Re: The fallibility of surgeons

[Guest guest]

Kay,

What a fantastic letter. I feel you shared your experience in a

thoughtful and responsible manner and the ultimate conclusion that I

come to, is that because someone has a bad or good experience, it

does not insure that my experience will be the same.

I have recently gone through a similar situation in the way that my

insurance papers were handled by my surgeons office. I guess the

correct statement was how my insurance papers were never handled.

Upon discovering that nothing had been done in the promised

timeframe, I was then threatened and told I would be put at the

bottom of all pending surgical requests.

This was my experience, and I left that practice because working with

those in charge corrected nothing. Since then, the situation has

changed and hopefully, new patients will never experience what I and

many others did because we had the " balls " or is that temerity, in

polite circles, to speak up.

I do not take anything away from those who were treated wonderfully.

They SHOULD have been. However, the flame war that started because I

shared my experience was enlightening. Somehow, I feel recent

actions on behalf of my prior surgeon have vindicated me.

Regardless, ultimately, I feel what happened to me was meant to be,

because my current surgeon and his practice have reduced my anxiety

level to zero, just in their efficiency, " bedside manner " and

reliability.

Thank you for sharing your story. The moral is, we are all entitled

to a little support, and your experience does not invalidate mine and

vice a versa.

Hugs,

theresa

> This will be a long-winded post, because I've had two DS surgeons,

> both of whom have generated some controversy.

>

> I've been bemused in recent months to see that both the surgeons

with

> whom I signed up for the operation–Hazem Elariny and

> Ren–have proved to be less than committed to the BPD/DS. They're

> both young surgeons who are still carving out identities for their

> practices. Elariny seems uncomfortable with malabsorption as a

means

> to weight loss, as he is persuading more and more of those who come

> to him for the BPD/DS to opt for Elariny's stand-alone sleeve

> gastrectomy instead. Ren has become a proponent of the Lap Band

> since the FDA approved that procedure recently. I thought that

meant

> that she too was beginning to prefer purely restrictive procedures

to

> malabsorptive ones, until the recent news that she's embracing the

> BPD without the DS.

>

> Many people have asked me how I came to switch from Elariny to

Ren.

> Last winter, on the night before my scheduled BPD/DS, Elariny

called

> me at home to tell me that he had just reviewed the pre-op tests I

> had taken nearly two weeks earlier. Though I had no history of

heart

> trouble, the EKG disclosed that I was a possible candidate for open-

> heart surgery, he said. While I was still recovering from the

shock

> of this, Elariny went on that if by chance I got to have my

operation

> the next day, I'd have to agree to have it open, rather than lap,

> because of adhesions. (I had had one previous abdominal surgery,

so

> I didn't realize until later in the conversation that he'd confused

> me with a patient who'd had three Caesarean sections.) If I

insisted

> on having it done lap, Elariny said, I'd have to be willing to wake

> up with " just the top " of the operation done–which was my

> introduction to Elariny's stand-alone sleeve gastrectomy. He tried

> to sell it to me as a " superior " operation to the DS, but I was in

no

> shape to process the information.

>

> Having received lots of sweet e-mails from fellow members of AMOS

> wishing me well, I thought it was only fair that I let them know

that

> my surgery was canceled the next day as I lay on the table (Elariny

> did not show up at the hospital, choosing to deal with the

> anesthesiologist and the cardiologist by phone instead). It was

> the " surgery canceled " post to AMOS that brought about my parting

> from Elariny. He didn't appreciate my telling other pre-ops that

he

> had waited until the night before my surgery to review the pre-op

> tests, and told me to find myself another surgeon. (He had also,

by

> the way, left me on my own, without map, suggestion, or referral,

to

> figure out whether in fact I had a heart problem. A stress test by

a

> cardiologist found no abnormality and cleared me for surgery,

meaning

> that had Elariny looked at my tests even a few days earlier, my

> operation could have proceeded on schedule.)

>

> What continues to baffle me is the reaction of my fellow Elariny

> patients to my news about Elariny. Many of the same people who

had

> embraced me so warmly before, with the empathy that is so evident

on

> this list and others, now attacked me–there's no other word for

> it–for saying such mean things about their savior. Elariny

> couldn't have acted like that, spoken like that; I must be a liar,

I

> must be crazy. I was called a psycho on more than one Internet

> site. A member of this list with whom I had commiserated in a

> private e-mail used the matter as an excuse to betray a

confidence.

> And then there were those who lined up to " take credit " for blowing

> the whistle on me. Each Elariny loyalist was serenely certain that

> it was her exposure of the " incriminating " Internet posting that

had

> put me out on the street to find another surgeon. I suppose they

all

> must have wanted me to post their names publicly, so that they

could

> win the applause of their fellow Elariny devotees. I denied them

the

> publicity; I didn't even respond to their e-mails. I simply

deleted

> their messages and blocked their addresses.

>

> This surgery is no mere operation; it's the Holy Grail. Between

the

> night of Elariny's dire pronouncement and the day I was cleared for

> surgery, I daydreamed about digging my " defective " heart out of my

> chest with a dull knife (if it was keeping me from having the

> surgery, I wanted to be rid of it). How could anyone believe that

I

> had just " made up " a set of circumstances that caused me to have to

> start this emotionally draining process all over again?

>

> I was ready to go to Dr. Baltasar in Spain on a raft if I had to,

> rather than get in line for another U.S. surgeon. Dr. Ren's office

> penciled me in immediately, and for that and much more I am and

will

> remain grateful to her. Some will say I should I have waited for a

> more experienced surgeon, and maybe they're right; but at that

point,

> waiting was intolerable. To those who poo-poo the importance of

> bedside manner, I must say that the warmth and empathy that my

family

> and I found in her was therapy in itself, a huge factor in getting

us

> all to and through the surgery. And the BPD/DS she performed on me

> would appear at this point to be flawless. At nearly eight months

> post-op, I have had no pains, no gastrointestinal distress, no

> vitamin or mineral deficiencies, no problems of any sort, and my

> weight loss is proceeding on schedule.

>

> Deb Mullen's surgery with Dr. Ren preceded mine, but I heard

nothing

> of her difficulties until well afterward. I'm not qualified to say

> whether what happened during Deb's surgery was inevitable due to

> Deb's anatomy, was the product of the surgeon's inexperience, or

was

> some combination of the two. I don't need to know the answer to

that

> to empathize with Deb's pain and feelings of betrayal and

violation.

> That my experience with Dr. Ren was almost the antithesis of Deb's

> never led me to believe that Deb must be deluded, dishonest, or in

> need of psychiatric care. I will never say that Dr. Ren " couldn't "

> have made the statements Deb attributes to her, even though they

were

> so different from what Dr. Ren has said to me. Deb still has my

best

> wishes; Dr. Ren still has my gratitude.

>

> I am a firm believer in malabsorption as a means to permanent

weight

> loss and therefore no fan of any purely restrictive surgery. Dr.

Ren

> has taken heat on this list for advocating the Lap Band, but at

least

> it offers enough restriction to do some good to the more moderately

> obese among us, it's adjustable, and its minimal invasiveness means

> that it will be undergone by those who otherwise would be unwilling

> to try any weight-loss surgery at all. I still doubt that it will

> prove to be the answer for a significant percentage of the morbidly

> obese. Dr. Elariny's stand-alone sleeve gastrectomy has come in

for

> comparatively little criticism on this list, even though it tries

to

> force the reduced stomach to carry the full burden of weight loss

and

> maintenance, a function the BPD/DS's creator says it can't carry by

> itself. If we care that people who come to Drs. Ren and

> for the BPD/DS will now be offered only the BPD instead, we should

> care that Elariny is persuading increasing numbers of those who

come

> to him for the BPD/DS to opt for the unadorned sleeve gastrectomy.

> Some of them (as I've seen on the Elariny list) even come away with

> the impression that the sleeve gastrectomy is " minor " surgery,

which

> it is not. And if we care that the BPD leaves the patient without

> the pylorus, we should care that Elariny is reported on the DS-

> Elariny list to be offering his sleeve-gastrectomy patients the

> option of intentionally disabling the pylorus. If there has been

any

> discussion of that on this list, I've missed it.

>

> Meanwhile, I'm loving malabsorption. It has set me free: free from

> stuffing myself beyond satiation today because I must begin the

diet-

> to-end-all-diets tomorrow. No more dieting for me. I love the

> feeling of being satisfied with little food. I love being able to

> stop with " just one " of a sweet treat without feeling deprived.

> I feel smug when a package of cookies or candy lasts for weeks or

> just goes unopened. At eight months out, I've lost more than sixty

> percent of my excess weight. Bones are bursting out all over me.

> And I'm glorying in the unfamiliar lingering glances of men.

[Guest guest]

Thank you for your thoughtful, insightful post. I was not aware of

the decision that Dr E made not to do the DS now. If this is true,

then I trust that will remove his name from the DS list and

his happy post op DS patients will not refer more patients to see him.

I am glad you had a flawless surgery by Dr Ren. I wish you well and

a long and thin life.

, Seattle

> This will be a long-winded post, because I've had two DS surgeons,

> both of whom have generated some controversy.

>

> I've been bemused in recent months to see that both the surgeons

with