Aviator

Including your Pre-op BMI
Any other co-morbidities.

The pregnancy issue aside, VSG, while still a major operation, is far simpler. RNY is likely more effective, e.g. a greater % of your excess weight should be lost with RNY. In my pre-op BMI range (40) the statistical difference between VSG and RNY is 15 lbs. At higher BMIs the difference is markedly higher. The statistical complication rate is definitely higher for RNY.

We discussed going out of the country for surgery in another thread - and really, I'm not picking on you. Nor am I trying to convince you one way or the other. It is a decision you have to make

The issues of going to say Mexico or Puerto Rico that you should research:
1) How accessible is the doc going to be post-op?
2) If you have a malpractice related complication, what alternatives are available for redress?
3) Be aware that if you do have complications, and your foreign doc is "suddenly unavialable", a doc here in the US may be less than willing to risk his malpractice insurance and potential litigation for the piddldy amount of money he would receive for "aftercare" or cleaning up someone else's mess.

VSG here in Houston is $13,500. The quote you received was $9,500 in Puerto Rico. I guess RnY just costs your deductible amount. Each has an upside and a downside. Tough call...

My suggestion would be to arrange your choices in order of your "perceived risk". Put the cost next to each one. Write down "failure scenarios". Then put down intangible costs - airplane flights etc. - even for "follow up" visits. Then assign a $ value to the risk in each one. Share these thoughts with your surgeon. The choice may become clear.

(I'm betting you will pick RnY close to home. Any takers?)

BTW, I was similarly conflicted.

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Aviator aka AeroBear
Vertical Sleeve Gastrectomy
Surgery date: Dec 31, 2008
Post Op wt: 310
Current wt: 229.7
Goal wt: 210
Check out:
http://www.thinnertimesforum.com/per...-log-book.html

NorCalRN

Aviator,

I appreciate you being so straight forward. Do You mind sharing how you were similarly conflicted?

And just for clarification, the hospital I know of is in Costa Rica, and I would be required by the surgeon to stay there for 1 week post-op for daily follow ups in case of leaking, etc. The money spent for plane tickets and hotel, etc would be trivial compared to the surgery itself, and no- I would not travel back to Costa Rica for any follow up care later, unless it was more surgery (eg. my coworker plans to go back there for her excess skin removal, her experience has been so great with the surgeons, hospital, etc), although the Surgeons are readily available by phone and email if I need to speak with them. I have already done the homework and verified that my current physicians will do my follow up care here at home if this is what I decide to do. My insurance WILL cover any emergency surgery if that kind of need arose once I am back in the US.

Obviously, since most of my research has been into the VSG- I need to continue doing more research into the RNY to answer my personal questions.. My biggest obstacle to the RNY is that I am very much a "natural health" kind of person, maybe a modern-day hippie? lol. I am soooo resistant to the thought of having to uber-supplement myself with man-made vitamins that I currently get from my food, etc just because I can't eat enough or what-not. I know this sounds very trite and petty, but it is a major brain-block I have right now. It is all about changing the route and method of my digestion vs just changing the size.

Many many thanks to the ladies that responded to my original post- I have been reading so many pregnancy stories and I love them! Congrats to all the new mommies and I can't wait to join your ranks in the near future! You have all alleviated a ton of my anxiety on that front!

NorCalRN

Aviator

Sure NorcalRN. I started off wanting to do the lap-band. It seemed harmless enough, and was completely reversible. I joined TT in April 2008 and began lurking mostly. I went to a couple of WLS seminars and the concepts of all three procedures were introduced. Then in July something major happened. A doctor died of sepsis two weeks after having the band "installed" - while traveling! Now I travel a lot...I mean a lot! Mostly long haul internationl: China, India, Middle East, South America, Europe... and getting in infection could kill me.

Then I went thru my "no-holds-barred" phase, and decided to do RnY - the hands down winner on the largest amount of probable wt loss. Well my wife is a physician, and she was dead set against it. She was very concerned about my travel and having complications. My surgeon also urged me to consider VSG. I looked at all the risk factors and decided VSG was the way to go. Im now 4 monts post op and down 63 lbs and still losing.

Check out the whole story in Personal Stories/Aviator's Log Book. Its my story from Pre-op till now. You may find it interesting and informative. Also some of my travels, and some pics.

__________________

Aviator aka AeroBear
Vertical Sleeve Gastrectomy
Surgery date: Dec 31, 2008
Post Op wt: 310
Current wt: 229.7
Goal wt: 210
Check out:
http://www.thinnertimesforum.com/per...-log-book.html

NorCalRN

Aviator,

It seems that many of us have followed along the same thought processes. I started out completely anti-WLS. Then I started to think hey, LapBand is pretty minor, its reversible, etc... Then I researched and realized how scary LapBand can be. My Ins covers LB, but not any of the common complications, unless it requires removal-which ironically they will cover. So I looked into VSG, since I already shared my resistance to RNY... And now I am at a crossroads.

I've actually read most of your blog thread, and found it very informative and helpful- THANKS!

My fiance has given me an ultimatum though- I can have whichever surgery I decide on, no matter the personal cost. But I cannot go out of the country. So... I definitely respect his wishes, and will comply. I actually wanted to ask you about your surgeon/hospital because you said you were self-pay and I think you quoted the lowest numbers I've seen in the US so far... Can you pass on the info to me? Would be much appreciated.

I've been researching like crazy, and now my final concern between the two surgeries is the rate of weight regain down the road. My FIL had RNY about 6-7 years ago and has regained some weight. My MIL had VSG about 2 years ago and he is worried that she will def regain a lot of her weight. Know of any statistics along those lines??

Thanks again for piping in- I appreciate folks who aren't afraid to be the devils advocate. Much Respect to you, Sir!

Aviator

Jason Balette is great. He is on staff at two major hospitals Memorial Hermann and St. Lukes - both of which have branches in The Woodlands.

Jason Balette

There is a fabulous hotel close by: Woodlands Waterway Marriott Hotel

Cool shopping: The Woodlands Mall

And is only about 30 minutes from IAH (airport)

Oh.. Bones and I both office in The Woodlands too.

If you and you husband come, PM me. We can get together and I'll show you the ropes. Bones can give your hubby an idea of what to expect, aside from my Log Book.

RnY does have a rebound. Usually VSG does not. Jason will explain.

__________________

Aviator aka AeroBear
Vertical Sleeve Gastrectomy
Surgery date: Dec 31, 2008
Post Op wt: 310
Current wt: 229.7
Goal wt: 210
Check out:
http://www.thinnertimesforum.com/per...-log-book.html

ardita

Hey NorCalRN,

Five days post op VSG self pay here. I made a surgeon change at the 11th hour because my original did not do VSG and I decided that was what I really wanted. Had I not coming sliding in to new surgeon, ready to go and having them slip me right in to the surgery schedule of theirs, I would probably have opted to go to Houston to Aviator's doc and hospital.

After your surgery and post op appt, most medical issues get sent to your PCP, so though it would have been unsettling to not have surgeon near by, it would not really have been an issue. I am finding the experience to be a bigger head game than I expected and I am in the regrets stage but hope to get out. I am also down 11 lbs in 5 days so should not be so regretful but I do resent my body having been irreparably reconfigured. I was not at all interested in LapBand and originally planned RNY. The thought of the major body redesign was too much for me though ironically, in this stage of regret, RNY is reversible (go figure) while the much less intrusive VSG is not.

Good luck with your decision.

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NorCalRN

Aviator- Thank you! If we come down to TX, I will def be in touch. It's so nice to be able to pick the brains of those who have gone before!

Ardita- Congrats on your weight loss and hang in there! I too have been overall resistant to the body-reconstruction thing. But I remind myself that all this fat has already reconstructed my body in so many ways I HATE! So WLS is my way of fighting back and regaining the life I have lost to being fat. Like I said, hang in there and I am sure that once the weight starts pouring off of you and you begin to re-live your life, the reconstruction won't be too big of a deal anymore. Good Luck and keep updating with your progress!

NorCalRN

kizzy

I'm having to have surgery out of country too. I've chosen Mexico...I've done TONS of research...2 years worth on a Dr. who I feel is awesome IMO and I'd completely trust with my life. Anyways he charges $9,500 for the VSG and that includes airfair & hotel stay plus the hosptial & surgery!
Here is his website
DrJoya.com GASTRIC SLEEVE, RNY, LAPBAND, SURGERY: Laparoscopic Obesity Surgery
He has training from the united states and the hospital is based out of Texas
DrJoya.com GASTRIC SLEEVE, RNY, LAPBAND, SURGERY: Laparoscopic Obesity Surgery

Also search Dr. Joya on YouTube - Broadcast Yourself. and you can watch videos of people who have had surgery done with him.

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Aviator

Please let us know how it goes. I was just in Big D over the weekend for a christening. HOT up there! Greetings form Lake Conroe.

When is the surgery date?

Mexico eh? Are you going to take...um...a weapon?

__________________

Aviator aka AeroBear
Vertical Sleeve Gastrectomy
Surgery date: Dec 31, 2008
Post Op wt: 310
Current wt: 229.7
Goal wt: 210
Check out:
http://www.thinnertimesforum.com/per...-log-book.html

kizzy

LOL yes very hot...the weather here is crazy.


Yeah I was just thinking that myself...what weapon do you suggest

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