Dilemma
 

When I finally made the decision to go ahead with WLS, I made the decision based on a lot of things, but the main factor was that my insurance company will finally cover the lapband procedure/aftercare/etc. I am currently in a holding pattern because I don't have 6 months' supervised weight loss efforts (though I have a huge history of weight loss attempts). So, I thought I'd see what I could find out about the surgeons in my area. I work at the hospital, so I know the bedside manners and the way the surgeons treat people.

I just found out that, yes my insurance company will pay for it, but now there's only one doctor who can/will do it here in town, and he's only done 5 of them to date. He's done well over 200 RNY surgeries, but only recently started doing the lapband. The program itself only started about 2 years ago, so it really doesn't surprise me, but it disheartens me. I can't stand this doctor. That's putting it very mildly. He has a very big attitude problem with patients and staff alike, and his bedside manner absolutely sucks.

Unfortunately, because I live in a very small state, and my insurance won't cover any out of state procedures, I'm left with three choices: Say forget it and don't bother with any surgery, put up with someone I loathe for the rest of my life (as it really is a lifetime commitment, and you have to agree to come in for check ups yearly for the rest of your life if you remain banded), or go ahead and have the RNY done with another surgeon.

Any advice ladies?

wow. you DO have a few issues here. there's GOTTA be a program somewhere else. is there any chance that there's someone within a reasonable travel distance who is on your insurance and who might be a better 'fit' for you?

gotta tell you - the REAL issues are the support afterwards, and ya gotta trust and be able to talk to the people involved. he's probably a good technician, but that alone doesn't mean you'll have a good outcome. check out the support system that's associated with him - that's the real test.

you're a candidate for either surgery. i can't help you there. keep us posted! let us know what you're thinking

Does he have a support staff you CAN be comfortable with?

Wow ... that is a tough position to be in. Follow up care with your surgeon is really important with the Lap-Band ... and in the first year you'll probably be seeing him at least monthly. How is the rest of his office staff? Does he have a support group from which you can get support?

I'd be concerned with such an inexperienced doctor ... but I'm a natural born worrier.

After care with the Band is really super important. Make sure that this doctor understands how Lap-Band after care differs from RNY after care. They are considerably different approaches.

Doctors who have a lot of experience with RNY but little with the Band tend to treat their Lap-Band patients like RNY patients with the same after care instructions and diets. Talk to the surgeon and ask him what his plan is for your after care and how it will differ from his RNY patients.

I suggest carefully reading the book "Laparoscopic Adjustable Gastric Banding" by Jessie Ahroni and be really educated on after care so that when you're asking him questions you know what kind of answers you should be looking for. Jessie Ahroni is a Nurse Practitioner and clinician who works with Lap-Band patients and is also a Lap-Band patient. She really knows her stuff and her book is very easy to read and understand.

If he gives you answers that indicate you'll be treated the same as his RNY patients then be alert to the need to educate him or find a new doc for aftercare if necessary/possible.

I don't mean to be discouraging - but the truth of the matter is that patients with experienced doctors tend to loose more weight with fewer complications than patients with inexperienced doctors. This is reflected in the results of the FDA trials. The weight loss results were less than impressive and the complication rate was higher than it is now. The results statistics have improved as Lap-Band surgeons have gained experience both in performing the surgery and in caring for patients after surgery.

Arm yourself with as much information as possible before making a decision.

Best wishes,

Thank you all for your suggestions. As it stands right now, he's my only option for lapbanding. My insurance absolutely refuses to pay for me to go out of state, and there's nobody else in my state who does it. His staff seems nice, but I'm not sure I could handle seeing him that often.

I'm biding my time, going for my weigh ins every month, and hoping in the mean time that another option will open up. If not, I'll have to seriously consider having RNY done, or waiting a bit longer. Either way, I'm not giving up entirely!

Hi brandnewme,

I'm not really experienced with insurance companies, but I'm wondering if you can appeal that whole out of state thing based on their band inexperience? I had a really great surgical team in northern Colorado (Dr. Johnell in Greeley) and since it looks like you're in Wyoming it wouldn't be very far. My suggestion is to call Dr. Johnell's office and ask the staff if they've ever found a way around this problem. They're really good at working with insurance companies and if there are any ways around this problem, they'll know them. If you want any info on them, PM me.

Just my thought,
Chickadee

Chickadee, thanks for the information! I'm PMing you now.