DS Revision with an unknown?

[vorpalswrd]

Here is my basic run-down. I had the lap-band done in 2008 - lost 120 pounds, gained 60 back. Now at 300 pounds I am looking for revision to the DS. I have had no complications with my lap-band, but I did have my gallbladder out in 2009 (though I had had problems with it prior to WLS). I am having a very difficult time finding a surgeon in PA who will take my insurance and I have also called surgeons in NY, NJ. and a few other states as well as I am willing to travel, but to no avail.

I have an upcoming seminar with the only surgeon I have found so far the does the DS AND revisions AND takes my insurance - Dr. Melihan of Temple University. Problem one: I can't find anything about his DS/revision experience on the internet/forums, but I can ask those questions in person although it doesn't fill me with confidence. Problem two: I have met him before, back when I was researching surgeons initially for WLS options back in 2007 and I have to say I found his demeanor...harsh. I won't say anything more, but our personalities clashed...hard.

I guess I am kind of feeling torn. What if hasn't done many surgeries? Someone has to be those early patients or we would have no vetted surgeons, but we always don't want it to be us on the slab. Would you just go with the RNY or just stick with your current WLS and go to a medically supervised bariatric program (I am starting one of these in January regardless to start jumping through insurance hoops if I need them and I figure it can't hurt)? Thoughts and ideas please, thanks guys (x-post Duodenal Switch)

[robin1222]

I am new too, that said, I have an appointment with Dr. roslin in NY. You can ask for insurance to pay, they dedline then appeal sometimes its only one appeal. Try to get an office who is willing to work woth you for appealing. Many are now able to do that. I live in Mass and my insurance covers New England but since there is no one here i got approved for Dr. roslin after seeing two dr.s here who wont do it. No one in Mass is vetted, ( odd since Mass is the highest level of educational medicine and more hospitals than anywhere. But very very conservative will not to DS without more longterm results.... 15 yrs isnt enough i guess.
Good luck

[larra]

Hi to both of you!

Vorpalswrd, I responded to you on aother forum, and will just repeat that you really need an experienced DS surgeon (not just experienced with bariatric surgery, but specifically the DS) for any kind of revision, and the one you have named is not known for doing the DS. He may be a fine surgeon for other operations, and he may have done the DS at some point, but this isn't something he does all the time. I understand that sometimes our choices are limited, but would still urge you to keep looking for a surgeon who is experienced with revisions from other bariatric operations to the DS. Robin has given you some great advice about appeals, and having a surgeon's office staff help you. Please listen to her (and to me too, of course!).

Robin, welcome to you also. The DS has actually been done in the USA since 1988, thus over 25 years of experience, not just 15. They do seem to be very conservative in MA, don't they, or just comfortable and set in their ways. In any event, you've chosen an excellent surgeon who does lots of revisions. Best of luck to you, really to both of you, for a safe and successful surgery.

Larra

[Deleted]

Welcome to the boards ladies.

I was revised from RNY to DS. Complications kept me in the hospital for 3 weeks. Recently my girfriend, who came to support my husband, told me she called her mother to let her know she would not be home to get her kids when planned. She waited a year to tell me the nurse was worried enough to call Dr. Keshishian back to the hospital (he lives 2 hours away) after my second surgery. I did not know any of this. I was out of it.

In the hands of a lesser surgeon I would have died. Travel for surgery if needed your health and life are worth it.
Best,
Whitney

[swaglious]

I really struggled with this at first and thus here is my experience. For me... I won't go to a surgeon who does not do the DS as a primary operation nod certainly won't go to a DS who is not familiar with difficult revisions (RnY to DS). When I started my investigations I thought that a world class surgeon is a world class surgeon. We are only good at what we know how to do and what we have had experience doing. This surgery is a huge surgery and I did not know just how difficult it was until the world class surgeon wanted to in 3 stages what a couple of surgeons in the world are able to do in 1. BTW those couple of surgeons have a lot of experience with that surgery.

If I am putting my health and life on the line then I need the best at this surgery. Can another surgeon do the surgery perhaps but why do I want to take make my car to the guy who washes my car and changes my oil when I need a certified special mechanic to overhaul my engine? I could be taking a risk and I need to make sure that the work I need done is going to be done right the first time by somebody who has done the surgery many times.

[CVHarris]

Swag funny analogy about the major over haul. Dr. K used the same comparison when he talked about the ds and explained it, to MR. He was like the DS is not a tune up or oil change its a major overhaul. Then MR got the complexity of the DS