHOULDN'T be, as it isn't considered "experimental" or "investigational" anymore... but it's just one of those things you never know.

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10/16/06 - special edition
on October 16, 2006 12:20 pm

This particular post has special meaning, which is why I made it seperate from the other 10/16 post.

just the other day, I received a message from a concerned person about my choice of surgeon. The fact that I am having DS, and the OH listing for my surgeon shows him as having performed something like 30 DS procedures. The person who contacted me was concerned because it is commonly accepted among DSers that due to the steep learning curve required to master the DS (being the most complicated of bariatric procedures so far), that it's a really good idea to choose a surgeon who has performed a minimum of 50-100 DS surgeries, with few exceptions.

Before I get any further into this thought, let me say this.... if you are seeking to have the DS, and have not yet found or selected your surgeon, by all means check out the listings both here at OH, as well as the surgeon listing over on http://www.duodenalswitch.com
I would say to use those listings ONLY to get the names, addresses and phone numbers of surgeons in your area who are REPORTED to perform DS as part of their practice.
Supposedly, much of this has recently been taken care of here at OH, but you can never tell..... some surgeons listed as performing DS either never did, and had their listing that way only as a way to get more people in the door (AKA: "Bait and switch") or, perhaps they once DID do the DS, but since it is a more complicated and time-consuming procedure, they gave it up for the simpler and faster RNY and LAP-Band.
Aside from whether they even do it or not, there's the discrepancy on how many (of ANY procedure) they've actually done... I don't hold anyone to blame for this... not OH and DS, not the surgeons... unless OH is going to employ someone whose only job is to constantly call surgeons offices to get updated statistics, you're never going to have an accurate count. in a busy week, a surgeon could realistically perform 10-15 procedures without clocking overtime.... figuring the 3 popular procedures (Band, RNY and DS) range from about 1.5 to 3 hours each.
That all said.... use the surgeon listings on OH and DS only to get contact info.... call the surgeons you're interested in, and ASK THEM how many procedures they've done, how many lap and how many open, how many lap they had to convert to open, how many mortalities and what were the causes.... etc.

now back to where I was... I often wonder about that "50-100 minimum" suggestion... I mean, how does a surgeon GET to 100 procedures? did Dr Hess do so bad back in 1988-89? Did Dr Gagner have a problem when he did the first Lap-DS back in 99?

all I'm saying is, sure there's a learning curve at least to a point.... but something you've got to think about is... you've got to be good enough to even DO IT AT ALL, before you can do your first. (addendum...) there's training, then assisting with those more experienced, then performing it under direct supervision of someone experienced, and so on until you're good enough.... and besides, SOMEONE'S gotta be first, otherwise NO surgeon would EVER get to that magic number. (end addendum)
Go with your feelings, review your potential surgeon's education and training, and ASK QUESTIONS.... regardless of the procedure you've chosen.

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10/16/06 - not much
on October 16, 2006 12:15 pm

still to early for anything exciting to have happened.
One good thing though... I was bored this afternoon, so I called my insurance co. just to verify that they have received all the paperwork from my surgeon. They confirmed at least the fact that they had received the correct NUMBER of pages. Of course, they don't know yet if they have everything needed, and I wasn't expecting that... they only got the packet on Friday 10/13

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