In pursuit of DS with Dr. Gagner; update after meeting with Dr. Dent

Dr. Dent was very kind, but said that with my BMI (36), there is no way OHIP would agree to cover DS or RNY. He encouraged me to try to get my lap-band working again. He agreed that Dr. Gagner is an excellent surgeon, but said that he would not under any cir****tances recommend me for the DS. When I asked why not, and what  the complications might be for someone with my BMI if I were to go ahead with it, he said I could very well end up being 80 lbs and looking like a concentration camp victim. He also said the mortality rate for the DS compared to the RNY is 4x greater, and that after 30 days, it is 27% higher. I'm still going ahead with my consultation with Dr. Gagner, but now I don't know what to think.

None of what Dr. Dent told you is true. I have spent the last six months doing extensive research on this issue. There is no evidence that people starting with lower BMIs lose an unhealthy amount of weight, they end up in the 80-90% of excess weight lost just like everyone else. There are studies from Europe where the DS is being performed on people with BMIs between 25-35 to cure diabetes and 98% of these people maintain a healthy weight. Less than 2% of people with BMIs LOWER THAN YOU had to be revised for malnutrition.

The mortality rate for the DS vs. RNY is exactly the same when comparing people of the same BMI. The DS is disproportionately performed on people with very high BMIs (60+) where the RNY is almost never performed. People with very high BMIs have more complications, which gives the DS its higher rate. But when you compare apples to apples (a 40 BMI RNY patient and a 40 BMI DS patient) the mortality is the same.

Dr. Dent appears to be biased against the DS. Does he even perform it? If not, I would request a proper assessment by a doc that is up to date on the resarch and actually performs the surgery - Dr. Hong in Hamilton.

I agree with Pat.  I had the Lap Band inserted in 2003.  Lost weight through restriction and vomiting, about a hundred and twenty five pounds, then ended up in treatment for an eating disorder that was well on its way to permanent kidney and liver failure. I then gained all the weight back and then some. I never, ever thought I would find a doctor that would do both the removal and the RNY.  I saw a bunch of different doctors, and it to make it even harder, the surgeon who did my original surgery lost his license for sexual misconduct and drug use.  The partner he left behind (as he is doing the same thing in Mexico, GROSS) did not want anything to do with me for two reasons - A) I was a failure in the eyes of the band community B) He didn't want to pick  up the pieces that his partner had left behind.

When St. Joe's in Hamilton announced their Bariatric program, one of thier criteria was No Previous Bariatric Surgeries.  Once they saw the amount of people that were being referred, they changed that.  I was VERY lucky to have Dr. Hong.  He had performed an extreme amount of Band to RNY conversions with no deaths, and he started in the States and moved here when the Bariatric Program started.  I am pretty sure that Anvari would have said no, so he wanted me to meet Hong specifically.

Despite all the potential complications that I had, four previous abdominal surgies, huge keloid scarring, whi*****luded having the band completly encapsulated with scar tissue.  He very clcearly laid out the problems that may occur, and I took that risk, because Band life was so miserable.

The surgery had a few complications, but I really believe that Dr. Hong is a great surgeon who tried to help out the folks who have been refused service. 

It's worth a try.  Don't hesitate to contact me.  Us 'Lap-Banders' need support when we have 'Gone against our tool'.

 It's good to know there are doctors/surgeons out there willing to help those in dire cir****tances.

I met with the "partner left behind" a few years ago and I was not exactly impressed with him.  I'll leave it at that as I don't want to say something to **** anyone off.  Although oddly he said he would have no problem doing the surgery on me close to my heaviest weight.  When other surgeons heard that they were baffled.

At any rate I'm glad things seem to have worked out for you in the end.  For the longest time I wanted the lap-band, however I suppose I can see why it was not the best option for me.  

Dr. Dent is not even a surgeon - he is just a bariatric specialist.

Why not consider the VSG?  At your BMI, you'd be good for sure - get rid of the complications that can come with the band, and avoid the need for life time supplementation etc.  And you could get that done in Ontario most likely.