Question:
I am having trouble deciding between a lap RNY vs Open Rny and doctors please help.

The thought of conventional open surgery scares me to death!!! The reason due to a previous very painful recovery experience in 88 with an old Gallbladder surgery. This surgery took a year to recover from. The whole experience left me extremely fatigue, depressed, and painful!! I'm just the kind of person who takes such a long time to heal and regain my strength after conventional surgery and have a low tolerance for pain. I was just 25 then vs 42 now much thinner then 230lb. vs 330 now, so surgical risk are compounded due to weight. Please help me decide I could have the open with Dr. Appel in Atlanta and my insurance would cover most all cost except co-pays. The lap procedure is Dr. Champion also in Atlanta but my insurance will pay 70% with a larger out of pocket expense because he is out of network. The insurance is a factor but my health and long term success are the most important. If anyone has any advice or has had similiar dilemma or experience with either deciding on procedures or surgeons please tell me how you decided. I am really overwhelmed and this is such an important life decision. I want to make the right choices thanks to all any constructive advise is greatly appreciated.    — [Anonymous] (posted on August 24, 2000)


August 23, 2000
I would like to respond to you privately in regards to your choices of physicians. There is another doctor in Atlanta that does the Lap RNY at Emory and I will be glad to share this with you in a private e-mail. My e-mail is [email protected]
   — Terry M.

August 24, 2000
One of the reasons why I chose a lap procedure was because I have fibromyalgia. I wanted to minimize the amount of pain now to avoid problems with fms later; also I reasoned that a lap operation would be easier to recuperate from and would minimize the drain on my energy. Luckily the copay was not an issue for me; what was a determining factor was the time required to be off work, as at the time I was working for Computer Associates. Their short term disability policy only pays a 50% of salary up to a maximum of $170 per week; needless to say the maximum was far below my salary. I could not afford to be off work any longer than necessary without income, so the lap enabled me to return more quickly. I also had my gallbladder at that time. The pain from the two surgeries combined was such that the area surrounding the gallbladder was much more tender and took longer to feel "right" than the RNY sites. I also felt I could return to normal activity with several small incisions faster than I could with an open; plus, I tend to have keloid formation around scars and wanted to have the scar as small as possible.
   — Joyce L.

August 24, 2000
As you said "The insurance is a factor but my health and long term success are the most important." Go with what your instincts tell you to do. I chose to have the open RNY w/ Dr. Appel because I was paranoid that something would be "missed" w/ the LAP procedure. None of this was based in real fact, just my paranoia. I had also heard in my support group of doctor's finding cysts, cancer, etc during open surgeries. I actually didn't think the pain was that bad. But then again, I had built it up so much in my mind that ANYTHING would have been anticlimatic. Good luck with whatever you decide!
   — Maxine E.




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