Question:
What is the thought process in choosing a surgery style?
— Ken G. (posted on March 4, 2000)
March 4, 2000
Hi Ken: I have no desire to enter the 'discussion' of late, or sing the
Kennel Ration song (lol Cheryl) that goes "my surgery is better than
yooooour surgery! My surgery is better than yourororors....."
Anyway! Please reread your post, you seem to have answered all your own
questions! Good luck with your decision. Jaye Carl, open proximal
(divided) RNY 7-29-99, 94 pounds gone forever!
— Jaye C.
March 4, 2000
Tarren and Ken looks like you both have made the best decision for
your situation and concerns.. I'm doing great feeling the best I have in
years..I know without a doubt RNY was the best decision I ever made for
me also. Now I'm headed outside, it's a beautiful day and I feel like
playing volleyball with my Boxers have not done that in years.. ;-)
— Victoria B.
March 4, 2000
Oh, Ken, it seems like your thought processes are very good. I also think
some of the replys you've received so far have also shown how other people
came to their conclusions. Now may I add yet another reasoning why people
choose the surgery they ultimately have? This is not a pretty picture but a
very valid and all too frequent reason to select one operation over
another. This has to do with insurance coverage, doctor selection, whether
you want an open or laparoscopic approach, and geographic location of
patient and doctor. Let me explain what I mean. For all the reasons listed
by my fellow list members ultimately we are all forced to evaluate a final
consideration. Is the surgery you want to have available near to your home?
Is there a doctor located at a reasonable distance from your home who can
offer the surgery you want? Is there a doctor in your state or geographic
region who offers the surgery you want? Then decide if you do have to
travel a distance to have the operation of your choice, can you drive the
distance pre AND post op? Can you afford the airline ticket and make
transportation and living arrangements for a period of time pre op and post
op if necessary? Can a family member or support person make the trip with
you and then all the arrangements for that person while you are in the
hospital? Do you have family and friends located near a doctor or center
where the surgery you want is offered and if so can they help you and be
your support away from home? Can you make arrangements for the family,
children, people depending on you back home to be taken care of while you
are out of town? Can THEY handle you being out of the area or state?
Lastly, will your insurance company pay for the operation you want to have?
Will they pay for the type of surgery you DON'T want but it is WLS, and
only for a doctor in their insurance network? Will the insurance pay for
out of state doctors and hospitals or treatment centers? Are you able to
switch your insurance company to another "WLS Friendly" carrrier?
Are you thinking about self pay if the insurance won't pay? Can you swing
the cost as there are wide differences in prices for the whole surgical
package without mortgaging your house or robbing a bank (HaHa) or being in
debt for the rest of your life? Can you even qualify for a loan? Are you
able to cope with this whole aspect of the decision for surgery? I think we
all know people who have chosen their doctor and surgery type based on
location, convenience of destination, insurance company providers,
recommendations from a PCP, financial considerations, and family concerns.
This is not the prevalent posture people make when they are researching WLS
but ultimately, if we are honest, we'll see that this non-medical
justifications and pros and cons of which surgery to have are just as valid
as the medical pros and cons!! This is so true because there is limited
availability of certain operation types and approaches. Some people say if
they can't have the operation they choose, they'd rather not have the
surgery at all. Some people say they want a certain type but it's not
logistically available to them. Some people are lucky to live in areas
where all types of WLS are available and this can also make the case for
one type over another. Let me just say that I did travel from Florida to
New York City to have the type of surgery I wanted to have. But let me also
tell you that I had family, 3 sisters, friends, and all the extraneous help
in New Jersey-so that is why I chose to go to New York. And for me, I also
was able to switch insurance companies, and lastly, I think that if I had
not been able to work out all those details for the travel I would have had
surgery which was granted, not my first choice, but gratefully, an option
was available. Sorry this is so long, but I guess I wanted to give another
side of the equation. Even though we can have all the information we need,
ultimately we have to ask ourselves the realistic and hard bottom line
questions and sometimes thes factors I've mentioed are heartbresaking
reality for some people.
— Fran B.
March 4, 2000
ken, though you state you have only been with us a month you sound very
knowledge. As most have stated, it truely is your own decision made after
you have done your own homework. i have been going crazy trying to decide
DS or RNY? I had to really think hard about each procedure and apply it to
my lifestyle; which at this point i'm favoring the DS. I have set up appts
with (4) surgons, (2) who does the DS and (2) who does the RNY. All four
are very experienced in thier procedure type, but i want then to sell the
procedure to me and from that i,along with knowing me will decide! I think
it's Michelle who has really provide you with a great lay out of each
procedure, BEST OF LUCK NO MATTER WHAT YOU CHOOSE. I READ YOU PROFILE; YES
I TO AM READY TO BEGIN THE JOURNEY.
— TJ J.
March 4, 2000
hi,
i just wanted you to know that i also have followed this site for about two
months. have not had surgery yet. i went to see four surgeons in my area.
I wanted to find out which method was truly for me as i did not know
anything about these types of surgery. Some of the things i have learned
are these: If you suffer from heartburn you should consider the rny, also
if you like sweets the rny is a good way to go because of the dumping
syndrom. If you have suffered from ulcers you should consider the vbg, if
you do not like sweets but like to eat large amounts the vbg is the way.
The ds is one i was interested in but all four of the surgeons told me that
the ds holds more risk in that there is less absorption and this can become
a problem later, years down the road. most of them would only consider the
ds if i insisted, or if i have already had one of the other methods and
they did not work. At least these are some questions you should answer
yourself honestly. Also, you will want to discuss this with the surgeon you
choose. good luck.
— twenc
May 21, 2000
Ken, Thanks so much for your info. Im getting ready to get a date for
surgery and I, from the very start wanted RNY. My surgeon says that he
prefers VGB because if there is ever an ulser or cancer that its a lot
easier to take care of and diagnose. If I were to do the VGB and it could
stretch then believe me, Id gain the weight back. I dont necessarily eat
when Im hungry and a lot of times I eat when Im full. I think that the RNY
would really help me in that area. Im sure after throwing up and having
dumping syndrome that Id get the point, (I HATE to throw up). I think that
it is going to take something that drastic to help me and isnt that why we
all decide to have surgery? I only want surgery once and with everything
Ive been reading, it seems that a lot of people are having revisions to the
RNY. Your post has really helped me in my decision making. Thanks, Tina
— Tina C.
May 22, 2000
Ken, my thought process was similar to Melanies and I will echo
here what she said. One additional point that I would make is that
you might want to take your BMI into consideration. My surgeon does both
the RNY and the DS. He recommends the RNY for individuals with
BMIs that are under 50 -55 and the DS for individuals with higher
BMIs. His recommendations are based on the percentage of weight one
can reasonably expect to lose and the probability of weight regain. I
suggest that you consult with a surgeon that does both procedures and
and secure a recommendation as to which might fit into your
situation best. Good luck to you whatever you choose.
— Kathleen B.
May 23, 2000
Ken... Thanks for posting this question. After a lengthy consultation
with my surgeon (about 2-2.5 hours), I was convinced the DS was for me.
Keep in mind that my surgeon has been performing WLS for a very long time
(in excess of 14 years) and has done them all. He feels the overall
quality of life is the very best in having the DS. With having the DS, he
explained, is basically fixing what nature messed up. Although there is
more to do during surgery, he feels the patients will reap the long-term
benefits in having a normal life.
Ken, I think you are making good decision in trying to figure out all the
reasons for choosing a surgery.
I can tell you, that for me, the DS was the ONLY way. I have so much
freedom with my life and I am still able to enjoy whatever food I want. I
am current down 140+ lbs and eating any food I care to have. I have lost
over 81% of my excess weight and today is my 10 month anniversary.
Also, you said you are worried about the stomach stretching. With the
malabsorptive part in place, this will help you maintain your weight.
Another thing I asked my surgeon was about long-term regain. He said that
out of all his DS patients, the very most that was regained after weight
stabilization, was 8-10 lbs.
I would suggest that you try and contact surgeons who do both the RNY and
the DS and see what they tell you. My doctor will email you back, usually
within 24 hours. If you want it, here is his email address:
[email protected]
In addition, you may want to check out the surgeons section of
www.duodenalswitch.com and email some of those surgeons. Dr. Ken welker is
another good one to ask. I believe any of these doctors would be willing
to address your concerns.
Good luck to you!!
— Kris S.
January 8, 2001
I for one appreciate hearing directly from a number of people why they
chose a particular operation. If forces me to question myself over and
over again. The my surgery is better that yours bit may be just a trick of
phrasing for some and not ment as a challenge. "I chose X-type of
surgery and these were my concerns and reasons" is a good template.
Watching people sort through the information is important to me. Thanx.
— Patricia B.
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