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Post by jojo99 on Apr 28, 2015 22:02:24 GMT -5
I thought I saw a thread on this somewhere. If someone could direct me to it, that would be great. I thought I saw a letter or something you could give to your PCP.
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Post by goodkel on Apr 29, 2015 1:18:30 GMT -5
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derinoe
Junior Member
Posts: 75 
Surgery Type: DS
Surgery Date: 06/04/2014
Surgeon: Dr. Marek L.
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Post by derinoe on Apr 29, 2015 11:02:05 GMT -5
You could get your surgeons office call and talk to your PCP, and as for me I would make an appointment and go over each little detail with them personally. Its a huge change and you need to make sure they have all the information.
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Post by jojo99 on Apr 30, 2015 22:12:57 GMT -5
Thanks so much. I found some good info and printed it all and took it to my PCP. I had discussed the idea of WLS with her before. When I told her I wanted the DS, she was pretty vocally against that idea and said the bypass was better. She said everyone she knew who had the sleeve or DS has failed. I was shocked. I asked if she was sure she knew the right surgery. She was still very supportive though and encouraged me to do what I thought was right for me. I asked about labs and such but she said they didn't do any WLS follow-up and that I would follow up solely with the WLS center/ie: surgeon. That just didn't sound right to me. I know I will follow up with him for the actual surgery recovery, but will I see Dr. Sudan twice a year for labs forever?
I left pretty confused, but she took all the info I had and said she would read it. I'm still not convinced she was talking about the right surgery. I mean, can you really actually fail on the DS? With the malabsorbtion, it seems to me you'd actually have to be trying pretty hard to NOT lose weight. And, I would imagine it would be based on what you were eating (carb heavy?). If a person was eating like that, I figure they would have probably failed at any of the WL surgeries.
My PCP is actually really awesome and I think she will be on board when she understands it better. I also think she will do the labs for me in the future if I need her to. She basically said so (hush, hush).
Has anyone ever heard of mass failure with the DS? Is my PCP just crazy?
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Post by goodkel on May 1, 2015 4:30:17 GMT -5
Thanks so much. I found some good info and printed it all and took it to my PCP. I had discussed the idea of WLS with her before. When I told her I wanted the DS, she was pretty vocally against that idea and said the bypass was better. She said everyone she knew who had the sleeve or DS has failed. I was shocked. I asked if she was sure she knew the right surgery. She was still very supportive though and encouraged me to do what I thought was right for me. I asked about labs and such but she said they didn't do any WLS follow-up and that I would follow up solely with the WLS center/ie: surgeon. That just didn't sound right to me. I know I will follow up with him for the actual surgery recovery, but will I see Dr. Sudan twice a year for labs forever? I left pretty confused, but she took all the info I had and said she would read it. I'm still not convinced she was talking about the right surgery. I mean, can you really actually fail on the DS? With the malabsorbtion, it seems to me you'd actually have to be trying pretty hard to NOT lose weight. And, I would imagine it would be based on what you were eating (carb heavy?). If a person was eating like that, I figure they would have probably failed at any of the WL surgeries. My PCP is actually really awesome and I think she will be on board when she understands it better. I also think she will do the labs for me in the future if I need her to. She basically said so (hush, hush). Has anyone ever heard of mass failure with the DS? Is my PCP just crazy? Labs will be a lifetime thing. You require a pcp who will draw the labs you request of them. You MUST fire her if she will not order all the labs you require. She will also need to give you a hard copy of the results so you can follow them yourself. This is a deal breaker. Yes, eating carbs will sabotage your weight loss and can cause significant gain once in maintenance. "Mass failure"? What does that mean? Here's one study about results, there are more in the DS Data section: Obesity Surgery, 17, 1421-1430 (2007) Duodenal Switch: long-Term Results Picard Marceau, MD, PhD1;Simon Biron, MD, MSc1; Frederic-Simon Hould, MD1; Stefane. Lebel, MD1; Simon Marceau, MD1; Odette Lescelleur, MD1; Laurent Biertho, MD1; Serge Simard, MSc2 'Department ofSurgery, Laval University, Laval Hospital, Quebec, Canada; 2Biostatistician Laval Hospital Research Center Results: Survival rate was 92% after DS. The risk of death (Excess Hazard Ratio (EHR) was 1.2, almost that of the general population. After a mean of 7.3 years (range 2-15), 92% of patients with an initial BMI > 50 kg/m2 obtained a BMI <35 and 83% of those with an initial BMI >50 obtained a BMI <40. Diabetes was cured (i.e. medication was discontinued) in 92% and medication decreased in the others. The use of the CPAP apparatus was discontinued in 90%, medication for asthma was decreased in 88%, and the prevalence of a cardiac risk index >5 was decreased by 86%. Patients' satisfaction in regard to weight loss was graded 3.6 on a basis of 5, and 95% of patients were satisfied with the overall results. Operative mortality was 1% which is comparable with gastric bypass surgery. The need for revision for malnutrition was rare (0.7%) and total reversal was exceptional (0.2%). Failure to lose >25% of initial excess weight was 1.3%. Revision for failure to lose sufficient weight was needed in only 1.5%. Severe anemia, deficiency in vitamins or bone damage were exceptional, easily treatable, preventable and no permanent damage was documented.Conclusion: In the long term, DS was very efficient in terms of cure rate for morbid obesity and its comorbidities. In terms of risk/benefit, DS was very sucessful with an appropriate system of follow-up. Read more: weightlosssurgery.proboards.com/thread/2058/long-term-results-2007-study?page=1#ixzz3YsQqFWK2 |
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Post by caprice on May 1, 2015 5:10:19 GMT -5
It seems odd to me that a PCP would think a surgeon would be the expert on nutritional needs.
Maybe because I traveled to another country and had no expectation of follow-up with my surgeon, I don't know....
I would strongly urge you to "cut bait" with your PCP if, after your next visit, she does not have a better understanding of what her role should be in keeping you healthy, and not dead. This really can be serious shit post op if you are not staying top of your labs/nutritional needs.
edited to add: And yes, she does not have a clue when she knee jerks with "the DS is an unsuccessful surgery". If she insists on keeping that attitude, you are putting yourself at a disadvantage in keeping her. God knows you will have enough battles to do with truly uninformed people, you don't need that crap from someone you are paying to help you be a healthier person.
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Post by jpcello on May 1, 2015 5:56:32 GMT -5
I left pretty confused, but she took all the info I had and said she would read it. I'm still not convinced she was talking about the right surgery. I mean, can you really actually fail on the DS? With the malabsorbtion, it seems to me you'd actually have to be trying pretty hard to NOT lose weight. And, I would imagine it would be based on what you were eating (carb heavy?). If a person was eating like that, I figure they would have probably failed at any of the WL surgeries. My PCP is actually really awesome and I think she will be on board when she understands it better. I also think she will do the labs for me in the future if I need her to. She basically said so (hush, hush). Has anyone ever heard of mass failure with the DS? Is my PCP just crazy? The DS is not a guarantee that you will meet your goal. No WLS is a guarantee. It's hard but it can be done (I witnessed this personally). There are many reasons someone fails at the DS. The situation I witnessed was this. She weighed about 400 pounds when she had her DS. She lost almost 200 pounds during her weight loss window but like the rest of us, as she got farther out from surgery she started eating more but eating the wrong things - lots of sugar and carbohydrates to be specific. We absorb those 100%. She may not have had the issues with gas and bloating or maybe she just didn't care. There could be many reasons why your PCP is not behind your decision. Don't let your PCP's reaction affect you. If you're concerned she will not support you, then you need to find another PCP. |
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Post by aa on May 1, 2015 12:10:23 GMT -5
My labs are done by my surgical team. I only see my surgeon yearly; however, the labs are done twice a year through a Rx from them. I then go over them w/my nutrit. there who knows the DS.
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Post by newyorkbitch on May 1, 2015 18:36:57 GMT -5
I have not seen my DS surgeon in many years. He doesn't even live in the same country as I do anymore. I get my labs done through my internist and/or hematologist - whomever I happen to be seeing. I do all the stuff they want, plus I add stuff I want to see.
Personally, I think it's very important that your internist understand what labs you need or at the very least be willing to order what you want/need and help you deal with whatever comes up.
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Deleted
Deleted Member
Posts: 0
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Post by Deleted on May 2, 2015 18:48:36 GMT -5
Hi,
I'm about to have revision surgery. I also happen to be a physician (GP/rad). I will say that many. many doctors do not understand obesity and certainly do not understand or appreciate the importance of bariatric surgery (not to mention clueless in post-op advice). That is fortunately changing (especially as more data/evidence is being published) , but there is still a lot of ignorance (and worse judgemental-ism) out there among the medical community about this.
Unfortunately, we all have to do our own research and be our own advocates sometimes with this issue. Fortunately, there are great resources out there (like this forum!).
Best of luck!
R
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Post by west4thavenue on May 3, 2015 16:34:45 GMT -5
Bon voyage, R. Let us know how you are doing as soon as you can.
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Post by teetster on May 5, 2015 12:52:20 GMT -5
Dr. Sudan's office will see you for the rest of your life for follow up if that is what you desire, or you can find a PCP who is more willing to order the labs you need. I live 4 hours away from Dr. Sudan so I have my PCP order my labs. Yes, the first time she did it she almost flipped out about the amount of tests to order, but she got over it. If she didn't, I would have had to find someone else.
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