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Post by Deleted on Aug 6, 2013 20:16:18 GMT -5
FROM DR. ROSLIN: you mean long distal bypass if u do not have fundus or pylorus u r asking for trouble you need low pressure low pressure and distal bypass not good combo Did he misunderstand or did I? If he leaves your stomach alone you would have both your pylorus and fundus. It looks like he is thinking you were asking about a pouch and the DS intestines. I thought that you were asking him about doing the intestinal portion only? That is widely done in Europe and has been for years as a cure for Type II. Agreed, the Doc's response made no sense to me.
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Post by nyuboi on Aug 6, 2013 20:18:01 GMT -5
FROM DR. ROSLIN: you mean long distal bypass if u do not have fundus or pylorus u r asking for trouble you need low pressure low pressure and distal bypass not good combo Did he misunderstand or did I? If he leaves your stomach alone you would have both your pylorus and fundus. It looks like he is thinking you were asking about a pouch and the DS intestines. I thought that you were asking him about doing the intestinal portion only? That is widely done in Europe and has been for years as a cure for Type II. I just sent in your post to him because I felt the same way you did.
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Post by newyorkbitch on Aug 6, 2013 20:40:26 GMT -5
You could have asked a clearer question:
"What about doing the repair of my hiatal hernia, no gastrectomy or pouch, with the intestinal portion of the DS?"
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Post by nyuboi on Aug 6, 2013 21:36:14 GMT -5
** DR. ROSLIN'S RESPONSE to me asking about intestinal portion only of DS with no sleeve **
how in hell is your gerd and dyspagia be helped by that? additionally wt loss with a non resective ds is minimal it was tried with bands too without great success
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Post by Deleted on Aug 6, 2013 23:06:39 GMT -5
** DR. ROSLIN'S RESPONSE to me asking about intestinal portion only of DS with no sleeve ** how in hell is your gerd and dyspagia be helped by that? additionally wt loss with a non resective ds is minimal it was tried with bands too without great success That makes sense. It's the alterations to your stomach that will help those problems.
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Post by leeayn on Aug 7, 2013 15:08:11 GMT -5
My daughter had a Nissan at the age of 15, she is now 31. She is severe asthmatic and had GERD something horrible! After about 5 years, she is able to throw up, and it is "loose" again, we assume. But it is a GOOD thing, the Nissan!
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Post by nyuboi on Aug 7, 2013 15:29:40 GMT -5
I'm meeting Fielding tomorrow at NYU to discuss if he would still do a DS. Will show him Roslin's dictation and see his position.
Either way I'm scheduled for an RNY on Tuesday. I don't know if I should cancel it or just trust Dr. Roslin and get it. I threw up just minutes ago. :/
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Post by newyorkbitch on Aug 7, 2013 17:15:46 GMT -5
Fchrissakes don't do a DS with Fielding, no matter what.
It is time to go forward with Dr. Roslin's plan.
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Post by nyuboi on Aug 8, 2013 11:54:44 GMT -5
Fchrissakes don't do a DS with Fielding, no matter what. It is time to go forward with Dr. Roslin's plan. You mean the RNY on Tuesday?
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Post by newyorkbitch on Aug 8, 2013 13:11:40 GMT -5
Yes.
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Post by newanatomy on Aug 8, 2013 13:20:05 GMT -5
Good luck to you nyuboi. You are going to be getting the surgery that many skilled surgeons believe is the best to help you be your best. Go into to it with a great attitude! There are a lot of success stories out there by RNYr's. You will do fantastic.
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Post by Girlrocker on Aug 8, 2013 13:23:01 GMT -5
No smoking. No eating. Drinking will "dump" into small intestines (with RNY), I have great times a head of me! Perhaps I'll just become a DS forum addict.[/quote] You rang Why do you think I troll this board? So I can live VICARIOUSLY as a DS'er! Oh hey - also there is a much higher rate of alcoholism/transfer addiction as an RNYer!
Sorry not trying to be a downer- I'm in the same boat as you are. I am really impressed with your dogged persistance- you have really done exhaustive research here. HOWEVER- You really have to cut out ALL nicotine NOW! Should have done it 2 weeks prior to surgery. End of rant. [/quote] [/i] Agreed, dogged persistence, cut out nicotine! But as a RNY to DS revision, just want to interject a 'be careful there' re: the alcoholism transfer. This is not related to the physical aspect of the surgery/RNY, it's related to behavioral issues, which are likely in place in some form without surgery. The limits of the weight loss many of us experience with the RNY, because it doesn't deal with the malaborption as effectively long-term for metabolically challenged obese folk can mean we live much like we did without surgery. Meaning, issues of depression, compulsion that were likely there already get exacerbated when a bariartric procedure doesn't work for us. Its a devastating double whammy of failure feeling. My RNY failed me, couldn't get and stay under 200 lbs, and I wound up yo-yoing the same as I did before I had it. But I'd be lying if I didn't say I also know a LOT of RNY success stories, long-term. I didn't have any other problems with the RNY - I could eat and drink at the same time, it's not a 'never' proposition, just happens further out; I didn't have any food intolerances; I did dump from sugar, but now instead I have teriffic Big D if I eat flour and some other carbs that don't agree with me. I wouldn't choose or recommend the RNY, but as I said before, you have much different issues to consider, hence the discussion of what elements of the bariatric procedures will work for you and your long term health. There are many people who are 'hybrids' for such reasons. I don't want to hijack this from the mission at hand - you sorting what your best options are, and in doing so, what you have shared here is invaluable. I'm just saying if you do have RNY surgery, like any surgery, know fully what you're getting into and be mindful of misnomers. I'll also throw in that learning what I have about fats because of the DS, the surgery itself, even more about Atkins, and there's another doctor I read about here, searching for the name now, that was also about the benefits of full fat, makes me wonder sometimes if I had done this before what would have happened. Not to the extent I wouldn't have had my revision, as I said I believe firmly in the DS being the superior combination of small stomach/malabsorption. But I think there is something to eating real, full fats, especially for those of us metabolically challenged, with or without surgery. I'm a Dr. Keshishian patient, as you know, and I do favor, trust his opinion. But you have to do what you think is best, right for you, factoring in all the elements you need to consider specific to you (health, weight loss, insurance coverage, etc). Rooting for you to get healthy and well.
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Post by nyuboi on Aug 8, 2013 22:27:44 GMT -5
** DR. ROSLIN CANCELED MY SURGERY **
REASON: For posting his last two emails here on the board.
I get a phone call today saying Dr. Roslin is taking me "off the books for Tuesday." The girl said I was going against medical guidance in pursuing a DS. I said "But I am NOT getting a DS, I am scheduled for an RNY for this Tuesday." She said "Dr. Roslin told me to inform you he will not be operating on you and to go elsewhere." She said him and I had been corresponding via email, so that I could contact him this way. The email I sent him and his response is below...
What a day from hell.
I guess someone sent him a link to this thread.
Don't get me wrong. I can see his issue. But we all talk about our experiences with the different surgeons. I only pasted a two sentence reply from him. I DO understand his issue I suppose, but to cancel surgery on me 4 days before and say I'm no longer welcome there?
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Post by nyuboi on Aug 8, 2013 22:40:35 GMT -5
** Email to Dr. Roslin **
Dr. Roslin:
I just received a phone call saying you're canceling my surgery. I have already paid for hotels for family, and made various arrangements. In addition, I did all the preop testing (Bloodwork, EKG, urinanalysis, X-rays) and was cleared by my PCP. I also signed all consent forms, and paid to personally meet with your psychologist, and met with the nutritionist.
I do not understand and request an explanation. You can't get mad at me for getting a second opinion - any responsible patient should do so before having life-altering surgery.
When I was asking you questions about the DS via email this week, I was simply trying to understand so I knew what I was talking about and didn't look stupid on the DS Internet forums. I wanted to accurately explain why I wasn't getting the surgery to people I was interacting with online for over a year. You once referred to them online as the Harvard of Bariatric patients. They speak very technical and were asking why I didnt get a sleeveless DS. I wanted to ask you those questions via email so I knew what I was talking about when I answered them.
In addition, I do not have healthcare coverage out of New York and you are the only surgeon who is in-network with my insurance. Dr Pomp, Dr Bessler, Dr Inabnet, and Dr Fielding all do NOT take my insurance.
If I switch my insurance I may be able to get coverage with NYU, but Dr. Fielding was the one who wanted to leave my lapband in when my esophagus was really bad off, so I don't trust his judgement.
Please explain why you're doing this. Is it because of my emails this week or because of consulting other surgeons?
Again, I DO trust your judgment. I was not challenging you, I simply wanted to be an informed patient and understand the details of the ruled out alternatives.
I have no alternate options or surgeons.
Please get back to me at your earliest possible convenience either via return email or at 516-xxx-xxxx. The surgery was less than five days away.
Very truly yours,
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Post by nyuboi on Aug 8, 2013 22:41:30 GMT -5
** Email from Dr. Roslin ** (which he CCed a risk management attorney on)
A doctor patient relationship is one of respect of boundaries.
I take care of patients and am willing to answer emails.
I find the posting of emails that were responses to questions crosses those boundaries.
As a result, I suggest you find another provider.
I wish you the best of luck and years of good health.
Sincerely Mitchell Roslin MD
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Post by Deleted on Aug 8, 2013 23:04:04 GMT -5
nyuboi,
I am sorry that your surgery was cancelled and I wish you luck. That being said I do have to admit I was shocked when you posted the Doc's email responses on this board and that you told him you were sharing them. There are ethical and legal ramifications to posting a physician's responses to emails that a patient sent to him, without his consent. What if somebody took his comments to you as medical advice and then came back and tried to sue him for giving medical advice that caused harm to a person?
Again I am sorry, but Physician's have egos and they are afraid of liability. I think he feels you put him in a very awkward position on both cases.
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Post by nyuboi on Aug 8, 2013 23:15:31 GMT -5
nyuboi, I am sorry that your surgery was cancelled and I wish you luck. That being said I do have to admit I was shocked when you posted the Doc's email responses on this board and that you told him you were sharing them. There are ethical and legal ramifications to posting a physician's responses to emails that a patient sent to him, without his consent. What if somebody took his comments to you as medical advice and then came back and tried to sue him for giving medical advice that caused harm to a person? Again I am sorry, but Physician's have egos and they are afraid of liability. I think he feels you put him in a very awkward position on both cases. You're right. I didn't think. Good points you make.
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Post by Deleted on Aug 8, 2013 23:23:38 GMT -5
You got in trouble for doing this before, if I am not mistaken. I haven't bothered challenging you about this issue because, well, challenging you is pointless. You have now alienated this doctor twice. You have also posted the correspondence from numerous OTHER surgeons.
Do you think you might POSSIBLY learn something from this experience this time around?
Allow me to point out the obvious:
HE INCLUDED AN ATTORNEY IN THE CORRESPONDENCE LOOP. This should be a hint to you that you need to SHUT THE FUCK UP ABOUT THIS SUBJECT IN PUBLIC VENUES.
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Post by Deleted on Aug 8, 2013 23:24:09 GMT -5
nyuboi, I am sorry that your surgery was cancelled and I wish you luck. That being said I do have to admit I was shocked when you posted the Doc's email responses on this board and that you told him you were sharing them. There are ethical and legal ramifications to posting a physician's responses to emails that a patient sent to him, without his consent. What if somebody took his comments to you as medical advice and then came back and tried to sue him for giving medical advice that caused harm to a person? Again I am sorry, but Physician's have egos and they are afraid of liability. I think he feels you put him in a very awkward position on both cases. You're right. I didn't think. Good points you make. Again, I feel for your bro and I understand how your mind was running a million miles an hour trying to get an answer...so things happen. I know it probably sounds like patronizing BS now, but I do believe that things really do happen for a reason (sometimes I have no effing idea why) so I think that even though you are disappointed now that things will work out well for you in the end. I know it isn't what you wanted, but you now have time to explore some other options. Take care and best of luck to you Paul.
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Post by nyuboi on Aug 8, 2013 23:24:10 GMT -5
I will post about NYU tests today and what their bariatric team said tomorrow...
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Post by nyuboi on Aug 8, 2013 23:28:30 GMT -5
You got in trouble for doing this before, if I am not mistaken. No, nothing like this before. Thank you for the feedback.
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Post by Deleted on Aug 8, 2013 23:31:09 GMT -5
I strongly recommend that you use more sense about posting what other medical professionals say to you in personal correspondence, as well.
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Post by nyuboi on Aug 8, 2013 23:44:59 GMT -5
I strongly recommend that you use more sense about posting what other medical professionals say to you in personal correspondence, as well. I am going to write what Dr. Fielding told me about my surgical options.
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Post by nyuboi on Aug 8, 2013 23:47:23 GMT -5
I strongly recommend that you use more sense about posting what other medical professionals say to you in personal correspondence, as well. Didn't the mods tell us not to comment on each others posts last year? ;-) Again, thank you for the feedback, EN.
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Post by goodkel on Aug 9, 2013 0:51:10 GMT -5
Sigh.
Perhaps this was a good thing.
You obviously do not want the RnY. The effort you put into trying for the DS even after you were scheduled for the RnY proves that.
What do you plan to do from here? Maybe discuss this in greater depth with Dr. Anthone? Or Dr. Keshishian?
Whatever you do, I think you've learned your lesson about keeping your conversations with other surgeons close to your vest.
Ps. The way to get the best second opinion is to make NO mention of previously consultations. You don't want a surgeon's reply to be colored in any way by what a previous surgeon has said or by not wanting to disagree with another respected surgeon in their field.
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Post by nyuboi on Aug 9, 2013 2:19:33 GMT -5
Sigh. Perhaps this was a good thing. You obviously do not want the RnY. The effort you put into trying for the DS even after you were scheduled for the RnY proves that. What do you plan to do from here? Maybe discuss this in greater depth with Dr. Anthone? Or Dr. Keshishian? Whatever you do, I think you've learned your lesson about keeping your conversations with other surgeons close to your vest. Ps. The way to get the best second opinion is to make NO mention of previously consultations. You don't want a surgeon's reply to be colored in any way by what a previous surgeon has said or by not wanting to disagree with another respected surgeon in their field. Very very good advice. I generally don't tell a surgeon I meet with what others thought because I don't want them to alter their opinion based on that. I am there for THEIR feedback and opinion. In regards to your where to go from here question, I found NYU very helpful in painting a road of several options for me, including DS, RNY, or a modified DS. Will talk about these tomorrow. Trying to cool off from everything today. I was so upset when I got that phone call. Goodnight from sleepless in New York.
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Post by nyuboi on Aug 9, 2013 2:24:36 GMT -5
Out of the frying pan, into the fire. I am not a fan of Roslin's ego, and haven't been for a long time. He is a respected cutter, and he has written some nice DS-supportive pieces, but I've observed (third hand) things that have made me uncomfortable in the past. He apparently doesn't like being second-guessed - in particular, I suspect, by the other top surgeons (Keshishian, Rabkin, Anthone, e.g.), even when they agree with him. I guess that's why he told me to go to CA and have that [Dr. K] operate on me when he found out I contacted Dr. K. (And I was respectful enough to Roslin to not post what Roslin had said about Dr. K But anytime you have gotten a second opinion, its always a "well let them operate on you" comment.
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Post by nyuboi on Aug 9, 2013 2:30:05 GMT -5
Out of the frying pan, into the fire. "I find the posting of emails that were responses to questions crosses those boundaries." I'm not understanding why he is uncomfortable with YOU, the PATIENT, sharing HIS advice, which YOU PAID FOR. They are YOUR HIPAA rights, not his. I don't buy the argument that he's worried someone will take medical advice intended for you. What boundaries? Did he TELL you about these boundaries? Is he EMBARRASSED by what he said, at least one of which was quite casual and possibly unprofessional (and misspelled)? ("how in hell is your gerd and dyspagia be helped by that?") My friend said the same thing - that if anything hes probably embarrassed about giving me one sentence replies with no grammar and unprofessional ("how in the hell" going online. All I did was share his reply to me asking why not pursue Dr. K's idea of a sleeveless DS.
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Post by nyuboi on Aug 9, 2013 2:34:50 GMT -5
Out of the frying pan, into the fire. I don't believe this is about your posting his emails per se - it is about your questioning him and doubting him - his litigious-meter was tripped. I was wondering if it got back to him that I contacted half of the DS surgeons on the vetted list for feedback..... That's why I made it a point in my email to say I wasn't challenging him, that I believe his advice, and that I just wanted to make sure I was fully understanding why DS was being ruled out.
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Post by goodkel on Aug 9, 2013 2:38:54 GMT -5
Sigh. Perhaps this was a good thing. You obviously do not want the RnY. The effort you put into trying for the DS even after you were scheduled for the RnY proves that. What do you plan to do from here? Maybe discuss this in greater depth with Dr. Anthone? Or Dr. Keshishian? Whatever you do, I think you've learned your lesson about keeping your conversations with other surgeons close to your vest. Ps. The way to get the best second opinion is to make NO mention of previously consultations. You don't want a surgeon's reply to be colored in any way by what a previous surgeon has said or by not wanting to disagree with another respected surgeon in their field. Very very good advice. I generally don't tell a surgeon I meet with what others thought because I don't want them to alter their opinion based on that. I am there for THEIR feedback and opinion. In regards to your where to go from here question, I found NYU very helpful in painting a road of several options for me, including DS, RNY, or a modified DS. Will talk about these tomorrow. Trying to cool off from everything today. I was so upset when I got that phone call. Goodnight from sleepless in New York. But, you DID mention that you had already consulted with Dr. Roslin when you contacted the other doctors. Do you have hard copies of all your pre-op testing? If not, get them. You can send them to other surgeons for consultation. If they have any questions, just tell the truth: that you were scheduled for the RnY, but decided that what you really wanted was the DS.
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