Some advice please- disheartened

[Elmo10]

Hi guys. I went to see the consultant a few weeks ago and I was really disappointed. So far the bariatric team nurses, dietitian and psychologist have all been really nice and really took the time to speak to me and understand me. However when I went o the consultant appointment it was literally 5 mins. I didn't get to ask any questions i had prepared. I became nervous as I felt the consultant wasn't listening to me. He spoke over me when I was speaking And cut me off as if i was stupid. It all seemed a waste since I take annual leave for all my appointments and also it takes me an hour to drive. The main thing I am upset about is that I wanted a gastric sleeve. All the other health professionals were happy with this. But the consultant wasn't even listening to my reasoning. It seemed he wanted me to have a gastric bypass. I knw the consultant knows best. But I have done thorough research and it is the sleeve that I want. And I won't bore everyone with all the pros nod cons as I am sure u would have all read them. So. Am wanting advice... Do we not have a say in what we want? Is it fair to be pressurised into a procedure u don't wasn't? What can i say or do make him change his mind? Or listen to me? I'm so upset by all this. I really want to lose weight to live a healthier longer life. This is absolute last resort for me and not an easy option. I have never had any surgery and the idea of surgery was nt taken lightly or as a quick fix. I came in wanting gastric band then changed mind to gastric sleeve. But I feel a gastric bypass I way too intensive for me. And recovery is longer. The risks r increased. And generally I feel I don't need it. It's quite late now and I am worrying about this I can't seep so posting on here I've come to the point where if he is adamant I should have bypass when I want sleeve I might even decline altogether and try myself to lose weight. Which obviously hasn't worked as I wouldn't be here today and it'll be a waste of almost two years of weight management Gp, seminar, nurse, psychologist dietitian appointments if I was to give up now. I just felt so upset by the appointment I cried after. The way he spoke to me was as if he was speaking to me as I was stupid. Or something stuck to the bottom of his shoe. Such a let down wen everyone has been so nice. I was warned that he des speak a bit cut throat and not to let that put me off but I just thought it can't be that bad but it was. At least if he listened as to why I wanted sleeve over bypass it would have been ok. But he cut me off, said what he thinks, gave me review instructions and ushered me out. I am do to see him in a few months to discuss the surgery after he has got favourable letter of psychologist and lost a few more pounds to goal. Don't know what to do? Can't afford private. And really want to lose weight as want to try for a baby when healthier. :'(

 

[1happyloser2b]

Hi guys. I went to see the consultant a few weeks ago and I was really disappointed. So far the bariatric team nurses, dietitian and psychologist have all been really nice and really took the time to speak to me and understand me. However when I went o the consultant appointment it was literally 5 mins. I didn't get to ask any questions i had prepared. I became nervous as I felt the consultant wasn't listening to me. He spoke over me when I was speaking And cut me off as if i was stupid. It all seemed a waste since I take annual leave for all my appointments and also it takes me an hour to drive. The main thing I am upset about is that I wanted a gastric sleeve. All the other health professionals were happy with this. But the consultant wasn't even listening to my reasoning. It seemed he wanted me to have a gastric bypass. I knw the consultant knows best. But I have done thorough research and it is the sleeve that I want. And I won't bore everyone with all the pros nod cons as I am sure u would have all read them. So. Am wanting advice... Do we not have a say in what we want? Is it fair to be pressurised into a procedure u don't wasn't? What can i say or do make him change his mind? Or listen to me? I'm so upset by all this. I really want to lose weight to live a healthier longer life. This is absolute last resort for me and not an easy option. I have never had any surgery and the idea of surgery was nt taken lightly or as a quick fix. I came in wanting gastric band then changed mind to gastric sleeve. But I feel a gastric bypass I way too intensive for me. And recovery is longer. The risks r increased. And generally I feel I don't need it. It's quite late now and I am worrying about this I can't seep so posting on here I've come to the point where if he is adamant I should have bypass when I want sleeve I might even decline altogether and try myself to lose weight. Which obviously hasn't worked as I wouldn't be here today and it'll be a waste of almost two years of weight management Gp, seminar, nurse, psychologist dietitian appointments if I was to give up now. I just felt so upset by the appointment I cried after. The way he spoke to me was as if he was speaking to me as I was stupid. Or something stuck to the bottom of his shoe. Such a let down wen everyone has been so nice. I was warned that he des speak a bit cut throat and not to let that put me off but I just thought it can't be that bad but it was. At least if he listened as to why I wanted sleeve over bypass it would have been ok. But he cut me off, said what he thinks, gave me review instructions and ushered me out. I am do to see him in a few months to discuss the surgery after he has got favourable letter of psychologist and lost a few more pounds to goal. Don't know what to do? Can't afford private. And really want to lose weight as want to try for a baby when healthier. :'(

You should get what you want not what they are trying to get you to pick! Next time you tell that person you want to speak to someone who will listen to you and not talk over you! Don't let any make you change your mind!

 

[tealovingsleever]

Hi, I presume you're NHS? I was and they wanted me to have a bypass and I said no, even on the day of surgery they wanted me to do it. I stuck to my guns and got my sleeve and I love it. It is your body and they can't make you have something you don't want. If the sleeve doesn't give you the loss you want they won't convert it though xx

 

[Elmo10]

Hi tealovingsleever. Thanks so much for your message. I'm glad I'm not the only one being pressurised. Yes I am nhs. I am under north Tyneside with mr Seymour. I suppose they probably want everyone to have a gastric bypass as it is the gold standard. But all the nurse dietitian and psychologist thought it was too
Drastic for me. Thy said apparently I am
One of the "smaller ones". My bmi is 39 currently. Although I am very short and the effects of the weight are really taking its toll
On me. I am not a naturally assertive person and over the years of having body image issues and low confidence I find I'm not very assertive so
I found myself claming up and not putting my thought forward when he didn't let me speak. What did u say to them when u said u wanted a sleeve? Did u have to give reasons or did u just say this is what u want? I'm not
Worried whether they will
Redo my surgery after or not because I know
For definite this is my last resort and this is what is going to work for me. The sleeve. For a moment after the consultation I was thinking ok I'll go with what he says as I really want the weight gone. But then I felt I was being pressurised into something I really didn't want it all seems wrong to
Me. I really hope he comes around next time I see him and agree to the sleeve. X

 

[JoJoTGirl]

You can't go ahead with something you aren't "comfortable" with. My BMI was much higher than yours and I too came into the process as a very last resort thinking I would go only band, band or band because it was reversible. I too decided that reversible wasn't actually all that good for me and copromised on sleeve as I was terrified by all the horror stories about malabsorbtion etc with the bypass (some of which I now know are avoidable / treatable anyway.....not dissing bypass in any way - I was just too chicken reallY!).
I decided that as I was in a position to go private, I would rather than jump through the NHS hoops and / or use their resources. Not everyone is as lucky as me I know but that doesn't mean that you should be forced into doing something you don't want to. Throughout this process I have been amazed to have encountered only supportive and encouraging health care profesionals but I have heard from others that not everyone is so. Don't let yourself be bullied any further. Take a partner, relative or trusted friend to the next appointment with you and prepare them to speak up on your behalf if you feel you can't again. When the point of dicussion is such an emotive issue for an individual, it can be difficult to speak up but if that companion does so in the first instance, it will be easier to join in and state your case. I wish you the very best of luck and am sorry you are feeling so upset by this rotter of a doctor!

 

[Elmo10]

Thanks once again for the response. I was feeling really down and alone the last few weeks and ready to give up. But I'm feeling stronger now
From what u guys have said. I do have to give credit to the other health care professionals though as they were really nice it was just this one occaision. Probably won't make sense but u know when u have a gut feeling. I know in my self that it's not the bypass I want. And I will defo be much stronger next time. Unfortunately don't really have anyone I can take with me. My partner works away and family members don't really no. But I'll be stronger next time now that I know I'm not the only one that faced this dilemma. I won't let the consultant make me nervous.
At the end of the day losing weight will reduce my chances of so many major diseases and not only will help me it'll save the nhs money in the long run. Many hugs. Feeling a bit better now

 

[rickysmrs]

if you get the chance to speak with the pysc before they send in there assessment make sure they are aware of what you want and let them know how presserised you felt with the consultant. They may be able to put it in there assessment letter to him. Hope all goes well. x

 

[Stephers]

Hi Elmo10, I'm sorry you've had such a horrible consultation. My NHS team consistently advised me to have a gastric bypass. By the time I'd decided to go private I had chosen a sleeve after lots of reading around. When I spoke to my consultant he explained his rationale for a bypass in my case, it made sense and I was happy with his reasoning. It's a shame your consultant couldn't offer you the same consideration.
Maybe it would be helpful to talk to a more friendly member of the weight loss surgery team. They can let you know what the consequences of changing your consulant would be, and if it wont delay you further, how to go about it.
Best of luck, keep going, don't let this break your stride.

 

[Sharonimo]

Thy said apparently I am one of the "smaller ones". My bmi is 39 currently. Although I am very short and the effects of the weight are really taking its toll on me. I am not a naturally assertive person and over the years of having body image issues and low confidence I find I'm not very assertive so I found myself clamming up and not putting my thought forward when he didn't let me speak. What did u say to them when u said u wanted a sleeve? Did u have to give reasons or did u just say this is what u want?

Hi Elmo,

I had the same problem. My surgeon (Mr Sufi on the NHS) is very very pro bypass -- it is his preferred surgery of choice even though there have been THREE bypass deaths at the Whittington in the past 5 years (one of which was in the last 6 months).

When I went for my first consultation with Mr Sufi I had print outs with me:

1. of all the Springer Link medical research on sleeve weight loss
2. all the complications associations with bypass
3. the 2 x news / coroner's reports of the (at that time) 2 x bypass deaths at the Whittington **

** There has since been a third, late 2012 (someone I am vaguely aware of, did not know personally, but someone who was a member of the Whittington Support group that I attend).

I made my case with conviction to Mr Sufi and he let me have my choice -- they CANNOT force you to have an operation that you do not want -- especially if your MAIN reason for not wanting the bypass is "I do not want to die on the operating table and you've already had THREE bypass deaths but ZERO sleeve deaths -- how much clearer can I make it? I do NOT want to be the next bypass statistic.".

They would be sued to kingdom come and medically negligent if they performed a bypass operation on you that you had not consented to -- especially if anything went wrong.

(Yes I know things can also go wrong with a sleeve op -- but the same principal applies -- if someone wanted a bypass and was forced into accepting a sleeve because the surgeon was tired and just did not feel like putting in the extra time that day ..... and they ended up with a sleeve with a leak, then the patient could sue for NOT giving them the operation they had consented to.)

I wish I could say "PM" me (private message me) but you need to have made at least 50 posts on this forum to be able to PM other members.

 

[tealovingsleever]

What did u say to them when u said u wanted a sleeve?

Hi, sorry for the delay getting back to you, I've just got home from work.

I told them I was young, my eating habits weren't generally bad just large portions, I didn't want malnutrition etc.

To me the sleeve made sense as I had to pick the right foods but it limited my portions.

They accepted it, just have your answers ready, write them down if it helps. Remember this is your journey and you have to live with it. Sometimes I think the surgeons forget that and just start with the one that will give the most chance of success.

I had my 6 month check up in jan and my surgeon said we'll have to consider whether I have a bypass in July depending on how much I lose! I couldn't believe it. I told him if I didn't lose another lb I wouldn't be having another op!

Anyway hope I've helped. Unless you're diabetic the bypass seems way OTT for someone with your BMI, mine was over 50 xx

 

[tealovingsleever]

Don't know how I put that all in a box!

 

[Elmo10]

To everyone that has replied to this thread. THANK YOU so much. Yeah he didn't really give me much reasoning for the bypass. I am not diabetic either. He said it was the gold standard (which i can appreciate but still don't think its for me) and he also said because i was of carribean ethnicity more likely to Get diabetes. Which is correct. But again losing any Weight will help that and doesn't necessarily mean i should go for a bypass. This was when i started talking about why i wanted a sleeve and he cut Me off. Everything u guys have said makes sense. I will try not to get so nervous next time and succumb to pressure. Yeah I am also against the bypass because of malabsorption and dumping. And the death rates. I already did think of speaking to the psychologist and hoping she might put it in her letter so that's good advice. And I think I may print out some of those papers too to take with me. I think your right sometimes they think all patients are the same instead of looking at everyone on a individual basis. I actually work in the medical field myself dealing with patients and have a phd so I'm quite aware of the risks and complications etc. (i know i don't know how i let myself get to this stage when i know all the complications of being overweight eek. But better to get help earlier that never. Which is why I am here) the psych and nurse thought sleeve was best for me as I am 26 and with my weight and hoping to conceive in a few years and getting married end of year too. And also I read (correct me if my source was wrong) the recovery for a bypass can be up to 3 months Wherease it is 3 weeks for sleeve. Given my job I really want the least recovery time and complications. And although there is chances of death in both procedures it is higher as per the stats with bypass. How scary about the death rates at Whittington though. I did placement there a long time ago :/ . Thanks once again to everyone that has written on here. Xxx

 

[tealovingsleever]

Glad we have helped. I was off work for 2 weeks with my sleeve and could have gone back sooner, everyone is different though.

 

[Sharonimo]

And also I read (correct me if my source was wrong) the recovery for a bypass can be up to 3 months Wherease it is 3 weeks for sleeve.

Actually I believe there is little difference in recovery times (for laproscopic keyhole surgery -- sleeve or bypass), certainly not as much as you mention. Granted I only took 2 weeks and was back to work in Week 3 post sleeve, but I am not sure there would have been that much difference with a bypass.

The only reason I could think why someone might have a 3 month recovery time is due to "open" surgery, otherwise the norm is about 2 - 4 weeks (average).

How scary about the death rates at Whittington though.

It's not unique. In fact it might be slightly high because the Whittington is one of the largest dedicated bariatric centres in the UK -- the more ops you do, the more statistics you will get. I think there is unlikely to be any UK hospital specialising in bariatrics that has not had at least one fatality.

 

[paddyp]

Sharonimo can I just ask - how do you know the deaths were due to the bypass and not just due to surgery itself? If the patients were very high risk ie super morbidly obese, then I understand the bypass would be the most likely surgery, however if they were high risk and had the sleeve then the outcome possibly would have been the same?

I always worry when statistics are quoted without background information because it doesn't always paint an accurate picture and has dramatic effects on (people like) me who worry more.

 

[Elmo10]

I suppose the more co-morbidities you have such as diabetes or circulatory/heart problems/the more increased weight the more there is an increased chance of complications arising from any type surgery or even death. I find the idea scary too. I've never had any surgery before so this is a big deal for me.Its like what comes first the chicken or the egg. Often with increased weight we have health problems such as diabetes or heart problems but we want to have bariatric surgery to improve that. But then those factors can arise to increased chances of complications. So it all goes hand in hand. And I think any statistic of death or complications still matters even if it's because of of the other factors it's still precipitated by the surgery or precipitated by the disease when doing surgery which ever way you want to look at it. Then again u may just be unlucky and have no other health problems but still end up with a complication. Scary as it is its Kind of a gamble really. But my prayers are with everyone. May everyone get out of the surgery healthy and well. Xxx

 

[Elmo10]

Although the problems may arise with any surgery. I think as the bypass is more intensive of the procedures there is more of an increased chance of complications and death. That's what the consultant said at the seminar. He did give some statistics a ratio for both out of 1000 patients but i can't remember and had a look online and couldn't find them either. This is one of
The reasons I want to get the sleeve. I was going to say this to him before he cut me
Off also. X

 

[Sharonimo]

Sharonimo can I just ask - how do you know the deaths were due to the bypass and not just due to surgery itself? If the patients were very high risk ie super morbidly obese, then I understand the bypass would be the most likely surgery, however if they were high risk and had the sleeve then the outcome possibly would have been the same?

Because the causes of death were:

1. bowel obstruction
2. intestinal complications post op
3. starvation due to malnutrition *and* bowel obstruction

The bypass carries higher risks *due* to the 3 part surgery: (1) creating the pouch, (2) creating a stoma to attach the lower intestine to the pouch, (3) creating another stoma to reconnect the original intestine (from the remainder large stomach left behind) to the lower part of the intestines.

Of the many many bypass death reports I researched before my own op, complications due to bowel obstruction / hernias / Petersen's hernia / the intestinal re-routing were the LARGEST factor in bypass deaths, not the weight and health of the patient pre op.

The 3rd death (3) above was reported in the Evening Standard: Woman starves to death after weight-loss surgery - News - London Evening Standard ...... and apart from starvation the report also mentions:

A post-mortem examination gave the cause of death as bowel obstruction, contributed to by malnutrition.

I won't link all the others before I am accused of scare mongering (although I have links for anyone who wants to PM me privately).

I *can* understand why if someone is over 25 stone they would consider the bypass their *best* bet, their best chance of getting the weight off, certainly if I had been nearer to 30 stones myself I might have been willing to take the extra risk due to the (likely) extra weight loss.

However, I also know that these statistics are *rare* they are only 1 in (approx) every 500 ops ...... but for me, I decided not to take the extra risk, as statistically the sleeve does have a lower mortality rate.

I *know* that there are many 100's of happy, successful, slim and healthy post op bypassers on here (and elsewhere) who have been totally happy with the op. And if I had chosen differently it is entirely possible I might have ended up a happy bypasser.

It's just that, for me, when I was weighing up the various risk factors the slighty higher mortality rate, and complications post op of the bypass, made me veer towards the sleeve.

 

[Elmo10]

Wow sharonimo. Thanks for all that info. And I wouldn't mind seeing the other links. Would rather know. I hope if the consultant goes on about having a bypass again I can explain all this to him and not get all nervous and clam up like last time.

 

[paddyp]

Thanks for the info Sharonimo. I would be grateful if I could see the links too as I will mention it to my surgeon when I finally get an appt.