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Brisvegas Girl

Lower BMI Sleeve..Surgical Revision After Lapband Eroded

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Hello...I'm booked in to have Gastric Sleeve surgery this coming Tues 26/06. I got the call yesterday afternoon telling me there'd been a last minute cancellation on the Surgeon's (who is filling in for my usual Surgeon who is on LSL) list and I was going to be scheduled for the operation instead!!! :o  I had Lapband surgery in Oct 2009 weighing in at 112.5kg's and was 54kg's when I fell pregnant with our Rainbow Baby in Dec 2013 :wub: 

 

When I was around 22wks I suddenly lost all restriction in my band. Both my GP (who works with my Surgeon) and my Surgeon thought there was a leak in either the port or the tubing. As I was pregnant, I couldn't have a barium swallow to confirm and had to wait 6 wks after my daughter was delivered to have surgery to correct it. When my surgeon went in to find the issue, he discovered that my band had eroded into my stomach and removed it immediately. :unsure: 

 

I now weigh 81kg's and have a BMI of around 30. I'm wondering if there's anyone reading this post who's had the Sleeve done with a BMI similar or the same as mine and if so, how successful has it been/not been for you?? I've been told I'll be in hospital for 3 nights (am going Public) so am quite anxious about being away from my daughter even though she'll be at home with her Dad (my Hubby :)) and both my sisters will come visit her as well. She's coming up to 9 months next week so is old enough to miss me this time. Last time when I had the band removed, she was only a little over 6 wks old (what was meant to be Day Surgery ended up being a 2 day stay) so didn't really notice I was gone. I, on the other hand, didn't cope very well at all :lol:

 

I'm also feeling a bit unnerved that my normal Surgeon isn't doing the operation as his fill in hasn't done all that many sleeve surgeries as such (about 30). He's a General Surgeon who works in 2 hospitals here as well as one day a month with my normal Surgeon in the Private Health Sector. He's Australian and trained o/seas in America as well as here and is apparently highly skilled in other Upper GI surgeries that are more complicated skills-wise than doing a sleeve as well as being highly experienced in Laparoscopic surgeries of various types. I've been told by the Practice Manager that my

normal Surgeon wants him to go and work fulltime in his practice over in the Private Health Sector/Hospital next year.

 

Nevertheless, am still freaking right out!!!! :unsure:  Unfortunately my normal Surgeon isn't back until the end of Sept/beginning of Oct and being a Public Hospital, it's a case of take the opportunity offered to me or go back to the bottom of the list :( Anyhoo...I'm also wondering what to expect after it pain-wise and such and how long it took to recover enough to be able to do basic stuff around the house etc. Am reading up on previously posted threads here, so will see what info I can get from them :)  Any other hints/tips will be gratefully received as well :)

 

P.S......Apologies for the novel!!! :lol:

 

 

 

 

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The lapband didn't work out for me and I had the sleeve done instead. I was also done by a Brisbane surgeon (but in the private system) :) . I was about 85kgs when I called it quits with the band and my surgeon had no issues with swapping me to a sleeve. I was in hospital for about a week because of complications (not anyone's fault - just my body hates me!) but I was told 2-3 days is a normal stay for the procedure. 

 

I am now curious as to who your surgeons are/will be! Just going what you have said about the fill-in surgeon, he sounds ok :) but if you aren't comfortable with it, don't go through with it.

 

I am very happy with my sleeve :) I am not at goal weight yet, because I won't put the chocolate away but it has really helped me :)

 

You probably won't lose weight as fast as someone who has only ever just had a sleeve. Band-to-sleevers tend to have a slightly slower weight loss experience.

 

Best of luck :D

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Personally I found the pain was managed with Endone, but omg it tastes so bad crushed up (you can't swallow tablets). After a few days I generally went down to one dose a day, but I went back to work early and found sitting at a desk seemed to put some kind of uncomfortable pressure that turned to pain and for a week or so I kept having a pill a day but all good now. I manage everything fine except try to be careful about picking things up off the floor.

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@BeeBop My normal Surgeon is Blair Bowden :)  He's fantastic!!! I had the lapband done Privately with him but am unable to afford to go Private again to have the sleeve done. I won't post who his fill in Surgeon as I don't want to give the wrong impression of him to anyone..especially anyone who may know him or is being operated on by him. Am happy to PM his name to you :) 

 

I was told by the FIS (fill in surgeon...Decided to use an acronym to make it easier :lol: ) that I would lose 15kg's pretty easily after the surgery and that anymore than that would be a bonus basically :mellow:  I'm aiming to get back down to where I was before shiz hit the fan with pregnancy and the band eroding LOL Is a 27kg loss achievable do you think in light of my starting weight??

 

I'd love to have the option of waiting for Blair to come back and do the surgery, but being a public patient in a public hospital doesn't give me that option. I could say no to this guy doing the surgery, but then it'd be back to the bottom of the list to wait God knows how long for Blair to do it and then what if he's on holidays or sick etc when my turn came up again?? I'd be in exactly the same position that I'm in now so I think I have to trust that if Blair thinks/knows he's good enough then I have to believe it too.

 

Appreciate the reply and well wishes too and Congrat's to you being halfway to goal!!! :) 

 

 

 

@DavidR Thanks for replying to my post :)  Was wondering about the tablet situation. I've had Endone before, but never crushed up!! Sounds vile, but what else can you do??? Is the tablet thing just temporary until everything heals or will I have to crush them up for the rest of my life?? :unsure:

Work's not going to be an issue as I'm home looking after my daughter. Picking her up sounds like it might be an issue for a while, so am going to have to think about how I can do that safely????

 

BTW...Congrat's on the weight loss thus far!! Fantastic results!!! :)

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goldilocks - my surgeon's recommendation is for only light activity for the first 6 weeks. I've been really conscious about lifting things, especially my kids. I'm just following the 'plan' and making sure I can honestly say I didn't do the wrong thing and put myself at risk. Re: the pills, nah, I think as of 4th week you can start having pills again. I'm just double checking with my surgeon on that before I start taking vitamins in my 5th week. By the way, are you aware you can access your super to pay for the op if you don't want to go public? You can choose the surgeon you want with a referall from your GP and assuming they aren't busy you could be having surgery a handful of weeks later.

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I was considered a "lower" BMI sleeve when I was booked in, although I was over 100kg so not as low as you! As far as weight loss, I was told that my weight loss would be slower and much less than someone with a lot more weight to lose.. not really sure why that is, because my surgeon said the sizes of the sleeves he does are the same regardless, but I guess it's just how it works with your body, and the literature shows that lower BMI/weight = less weight loss, and possibly slower weight loss. Anyway, he said he'd consider the surgery a success if I got down to around 80kg and that it might be difficult for me to lose more than that, although I'm now just over 70kg (weighed in at 70.6kg this week!) and my own goal weight is between 60-65kg. 

 

I'd say that it's definitely doable to get down to your pre-pregnancy weight or around there, but it might take longer to get there. You might lose the initial 15kg easily and slowly lose the rest over the course of a year or so. That's probably what happened with your band too, right? Or did you lose from 112kg to 54 very quickly?

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@DaveR Yes, did that for my Lapband surgery so that's off the table this time unfortunately :(  Ok, good to know that the pill situation is only temporary. I know that I'm supposed to take a multivitamin (the hospital dietician recommends Centrum) but wasn't quite sure when though the dietician will apparently call 2 wks post op to check up on me and answer any questions/give further instructions.

 

Yep, will be taking a leaf out of your book Luv and making sure I follow the rules to a T as well :)  Don't want to stuff it up in any way, shape or form :lol: 

 

Thanks for the heads up!! :) 

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@Satellites Firstly, Congratulations to you Luv on your weight loss so far!!! :)  That's a fantastic effort to be 80% to goal after 7 months!!! :) Regarding my weight loss with the band, yes, I did lose the majority of it in the first 10 -11 months then I'd say the last 10-12 kg's in the following year to 18 months without really trying too hard. A few kg's here, a few kg's there and eventually it all added up.

 

Yes, was reading some research findings that were presented to the IFSO World Congress at Montreal last year regarding outcomes both short term and 10yrs down the track for low BMI sleeveing, as well as other stuff regarding complications, complication rates, what type of stitching they use to sew the stomach so as to minimise complications, band vs sleeve findings, surgical revision from band to sleeve etc , etc. Anyhoo, it is a slower loss when you get sleeved with a lower BMI but should still be able to achieve a successful result.

 

I think the reason that happens is when you start off a considerably heavier weight, after having the band or the sleeve, you end up eating significantly less which equals less calories. Your body then starts accessing its fat stores and using them up for energy. The more fat you've got to use, the more you lose I reckon!! :lol:  Well, that's my very non scientific explanation anyhoo ;)  :D 

 

That's fine if it takes a year to get back to where I was, as long as I do as I've got all my clothes in storage at the moment and I want to get back into them!!! :lol:  I'm going to do everything I can to make sure I do!! Were you in much pain immediately after the operation?? How long did yours take to do?? Trying to get a feel for what I should expect. I handled the Lapband op well though I know this one is more complex than that plus I've had my gallbladder removed 2 yrs after the band and I had a C-Section to deliver my daughter and handled both procedures quite well too. Hmmmm...not sure any of those will compare with this??

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I had a feeling your normal surgeon was Dr Bowden. He was mine too :) Your goal of losing 27kgs sounds perfectly reasonable to me :) If you put the work in, you can achieve it :) I need to lose about 27kgs myself. My weightloss has slowed but I am aiming to be at  goal by the end of September. 

 

Also, I had absolutely no problems taking multiple tablets whole immediately after the operation - it was the surgeon who gave them to me and sent me home with some. I had never heard anyone who had to crush them until now. But if in doubt, ask :)

 

You will likely be put on a pain pump after the operation and be sent home with pain relief so you should be ok pain wise :) I didn't have a straightforward recovery so I can't give you much of a picture unfortunately.

 

Good luck with the op :)

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Hi.

I was a low BMI (30.4) but had some co-morbidities (sleep apnoea requiring CPAP and endometrial hyperplasia requiring a Mirena IUS).

I was sleeved 2nd Feb and have lost 16 kg since then.

My BMI is now 23.45

I have therefore lost 124% of my excess weight in 3 1/2 months.

 

Bye-bye sizes 16,14,12 and 10!  Given them all away.

I've had to do an Op Shop visit to get a top and some jeans.

 

I didn't have any pain relief in hospital except for liquid paracetamol which I had taken in with me for my usual ME/CFS Fibromyalgia malaise, pain and low grade temps.

I didn't need any to go home with.

 

My surgeon didn't want me swallowing tablets post op due to their size, so I have skipped a lot of supplements that I was previously on, and was using a pill cutter to chop up the Panadol Osteo (for my usual ME/CFS Fibromyalgia malaise, pain and low grade temps).

It takes about 10 weeks for the stomach to heal.

 

I hope that you have found this reassuring and all the best for your operation.

:)

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@Beepop  Had a pain pump for 24hrs after my daughter was born so am familiar with that if that's what happens post Op :) That's interesting about the tablet situation from what you and the other posters have said. Obviously every surgeon has their own preference in that regard. I've also read on a few website's that some Surgeon's don't want you to take any fluids at all by mouth for the first 48hrs to minimise the risk of stretching yet I know that it'll be clear fluids only for the first 24-48hrs at the hospital :huh: 

 

Thanks for your well wishes and good luck to you reaching goal by Sept!! :)  I'm sure you'll get there Luv :) 

 

 

@denzel  Thanks for replying and for your insight about my upcoming Op :) Congratulations on your weight loss as well!!! :)  That's an amazing result in such a short space of time :) 

 

I can't believe you experienced no pain either post Op!! Can only hope it's minimal for me. The pain from my Lapband surgery wasn't too bad. It was far, far worse after I had it removed as I also had shoulder tip pain from the gas that I didn't have when I had the band done originally... :huh: I used to cut up all my tablets when I had the band so am familiar with that routine :lol: 

 

I am feeling somewhat more reassured but still incredibly nervous and anxious at times. I started to have a mini anxiety attack at the hairdressers yesterday FFS's!!! :lol:  Being kept flat out for the last few days organising everything before Tues has helped though I'm pretty sure I won't be sleeping too well come tomorrow night!!! :unsure: Also can't believe I've had to do the Optifast prep for all of 5 days before the Op either. How much do they expect my liver to shrink in that short a space of time??? :rolleyes: Nevertheless, have been doing as I'm told (for a change ;) :lol: ). 

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Hi Everyone,

All went well with the operation on Tues. Was in a fair amount of pain @ nausea afterwards so was kept in recovery until around 5-5.30pm. Anaesthetics seem to knock me around a little bit too.

Anyhoo...the pain started to ease off by the early hours of Wed morn @ was well controlled with IV Panadol @ a morphine type drug that comes in a very small tablet you put under your tongue to dissolve.

Nausea stayed with me all of yesterday and a little bit this morn but was dealt with effectively using Maxalon. Was on a drip all day yesterday (and a little this morn) and only allowed small sips of water.

Was also up Tues night going to the toilet @ from yesterday morn, walking around my room/to the toilet @ back/shower etc regularly until physio came then started doing laps of the ward. She said to do at least 3 laps a day plus any extra I could manage.

Drip came out this morn. Had my last morphine tablet yesterday arvo @ the last of the IV Paracetamol first thing today. Have had 2 Panadol tabs at lunchtime (nothing since) @ have been on free flowing fluids since mid morning.

No more nausea either. Just have to make sure I sip slowly @ regularly or else I do end up feeling sick. Had soup @ Sustagen for lunch (ate 1/2 the soup @ got through the Sustagen popper within a couple of hours).

So far,so good. Will be discharged tomorrow all going well!!😊

P.S...Sorry for the TMI question...but wondering if having the sleeve speeds up your bowel motions?? Things seem to move a lot quicker at the moment??

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Whatever you do....

 

DON'T TRUST A FART!!!

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I have been sleeved about 8 weeks. Got sleeved at 86 kg (dont know my BMI but Im about 163 cms) have lost about 8kg including 2 weeks opti.  Im about 78 kg now. Though to be honest Im not trying hard. If I made and effort I would be loosing more. Im too lazy to excerise and generly eat a couple of cupcakes or somthing else sweet daily

I can already eat more variety of foods than I could when my band was tight.  Bread, toast fried egg. Unlike David I was talking a range of oral pills the morning after surgery. Took them slowly the first few days though. My surgeon says ex banders cope with the sleeve well as they are already used to restriction and chewing etc. You will probably be fine and heal quickly. This is what I found.

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@kazbo Bahahahaha!!! I did read that on another thread you posted in @ remembered it too when I felt the tell take rumble in my nether regions happening!! My number 1 mission is to avoid a "Shart" at all costs!!!ðŸ˜

@Jinie I'm roughly the same height as you Luv😊 I'm taking my panadol cut in half just to be extra careful for the moment. Took them whole the first time yesterday. I was a bit dubious about it all to be honest. They went down but I had to take them 20mins apart as it felt a bit weird. I think cutting them up for the time being is the safest bet. Yes..I think I am healing a bit quicker than I would've if I'd been at my original pre-banding weight😊

AFM: All going really well still😊 Had chicken soup @ Chocolate Sustagen for dinner. Ate the soup slowly @ got through most of the Sustagen popper within the next hour or so following dinner. Had half a cup of hot milo before bed.

Still not feeling particularly hungry but I know it will return over time. Am a little sore but haven't had any Panadol since yesterday evening.

One of the Consultants who saw me late arvo yesterday said to take 2xPanadol every 6 hrs when I get home for a few days to create a pain barrier then to start dropping a dose until I stop taking them.

She also said the body goes through an inflammatory response in about 2 weeks which is normal @ part of the healing process which is why you have to be extra cautious about not lifting anything heavier than 5 kg's for the first 6 weeks. She said healing should be complete by then. 8 weeks at the most.

I'll also be given PPI's (Protein Pump Inhibitors) to take for the next 6 weeks @ most prob Losec tabs too...not 100% sure about those as yet.

Am awaiting another blood test this morn @ expect to be given the green light to go home today😊 Can't wait to see my daughter/partner @ to sleep in my own bed!! Have gotten bugger all sleep around here but that's hospitals for you!!😀

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Am home...Yay!!! Was discharged mid morning and left with a script for Losec tabs (which idiot me didn't realise are PPI's!!! :rolleyes:  :lol: ). I'm to take them 2xday for the next 6-8 weeks depending on when my follow up appointment with the Surgeon is then he'll most likely tell me to stop taking them.

 

Have been concerned about the amount I have consumed today (detailed in on the other thread), but to cut a long story short, I've had a little over 1.7L's in fluid :o  The hospital dietician said to aim for 2L's of fluid a day, but I feel at 3 days post OP, over 1.7L's is too much??? :unsure: Now I'm worried because of the adhesions from the band that my Surgeon didn't remove enough of my stomach when he did the Op??? :mellow: 

 

I also felt a couple of moments of hunger when I smelt my Partners lunch and dinner cooking but it was only literally for a few seconds I felt hungry then it passed. Is any of this normal for so early in the piece?? Other than these couple of concerning things, I'm doing great and have no pain, just soreness which is at the bare minimum. Have only taken 4 Panadol's over the course of the day.

 

What do you experienced sleever's think???

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The hunger you felt is your brain not your stomach. Your brain associates the smell of food with pleasure and it sent a signal for you to experience that pleasure.

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Hi Everyone......

 

4 dpt surgery (dpt=days past...acronym I used a lot from my IVF days!! :lol: ) and I'm feeling good!!! :)  Woke up a few times last night as I felt a little sore when I was turning over in bed trying to get comfortable. Today the soreness is barely there and I haven't needed to take any Panadol as yet. Although thankful, I'm still in disbelief wondering why I'm not feeling sorer after only 4 days post Op?? :unsure: 

 

What I am feeling is tired if I do too much too soon and my body lets me know it as I start to feel a little light headed and a smidge clammy so I've had to reassess things in that regard. It can be difficult with bub to attend to so have to find different strategies to use. At the moment it's all good as Daddy is home on the weekends as he's a Mon-Fri worker, but Monday's fast approaching so will have to have a plan of action in place by then :)  I do have 2 of my sisters that can help out when they can around their own work/family commitments so I'm not totally on my own.

 

My "Speedy Gonzales" bowel situation has resolved itself today, so perhaps it was some kind of initial reaction to the operation??? :unsure: Today I haven't felt particularly hungry at all, but am managing to get things down slowly but surely. Takes me over an hour to drink a cup of liquid, but that's par for the course I expect. A smidge longer to get yoghurt/custard down with a break in the middle usually. Again, that's fine. The Lapband was good training for this, so I expect to adapt to the sleeve a lot easier because of it.

 

Hope everyone's having a great weekend thus far :) 

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Weighed in first thing this morn in my birthday suit (was bloody chilly too I might add!!! :lol: ) and I'm 2.8kg's down. All the dressings are off as of yesterday and everything is healing well. All soreness well and truly gone and the tiredness is almost over as well.

 

Am averaging 2.5L's of fluid a day. Am finding I can drink that much more that much quicker as the days go by. Was a bit worried about it, but another Member assured me over on another thread that that's normal. Was beginning to wonder just how much stomach the Surgeon left behind!!! :unsure:  :D 

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Nice one golidlocks, hope you keep up the awesome progress!

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Hi Goldilocks 1973

 

I have been reading all your post,yay that you are doing so well :)

I see that you went public with your sleeve.

Can l ask you how long you had to wait on the public list before getting it done and who did you see.

 

I am so new to this and l need to get one of them done,want the sleeve done though.

 

Can you please help me :(

or PM me

 

Thanks Omi

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@DavidR Thanks Luv :)  I know this kind of loss won't go on indefinitely as it's really only due to being on fluids, but I'm taking it as a win just the same!!! :D  You're looking pretty good yourself Mate!!! :lol:

 

 

@Omi78 Hello Luv, of course I can help you :)  Blair Bowden is my Surgeon. I initially went Private with him for the band, but couldn't afford to do it this time, so went Public with him instead :)  He's currently on Long Service Leave from the hospital I went with this time (but still available at the Private one for procedures) so his fill in Surgeon did my sleeve instead.

 

As you have read, I wasn't too thrilled with that idea to begin with, but didn't have much of a choice. So far so good though. I waited 7 months from when I had the band removed for this operation. I had to wait a minimum of 4 months for the hole in my stomach to heal after the band eroded through it :o. I was initially told I would have the procedure within 12 months but I have a couple of what they call "Co-Morbidities" that made me go up a Category on the wait list.

 

 There are 3 Categories in the public hospital I went to..Cat 1 is the most urgent which means getting a procedure done within a month, Cat 2 within 3 months and Cat 3 within 365 days. I went up a Category plus had a "next available slot" on my file as well as the fact there was a last minute cancellation from another patient being unable to be operated on that day, so I got offered the place as the Surgical Co-Ordinator knew I could come in at short notice. I was given 5 days notice when she called me.

 

Where are you up to in this process?? Have you been to your GP to get a referral to see a Bariatric Surgeon (most of them are also General Surgeons) at your public hospital?? If not, that's the first step. Your GP will write the referral and send it off to the hospital for you. I won't explain that process further to you in case you've already gotten that far :) 

 

Please feel free to ask for any other help or questions you need answered etc ok?? Thank-you for your kind words too :) 

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Hi Goldilocks1973

 

Thank you for getting back to me :)

 

So ill fill you into WHY l need to get this done,well l've had 4 kids all boys lol,16,13,8,and nearly 2 with a rare condition and lm over weight,l have trid so hard to move it with no luck and what makes it hard now is l also have slow thyroid and the weight wont move.

And lve always had a bad knee,stuffed it up playing basketball and it's just got worst over the years,l then had a fall and smashed it,i now need a full knee replacement,so carrying the weight my left knee went,,long story..... 11 weeks l had both of knees done,heavy duty arthroscopys to try and do somthing with them,left knee is working abit better but the right is stuffed,lm on so many pain pills so l can walk,l could cry lol

They will NOT give me a knee replacement as lm to YOUNG :(

 

So my knee surgeon and my GP both think that l need this done,and NEED it done NOW but my GP said to get it done on the public list here in Victoria is about 4 years and said l should just Private health,dont have that money :(

He said this as the last time he sent someone to the guy near us this guy waited 4 years to have it done

 

Need it done to try and move the 35 / 40kgs and hopefully that might heap my knee pain as they dont want to give me a new knee for at least 10 year.

 

What is Co-Morbidities

 

I live in rural Victoria and at this point lm happy to get anyway,maybe l should fly to yours.

 

Thank you so much for your help,lm going crazy as l have know idea what to do or were to start.

 

Cheers Omi

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Here's a shameless Copy&Paste of the definition of Co-Morbidities:

 

In medicine, comorbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases. The additional disorder may also be a behavioral or mental disorder.

 

 

 

 

 

Obesity Comorbidities

To follow is a list of comorbidities (additional conditions or diseases) related to obesity which may help you in qualifying for weight loss surgery.

  • Family history of heart disease
  • Family history of stroke
  • Family history of diabetes
  • Family history of heart attacks
  • Hyperinsulinemia
  • Diabetes
  • High blood pressure
  • Coronary-artery disease
  • Hypertension
  • Migraines or headaches directly related to obesity or cranial hypertension
  • Congestive heart failure
  • Neoplasia
  • Dyslipidemia
  • Anemia
  • Gallbladder disease
  • Osteoarthritis
  • Degenerative arthritis
  • Degenerative disc
  • Degenerative joint disease
  • Recommended joint replacement from specialist
  • Accelerated degenerative joint disease
  • Asthma
  •  
  • Repeated pneumonia
  • Repeated pleurisy
  • Repeated bronchitis
  • Lung restriction
  • Gastroesophageal reflex (GERD)
  • Excess facial & body Hair (Hirsutism)
  • Rashes
  •  
  • Chronic skin infections
  • Excess sweating
  • Frequent yeast infections
  • Urinary stress incontinence
  • Menstrual irregularity
  • Hormonal abnormalities
  • Polycystic ovaries
  • Infertility
  • Carcinoma (breast, colon, uterine cancer)
  • Sleep apnea
  • Pseudotumor cerebri
  • Depression
  • Psychological/sexual dysfunction
  • Social discrimination
  • Premature death

 

 

So, your knee issues is one Co-Morbidity, as is Premature Death that you have. What else from that list have you got?? When you're playing the public hospital game, the more the better to get you in for surgery quicker!! Do you have any Superannuation at all that you can access to go Private?? The only issue is that you wouldn't be able to go on the Public waiting list here unless you were a resident of QLD which unfortunately, you're not.

 

There are also medical loans you can get as well..I've never had one, just know that they do exist. Other than that, I'm really not sure what you can do to try to speed up the process that little bit quicker on the Vic public health system other than the Co-Morbidities thing??? :unsure:  Perhaps some fellow Vic Sleever's here on the site can chime in here on the thread or PM you to help you out??

 

Is your knee Surgeon at a public hospital?? He/she could write the referral to the Bariatric Surgeon at the nearest public hospital that has one (and list your Co-Morbidities in the letter) asking that you are seen for an appointment asap to get things happening a little bit quicker which often happens within the system. Kind of jumping the queue. Either your GP or your Surgeon needs to write the referral and send it off first so that you can get an appointment.

From there, you'll be assessed and the Surgeon (or his/her Consultant that works within the team) will decide (usually) what Category you'll go onto.

 

Do you mean all four of your kids have a rare condition?? Either way, with the kids, your knee's, thyroid etc, you've been dealt a difficult hand and for that I'm sorry and feel for you, I really do :(  I don't know how old you are, but regardless, you definitely need this surgery firstly to take the pressure off your knee's as well as being able to be fit and healthy for yourself and for your kids :)

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