Re: Surgeon switching back to Scorpinaro

[Guest guest]

You asked SO MANY questions that I responded within your message.

> In a message dated 10/19/2001 8:29:42 PM Central Daylight Time,

> romanstenseventeen@y... writes:

>

>

> > This will still be lap. And my surgeon is ! She gave

me

> > very good arguments...

> >

> >

>

> Yes, I understand that she is staying lap. But I believe in order

to stay

> lap she has to give up on the DS. The DS is a more complicated

procedure

> because you have more delicate work to do around the duodenal

area. Instead

> of just cutting it out, you have to maticulously cut the intestine

just below

> the duodenum but before the entrances of the bile fluids. That end

has to be

> sewn shut. Then intestine has to be brought up and attached to the

stomach.

**she did explain this.

> She may have given you good arguments but did she give you clinical

evidence

> to back it up. Is the evidence based on DS patients everywhere or

just the

> patients of HERS that have had problems. The problem may be HER

and not the

> procedure.

**she gave me percentages from research. Her bpd/ds people are doing

fine... so it is not 'HER' problem.

> Make sure you aren't going along with this just because it would be

terrible

> to put off you wls any longer! I know that would be terrible, but

you are

> going to live your whole life with this procedure.

>

> There is a good chance you will never know the difference. But a

lot of this

> is I would be leary of this doctor saying these things.

>

> Also in a BPD procedure the common channel was made smaller because

the

> patient can eat more. Is she going to do this? Is she going to go

by what

> the research says a BPD should be, or is she making up her own???

**The intestinal tract stuff is all the same. Same measurements.

Also will

> you end up with NO restriction. Standard BPD patients say they

usually end

> up eating MORE than they did preop. This can be o.k. because they

still lose

> weight, but this also means increased bms. If the doc did not

bring all this

> up in the discussion, I am not sure she is being forthright. That

is what

> would concern me.

This was mentioned... I wanted this procedure because I eat a normal

amount and still lose weight. I don't want excessive BM's so I'll do

my best to avoid that.

I wonder if she is offering the BPD just so people will

> turn it down and go with the RNY.

When I first met her back in April... she explained the ds as the

most drastic. Saying something like same results with band and rny,

but the percentage of weight loss was NOT the same.

>

> Dawn--South Suburban Chicago area

> Dr. Hess, Bowling Green, OH

> BPD/DS

> 4/27/00

> www.duodenalswitch.com

> 267 to 165 5' 4 "

> size 22 to size 10

> have made size goal

> no more high blood pressure, sore feet, or dieting

>

>

>

>

>

[Guest guest]

I posted here to find out if anyone else had this specific version

not because of doubts.

>

> How long of a common channel? If she is going with a longer common

channel,

> then she is not going by what a standard BPD is.

**answered in a previous question... intestinal tract stuff is all

the same.

>

> How big will your pouch be? As I said before a lot of BPD paitents

indicate

> they can eat more than they did preop? But also you don't want to

end up

> with a tiny stoma in order to have restriction? Make sure she

isn't just

> doing a very distal RNY. Did she tell you what your post op

> instructions/restrictions will be?

**Same size as the gastric sleeve or banana, just a different shape.

She does NOT do distal RNY. Post-op instructions will be the same as

the bpd/ds'ers. I did ask about the connection and how I do NOT want

to have to chew the hell out of my food... and I do not want a

stoma. She basically said that everything is bigger in this surgery

> If the BPD is really, really what you want then go for it.

However, since

> you posted about it here, I have my doubts.

**I posted because this is a support egroup... and as I said before,

I wanted to find someone who has had the same thing.

> Dawn--South Suburban Chicago area

> Dr. Hess, Bowling Green, OH

> BPD/DS

> 4/27/00

> www.duodenalswitch.com

> 267 to 165 5' 4 "

> size 22 to size 10

> have made size goal

> no more high blood pressure, sore feet, or dieting

>

>

>

>

>

[Guest guest]

,

Thank you! I was starting to get worried about using Gagner for my

upcoming? surgery because of all this. Tell me again how 's

thoughts on this are not in any way associated with Gagner!!! I'm

scared!

> > > In a message dated 10/19/2001 8:13:51 PM Central Daylight Time,

> > > romanstenseventeen@y... writes:

> > >

[Guest guest]

Dr and Dr Ren trained as a lap fellows with Gagner. That

would have predicted that they would go on to do the srot of surgery

he does. However, they both are having trouble doing the lap DS and

are trying to sell people on other options.

I imagine that Dr Gagner is gritting his teeth now if he has heard

about the crap coming out of the mouths of his former fellows.

, Seattle

> > She is very wrong. From the time she got out on her own (she was

a

[Guest guest]

Marcia,

I am sure Dr. did a fantastic job for you. My only

question would be, if compliance is an issue, then NO WLS should be

done. Every form of WLS has a strict level of compliance necessary,

regardless of type. If compliance is not an issue, then, what type

of surgery is better than the DS? I have examined them all, and if

circumstances prevented me from having the DS, I would consider a

different type, however, I would do so knowing that it would be a

much more difficult road and I would have to disregard my sordid past

in dieting and weight regain to think that any other surgery would

ensure my weight loss was permanent.

I think that this is basically why most of us feel the DS is the only

permanent answer.

Theresa

Please don't make the assumption that she is exploring other

> avenues of WL relief because she CAN'T do DS, rather that not all

morbidly

> obese people SHOULD have DS.

> This is only MHO

> Respectfully,

> Marcia

[Guest guest]

I agree with you 1000% Theresa! I think other WLS require STRICTER

compliance than DS.

What I wonder is, if these Dr's aren't comfortable doing DS lap, why

not do it open rather than pushing BPD? Having open surgery is not

the end of the world. I'd far rather go that way than have lap with

someone who wasn't completely comfortable doing it. Yikes!

Chris

> Marcia,

>

> I am sure Dr. did a fantastic job for you. My only

> question would be, if compliance is an issue, then NO WLS should be

> done. Every form of WLS has a strict level of compliance

necessary,

> regardless of type. If compliance is not an issue, then, what type

> of surgery is better than the DS? I have examined them all, and if

> circumstances prevented me from having the DS, I would consider a

> different type, however, I would do so knowing that it would be a

> much more difficult road and I would have to disregard my sordid

past

> in dieting and weight regain to think that any other surgery would

> ensure my weight loss was permanent.

>

> I think that this is basically why most of us feel the DS is the

only

> permanent answer.

>

> Theresa

>

> Please don't make the assumption that she is exploring other

> > avenues of WL relief because she CAN'T do DS, rather that not all

> morbidly

> > obese people SHOULD have DS.

> > This is only MHO

> > Respectfully,

> > Marcia

[Guest guest]

, as you know, I too had a consult with Dr. Ren not long ago

(Aug. 22nd), and I can't agree more with all that you said here. At

that time, she went over all the options with me, discussed the

pluses and minuses of each, and then, once convinced that I was aware

of all of the above, let me make the decision on which surgery I

preferred. I was very clear about wanting the DS and why, and she

said then that's what I would get.

My sense about her going forward with the DS is as you said; that in

her opinion, the lap DS is the most risky of surgeries, and in the

future, would prefer to perform the BPD instead. I will also add that

she made it clear that if she, during surgery, encounters problems

with the lap aspect of it, will have no quams about opening me up if

need be.

IMHO, she truly has the best interest of her patients at heart. I've

heard this from many of them, all of whom speak very highly of her;

both in terms of her capabilities as a surgeon as well as her warm,

caring nature as a human being.

Just wanted to add my experience as well.

~ D.

pre-op 11/6/01 Dr. Ren

> Marcia,

> I had my consult with Dr. Ren on Sept. 19 2001 and

> after telling me about the DS she then said that soon

> she would only be doing the BPD. She brought up the

> fact that the BPD is easier to do Lap and hence less

> risk. She talked a lot about how the Dr. from Italy

> has been doing this surgery successfully for 20 yrs.

> She drew a picture and showed me all the differences

> including a shorter common limb (50cm)and the change

> in dietary requirments post op. I respect her right

> to alleviate the stress that performing the BPD/DS

> causes her before during and after sugery. She fully

> admits that its a much more difficult procedure to do

> Lap and only wants to do what she feels is safer for

> her patients. It was very obvious to me that she

> cares greatly about her patients and in fact she even

> said she takes each patient home with her each day.

> Being a retired nurse I totally understand where she

> is coming from. she gave me the option since I came to

> her specifically for the DS from out of state and had

> prior approval. Just thought I'd add my experience.

> BE HAPPY

>

> =====

> B 36yrs

> Pre-op 11-13-01

> Wt.308 BMI 49

> BCBS of MI Blue Choice POS

>

> __________________________________________________

>

[Guest guest]

My personal view is that Ren, , and Ganger are Lap surgeons

first and DS surgeons second. This explains their sudden interest in

the lap-band as well as Gagner's interest in doing " remote surgery "

with robotics. Hopping on to the latest trend gets headlines and

makes for nice journal articles. None of these surgeons bothered to

attend the informal evening session on the DS, and I think that

speaks volumes to there lack of commitement.

I agree with the premise of you question, why not do it open if lap

is not safe? From the patients point of view this makes perfect

sense. From the surgeons point of view the Lap technique may be seen

as the focus rather than the DS.

This is not to say the these surgeons are not good surgeons. But I

would advise people who feel as commited to the DS as I do to find

surgeons that feel likewise.

Hull

> I agree with you 1000% Theresa! I think other WLS require STRICTER

> compliance than DS.

>

> What I wonder is, if these Dr's aren't comfortable doing DS lap,

why

> not do it open rather than pushing BPD? Having open surgery is not

> the end of the world. I'd far rather go that way than have lap with

> someone who wasn't completely comfortable doing it. Yikes!

>

> Chris

>

[Guest guest]

Hi to you Nick-

From what I've heard, from numerous (unbiased)sources, the DS is the

most complex and risky of the weightloss surgeries currently

available. As we all know, any time anesthesia is involved, there is

inherent risk. But as far as the DS versuses the other WLS in that

regard, and to what degree it is or isn't more or less risky, I

cannot say. I'm not a doctor (yeah, nor do I play one on t.v.-haha);

I'm only relaying what I've learned through various forms of research.

However, having said that, I will add that that has NOT changed my

opinion on the surgery, nor my desire to have it. During my consult

with Dr. Ren a couple of months ago, I made this very clear and, to

be honest, got nothing but understanding and compliance from her. She

did go over all my options, making sure I was an educated consumer,

so to speak, but did not hedge when I expressed my desire to go

forward with the DS, while assuring her of my level of commitment

post-op.

Obviously, I am well aware of her recent decision to move towards the

BPD and limit the number of BPD/DS surgeries. Personally, I think

that's a shame. But I do respect her decision; she's the one who went

to medical school and dedicated her life to medicine(and from what

I've heard, gives 100% 24/7), and has to live with that decision. I'm

sure she's not taken it lightly and put a lot of thought into it

(even if the result is something many of us don't like or agree

with). I don't think this makes her any less of a good surgeon, just

one with perhaps more limited options.

So, if a future patient has a consultation with her, and it is

subsequently decided that she will not perform a DS on them, assuming

that's what they want, then they should find a surgeon who will

perform it. That's all. I think this surgery business is serious

stuff and I personally wouldn't compromise my choice, of which I was

sure I wanted, merely to appease the doctor. Afterall, I have to live

with the results the rest of MY life!

Anyway, enough said. We all do need to stick together and support

each other, pre and post-opers alike. As someone who's due to have

surgery in 2 weeks (though I'm still waiting to hear if I got the

okay from Oxford yet), I for one need all of it I can get! And I know

I'm not alone in that sentiment.

Best to you,

D. in NYC

pre-op 11/6/01 Dr. Ren

> Hi -

>

> You said: " " the lap DS is the most risky of surgeries . . . " If

that is

> so, there are other versions of the DS which are far more common

than the

> pure lap version.

>

> It would seem to me that a procedure that is so risky that it is

often

> performed in two stages is, in fact, more risky.

>

> Could it be that the open DS and the lap assisted DS are less

risky? Is the

> RNY less risky than either of these? I don't think so, myself, but

it would

> be interesting to hear other people's comments.

>

> When a surgery as superior as the DS is available, I am left with

the

> question of why any surgeon would perform it completely lap when

safer and

> equally effective versions are more commonly performed.

>

> Best -

>

> Nick in Sage

[Guest guest]

Hey Lisbeth,

A few days, eh? Wow! It's amazing how there is such a discrepency

between individuals and their insurance experiences. If only they

could all be as easy as yours (Elle, if you're reading this, I'm

wishing you good thoughts in your battle and know that you will come

out victorious! Hang in there and do NOT give up!)!

I have Oxford Freedom(through Cobra at the moment, actually), so

let's hope that I have the same luck as you. I know of another DS'er,

however, who didn't get approval until 3 days before surgery...eeks!

I am confused about something though I read in a subsequent post of

yours. You said that when you called Dr. Ren's office, when

contemplating surgery, that she said she wasn't in your network, yes?

I'm confused because she IS in Oxford's network. Is it possible that

changed since when you had your surgery?

Anyway, thanks for the reply. And congrats on getting below the 200

LB mark! !

~ D. in NYC

pre-op Dr. Ren 11/6/01

> > Hi -

> >

> > You said: " " the lap DS is the most risky of surgeries . . . " If

> that is

> > so, there are other versions of the DS which are far more common

> than the

> > pure lap version.

> >

> > It would seem to me that a procedure that is so risky that it is

> often

> > performed in two stages is, in fact, more risky.

> >

> > Could it be that the open DS and the lap assisted DS are less

> risky? Is the

> > RNY less risky than either of these? I don't think so, myself,

but

> it would

> > be interesting to hear other people's comments.

> >

> > When a surgery as superior as the DS is available, I am left with

> the

> > question of why any surgeon would perform it completely lap when

> safer and

> > equally effective versions are more commonly performed.

> >

> > Best -

> >

> > Nick in Sage

>

>

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