Looking at two surgeons/programs - self pay (Long)
I've posted before - 60 yo - failed LapBand 2004-2007, self-pay - in northeast Ohio - looking at two COE programs - I've had consults with both the surgeons and now I have to decide. One surgeon/program is $5000 more than the other.
Surgeon #1 - has done over 500 sleeves with one leak - patient is alive and well
Says he will do EGD on surgery day before surgery and he will repair hiatal hernia and when he examined me - found a small umbilical hernia that he will repair at time of surgery - considers me a revision since most likely there will scar tissue from LapBand. Says I can stay 2-3 nights, if I choose, since I am coming from a couple hours away and I am a worry wart, lol. I had some difficulty understanding his accent, this is a teaching hospital - will see fellows or residents after surgery in hospital, not guaranteed a private room :(
I met with dietician before my visit with surgeon. She was quite thorough, even gave me a little quiz to make sure I understood diet requirements.
NO program fee.
*** diet says progresses to regular diet at 77 days after surgery (first mention of lettuce at day 63)
Surgeon #2 - has done over 300 sleeves with no leaks - over 3000 bariatric surgeries
Says he will repair hiatal hernia, doesn't think EGD is necessary, did not find any umbilical hernia upon exam but it is my understanding that hernias are difficult to find in morbidly obese people - so I will have to ask if he will look while in surgery and repair, also says there will be scar tissue from lapband. Says I can stay 2-3 days (again distance is 2 hours) in guaranteed private room. Hospital is private - no residents or students - I will see him post operatively.
Did not meet with dietician but given diet progression by email when i requested it and I noticed to my surprise **** regular diet begins at day 45 (sample menu included salads at day 37) - that kind of scared me
Program fee of $350
I'm guessing you can guess which is more expensive.
Please feel free to comment on : Diet progression differences, number of surgeries performed, importance of private room in hospital, availability of surgeon post operatively, program fees and anything else that I should consider.
I know this long but I keep going back and forth. Made the mistake on the LapBand - expensive and painful and such a disappointing experience - I want the sleeve to work.
Paula
Surgeon #1 - has done over 500 sleeves with one leak - patient is alive and well
Says he will do EGD on surgery day before surgery and he will repair hiatal hernia and when he examined me - found a small umbilical hernia that he will repair at time of surgery - considers me a revision since most likely there will scar tissue from LapBand. Says I can stay 2-3 nights, if I choose, since I am coming from a couple hours away and I am a worry wart, lol. I had some difficulty understanding his accent, this is a teaching hospital - will see fellows or residents after surgery in hospital, not guaranteed a private room :(
I met with dietician before my visit with surgeon. She was quite thorough, even gave me a little quiz to make sure I understood diet requirements.
NO program fee.
*** diet says progresses to regular diet at 77 days after surgery (first mention of lettuce at day 63)
Surgeon #2 - has done over 300 sleeves with no leaks - over 3000 bariatric surgeries
Says he will repair hiatal hernia, doesn't think EGD is necessary, did not find any umbilical hernia upon exam but it is my understanding that hernias are difficult to find in morbidly obese people - so I will have to ask if he will look while in surgery and repair, also says there will be scar tissue from lapband. Says I can stay 2-3 days (again distance is 2 hours) in guaranteed private room. Hospital is private - no residents or students - I will see him post operatively.
Did not meet with dietician but given diet progression by email when i requested it and I noticed to my surprise **** regular diet begins at day 45 (sample menu included salads at day 37) - that kind of scared me
Program fee of $350
I'm guessing you can guess which is more expensive.
Please feel free to comment on : Diet progression differences, number of surgeries performed, importance of private room in hospital, availability of surgeon post operatively, program fees and anything else that I should consider.
I know this long but I keep going back and forth. Made the mistake on the LapBand - expensive and painful and such a disappointing experience - I want the sleeve to work.
Paula
For me, you have not asked many of the relevant questions, or at least you haven't answered the questions I would have before choosing the best surgeon for me.
1) What size boughie do you use?
2) Tell me in detail, how close to you cut at the top and the bottom of the stomach? In other words, what will the capacity of my stomach be when you are done?
3) What are your EWL % and expectations? What percentage of EW to you expect me to lose? In how long?
4) Explain your eating plan, not just for early out, but for the whole losing phase? Maintenance?
5) What support will I have through out this process?
Those are just the first five questions for me.
Paula, this surgery is not standardized. Every doctor makes a different sleeve and their are huge repercussions including sleeve stretching, GERD, nausea and others, if it's not done well. You are right to do more research and to chose wisely.
1) What size boughie do you use?
2) Tell me in detail, how close to you cut at the top and the bottom of the stomach? In other words, what will the capacity of my stomach be when you are done?
3) What are your EWL % and expectations? What percentage of EW to you expect me to lose? In how long?
4) Explain your eating plan, not just for early out, but for the whole losing phase? Maintenance?
5) What support will I have through out this process?
Those are just the first five questions for me.
Paula, this surgery is not standardized. Every doctor makes a different sleeve and their are huge repercussions including sleeve stretching, GERD, nausea and others, if it's not done well. You are right to do more research and to chose wisely.
Elina,
Guess I was just writing what I was seeing as differences. I do so enjoy reading your posts and advice.
!) Both surgeons told me they use size 34 boughie and I was told by both that they do "tight sleeves". Both basically told me that 85% of my stomach will be removed, due to scar tissue from Band - not sure how close at top but both drew me pictures and the stomach looked the same size from top to bottom after cutting. Please tell me what you think those answers should be as far as how close the cut should be, in your opinion. I did watch your surgeon's video when he did the sleeve live online.
3) Surgeon #1 - - said if I followed program, no reason I couldn't lose down to his goal for me which is 180 lbs - I weigh 320 now. The average WL for his patients is 65-70%.
Surgeon #2 - said if I followed program, I should lose all my excess weight - which would be down from 320 to 160 (BMI 25). His patients lose 65-70% also but he reminded me that some patients don't follow the program.
4) Both have given me their diet plans - somewhat similar except for how quickly the progression is. For maintenance they both say 1000-1200 cal, with 20-25 g protein, non-starchy veg and 20-30 g carb per meal but protein first always. Same drinking rules, only 0 cal drinks, no drinking with meals, etc.
5) as for support - they both have monthly support group meetings but because of distance - I will not be able to attend very often and frankly - I did not follow up on what other support would be avaialble post op. That is something I do need to explore more. I do know that surgeon #2 did tell me that the beginning of the year - they have a "graduation" party for all the WL patients at one of the city's large hotels. I did notice at his office - they took my before picture and said they would use that when i graduated to show before and after.
I was also wondering if it is possible to negotiate the price if I choose the more expensive one - wondering how I would go about that and if it is tacky to even try. What do you think about that?
Paula
Guess I was just writing what I was seeing as differences. I do so enjoy reading your posts and advice.
!) Both surgeons told me they use size 34 boughie and I was told by both that they do "tight sleeves". Both basically told me that 85% of my stomach will be removed, due to scar tissue from Band - not sure how close at top but both drew me pictures and the stomach looked the same size from top to bottom after cutting. Please tell me what you think those answers should be as far as how close the cut should be, in your opinion. I did watch your surgeon's video when he did the sleeve live online.
3) Surgeon #1 - - said if I followed program, no reason I couldn't lose down to his goal for me which is 180 lbs - I weigh 320 now. The average WL for his patients is 65-70%.
Surgeon #2 - said if I followed program, I should lose all my excess weight - which would be down from 320 to 160 (BMI 25). His patients lose 65-70% also but he reminded me that some patients don't follow the program.
4) Both have given me their diet plans - somewhat similar except for how quickly the progression is. For maintenance they both say 1000-1200 cal, with 20-25 g protein, non-starchy veg and 20-30 g carb per meal but protein first always. Same drinking rules, only 0 cal drinks, no drinking with meals, etc.
5) as for support - they both have monthly support group meetings but because of distance - I will not be able to attend very often and frankly - I did not follow up on what other support would be avaialble post op. That is something I do need to explore more. I do know that surgeon #2 did tell me that the beginning of the year - they have a "graduation" party for all the WL patients at one of the city's large hotels. I did notice at his office - they took my before picture and said they would use that when i graduated to show before and after.
I was also wondering if it is possible to negotiate the price if I choose the more expensive one - wondering how I would go about that and if it is tacky to even try. What do you think about that?
Paula
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