Ok'd by my doctor, mostly!

Dec 01, 2016

I had my appointment with the Bariatric Surgeon at Kaiser's South Sacramento location today.

There was some confusion about having paperwork, and upon my confused expression they clarified that it should be in my "binder." I explained that I had never been given such a thing, and they figured out since I was asking about a revision, I apparently got to skip a lot of the initial stuff, including this mythical green binder.

I spoke with my surgeon for about 30 minutes. He asked me a lot of timing and history questions. When was my first surgery, where, when did I have my gallbladder removed, why (emergency surgery for stones), am I still taking anti-depressants, am I still taking my anti-nausea meds? How frequent are nausea and vomiting episodes? Describe your acid reflux, when did that start, how severe, etc.

Ultimately, he said that he recommended gastric bypass revision to correct my initial surgery's complications. I asked when we discuss which procedure and he said he recommended Roux-en-Y. I asked about he Duodenal Switch, citing my reasons why I was interested in that procedure. He countered with he only recommends that surgery for people with an extremely high BMI of like 60 or more. He said because of the long term nutritional deficiencies blah blah blah it's less than ideal. He also mentioned that he was less concerned about future weight loss and more concerned with doing a revision to correct the severe acid reflux symptoms.

He told me to lose 10 pounds and attend a two-hour nutrition class. Once I did that, call back and they'd schedule a psych eval. Until then, he ordered an endoscopy to look at the damage done by the years of reflux and some blood work.

I walked into my appointment with my metaphorical boxing gloves, but in the end I didn't want to turn a pleasant and easy conversation going mostly in my favor into a fight. I had studies showing that losing weight before a medically-necessary weight loss surgery had no merit and was not supported by anything anywhere. I was armed with stats on long term results of VSG, RNY and DS and studies declaring the DS as the best all around option for people in my situation. I came armed with IMR decisions finding that DS for patients with a BMI greater than 50 had no better or worse results than in people with BMIs under 50... and in the end I didn't pull out any of those points. Did I chicken out or was discretion the better part of valor here?

I am going to research RNY vs. DS more in-depth, but I really feel DS is the right option for me. At what point do I start my fight for the procedure I actually want, without throwing down too early and they just take away what they've already offered to do?

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Georgetown, CA
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Nov 02, 2004
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