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Post by lisalou79 on Jan 5, 2012 22:17:06 GMT -5
OK,
I have to post this information that I just received. Yes, I am throwing a mini fit. But, ultimately, I will do whatever the Dr. wants me to do because I know he is just wanting me to be safe.
Here goes....As some of you may already know I, after much struggle and fight, have accepted that I am a self payer.
I chose Dr. Ungson, based on my research of him, costs, and the glowing recommendation from you folks.
I submitted my health history to him a few days ago and just heard back from Luz.
She told me because of my BMI, 60.4, he will need to see front and side pictures of me to determine my surgery risks. Also, he wants me to consider a TWO-PART SURGERY.
Eh? I. Am. A. Frigg'n. Whale. Or, at least that's how I feel right now.
Ya know, I understand that with being big all my life that there has always been some degree of denial, on my part, as to my whole weight. I knew I was big, but holy shit! I feel like a fucking freak! (sorry for the dramatics but, I mean, DAMN)
Anyways, I didn't know where to go with this new information or the emotions I'm feeling right now...so I posted here.
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Post by vanishingmom on Jan 5, 2012 22:23:24 GMT -5
My bmi was 65 for my ds. Im interested in what the vets say about this. I've always been belly heavy with all my weight in my belly and chest so I'm surprised this never came up for me.
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anewmii
New Member
DS 4/6/2011 HW 445 CW 174
Posts: 42
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Post by anewmii on Jan 5, 2012 22:29:31 GMT -5
Lisalou, I had a BMI of 76 (445lbs) I was still able to have my surgery in one step. It had to be open, but it was so worth it. Good luck. I was also a self payer.
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Post by abright0 on Jan 5, 2012 22:33:44 GMT -5
BMI 67, surgery in one stage. Not sure why they would say two with your BMI.
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supershae
Full Member
"You have come this far, Don't give up now." -The Notebook
Posts: 154
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Post by supershae on Jan 5, 2012 22:34:51 GMT -5
My BMI was 64 when I had my surgery a week ago. I didn't have to have a 2 part surgery...although my surgeon did say that some people do have to do a 2 part. It just depends on how well you do with the first part.
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Post by charlee on Jan 5, 2012 22:36:43 GMT -5
BMI 63 - 1 part Lap DS. That just sounds...odd.
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Post by Dudette on Jan 5, 2012 22:37:56 GMT -5
Dang! That sucks! My highest BMI was 46. I dieted my ass off to get ready for surgery (my choice, not a requirement imposed by either of my surgeons) and went into the surgery with a BMI of 43.
After re-reading your post I noticed he said he wants you to *consider* a two part surgery. Well, you could always say "No. I want it all at once." and see what he says.
I would go ahead and send him those photos. It's just another minor hoop to jump through. I would also start on some sort of diet or exercise regime now. Not a huge diet, just try to get moving in the right direction. Start walking more and boosting your fitness. See if you can get your BMI down into the 50's. It can't hurt. The more you can lose before the surgery the less risky the surgery will be. Hope this info helps. Don't give up and hang in there!
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Post by bb212 on Jan 5, 2012 22:42:22 GMT -5
Lisalou- I'm so sorry!
But considering how many DSers here had theirs done in one step having a BMI similar to yours, you may want to get a second opinion from a DS doc in the states. A fair amount of the good ones also take self pay, but it would be higher than Dr. Ungston. But everyone can agree the DS is worth every penny!
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Post by lisalou79 on Jan 6, 2012 0:44:09 GMT -5
Hey, thanks everybody for your feedback. I took the front/side pics and e-mailed them to Dr.'s coordinator along with a list of questions I had.
I asked if things would change if I lost weight, how long between surgeries, costs for each surgery, etc. I'll have to wait and see what the Dr. says but if he thinks it's safer, and please correct me if anyone has doubts about Dr. Ungson from personal experience, I will trust his opinion because I heard he usually is one to accept higher risk patients even when others turn them down.
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Post by bb212 on Jan 6, 2012 1:01:32 GMT -5
Ungston has a great reputation. However there are surgeons with self-pay programs in the states who are just as good that may have a different opinion. So while Ungston is reputable and well respected, get a second opinion rather than taking Ungston's opinion as the final say. There are plenty of people who have gotten the DS in one step with a high BMI and they're doing just fine. DC also posted info from two medical studies on another thread with some hard statistics that show the one-step wasn't any more dangerous than the two-step.
Also did Ungston ask for blood test results, and EKG and an endoscopy (upper GI) from you? Or was his evaluation based on the photos alone with some basic info (weight, height, age, co-morbidities?).
I was a long distance patient for Dr. Stewart (self-pay) and he wanted these tests done before giving me a "yes" or "no", as they offered some insight into my overall state of health. I'm just wondering if Ungston was as thorough in looking at your medical information before offering his opinion on the two-stage option.
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aronsmom
Junior Member
Have band-want DS
Posts: 68
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Post by aronsmom on Jan 6, 2012 1:02:47 GMT -5
Keep your head up Lisalou. This is just the beginning of your journey, and even though there may be some bumps along the way, you'll look back and be so proud of how strong you've been and how far you've come. You are strong, and will get through this!
I agree with the other posters, see if there are other self pay docs that will do a one surgery DS.
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Post by vangy04 on Jan 6, 2012 1:09:14 GMT -5
Dr. Ungson is in Mexico, right? Have you considered Dr. Marchesini in Brazil? I believe the prices would be about the same, especially if he's wanting you to do it in two parts, which would be double the expense of flying and such. In September of 2010, I paid just under $20k and that included everything -- surgery (w/gallbladder removal), hospital stay, post-op private nurse, anesthesia, pre-op testing, hotel for almost 3 weeks, 2 round trip plane tickets, tourist stuff, and food. I sent a couple of e-mails, pictures that were requested, and had a date set in less than a month from initial contact.
I hope it works out the way you want it to! Good luck.
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Post by pattyl1 on Jan 6, 2012 1:30:51 GMT -5
Buchwald, Rabkin, Baltasar and others have done the full DS on people weighing over 800lbs. I think Rabkin even did it LAP.
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Post by lisalou79 on Jan 6, 2012 1:39:08 GMT -5
Thanks again everyone for the great feedback. I am definitely keeping my options open and will get a second opinion on my case, not sure what Surgeon yet.
As for how this information unfolded with Dr. Ungson, I submitted my health history which included my current BMI, height, weight as well as my prior surgeries.
I just posted on the other thread, regarding 2-part DS, that one thing I need to consider in my case is that I have a history of 3 C-sections and one appendectomy. This coupled with my high BMI may put me at an even higher risk for a longer surgery than just having a high BMI.
I'm not male, of course, but I did see in the one research finding conclusion where it stated
"Despite these variables, performing a sleeve gastrectomy first should be considered for heavier, male, and at-risk patients."
I can't be certain what constitutes as " at-risk" in this matter, but I have read where having abdominal scar tissue can cause a longer operation and with a higher BMI patient, surgeons tend to want to avoid a longer surgery.
Well, my brain is fried! I am going to have to sleep on this and start again tomorrow. Thanks to all for your support and feedback!
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Post by lisalou79 on Jan 6, 2012 1:44:21 GMT -5
oops, forgot to add that Dr. Ungson made this decision based on the quote below, taken from the reply e-mail sent from Luz today.
"He went over your medical history and he said based on your BMI he would need to see front and side pictures of your body; it is very important for him to see how your weight is distributed in order to determine the risk of surgery. He also told me to mention if you would be willing to consider a two stage surgery. I understand this may be a stressful but please keep in mind that our first priority is always patient safety and always have to be honest about what the safest option is for each case."
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Post by smokinstella on Jan 6, 2012 10:39:57 GMT -5
I am going to be getting my DS open with Dr.Buchwald in march, he wasn't at all worried about the fact I had 2 c-sections. Said he could just deal with it when hes in there if there are any issues from those previous surgeries.
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Post by larra on Jan 6, 2012 10:55:18 GMT -5
I hope things work out for you with Dr. Ungson. But if not, there may be another good self-pay option for you in the states if you can get your bmi below 60 - and you're really close to 60, so that should be do-able. I have no idea how to do a pm on this sparkly new website, but you can pm my back on good old OH for details.
Larra (same name on OH)
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Deleted
Deleted Member
Posts: 0
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Post by Deleted on Jan 6, 2012 12:30:22 GMT -5
I hope things work out for you with Dr. Ungson. But if not, there may be another good self-pay option for you in the states if you can get your bmi below 60 - and you're really close to 60, so that should be do-able. I have no idea how to do a pm on this sparkly new website, but you can pm my back on good old OH for details. Larra (same name on OH) PMs: there is a little envelope under the person's name - that goes to the PMs. And up top, next to the banner, there is a box that says (for me) "Hey, DianaCox, you have 75 messages, 0 are new." The word "messages" is a hotlink to your inbox.
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Deleted
Deleted Member
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Post by Deleted on Jan 6, 2012 12:56:13 GMT -5
Did you ask for lap surgery, or open?
Consider Dr. Marchesini if you are a virgin DSer. He has done a LOT of surgeries on people with much higher BMI's than your's and they also had several health risks.
Dr. Stewart in Denton, Texas is another with a good self-pay price and lots of experience.
Both of the surgeons that I mentioned above will probably want your surgery to be open, even though they do offer lap.
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Post by lisalou79 on Jan 6, 2012 14:40:54 GMT -5
I e-mailed both Dr. Marchesini and Dr. Stewart and I'm waiting for a response.
I asked for open as it is cheaper.
I am leaning away from Dr. Marchesini, though, not because he isn't a wonderful surgeon but because of the statistics on developing a pulmonary embolism from the long flight (it would be almost 14 hours for me)
I know of two deaths of people who did travel long plane rides to have their DS with Dr. Marchesini. To me, I am not willing to take this risk when their are closer self pay options.
I just feel like I keep trying so hard to have this life saving surgery and every door keeps getting slammed in my face. Well, nothing worth doing is easy I suppose.
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Post by jjthejetplane on Jan 6, 2012 15:08:17 GMT -5
I was way over a 60 BMI and I had one procedure, however I was asked and did hold myself to a strict, "shrink your liver" diet 2 weeks prior, but did warn that it would be a possibililty of 2 procedures if my liver was too fatty. They said they had plenty of room to maneuver and did it one procedure. It was done lap. I was quite the grouchy bear the 2nd week of the "detox." I lost 22 lbs. JJ
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Post by aa on Jan 6, 2012 15:09:06 GMT -5
I know several people who've had the DS in 2 stages. The surgeon felt it was safest for that particular patient. It's not odd, nor rare if your surgeon feels that way.
Definitely look around as others suggested, but remember you're not alone in people who have had it done in 2 parts.
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Post by sherbearmama on Jan 6, 2012 15:40:09 GMT -5
I can't speak to the high BMI since I was a light weight pre surgery but I will say this...regardless of the doctor you end up using, I would still try and loose some weight before going in for the DS. I lost 25 pounds pretty easily before surgery. I began walking (if I had a pool or access to one I would have swam instead) and I started drinking protein shakes to substitute some of my meals. My recovery was so easy and I have to believe that making the effort to stock up on protein and get my heart a little stronger made all the difference. I began losing weight in August and by October I'd lost 25 pounds. By December when I had my surgery I was back up by two pounds or so but the doctor was thrilled that I was getting so in shape before surgery. I wish you luck!!!! But I'm sure this will happy for you with which ever doctor you chose. Hugs, Sheri
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Post by Girlrocker on Jan 6, 2012 16:09:01 GMT -5
Please don't feel like the door is being slammed on you, or beat yourself up over your BMI/weight. You're taking a positive step to get healthy. But you also want to take it all the way. From what you wrote, it sounds like a 2-step surgery was a suggestion, and that based on your BMI, he just wants to get more medical information on you. There are many factors that must be taken into consideration about your health, body type, to determine what's best for your particular surgery. It's the same data they use to determine whether or not lap or open is the better route. I'm a recent revision patient, RNY to DS and also considered a light weight (start weight 240, highest weight 314) I went through the ringer with my RNY, 2 additional surgeries in one year. And then 9 years later I decided I'd had enough since the RNY was a failure for me, to pursue the surgery I knew all along was the right one, but couldn't get approved back then. No one wants to have more than one surgery if we don't have to, and I certainly preferred lap to open, but I knew it had to be open due to the scope of the revision I had done. So in the end, it's whatever is going to be best for your health; and if after you send your in your information, and he wants to do it in 2 steps, you can decline, see what he says. Getting the second opinions is a good idea, I had a total of 3 consults about a revision. I know how much you want this, and want it yesterday, but make sure you do the best for you, this is a big step, and you're worth it!
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Post by lisalou79 on Jan 6, 2012 17:30:43 GMT -5
Thank you all for the continued support. I did hear back from Luz and Dr. Ungson reviewed my front/side pics.
Ultimately, he told me he is willing to do my surgery-all-at-once if I commit to losing weight to get my BMI down, starting today, until the day of surgery.
I respect Dr. Ungson's decision and was given options to either find a Nutritionist here to work with or I could work directly with him. Either way, I have to lose weight before surgery.
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Post by Dudette on Jan 6, 2012 18:30:41 GMT -5
Lisa,
It would seem that Dr. Ungson asking you for the photos just further demonstrates that he's a good, conscientious surgeon and not just a yes-man. Don't stress too much over losing some weight before surgery. I did it and it wasn't that hard. It just took a few minor changes in my diet and my daily activity level. Plus, once you get on the liquid pre-op diet (about 5 to 7 days before surgery) you can't help but to lose weight. I lost 10 lbs. on that alone!
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Post by lisalou79 on Jan 6, 2012 18:43:50 GMT -5
Thank you Dudette. This has already been a long journey for me from making the decision to have WLS to finding a way to finance a self pay surgery. I guess this is just one more bump in the road on my journey but I know it is worth every bit of struggle I have to go through.
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momx4
Full Member
Posts: 162
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Post by momx4 on Jan 6, 2012 19:23:11 GMT -5
Hang in there!
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Post by Girlrocker on Jan 6, 2012 20:21:05 GMT -5
Glad to hear it! Dudette is right, losing weight before surgery isn't so hard, especially if you look at it as getting yourself in the best health you can before you have major surgery instead of dieting. If you drink sodas, juices, energy drinks with sugar, cut those out. If you use full mayo, butter, salad dressings (and you'll be able to again as a post-op) use low-fat/calorie. Half the bun instead of a whole bun, small size portions instead of large kind of thing. Some walking, and yes, with the pre-op liquid diet, you'll also lose. This is not a bump but a hoop to jump through to get to the other side, and it's worth it!
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Post by Dudette on Jan 6, 2012 20:37:38 GMT -5
Glad to hear it! Dudette is right, losing weight before surgery isn't so hard, especially if you look at it as getting yourself in the best health you can before you have major surgery instead of dieting. If you drink sodas, juices, energy drinks with sugar, cut those out. If you use full mayo, butter, salad dressings (and you'll be able to again as a post-op) use low-fat/calorie. Half the bun instead of a whole bun, small size portions instead of large kind of thing. Some walking, and yes, with the pre-op liquid diet, you'll also lose. This is not a bump but a hoop to jump through to get to the other side, and it's worth it! Exactly! I wish I would have said it this well. Here's some karma for you, Girlrocker!
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