|
|
Post by deew1234 on Dec 29, 2011 14:56:03 GMT -5
Needing some advice!! Met with surgeon nearly two weeks ago with the expectation of buying Optifast and setting my surgery date!! The surgeon tells me early on in my appointment that I would be better suited having the Biliopancreatic Diversion Duodenal Switch (BPD-DS) double surgery instead of Roux-en-Y!! He says that he does it in two procedures the first would be in March and the second a year and a half from now!! I have been given lots of mixed opinions on this surgery!! Many are saying go for one surgery instead of two, but my surgeon has already told me he prefers doing it in two stages!! I meet back with him end of January after I have my scope done to discuss my final decision on this surgery with him!! I would really like to have some advice from anyone who has had either version of this procedure done!! Any advice or information would be greatly appreciated!!  |
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Dec 29, 2011 15:02:06 GMT -5
Although the decision is ultimately up to you, my preference is that I want to undergo surgery as infrequently as possible. If there was a bona fide reason for doing the DS in two stages that was backed up by other surgeon's opinions, I'd likely do it that way. Bottom line: get another surgeon's opinion to see if that is reasonable.
|
|
|
|
Post by bb212 on Dec 29, 2011 15:05:45 GMT -5
Who is your surgeon- are the on the DSfacts.com list of vetted surgeons? Also what is your BMI?
I'd want the DS all done in one shot (and did), the post-op recovery is rough enough as it is so why go through it twice? It's not fun... Oy... Memories...
|
|
|
|
Post by sandyv63 on Dec 29, 2011 15:13:44 GMT -5
And besides, your insurance will likely only cover one of the two procedures. Your surgeon is correct in advising you to get the DS as it has the best success rate of any weight loss surgery (short and long term) but having it done in 2 stages is unnecessary unless you have a medical reason to do it this way. If you haven't already, check out www.dsfacts.com. You will learn all about this wonderful surgery from those who have gone before you. There is also a list of vetted surgeons who perform this surgery. I'm guessing your surgeon is not on this list but if you are in the state that I think you're in, there is another fine surgeon right in the neighborhood. If I'm wrong about where you live, make the effort to see another surgeon even if you have to travel or see if your current surgeon will agree to do the DS in one procedure. |
|
|
|
Post by deew1234 on Dec 29, 2011 15:14:01 GMT -5
Dr. Reed Guelph Ontario
current BMI 57.6
He informed me at my appointment when I asked why it was two procedures that it is much easier to do the second half of this after I have lost a good portion of weight!! Much easier to rearrange intestines!!
|
|
|
|
Post by Joanne on Dec 29, 2011 15:43:39 GMT -5
Yes and no. First, he is correct that the DS is the best surgical choice at your BMI. It has the best stats for the most weight loss, and the maintenance of that loss. However, the surgery works best when done in one stage. The surgery is very complex, and requires a great deal of expertise, and as such there are only a select group of surgeons that have the experience to perform the surgery. (There is a list of "vetted" DS surgeons at . I'm not familiar with the surgeon you mention, which means he probably doesnt have the experience to do it in one step. I'm a little confused in the wording of his name - is his name Ontario, or are you in Ontario Canada? If you're Canadian I'm not certain of the healthcare system and payments - there are other Canadians here who can help you choose another surgeon. The financial concern on a two step procedure with our US healthcare insurance system is getting insurance to pay for the second part of the surgery, which can be problematic. |
|
|
|
Post by abright0 on Dec 29, 2011 17:25:46 GMT -5
My BMI was almost 67, and my surgeon never suggested two surgeries. I would agree that you should seek a second opinion.
|
|
anewmii
New Member
DS 4/6/2011 HW 445 CW 174
Posts: 42
|
Post by anewmii on Dec 29, 2011 17:33:25 GMT -5
I too started with a very High BMI (76) and had my DS in one step. Although, I did have it done Open. Still, would rather have it performed open than in two procedures.
|
|
lo
Full Member
DS - Dr. Gilberto Ungson - 06/21/2011
Posts: 113
|
Post by lo on Dec 29, 2011 17:50:51 GMT -5
Joanne, her surgeon is Dr. Reed in Guelph Ontario and she is also in Ontario.
deew1234, I am concerned that Dr. Reed wants to do this in two parts. If you lose "enough" weight with just the sleeve then OHIP probably won't cover the second half since you'd be under the BMI that is required. Ask him how many *COMPLETE* DSes he's done. See if you can get in touch with Dr. Hong (?) and talk to PatXYZ on this board about him. I think she is seeing him for her DS.
|
|
|
|
Post by jjthejetplane on Dec 29, 2011 19:27:21 GMT -5
My BMI was much higher and I had mine completed in one surgery, but I had not had any other previous abdominal surgeries. I hope you get to do it in one surgery!
Best of Luck to you
JJ
|
|
|
|
Post by sherbearmama on Dec 29, 2011 19:27:47 GMT -5
Definitely get a second opinion. At least he's opened your mind up to this fantastic procedure!!! Good luck and welcome to the board!
|
|
|
|
Post by Paula on Dec 29, 2011 19:31:51 GMT -5
Do you have an opportunity to be able to get to Montreal? Thats where Dr. Gagner is located and he is well-known for doing the DS.
|
|
joanlaptods
Full Member
DS Mar 9,2011 Dr Gagner
Posts: 192
|
Post by joanlaptods on Dec 30, 2011 10:00:41 GMT -5
I agree check out Dr Gagner in Montreal.
|
|
|
|
Post by deew1234 on Dec 30, 2011 15:42:01 GMT -5
I am really unsure of what to do here!! I do agree with all of you in saying I would much rather have one surgery!! I do know that Dr. Reed will not do it any other way so I guess the question is where do I go from here? Wait for our next appointment at the end of January to tell him to refer me elsewhere?? This is so frustrating and my process has been held up so many times already!! How much longer am I likely to wait to get in with another surgeon?? Another question for everyone who knows OHIP!! I have heard from a few different people that there is a chance OHIP will not pay for the second surgery!! Has anyone personally had this happen?? So confused need more input!! |
|
|
|
Post by sherbearmama on Dec 30, 2011 16:06:43 GMT -5
I have heard of this happening. It didn't happen to me since i had it all at once but I KNOW this has happened many times before you. Do you have to get a referral from this doctor, or can you self-refer to one who is recommended by our veterans?
|
|
|
|
Post by msbatt on Dec 30, 2011 16:08:25 GMT -5
I had a 'complete' DS done with a BMI of 74---I really think you need a more experienced surgeon. I highly recommend Dr. Gagner, if that's possible.
|
|
|
|
Post by Paula on Dec 30, 2011 16:21:13 GMT -5
Im not sure how it works as far as referrals to medical people in Canada goes, but if you dont want to have a two-part surgery and the doctor you are seeing wont do it any other way...I think Id want to look at taking my business elsewhere if it was me.
Each time you have surgery in an area, scar tissue and adhesions form as a result. It can make subsequent surgeries more complicated. Im not sure Id want to go through one part of a procedure and then risk not being able to have the second part later on.
Are you willing to travel for your surgery? If you are, you might want to consult with another surgeon. I believe the surgeons listed on DSfacts.com are all located in Quebec. I know its frustrating to have to maybe wait longer.
|
|
|
|
Post by Joanne on Dec 30, 2011 16:27:02 GMT -5
What people are referring to when we reference the insurance not paying for the second phase of the surgery is that you will lose weight with Phase 1 (the sleeve). What happens many times is that you will lose just enough weight to no longer be morbidly obese - lets say you lose down to a BMI in the mid - high 30's. You will still be obese, probably still have some co-morbidities, but not technically qualify for bariatric surgery coverage. You could be left in limbo.
Not to mention subjecting yourself to two surgeries, and losing the synergy of how both parts work together.
Hopefully others more familiar with Canadian OHIP can give you some suggestions.
|
|
|
|
Post by Sandra C. on Dec 30, 2011 16:43:59 GMT -5
Ask your surgeons office if there is a patient who has gone through this same procedure with them. They could connect you and many of your questions could be answered by their experience. Making a new D.S. friend would be great too!! My surgeons office had this option available, but I didn't take advantage of it. Wish I had- hind sight. Another point to think about are the risks involved with multiple surgeries. Each time you go under anesthesia, with any kind of surgery there are risks. Having one D.S. surgery is better than 2, unless there are medical reasons necessitating 2 parts. My insurance- BCBS of Mi, will only pay for 1 WLS surgery in a lifetime. Not sure if a 2 part falls under this rule, it may because the Doc is asking for it. You have lots to research before signing up with any one. Get a second opinion with another surgeon, always wise!! Good Luck ;-)
Sandra
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Dec 30, 2011 18:00:44 GMT -5
Dr. Reed Guelph Ontario current BMI 57.6 He informed me at my appointment when I asked why it was two procedures that it is much easier to do the second half of this after I have lost a good portion of weight!! Much easier to rearrange intestines!! You need a surgeon with better skills, then. I got mine in one operation with a BMI of 63. I would not accept two surgeries except in the case of dire, as in life threatening, medical need. |
|
|
|
Post by valgroce on Dec 30, 2011 18:59:35 GMT -5
Two surgeries, two recoveries, twice the risk...if your BMI is under 50, then push for a single surgery. Your insurance may not even cover a second wls, your job situation could change and you lose insurance altogether...you just don't know in these times what might happen. Do it now while you can.
|
|
|
|
Post by valgroce on Dec 30, 2011 19:01:52 GMT -5
I'm reading more replies on this thread and even those with higher BMI's way over 50 have had it done in one stage successfully. I would recommend a second opinion too. Is he trying to do it Lap? If so, suggest an open procedure so you're not under anesthesia so long (lap takes longer to do)
|
|
|
|
Post by patxyz on Dec 30, 2011 23:52:18 GMT -5
I think Dr. Reed is new to the DS and may be currently unable to do the DS in one surgery (though he is the head of surgery in Guelph and an accomplished and very experienced bariatric surgeon). Or he may simply subscribe to the philosophy that it is more safely done in two procedures rather than one, some docs are simply of this opinion. Dr. Hong at St. Joe's Hamilton is of the opinion that in high-risk surgical patients that the two shorter surgeries are also safer than one longer surgery, and depending on what the risks are, there are merits to those concerns, but it depends on exactly what the concerns are. Dr. Hong though is capable of doing the DS in one surgery and has performed many of them laparoscopically. If I were you, I would express your concerns about having two surgeries and ask Dr. Reed if he can send you to see Dr. Hong for a second opinion at St. Joe's Hamilton about the safety of doing your complete DS in one surgery. There is also Dr. Gagner in Montreal, but you need special permission from OHIP to be referred to him, whereas Dr. Hong can make the call to do the DS without going through OHIP approval, so I'd start by getting a second opinion from him. Also - we have a Canada specific board here as well if you have questions about the Canadian system, as most people on the main board are American and won't be familiar with our eccentricities  |
|
