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Post by actiongirl on Jan 6, 2012 15:31:41 GMT -5
Just got back from my gastroenterologist consult. I was referred to this guy from my 1st, non-DS performing surgeon before I was sure I wanted the DS and switched to seeing Dr. Eleriny. I kept these previously scheduled appts since I'm 95% sure I'll have to do them for WLS, no matter whom I choose to see.
Ok, the PA came in and asked a bunch of routine questions including about who referred me and why. I told her the lowdown and she asked which surgery I was getting. I told her the duodenal switch. She said, "That's like the Roux-en-Y, the bypass, right? I told her no, it was more "like" a combo of the sleeve and the RNY, but was really it's own surgery. "But it's just the switch, so you won't have a staple line, right?" Sigh. Then, the Dr. came in commenting about how I don't need such a drastic surgery, that a switch will make me "a tiny little thing" and asking which Dr. I planned to go to. He said he'd be shocked if Dr. Eleriny performed a switch on me. I explained that I WAS on the lower end of the BMI, but that I have been obese for 10+ years, have insulin resistance, asthma, and probable apnea (exam scheduled) and am ready to handle my obesity head-on. We got on with the exam and I'm scheduled for the EGD later this month. He walked me out to reception, still offering that a switch was "too much" for me, that's usually for BMIs 50+.
At first I was angry and felt foolish. I gave myself a little while to calm down and now I'm just irritated. First of all, I'll take my WLS advise from a WL surgeon, not a gastroenterologist whose PA doesn't know "the Switch" includes getting a staple line, regardless of the fact that I was referred to his office from my previous potential surgeon on the referral pipeline of patients set to get WLS. I was excited because today was the 1st of my referrals and this guy is only causing me to doubt myself. I'm 221, 5'4". I know I'm a lightweight and to make matters worse (for my WLS case) I carry my extra weight well, but will I qualify for WLS? I know it's a drastic step to achieve a normal BMI, but losing weight has not been for a lack of trying on my part. I have done everything and NOTHING works. What if no surgeon will perform the switch on me? I would maybe consider a VSG if Dr. Eleriny strongly suggests it instead, but I want the DS. I'd probably just pursue another vetted surgeon somewhere else, to be honest. I just don't see the point in settling for less than the most effective tools to help me lose my extra weight.
I remember reading somewhere (maybe in the insurance guidelines on DSfacts?) about just staying vague with people about which surgery you plan to have until you actually get approved by insurance for WLS and get to your surgeon. Lesson learned. From now on, I'm going to appear non-committed to a specific procedure with everyone involved, except for with Dr. Eleriny. Maybe I should just tell them I'm getting the Lap-Band - that ought to pacify them.
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Post by Sandra C. on Jan 6, 2012 15:45:29 GMT -5
I had similar conversations, but didn't let them bother me, because they didnt have the background to have a valid opinion. I was 30 lbs more than you are now. My D.S surgeon said with my hip arthritis I didn't need to be that high a weight for a D.S. I could have had more time to diet before the surgery, and still qualified for insurance, which paid all my expenses, other than food replacement supplements required by my surgeon, pre surgery. You can travel to a D.S. surgeon, like mine. He's great!! See my post info below for his name and location. I would have traveled any where for my surgeries. Had Hysterectomy this year too. Looked into traveling, hotel close by hospital. They are used to people traveling, have ideas to make it easier for you. Ask the bariatric coordinator, they have the best connections to get you what you need. Are you in North Virginia? So close to many great hospitals, drivable distances. Johns Hopkins? New York, Wash DC.... look for more D.S. surgeons they are out there.  |
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Post by shann_ds on Jan 6, 2012 16:48:06 GMT -5
I don't think being a light weight should rule out a DS as long as you are willing to follow the rules. There's a lightweight board you can post to here & they can help you with more specifics. Although I wasn't one, I did have to fight for my DS and convince my surgeon that it was the right surgery for me. His first opinion was that it was too "extreme." Good luck & hold out for what you want!
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Post by ynona74 on Jan 6, 2012 18:52:31 GMT -5
I too am a light weight. I am 242 5'5" and want the DS. I don't think you should doubt yourself, and as long as you are up front with ALL involved I think you should be honest to whoever you see that you WANT the DS. Good luck with your next scheduled visits. Keep us posted.
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Post by majormom on Jan 6, 2012 18:52:44 GMT -5
All Dr Elariny will need to know is that you know what you're getting into, you're a grazer and get 70% of your calories from snacks, your metabolism is hosed, you do know how to follow orders but you'll be following Vitalady's vitamin plan, and you've got a great network of fellow DSrs that live close by and you're online with every day. ;D
You're a LW so expect to hear, "you aren't big enough...blah, blah, blah" from other medical professionals. Dr E really does love the DS and will do them for LWs who know their stuff. The ultimate decision is yours.
--gina
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Post by sandyv63 on Jan 6, 2012 20:59:56 GMT -5
I was only 226 when Dr. K did my lap DS so I'm a lightweight as well. He never suggested it was too drastic for me and I promise you, I am not wasting away. I also didn't look my weight and while the average Josephine didn't think I needed WLS, I knew better. If you diet and it does not work, you have metabolic issues and you'll be looking to revise to a DS if you go with a sleeve. Go elsewhere if your surgeon gives you grief. Your body - your decision. You know what you need. Now make sure you don't settle.
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Post by zoetrope on Jan 6, 2012 21:19:40 GMT -5
I was only a little heavier when I had RNY and then DS revision.
Do what you have to do, including being a little bit evasive with these folks along the way about which surgery (which they probably won't understand anyway).
I only had the RNY in the first instance (2004) because my doc at the time didn't believe in performing the DS on people under 50 or 55 BMI. My bad for not investigating further at the time. Abandonment when stoma failed before year one without bad behavior on my part. I ate like a freaking bird. Fast forward *seven* years to revision.
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Deleted
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Post by Deleted on Jan 6, 2012 23:00:12 GMT -5
My approach to doctors is pretty damned direct (I know that just blows you away with astonishment LOL). If I'm talking to a doc who purports to have an opinion about what I've done to myself, it takes me about ten seconds to shut him/her down with a reminder that I am providing my medical history, NOT asking for their advice on something I clearly know more about than they do.
My response in your place would have been, "I am here for abc, NOT to seek your input on the subject of bariatric surgery." Followed by the patented EN stare. If that didn't work, I'd walk out. I am a paying customer and you will treat me like one OR ELSE.
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Post by actiongirl on Jan 6, 2012 23:05:51 GMT -5
I've heard of potential DS patients, especially lightweights receiving grief from other doctors, but I'm still in the honeymoon phase of just finally deciding to get the DS and wasn't quite prepared to have someone pee all over my hopes. Actually, SINCE I carry my extra weight so well, have never really been victim of fat-shaming, and have ONLY ever gotten encouragement for my weightloss efforts, it was quite the rude awakening to have someone "correct" my stated weightloss intentions. Although I'd been warned through my research, I was completely unprepared to defend my position so soon in the process.
ETA: Reading back thru this post, most of the avatars are cute furry animals. It's comforting to imagine all these soft puppies & kitties are consoling me after a bad day! ;D
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Post by SLVinNorCA on Jan 6, 2012 23:17:08 GMT -5
My approach to doctors is pretty damned direct (I know that just blows you away with astonishment LOL). If I'm talking to a doc who purports to have an opinion about what I've done to myself, it takes me about ten seconds to shut him/her down with a reminder that I am providing my medical history, NOT asking for their advice on something I clearly know more about than they do. My response in your place would have been, "I am here for abc, NOT to seek your input on the subject of bariatric surgery." Followed by the patented EN stare. If that didn't work, I'd walk out. I am a paying customer and you will treat me like one OR ELSE. >weg< |
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Post by Deleted on Jan 6, 2012 23:30:23 GMT -5
My approach to doctors is pretty damned direct (I know that just blows you away with astonishment LOL). If I'm talking to a doc who purports to have an opinion about what I've done to myself, it takes me about ten seconds to shut him/her down with a reminder that I am providing my medical history, NOT asking for their advice on something I clearly know more about than they do. My response in your place would have been, "I am here for abc, NOT to seek your input on the subject of bariatric surgery." Followed by the patented EN stare. If that didn't work, I'd walk out. I am a paying customer and you will treat me like one OR ELSE. >weg< 1. Tone of voice is important. Be sure to keep your voice in the lower octave. Squeaking with rage doesn't work as well as using the sonorous, authoritative baritone. Those of us inclined to cussing and shrieking have to practice this  . 2. Practice setting your square cowboy jaw. Watch a couple old Gary Cooper Westerns to see how it's done. Remember to keep your tongue out of the way because biting your tongue at the moment of clicking jaw ruins the effect. 3. Put your shoulders down and back. Ask a military person to demonstrate the position of attention for this. (Helps to be married to one.) 4. Keep your hands open. You might puncture your hand with your fingernails if you don't make a point of doing this. Three guesses how I know. 5. Dip your head down a little so you don't get a neck spasm. Those hurt for a long time. 6. Take your time finding the person's eyes and locking on them. If necessary, declare, "Excuse me!" to gain yourself the necessary second or three of silence for this. 7. Do. Not. Blink. 8. Have your line rehearsed. Better yet, spend some time thinking up a few different possible responses so you have some clue in advance of what you want to say to the asshole. 9. Deliver your line with spaced words and sentence punctuation. Make sure your voice gives a period at the end of the sentence, not a question mark or an exclamation point. 10. Stare. Do not say anything more. Stare. This is hard. But the next person to speak "loses," so you need to hold your ground. 11. Give yourself recovery time afterward, preferably with a place to have a spiritual beverage and rant like a maniac. |
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Post by abright0 on Jan 6, 2012 23:39:48 GMT -5
My approach to doctors is pretty damned direct (I know that just blows you away with astonishment LOL). If I'm talking to a doc who purports to have an opinion about what I've done to myself, it takes me about ten seconds to shut him/her down with a reminder that I am providing my medical history, NOT asking for their advice on something I clearly know more about than they do. My response in your place would have been, "I am here for abc, NOT to seek your input on the subject of bariatric surgery." Followed by the patented EN stare. If that didn't work, I'd walk out. I am a paying customer and you will treat me like one OR ELSE. Totally Exalted! I have fired four doctors this past year. I don't even play. It's either listen to me, know that I know MY body (or that of my spouse), and deal with the fact that I have more knowledge about my medical conditions than you. |
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Post by Happy DSr on Jan 7, 2012 0:34:27 GMT -5
EN - I admire your ability to respond to medical folks with such directness.
Here is Canada, we are continually under-serviced with qualified doctors. With long waiting lists and medical professional scarcity, we have to be grateful for what we get, even if some of then are obnoxious idiots. I have been amazingly lucky to have several open, intelligent professionals, but I know others that have had to take what they can get. I look forward to the day that we have so many resources we can demand the best
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Post by Happy DSr on Jan 7, 2012 0:35:19 GMT -5
I just noticed my post count - so here is number fifty. Hurray!
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Psyche
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DS ♦ 08/06/2009
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Post by Psyche on Jan 8, 2012 2:57:36 GMT -5
Takes notes for future medical appointments >weg< 1. Tone of voice is important. Be sure to keep your voice in the lower octave. Squeaking with rage doesn't work as well as using the sonorous, authoritative baritone. Those of us inclined to cussing and shrieking have to practice this . 2. Practice setting your square cowboy jaw. Watch a couple old Gary Cooper Westerns to see how it's done. Remember to keep your tongue out of the way because biting your tongue at the moment of clicking jaw ruins the effect. 3. Put your shoulders down and back. Ask a military person to demonstrate the position of attention for this. (Helps to be married to one.) 4. Keep your hands open. You might puncture your hand with your fingernails if you don't make a point of doing this. Three guesses how I know. 5. Dip your head down a little so you don't get a neck spasm. Those hurt for a long time. 6. Take your time finding the person's eyes and locking on them. If necessary, declare, "Excuse me!" to gain yourself the necessary second or three of silence for this. 7. Do. Not. Blink. 8. Have your line rehearsed. Better yet, spend some time thinking up a few different possible responses so you have some clue in advance of what you want to say to the asshole. 9. Deliver your line with spaced words and sentence punctuation. Make sure your voice gives a period at the end of the sentence, not a question mark or an exclamation point. 10. Stare. Do not say anything more. Stare. This is hard. But the next person to speak "loses," so you need to hold your ground. 11. Give yourself recovery time afterward, preferably with a place to have a spiritual beverage and rant like a maniac. *cackles* Spiritual beverage. I love that! I usually call it medicinal. |
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Post by Girlrocker on Jan 8, 2012 5:17:49 GMT -5
I love the responses on this post  I'm a lightweight too - RNY 9 years ago, revised to DS 3 weeks ago, at 240. I've learned many many things throughout this journey. The day I decided to pursue surgery after spending more than half my life struggling with obesity was the day I acknowledged my own self-worthiness. And I learned when I would share and when I wouldn't. Not because I have anything to hide but because I don't want to waste my time and energy :-) When I decided to explore the possibility of a revision, I saw Dr. Keshishian first (after researching and, seeing he was in my insurance network) I also saw the WLS specialist my primary care wanted me to see - Dr. Quilici - who was in the same hospital, and who does indeed have a fine surgeon reputation, formerly at Cedars. Dr. Quilici wanted to put a lapband around my RNY pouch. And for a split second I thought about it - I had such a bad time with my RNY and complication surgery following, that the fear of surgery again kicked in briefly. But I got past it quick. And what I told Dr. Quilici was the solution for me was not going to be putting in a foreign object in my body - and a surgery option I never wanted in the first place - around a surgery I was so unhappy with. I didn't want the RNY anymore. What he was proposing was not a revision. And when I went back to my primary, I repeated same, told him I decided to go with Dr. K. He looked at me and said, I'm not familiar with him, but you've done your homework? I said yes, I have. He said, you need a rockstar to do this surgery, I said I knew that and I had found one. :-) The first time I met Dr. K was the thunderbolt moment - he told me my obesity is not my fault, and my problems are not measured solely in the weight number, but my entire history of the struggle. Check out the lightweight board, the first post is the Lighweight Credo and it's great. It's hard not to feel wounded by words sometimes, it's a very emotional decision, everything right on the surface, very vulnerable. Stand firm, ya done good. |
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I'm a lightweight too - RNY 9 years ago, revised to DS 3 weeks ago, at 240. I've learned many many things throughout this journey. The day I decided to pursue surgery after spending more than half my life struggling with obesity was the day I acknowledged my own self-worthiness. And I learned when I would share and when I wouldn't. Not because I have anything to hide but because I don't want to waste my time and energy :-) When I decided to explore the possibility of a revision, I saw Dr. Keshishian first (after researching and, seeing he was in my insurance network) I also saw the WLS specialist my primary care wanted me to see - Dr. Quilici - who was in the same hospital, and who does indeed have a fine surgeon reputation, formerly at Cedars. Dr. Quilici wanted to put a lapband around my RNY pouch. And for a split second I thought about it - I had such a bad time with my RNY and complication surgery following, that the fear of surgery again kicked in briefly. But I got past it quick. And what I told Dr. Quilici was the solution for me was not going to be putting in a foreign object in my body - and a surgery option I never wanted in the first place - around a surgery I was so unhappy with. I didn't want the RNY anymore. What he was proposing was not a revision. And when I went back to my primary, I repeated same, told him I decided to go with Dr. K. He looked at me and said, I'm not familiar with him, but you've done your homework? I said yes, I have. He said, you need a rockstar to do this surgery, I said I knew that and I had found one. :-) The first time I met Dr. K was the thunderbolt moment - he told me my obesity is not my fault, and my problems are not measured solely in the weight number, but my entire history of the struggle. Check out the lightweight board, the first post is the Lighweight Credo and it's great. It's hard not to feel wounded by words sometimes, it's a very emotional decision, everything right on the surface, very vulnerable. Stand firm, ya done good.