Re: Re: Why Dr. R- GEORGIA

[Guest guest]

WOW! Thanks for the letter and info! It helped! GEO

Lori wrote:

> This letter was written 2-3 weeks ago---

>

> In MiniGastricBypass (AT) e, " "

> wrote:

> >

> > It wasn't any one thing. Some of it is just personal to me and

> your

> > personal reasons could tip the balance in an entirely different

> > direction.

> >

> > Bottom line: Compared to Fobi and RNY, Rutledge's procedure

> produces

> > the same weight loss, has far less " under anaesthesia/in surgery "

> > time, less hospital time, lower hospital costs, less stay-in-the

> area

> > time and expense, less pain/recovery, has the same or less

> > complications afterwards as any other procedure, but allows you to

> > still eat reasonable sized portions afterwards. After I contacted

> 90

> > of his patients and got great feedback, it was a no-brainer to me.

> >

> > All the procedures, the Fobi, the RNY, and Rutledge's procedure,

> have

> > a pretty good safety record, and similar weight loss results

> (almost

> > identical, actually).

> >

> > All the procedures (Fobi, RNY, and Rutledge's) have the risk of

> > obstructed bowel, ulcers, etc. None seems to be any more or less

> > safe

> > than any of the others

> >

> > (NOTE: I am *not* including that " Duodenal switch " procedure in

> any

> > of this. If you look at that and notice that you are cut from stem

> > to

> > stern and have a lot of potential complications, etc. from it, that

> > was *right out* to me.)

> >

> > With *no* procedure did I find that the majority of patients were

> > reaching their goal weights. *All* the procedures leave the

> majority

> > of people still " obese, " though less obese than they were, but 30-

> 70

> > pounds overweight at about 14 months.

> >

> > Any of these procedures, done as an " open " procedure, instead of

> > laparoscopic, will leave a big scar, and you will be in pain a lot

> > longer and have about a 6-8 week recovery time. You're also at

> risk

> > for complications from the incision itself, including hernia and

> > infection. You're on the table under anaesthesia a lot longer, too

> > --

> > as much as 4-7 hours. I'm a pain wuss, and (I'm the Barbie Wannabe,

> > remember?) scarring is a *BIG* deal to me, so the open procedure

> was

> > scratched from my list pretty early.

> >

> > Any of the procedures (Fobi, RNY, Rutledge), done laparoscopically,

> > will have a 1-2 day hospital stay, less pain, and leave 5

> > trocar-sized

> > (about 1 inch) scars. The Fobi and RNY take 4-7 hours on the table

> > under anaesthesia, Rutledge's procedure takes 30 min. - 1 hour.

> I'm

> > of the opinion the less time in surgery under anaesthesia, the

> better

> > for the heart and brain. Hospital charges are less, too. The

> > after-surgery recovery time was shorter for Rutledge patients and

> the

> > required stay in the area after surgery was shorter.

> >

> > None of the places offering a laparoscopic procedure were close to

> me

> > and required you to stay " in the area " anywhere from 1-3 weeks

> after

> > surgery. The costs of travel and lodging were significantly

> > different

> > depending on where the clinic was located and how long I would have

> > to

> > stay out there after surgery. Rutledge had the shortest mandatory

> > after-surgery stay, and was also in an area where prices were

> lower,

> > generally. I also discovered on travelocity and priceline that

> there

> > were some *great* prices ($130 round trip) to Durham. Extended

> Stay

> > America's kitchen-equipped rooms are $270 for 7 days for 2 people.

> >

> >

> > Now, personal to me:

> >

> > I'd already spent a *lot* of time, first, getting approved by

> > insurance, then, after finally getting approved for the Fobi

> > procedure, deciding against it.

> >

> > I was convinced against the Fobi group by numerous patients who

> were

> > having trouble with incisions coming open after surgery, as well as

> > other complications such as obstructed bowel, hernia -- all

> happening

> > to people on the Fobi list within a 3 week period. Too many to

> suit

> > me. They claim they have a " low " complication rate, but they give

> it

> > in " percentages, " and I was hearing first hand from far too many

> > people with complications. I got run off the Fobi list when I

> asked

> > about these problems. There was a sort of moonie mentality on that

> > list that defied common sense and I'm a no-nonsense, give-me-facts

> > kinda person.

> >

> > [Let me interject here that I have found the people on the Rutledge

> > list to be a lot more involved in their pre-and post surgery than

> on

> > other lists, asking lots of intelligent questions, and giving and

> > getting intelligent answers -- another plus, and I'm not

> discounting

> > Dr. Rutledge's dogged determination to educate everybody whether

> they

> > want it or not, either. ]

> >

> > Then I saw pictures of a woman, my size, who had the exact same

> > procedure I had planned to have, where the doctor does a

> > panniculectomy ( " tummy tuck " to remove all the overhanging stomach)

> > and uses a low, bikini incision for both the panniculectomy and the

> > RNY, thus leaving no scar on the upper abdomen other than one small

> > 1/2 " incision (plus the hip-to-hip bikini line incision). The

> belly

> > button is moved during this procedure, too. Well, her pictures are

> > up

> > on the web at 14 and 27 days post-op and her belly and up to her

> > chest

> > is badly bruised and swollen, her incision is gaping in places (and

> > will leave a wide, ugly scar, from hip to hip) and her belly button

> > looked grotesque. It looked, in a word, brutal. I decided my

> flabby

> > belly was probably just fine. I'm 47, I should have some wrinkles.

> >

> > Oh yes, let me add that Roseanne had the Fobi done at the Fobi

> clinic

> > and if you've seen her, it's been over a year, and she's still fat.

> >

> > Now, last but not least, the Fobi clinic treated me like a damned

> > number. When insurance first turned me down, the Fobi clinic

> dropped

> > me like a hot rock. It was totally up to me to fight with

> insurance.

> > At the Fobi clinic, they have their process so " automated " that

> they

> > have a different person for *each* piece of paper (I'm not

> kidding).

> > So when I won the insurance battle and called the Fobi people

> again,

> > they at first couldn't find my file, then when they found it, I was

> > talking to a different person each day as " my paperwork " made it

> from

> > point A to Z, and there was no way to find out anything without

> > several phone calls, daily, just to get a human and not a voice

> mail.

> > By this time, the " process " had taken from February 1 to May 1. So,

> > in

> > a word, Fobi sucked.

> >

> > Fobi's group does not do the Fobi laparoscopically (so you're

> looking

> > at about a 6 week recovery time), but Dr. Marema, who studied under

> > Fobi and has had the procedure himself, does. Marema is located in

> > Ft. Lauderdale, Florida. I contacted him but had a lot of problems

> > getting anything scheduled with him, being an out-of-state patient.

> > Travel arrangements to Ft. Lauderdale were a logistical and price

> > nightmare from Southern Alabama, too, for some reason. I could go

> to

> > LA cheaper.

> >

> > His office is not set up for high volume and by that time, I was

> > getting pretty fed up with getting the runaround on the phone from

> > Fobi and then Marema's office, and running out of time. However, I

> > was

> > impressed with his standards and based on patient satisfaction and

> > information I gleaned about him, I would rate him A+. However, it

> is

> > a 2-4 hour procedure (even laparoscopically), which concerned me

> (he

> > does the lap Fobi which is similar to the RNY, but the Fobi

> procedure

> > also leaves you with a tiny 2-ounce stomach, so, yes, you will be

> > learning to eat like a bird forever.

> >

> > The Alvarado clinic in California does the RNY laparoscopically.

> But

> > Alvarado is a small practice and they've done a lot of " celebrity "

> > advertising (with Carnie , for instance) so they are over-

> busy.

> > Getting scheduled with them is really difficult. They don't have a

> > " patient packet, " and rely on phone calls a lot, but when they are

> so

> > busy, and only have one person handling the phone calls, it makes

> it

> > pretty impossible. They also were the highest-priced of everyone I

> > checked. (They're in LA). I've got to pay a good portion of my

> > surgery, so that was a definite consideration. Additionally, their

> > surgery takes about 4 hours on the table. I've had surgery with

> > general anaesthesia and from your own health standpoint, the less

> > time

> > under anaesthesia, the better. Travelling to CA and staying out

> > there

> > three weeks was also going to cost about 5 times more than staying

> in

> > North Carolina a week.

> >

> > I heard about a really good doc who does the RNY laparoscopicically

> > just outside of San Francisco, Dr. Gracia, but by the time I'd

> heard

> > of him, I had already submitted my packet to Dr. Rutledge and was

> > pretty happy with the decision. The one thing about this doctor

> that

> > got my interest was that he does vary the procedure by the patient

> (a

> > distal RNY, as opposed to a proximal RNY, will produce more weight

> > loss, whereas Rutledge seems to be totally inflexible on how much

> > bowel he will bypass) and he is world-renowned for his laparoscopic

> > skill. I simply didn't have any more time to pursue this, though.

> > The lap RNY has a longer surgery time, longer recovery time, and

> > greater expense (hospital), as well as the expense (for me) of

> going

> > to CA, so I likely would have decided against it anyway.

> >

> > Dr. Rutledge has both a good track record and *excellent* patient

> > relationships. That's a big plus in my book. I got back 90 patient

> > contacts and all the patients love Dr. Rutledge. There were very

> few

> > complications in the bunch, too, with most people reporting having

> > surgery, pain the first day, not much the next day, doing fine by

> the

> > third day and no complications.

> >

> > However, caveat, the only statistics I could get for Dr. Rutledge's

> > procedure are all people 2 years or less post-op. I'm disturbed

> > about

> > this. I would prefer to hear from people 5 years out. Did they

> gain

> > the weight back? Did they develop ulcers? Vitamin deficiencies?

> Did

> > any of them reach their goal weight? What percentage?

> >

> > With all the information Dr. R. otherwise makes widely available

> and

> > with all the statistics he keeps himself, I'm surprised that these

> 5

> > year figures -- the ones which the National Institute of Health

> > itself

> > would use to evaluate the effectiveness of the procedure -- are not

> > available on Dr. Rutledge's webpage.

> >

> > Maybe he'll share this information with us?

> >

> > Anyway, after a point, enough is enough.

> >

> > I had been putting off taking a new job until I had this surgery and

> > I

> > was going broke waiting. It was time to get off the pot.

> >

> > Dr. Rutledge had a lot more " plusses " in his column than any of the

> > others, for a variety of reasons and I never found anything to

> change

> > my mind.

> >

> > I'm scheduled on May 18. All prayers appreciated!

> >

> >

> >

> >

> > > Hi :

> > >

> > > I know you did a lot of research about wls and I was wondering if

> > you would

> > > share with me, and anyone else interested, what in particular

> made

> > you

> > > decide to go with MGB.

> > >

> > > Flo from land

>

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