I did some investigation on my potential surgeon

I did some detective work, something I LOVE to do, and found out a few things.

1) My (hopeful) surgeon does the sleeve

2) She is young, 38, but that doesn't bother me because she's had specialized training in laparoscopic bariatric surgery.

3) She works as a team with a nurse practitioner, who does the first visit and most of the follow up.

4) The NP is 48 and I tend to have good working relationships with older women. (not that 48 is old, just older than me)

5) Both the surgeon and NP have family roots in the area. Stability is VERY important to me.

6) they are both in the field because they enjoy helping people change their lives and

7) The surgeon and I grew up in neighboring towns. (Facebook snooping, LOL)

8) They do the seminar and support groups together

8) Their office and the hospital are only 2 miles from me, which is hugely important to me.

9) If their was a complication and the surgeon happened to be out of town I know the rest of the surgeons in the group (I used to work with them) and I fully trust they would be able to take care of me. One of them did my gal bladder surgery, he's a really sweet guy and on my birthday he would come to my office and sing to me. I also worked in the ICU of the attached hospital, on graveyard shift, so I got to see them all in action during crisis situations, not an asshole in the bunch.

I'm sure I'd be also following up at some point with the surgeon, but having a Nurse Practitioner solely dedicated to the batriatric program is a major plus for me. She's the one that coordinates with the insurance companies to get approval. NP usually have more time for questions and are generally more available. Having one person who gets to really know me helps my anxiety level stay low. Not having to wait for the surgeon to get out of surgery to get a question answered is priceless. Having a direct number instead of having to go through the hospital/clinic switchboard is a major plus. When I called to sign up for the seminar tomorrow the number listed was for the NP.

My PCP is in the same office group and with electronic records things like med lists, labs and clinic notes don't have to be faxed back and forth. Electronic records makes things like visits with specialists and pre-surgery admissions a breeze. I am not opposed to going up to the Twin Cities or Rochester if needed, but being so close that I could walk to follow ups saves a lot of hassle.

I have a physical with my PCP schedule for March 11th and I'm sure she'll be supportive of surgery, especially with the family history. I have a stress echo scheduled for next Tuesday. I'm not worried about surgery being approved. I have Medicare and UCare (medical assistance). I may or may not qualify under Medicare, it depends on what the stress echo shows but I qualify under UCare just with my BMI being slightly over 40.

I don't have to worry about taking time off work. Right now the client load is so small I only have 3 hours a week. If it looks like surgery could happen soon I just wouldn't pick up another client until I had sufficient time to heal, my employer is VERY flexible. I have SSDI as my main source of income. I have the UCare because I have a job and they pic up whatever Medicare doesn't so no cost to me, plus they'll pay for vitamin supplements if my surgeon has her patients take them.

Unless I find out something I really don't like I'm going to stick with this surgeon.

Sounds good - and VERY thorough!  Maybe you could hire out your detective skills!

I've thought of doing that. Hmm, more research to do to find out how I could become a private investigator.

Did you ask her how many sleeve surgeries she has performed, what is her leak rate, what is her patients EWL average? I would also find out what size bougie she uses. Get a copy of her eating plan and find out what kind of diet you will be on during weight loss. It's great that you have a good relationship with that group and that you feel comfortable with them, but it's important to have your sleeve done correctly and that you have good follow up as well. That will give you the best long term outcome.

I found a video she did and on there she said 3 weeks of liquids after surgery, then soft foods for awhile. Every post-op visit the nutritionist evaluates what you've been eating and makes necessary adjustments. They do labs at 3 months post op to detect vitamin and mineral deficiencies. She said RNY has an average of 70% EWL, 60% for sleeve and 50% for band. In the vid she did say the RNY is the most common surgery she performs. Patients with the sleeve can eat half a cup up to a cup. Based on EWL alone RNY is what will probably get me into the overweight stage. Something to think about. I see my psychiatrist next week and will ask if my XR can be converted to the non-xr version without much of a risk of destabilizing my depression, which has been under great control. My other medications can be crushed for faster absorption. The surgeon said they have an extensive pre-op program that lasts for a minimum of 6 months and could be as long as 2 years. You have to meet with the dietician 3 times, have several appointments with the team and get any clearances they decide you need. They'll probably want to get cardiology clearance but that's already in the works because of something else. So I could be killing 2 birds with one stone on that one. I don't think I'll need to get GI clearance as I have only minor heart burn caused by factors I can control.

I will ask about leak rate, how many she has done and the bougie tomorrow night.  That is if the blizzard doesn't cancel the meeting. I'm giving it a 50/50 chance. The coordinator said they both live in town so they may still hold it if the roads are iffy, for those who are also in town.

cece, thank you for your questions to ask! They are now on my list.

Here is a link about their long term follow up and other aspects of their program.

http://mayoclinichealthsystem.org/locations/mankato/medical- services/bariatric-surgery/long-term-follow-up

Good luck. You are very wise to do so much investigating. Not all sleeves are created equal and not all follow up plans are either. Sounds like  you have a winner. Keep warm and dry. It's about 70 degrees and sunny here in California. We need a little rain, though.

I'm still researching too.  What does it matter what size boogie is used?  I'm assuming the surgeon will use what is best for me?  Is this something I should ask?

That's all well and good and it certainly counts for something and certainly more than many here on OH........

Personally, I would like all of what you have listed plus...... WL stats that were much closer to 100% EWL

Given the choice I'd go for a Class A Azzhole that has WL stats much higher than 60%...... I'm not looking for a friend or someone who rides the float at the May day parade...... I want results......

If your 300lbs. and want to lose 170lbs. to get you to 130....... on your surgeons program you will be a success and right on his average at around 200lbs.

Make sure your goals and your surgeons goals are similar.

Sure.... sure a few that are going to chime in and say their surgeons average is 60% EWL and they made 100% EWL....... Guess what..... they aren't average.....

The other question to ask is the average regain of his VSG patients that are 3-5 years out.

Keep on doin the research !

frisco

Here is what I wanted to know:

1) How many sleeve's has the surgeon done?  I would not go to anyone that has done fewer than 300.

2) What is the capacity after surgery?  A year after surgery? Three years after surgery?  Anyone who says it doesn't matter hasn't had the sleeve for very long.

3) What EWL percentage do they expect?  I wanted to get to 100%, most doctor's have a percentage closer to 60%.  Why is that?  Hmmm....could it be sleeve size and aftercare program?  You decide.

4) Bougie size?  Some say it doesn't matter, I disagree.  However, there are many other factors that go into making a great sleeve.  If you like to research, why not read about the different techniques used and where the actual cuts are made (especially at the top and bottom).  Also, the curvature of the sleeve makes a difference, and there is so much more.  All of these things are not standard and the results are not standard either.   i would research this above all else and make your choice with prior knowledge.  The sleeves are as different as cars.  You might think you are getting a Porsche but you could be getting a Yugo.  Find out, it's your body and your future.  Do not just assume that the surgeon knows what is best.  Do your own research and than you can ask better questions.  The bottom line, is capacity in the future after the sleeve heals.  I wanted a tight sleeve.... some have other ideas.  You should get what you want.

5) Aftercare program and diet are going to be very important.  What is their plan?  How do people do on their plan?  Does this get you to where you want to go?

6) Years later, when you are navigating maintenance, will they support you and offer you advice and guidance? If not them, than who?  This is not a do it and forge*****pe of thing, you will need support even much later in your journey.  Start thinking about who that person/group will be for you.

And of course, you want to know their leak rate, their complication rate, and you want to compare this to the national average. 

That only gets me past the doctor.....don't even get me started on vetting the hospital.  :)