Doctor Shopping?

Melanie W.
on 12/26/13 5:46 am - WA

I tried unsuccessfully to have the sleeve done in September 2012. I woke up from surgery and the doc informed me that my liver was still too large and they couldn't do the surgery. I had a few bad experiences like getting into a car wreck in the parking lot that kind of gave me the heeby jeebies about going back there. I was also concerned that the doctor barely recognized me when I got into the car wreck...as a patient he should make an effort to know and recognize his patients.

I have gone to another surgeon who wants me to have bypass, but I am not comfortable with that at all. I was against weight loss surgery for so long until I heard about the gastric sleeve. It was like a lightbulb went off and I knew it's what I wanted. When I told this other surgeon I was uncomfortable with bypass because I didn't want a new stoma created and not be able to take nsaids and potentially be even more anemic he told me "maybe you shouldn't have the surgery at all." Needless to say I was put off by the entire conversation. I was also told I should only be eating 2-3 protein shakes a day and a lean cuisine for dinner. I tried talking to him about that because i only like 2 or 3 of those frozen meals and would be eating the same thing on end for months!!! It was like setting me up for failure and I told him it was impossible and asked if there were other options and he said NO.

I have an appointment on January 2, 2014 to see Dr. Landerholm at Puget Sound Bariatrics and am hopefully going to click with him. The lady I talked to the other day sounded nice and had had her band to sleeve revision done there. She also said they do a very low carb diet and don't put you on a shake diet. I want the surgeon to listen to me and help me, not just tell me canned answers. I also want them to recognize me and know who i am without having to pour over a chart. i know surgeons see many patients, but I did my medical assisting externship at virginia mason in seattle and knew patients by their names, it shouldn't be hard for doctors to know either.

I've been scared to get back on the wls bandwagon because of the surgery that wasn't completed. When I was talking to the gal at Puget Sound Bariatrics she was surprised that they did my "failed surgery" at their clinic and not in a hospital because of my BMI. Even my mom was surprised because she always has her surgeries in the hospital and she is 100 lbs less than I am. She said any BMI over 49 and it's done in a hospital not an ambulatory clinic setting. When I woke up from the failed surgery I no sooner had my eyes open and they had my IV out and had me out the door. I still had surgery even if it wasn't completed. I was in so much pain and wasn't even written a prescription for pain pills since i wasn't going to drink the god awful liquid stuff. I had to go to my primary care doc the next day and ask for some.

Please let me know what you guys think. I really want to finish this journey and have babies.

    
Member Services
on 12/26/13 7:21 am - Irvine, CA

Hi,

Try posting this on the Vertical Sleeve Gastrectomy Forum (VSG) for more responses from members that have had the procedure you are interested in.

Please keep us posted on your progress

Cicerogirl, The PhD
Version

on 12/26/13 8:08 am, edited 12/26/13 8:09 am - OH

Did the original surgeon tell you why he didn't just convert your surgery from lap to open so he could go ahead and do the sleeve procedure?   He might not have been comfortable doing open if he was only trained to do lap, but I can only imagine how disappointed you were to wake up to find that he did nothing!  I would add the question to your list of things to ask the new surgeon... whether he would convert to open if the liver size is still an issue (since it might be).

The surgeon who was so insistent about the frozen meals seems overly rigid.  It is common for surgeons to put people on the shakes with only one meal, but rather than have people get frozen meals with lots of chemicals (and usually some kind of carb (potatoes,mice, noodles), they want a simple meal of protein and veggies (which lets YOU choose your foods)!  I would have blown that guy off, to!

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Melanie W.
on 12/26/13 10:24 am - WA

the surgery was in their clinic (ambulatory center) and come to find out they don't convert to open surgeries at all! 

I am going to tell the doctor I want the surgery in the hospital and to slice me open if it doesn't work laparoscopically.

From what the registration gal told me with the patients they have you work with a nutritionist and a physical therapist and incorporate this into pre-op and post-op for 2 years.

I am going to go in there with the list of foods I do eat ( I am extremely picky). I want someone who will help me create healthy meals and give me options.

The meals I do eat that are frozen like lean cuisine are carby...not sure why that would be a good diet?!?!?

 

 

 

 

MsBatt
on 12/26/13 8:52 am

Yes, someone with your BMI should be having surgery in a hospital. (Frankly, I think ALL WLS should be done in a 'real' hospital.) I also think you need to research a procedure called the Duodenal Switch. The DS has the same stomach as the Sleeve, plus an intestinal bypass that makes a dramatic, permanent change in the way your body metabolizes food. The DS has the very best long-term, maintained weight-loss stats for patients of any size, but especially so for those of us with a BMI greater than 50.

Melanie W.
on 12/27/13 2:50 am - WA

I've researched the procedure, but I'm really not comfortable having my intestines rerouted. I am a-ok with having a piece of stomach taken out, but anything with my intestines I couldn't take it.

I already have anemia, low vitamin d and low b12 and don't want to have them go any lower with rerouting.

I know many people are fine with DS, I just don't think I'd be one of them.

MsBatt
on 12/27/13 3:09 am

What are you taking to treat your anemia? Is it iron-deficient anemia? Have you tried ProFerrin? It's a heme iron supplement that many people absorb better than other forms of iron. Have you tried sub-lingual B12? Some folks just don't have the stomach for regular B12. (That's a pun---B12 needs intrinsic factor to be absorbed through the digestive tract, and some folks just don't produce enough in the lower stomach. *grin*) And have you tried 'dry' vitamin D? It's a fat-soluble vitamin, normally, but for some folks the water-miscilbe formula works better.

Good luck!

Melanie W.
on 12/31/13 2:37 am - WA

i have whatever the doc prescribed for me for iron, but it kills my stomach and makes me nauseaus. I will have to check out proferrin. I have low storage levels so I need to bring them up and maintain them.

I do take sublingual b12, I would rather get it and inject myself though...from what i've read it helps better.

No I haven't tried "dry" vitamin D...interesting I will have to research that.

TurnThePage
on 12/26/13 9:49 am

Success with WLS  is 20% working with the tool you are given in surgery and 80% "head work". I'd suggest starting by shopping for a therapist specializing in weight loss and work with him/her for a few months before surgery. You have stated a number of points on which you are inflexible and some misconceptions that need to be addressed before you undertake the commitment necessary for WLS to work. This is not a magic bullet that will resolve all your difficulties and the food restrictions and obligatory exercise are not things you are going to like--but you will HAVE to do them regardless of your preferences and feelings.If you do not fully understand and accept this lengthy process, you will be very unhappy.

There is no reason for your surgeon to be your friend or even to recognize you out of context of the bariatric center. He is a technical specialist, which is completely different than a family care practitioner's role. The surgeon will have only a very small role in your health care for a very short period of time (aside from the surgery, perhaps 2 hours of face to face time over a year or two). Take some time before surgery to find and work with the people who will be your real support group. 

Many of the answers to your questions on the program are canned because each doctor has his/her own protocol, which he/she repeats to hundreds or thousands of patients and prospective patients each year---and then year after year after year. Yes, your doctor should be listening to and addressing your concerns, but you can be helpful by differentiating your serious health concerns from a long list of detailed questions about petty stuff. One way to do that is to read and learn as much as you can on responsible websites of major medical groups like Mayo Clinic, Cleveland Clinic, Duke University, etc. Go to the meetings with the doctor's staff and ask lots of questions there.

Meanwhile, use the intervening time wisely to work with a therapist to get to the root of your eating problems, help you unlearn old habits and create new strategies for getting over the inevitable hurdles. When you work through a lot of the issues with a therapist, you will find it much easier to select the right bariatric surgeon and practice for you. Your expectations for the process will be clear and more realistic, so you are likelier to be more accepting of and happier with the results.  Good luck!

Melanie W.
on 12/26/13 10:31 am - WA

I have gone to therapy before and have trouble with portion sizes. I know the surgery is a 'tool' to help not a fix.

I'm not asking a surgeon to be my friend, I want a surgeon that understands and will talk to me as a person.

I do understand I have things I need to do like exercise and watch what I need to eat in the first place.

×