How I chose the DS or A Series of Furtunate Events

Jan 17, 2009

Real people have WLS

One day in 2004 while eating lunch in the cafeteria, I found out that not one, but TWO of my coworkers had weight loss surgery.  WTF???  I'd seen and heard the lapband commercials on tv and the radio.  I had been struggling with my weight for as long as I could remember.  I couldn't believe that real people, people I actually knew had WLS.  One girl mentioned her surgeon was Dr. Dennis Smith in Marietta.  As soon as I got back to my desk, I googled him, found out the date of the next info session, and called to reserve my seat.

I find out about the DS

I walked into the session *knowing* I wanted a lapband.  I'd heard a little about bypass surgery and the less invasive lapband seemed like it was more my style.  There was only 3 other women with their major supporter there.  Dr. Smith walked in and began his presentation on WLS.  Dr. S did (and I believe still does) just about every type of WLS there is so you can imagine how long the presentation was.  He started with RNY -- blah, blah, blah, 60% EWL, blah, blah, blah, salads and low fat diet for the rest of your life ... I remember thinking "There's no way I want that!"  Then he went on to banding (I paid a little more attention here) --  blah, blah, laproscopic, blah, blah, least invasive, blah, blah, something about fills (I could learn about all this later right?).  I felt pretty confident about my choice.  He talked about the VSG -- I really didn't pay much attention here.  It was getting late and I was wondering how much longer this would take.  Finally he moved on to BPD/DS.  Okay, yet another surgery I had never heard of, what else is new?  Blah, blah, 80 - 100% EWL (my ears perk up).  Highest percentage of long term weight loss (I start to pay attention now).  Restriction, malabsorbtion (I can google this later).  He finally finished up.  Truthfully it had only been a little over an hour.  He took a few questions and then his office manager Dee talked about the process -- filling out the paperwork, determining what insurance will cover, etc.  She handed out the packets and we were finally free to go.

I was hanging around waiting to ask Dee some insurance question and Dr. S came over and asked what surgery I was interested in.  I said lapband and he asked how old I was.  I was in my late 20s.  He said given my age and the amount of excess weight I had (~120 lbs), the DS would be a better option for me.  Of course I wanted to know why.  He told me that the bands had a lifespan of 5 - 10 years.  I would have to have it replaced once, if not twice.  Also since I was under 30 and my lifespan would increase once I lost weight, I should look at something that had a greater change of keeping the weight off long term.  From that moment I knew the DS was for me.

No WLS for me (yet)

I spend the next few days filling out the paperwork for Dr. S.  I told my husband about what I'd learned about the DS.  He said he loved me no matter what I weighed but if it would make me happier to be smaller he was on board.  I even found time to go see my PCP and talk it over with her.  She felt I should have surgery before I got any comorbidities and before I got any older to make recovery faster.  Cool.  I faxed everything in and waited.

Dee called me in a few days and said my company had recently added a WLS exclusion to my policy.  With two toddlers I wasn't able to even consider self pay.  She said to call back if my insurance changed.  Bummer.

This time its for real

Over the next couple of years, I changed jobs twice -- each time keeping an eye on the benefits.  I started my current job as a consultant (think lots of travel and lots of free food).  I'd gained another 20 lbs by the summer of 2007.  That October, HR sent out an email reminding everyone that Open Enrollment was coming up and that WLS would be covered starting in 2008.  I called my husband as soon as I read the message.  He was as happy as I was.  I called Dr. S's office to see if I could get the process rolling again.

Finding a Surgeon

The receptionist said they didn't have my information on file anymore.  Me: Okay, can you send me another packet to fill out?  Her: No, you can only get a packet at after attending an info session.  Me: I already went to one before I filled out the papers the first time.  Her: There have been changes since then.  Me: Changes to the DS?  Her: You have to attend an info session.  (This goes on for about five more minutes before I finally give in.)  Me: When is the next info session?  Her: The next one is in 2 weeks but all the slots are full.  The next opening we have is in January. (This was in October.)   Me (through gritted teeth): Fine. Sign me up.  <-- First time this chick pisses me off

I'd been lurking on OH since I first learned about the DS in 2004.  I looked to see if there were any other surgeons in Atlanta.  Dr. Donald Maynard in Conyers.  Maybe I could meet him and get this 3 month diet started before January.  I called his office and spoke with his office manager Donna.  She said I would have to wait until my WLS benefits kicked in before I could see Dr. M.   Damn, I can't win for losing...

Open enrollment comes and goes.  I put the max out of pocket amount into my flexible spending account since Dr. S now doesn't take Aetna and Dr. M isn't on the list either.

In January, I get an unexpected call  from Donna.  She wants to know if I still want to setup a consultation with Dr. M.  Hell yes!  I get an appointment for later in the month.  I am not really looking forward to the info session with Dr. S (see my comments above) but at least I can get things moving.

Plan B becomes Plan A

By 2008, I had moved and I now live almost 50 miles from Dr. S's office.  I have to take off from work, get up at the crack of dawn, and fight rush hour traffic t get to the 9 AM info session.  I pull up at exactly 9 and make it to his office at 9:02.  I go to open the door and it is locked.  WTF???  Surely there are other people coming to the info session, right?  I knock.  No answer.  I put my ear to the door.  I can hear people inside.  I knock louder.  No one comes to the door.  I pull out my cell and call.  I get the same receptionist.  I tell her my name and that I am scheduled to attend the info session.  She says they lock the door right at 9 and that latecomers are not allowed.  Me:  It's only 9:04!!! I'm right outside the door!!! Her: You are late and we've already started.  Me:  It's only 9:04!  How much could I have missed????  Her:  You have to sign up for another info sessions and come back. (This goes on for another few minutes before I give in -- again.)  Me: When is the next info session?  Her: The next info session is in 3 weeks but it is full.  I can put you on the list but you have to be here 5 minutes before it starts.  Me (again through gritted teeth):  Fine.  Sign me up.  <-- Second time this chick pisses me off.

I drive to Conyers  (~40 miles) to meet with Dr. M.  The first thing I do when I get there is take a test.  Hello?? Am I back in school???  Good thing I'd spent a good deal of time here on OH and on dsfacts and duodenalswitch!  Then Dr. M came in and sat down with me for about an hour and talked to me one-on-one about the DS and answered all my questions.  I'd done my homework and I had a doozy of a list to ask.  I asked how many patients he'd lost, what type of follow up he does, and what determines if he will do the surgery open or lap.  He replied, "I only do open."  Lawdy, lawdy, lawdy!  I get keloids when I get minr cuts and scrapes.  What will my belly look like after an open surgery???  Good thing this guy is my backup plan (or so I thought).  I watched a video about a lady who had the DS and was started on his presurgery diet and exercise plan (which included visits with a nutritionist, exercise physiologist, and psychiatrist, and monthly support group meetings).  I spend the next few days calling around making my referral appointments and I even schedule a visit with the PCP I had all those years ago who was so supportive of WLS.  Its finally starting to happen for me!

So, its finally time to go back to anther 9 AM weekday morning info session.  I take off from work again.  It is raining cats and dogs outside.  Even leaving my house at 7:30 AM I am still 5 minutes late.  I call at about 8:45 t let them know I'm not going to be there on time.  The dreaded receptionist says usually I would have to reschedule but since its raining and there is a major accident on the highway she'll let me in.  Sheesh lady, get a clue.  So they've already started when I arrive but Dr. S is not giving the presentation like before.  They are showing a powerpoint presentation with a recording of Dr. S talking about the slides!  WTF???  I had to take two days off and drive all over town to hear a recording?  Such BS!  I sit through the whole thing dripping wet and mad at the world when the recording ends and Dee comes to the front of the room.  I'm expecting her to talk about insurance again (which she does briefly) and then she goes into Dr. S's $250 program fee.  THAT'S THE CHANGE THE RECEPTIONIST WAS TALKING ABOUT!!!!  For the second time that morning, my mouth fell open in awe.  The new process was to go to an information session, fill out the packet and send it in, the doctor and his staff review the packets and if you are accepted as a patient, then you get to pay the program fee and after all that you can finally meet Dr. S.  I understand the guy is one of the top weight loss surgeons in the country and lots of people come in for consults, but for the life of me I couldn't understand why I'd have to wait anywhere from six weeks to several months before meeting the surgeon.  Dr. S is a great guy and I will forever be indebted to him for telling me about the DS this process sucks ass (can you tell I'm still bitter).  Dr. M and a big ass scar were now my first choice.

Hurry up and wait ... and hurry up again

As I mentioned, I'm a consultant and I travel.  A lot.  At the last minute.  So what should have been a quick 3 month process took me the rest of winter, all spring and part of the summer.  While sitting in a hotel somewhere, Donna calls me.  I'm thinking she needs more info to submit to Aetna.  Nope, she just sent what they had.  She said 45 minutes after they faxed it, the guy from Aetna called.  Jokingly she said, "You're calling to tell us she's approved."  He goes, "Yeah."  Just like that.  Donna's trying to ask me when I want to have surgery and I am shocked silent.  I need to think about this.  Call my husband.  Look at a calendar.  When I got back to Atlanta, I setup my surgery for 10/8, two weeks away.  Just in time for my two week freak.  I suddenly started second guessing everything -- do I need WLS?  What if I die?  What if I don't die, but get really sick?  What do I tell people?  How long should I take off from work?  What about all those trips and projects I have lined up?  Who will clean the house?  Will I be in pain?  What will the hospital be like?  What if...?

Happily ever after

Those two weeks flew by and the surgery went off without a hitch.  I was off the pain pump after a couple of days and I never filled my prescription after I left the hospital.  No nausea, vomiting or leaks.  Only one bad reaction to food (I don't think I'll ever eat tomato soup again).  Most importantly, I'm losing weight and I am happier.  I truly love my DS!

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