should i tell my dr?

 Hi OH peeps. i had a question regarding insurance coverage. but first i'll give a little background to better understand. i went to the surgeons office on jan 2012. i had already set in my mind i want to get VSG. The surgeon was super nice but tried to convince me to get duodenal switch. He said ultimately its up to me, however at the time i just agreed to DS because of pressure. a week after i started attending the appointments for the nutritionist, diet etc. This whole time telling drs i'm getting VSG done. I was also assuming i would be meeting with the surgeon again before surgery so i would be able to tell him i wanted VSG. Cigna recently changed requirements for the diet so now my surgeons office is sending my paperwork next week instead of august as planned. so should i contact the surgeon office to remind them i'm getting VSG or does the insurance approve all weight loss surgeries no matter which the patient is getting? sorry for rambling and thanks for any feedback 

They need to submit the paperwork for the specific type of surgery you want to have.

I think it's a bit concerning that you felt so pressured by the surgeon that you agreed to have DS even though you didn't really want to.  Are you sure you would not prefer to switch to a different surgeon that didn't intimidate you so much?  Or are you typically intimidated by doctors?  And if you are typically intimidated by doctors, have you considered how you might deal with that so that you can advocate for yourself effectively?

 I TOTALLY agree with Kelly on this one...if you want the sleeve (which is a fantasatic surgery, in my opinion) you should get it!  Just remember, these surgeons...they work for YOU and if the sleeve is what you want, then that's what you get.  I'm so sick of drs being all "holier than thou" on this  type of issue.  I believe it's called "God complex."   If it were me, I'd get a new surgeon, this is your life and too important a decision.

Good luck honey!

Mallisa

I agree that you should call the Dr. and let him know your decision is VSG... I don't necessarily believe the Dr. has a holier then thou complex. I think these Dr.s see overweight patients every day and make suggestions based on what they feel is the best surgery for that person.

The OP said that he told her the ultimate decision is up to her but he is recommending DS. He obviously feels strongly that the DS is the better choice or he wouldn't be giving her that option.

Juls

 The VG is an effective surgery for some people, but most effective for those who have to lose about 70-80 pounds.  VG does not yet have long term statistics.  

DS has the best long-term statistics for keeping off weight.  It is the surgery most likely to be effective for someone with more than 100 pounds to lose.

If you insist on the VSG and your surgeon is not comfortable with that choice, then it might be most effective to find another surgeon.

I'm a bit confused by the question to be honest. Yes you should tell your surgeon that you want a different surgery then you agreed to. He doesn't know that you agreed because of pressure, so he's just assuming you're going ahead with what you said. If you dont' tell him - he wont' know.

You don't say who your surgeon is---but I suspect he wants you to have the full DS rather than just the Sleeve because your BMI is greater than . The DS has the VERY BEST long-term, maintained weight-loss stats for patients of any size, but especially so for those of us with a BMI greater than . It's also the very best at resolving or preventing co-morbs like diabetes and high cholesterol.

Have you researched the DS? The DS has the same stomach as the Sleeve, plus an intestinal bypass to induce dramatic, permanent metabolic changes. Most of us with a high BMI NEED that in order to be successful long-term.

Yes, you do need to talk frankly with your surgeon about this. I love my DS, but I agree that's NOT right for everyone. It does require a certain mind-set to be successful---no one should have a DS unless they're willing to devote the time and energy necessary to fully understand nutrition, metabolism, and malabsorption and its consequences. A successful DSer needs to take supplements daily, and, even more important, get regular bloodwork and do the homework necessary to track and understand their lab results. While the DS is the most effective form of WLS, it's also the one that can kill you the quickest. (They can ALL kill you if you don't follow the rules.)

 Before they submit ppwk, talk with the doctor again and ask him specifically WHY he thinks you will be more succesful with the DS than the VSG.  

What I can offer with Ms Batt is:

DS has best stats for long term weight loss and lowest stats for regain than any other wls.
DS is most recommended for those with higher BMI's because of this, however it's not reserved for them.  The requirements to get the DS are the same for other procedures. 
DS requires careful attention to nutritional needs.  So is the RNY, because they both create a degree of malabsorption of nutrients.  If you are unable or unwilling to grasp this, do NOT get either of these procedures.

Now, ask yourself - do yo lose weight easily when you diet?  Yes, I'm serious!
The reason that I ask is that the VSG and LapBand procedures simply limit how much food you can consume at one sitting, thus eating less.  Think of yourself on a diet with a dietary aid.  Bottom line, you're cutting calories.  If you cannot get results on your own, its important to understand that you get no added boost with these procedures.  Its also important to understand that these procedures are considered succesful if you lose only 50% of your excess weight.  If you are 150 lbs overweight, would you be delighted only being 75lbs overweight, or are you looking to get closer to a normal weight?  That's why these procedures are highly recommended to lightweights (those with BMI's 35-40)  Several manage to get to a normal weight, however there are also several with lackluster results, and some of those results are considered a surgical success.  Many are looking for a revision to finish the job.  

How many weight loss surgeries do you want in your lifetime?
Seriously, think long and hard about this.  Learn all you can.  Don't think convenience, think results.  Think of yourself and for yourself.  If you've learned all you can about the DS and know in your heart of hearts that cutting calories with the satiety of the VSG is enough for you to meet your goal, then assert yourself and say so.  If you lack the will to do that, then perhaps you're better off stepping back for a little longer and sorting out what you want and need.

 I have a different experience re dieting.  I got to the point that I could not lose weight when I dieted.  It would not come off.  Nothing happened.  And I would gain weight at the drop of a hat -- or at the drop of a cracker:)       Now that I am a fairly normal weight, I seem to lose weight like normal people when I am eating a sane amount of food.  And when I overeat (yes, I do), I don't gain as fast as I used to.   And it comes off easier.  From my perspective, either having the VSG or having lost the weight re-set my metabolism.  I don't know why, but that's my experience.   

I agree with some of the others- if you want the sleeve, that's what you should get. YOU have to live with it! My initial BMI was over 55, (now my BMI is 31 and I am still losing). My dr put me on  pre-op high protein, low carb diet and  I had the sleeve Dec 2011,  and I am very happy.  I used a dr from NY Presbyterian Hospital-Columbia University Medical Center in NYC & he didn't even suggest the ds. Most Drs in my area do not even do the DS and many have discouraged me from even considering the band. The sleeve not only restricts your intake, but it  reduces the hunger hormone ghrelin, without rerouting your digestive tract.

Many issues can come up as you move along in your journey, you should feel comfortable with the dr and his staff- if not, DEFINITELY find someone else!    Remember the journey really begins AFTER the surgery. Good luck.