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<MODERATOR> LORI YOU HAVE THE FIRST QUESTION FOR OUR GUEST:)
<Lori> how long does it take for a person to get nicotine out
of their system
<Dr. Simpson> well it depends....
<Dr. Simpson> how did it get there in the
first place?
<Lori> well i am a smoker waiting on surgery
<Dr. Simpson> nicotine is something that
will slowly leave the system over time.. I understand you were a smoker...
<Dr. Simpson> just kidding you. But generally
it is good to stop smoking a month before surgery....
<Dr. Simpson> then you will be in good shape
for the operation. Good luck.
<Lori> meaning i cant even use a patch?
<Dr. Simpson> You can use the patch, that
would be just fine--
<Dr. Simpson> good luck.Stop smoking.
<MODERATOR> MICHELLE YOU HAVE THE NEXT QUESTION
<Michelle> I am 2 weeks Post Op and need to get back on my Allegra
for allergies....my allergy clinic seems to be uninformed about what is
acceptible meds for me at this time. Should I contact my surgeon and have
him renew my Rx? Or perhaps just have him consult with the allergy clinic?
<Dr. Simpson> Allegra is just fine right
now, don't worry about it. take it and stop sneezing on the computer,
you are making my keyboard wet.
<Michelle> lol..should i be concerned about swallowing hte huge
tablet?
<Dr. Simpson> no, it isn't that big. You
can always crush it.
<Michelle> yummy...ok thx lol
<MODERATOR> PAM YOU HAVE THE NEXT QUESTION FOR OUR GUEST:)
<Pam> Hello everyone, I am 33 yrs old no major health problems,
am about 100 lbs or more over weight, maintenance has never been too much
of a problem for me..what surgery if any should I consider?
<Dr. Simpson> Well if maintenance isn't a
problem, my yard has some work which needs to be done.....
<Dr. Simpson> you should consider the surgery
which the surgeon in your health plan does...
<Dr. Simpson> all of the surgeries work for
weight loss, they all require that you will have to change your eating
habits...
<Dr. Simpson> all of them will have you eating
less than you can imagine, and so that is something which you will have
to get use to
<Dr. Simpson> so, it doesn't matter which
one you get, find a nice surgeon who you like and get along with, and
who
<Dr. Simpson> has a good support group where
you can meet like minded people. Good luck. Oh, do you do windows?
<MODERATOR> MARIA YOU HAVE THE NEXT QUESTION:)
<maria> What are chances of being approved if no med supv diet
in the past 8 yrs. only Weight Watchers & the likes? How long does
the entire process take (fromdecision to actual srugery)
<Dr. Simpson> For you Maria, we have a special
today only.....
<Dr. Simpson> just kidding, it will vary
from insurance company as to what their rules are...
<maria> What is the psych evaluation like?
<Dr. Simpson> those rules change by state
and sometimes by week. For example, one insurance company will require
that you...
<Dr. Simpson> have months of a supervised
diet done by a physician, and not a weight loss surgeon....
<maria> my pcp doesnt believe in WLS
<Dr. Simpson> the entire process can take
some time, the wait list for some surgeons is quite long, and for others
it isn't so bad...
<maria> so i think i am going to have a really hard time
<Dr. Simpson> in terms of the psych consult,
those are individual, and I cannot tell you the answer to that because....
<Dr. Simpson> they want to hear about those
voices. Some insurance companies do not have a problem at all...
<Dr. Simpson> for example, in Arizona, Pacificare
is quite easy to get approval to have surgery, where some insurance carriers
take forever and have...
<maria> Thanks for your help. My insurance is Health Net (Guardian)
<Dr. Simpson> a lot of requirements. I am
not familiar with that one, but your surgeon and his;her office staff
will be, so check with them.Good luck.
<MODERATOR> ANNA/VEGAS YOU HAVE THE NEXT QUESTION PLEASE:)
<Anna/Vegas(-140#@5mo> Dr. Simpson...First of all, I love your
sense of humor! :-) My question is regarding the emotional side of this
surgery. I am 5 months post-op. Started at 334 pounds - 5'8". I am
now 194 pounds. The weight loss has been rapid because I developed an
ulcer in the pouch right after surgery, and couldn't eat. It's getting
better now, however, I despise food. I hate it for what it did to me to
cause me to have this surgery in the first place. I'm still only eating
400-600 calories a day, some days only about 200 calories. WILL THIS GET
BETTER WITH TIME? or do you think I should see someone (counselor)? P.S.
I worry b/c I was anorexic back in high school and the feelings seem similar...
<Dr. Simpson> That is a great weight loss,
and sorry about the ulcer. It is normal after surgery to not have an interest
in food for a while....
<Dr. Simpson> and some of the counselors
who you see are not familiar with the normal weight loss and emotional
changes which happen...
<Dr. Simpson> it plays quite a mind trick
to go from living to eat, to eating to live, so that is something many
patients have to deal with....
<Anna/Vegas(-140#@5mo> okay ... counselor? or not yet...?
<Dr. Simpson> never hurts to see a shrink,
and many of us ought to see more of them - excluding me of course...
<Anna/Vegas(-140#@5mo> lol - my degree is in psychology! Lol
<Dr. Simpson> So, what you are experiencing
is normal for this time. Good luck. Which, in Vegas you need-- I will
be in your fair city next week.
<MODERATOR> LAUREN PRE-OP YOU HAVE THE NEXT QUESTION:)
<Lauren-preop> will there be a difference in medication absorption
post op via po route?
<Dr. Simpson> It depends on what kind of
bypass you will have, and how much you will absorb....
<Dr. Simpson> most medication it is not a
problem, some, such as birth control is an issue...
<Dr. Simpson> so use a mechanical birth control
form ....
<Lauren-preop> what about simple meds like acetaminophen?
<Dr. Simpson> so, probably most of those
will be fine. Tylenol isn't a problem.
<Lauren-preop> thank you
<MODERATOR> CHRISTINE YOU HAVE THE NEXT QUESTION:)
<Christine> Dr Simper, I am very concerned about the long term
effects of the surgery. I have read of some cases where death occurred
as late as 4 years after the actual surgery due to complications. At which
point can you safely say you are out of the woods and is it true that
life expectancy after WLS surgery is only 15-30 years due to malabsorbtion
etc And the other question: why not implant the greenfield filter in everyone???
What are the risks of the greenfield filter??
<Dr. Simpson> There is no truth to the rumor
that malabsorption will lead to an early death....
<Dr. Simpson> Greenfield filters have their
own risks, and they are not for everyone, and it does not make sense to
put them in everyone...
<Christine> why not?
<Dr. Simpson> in addition, they do not give
100 per cent protection against clots which can go to the lung....
<Christine> is it cost prohibitive?
<Dr. Simpson> it isn't cost, it is that they
are a procedure which can have their own risks....
<Christine> like?
<Dr. Simpson> and those risks are not worth
or give the indication to put them in everyone..
<Dr. Simpson> such as, they can have clots
at the filter and cause the patient to have swollen legs, venous distention....
<Dr. Simpson> the filter can dislodge-- I
knew a doctor who had the filter dislodge and it went to the patients
heart, requiring open heart surgery...
<Christine> ouch
<Dr. Simpson> this is not a benign procedure,
it is not something you put in everything, so it is something which we
give for patients which
<Dr. Simpson> cannot take anticoagulants
and have a problem with DVT (leg clots)...
<Christine> ty
<Dr. Simpson> if you can take the heparin,
then putting a filter in is not needed, and may cause problems. Good luck.
<MODERATOR> ANGIE 29 YOU HAVE THE NEXT QUESTION:)
<Angie-29> I'm 5 weeks post op with an open vbg but have only
lost 22 pounds am I doing something wrong and does this mean I won't be
able to lose all my weight...I have 125 pounds to lose?
<Dr. Simpson> How many diets have you been
on where you lost 22 pounds in five weeks? Not too many, I would venture
to say...
<Dr. Simpson> unless it is the pregnancy diet
-- have a baby, lose weight....
<Dr. Simpson> the key to weight loss after
surgery is the following: limit carbohydrates to 40 grams per day max,
drink lots of water, don't eat and drink at the same time....
<Angie-29> true i'm just a big worried cause the others who had
the procedure when i did have lost a great deal more
<Dr. Simpson> and WALK. walk, walk, walk,
and when you are done walking, walk some more, and don't tell me that
you
<Dr. Simpson> are walking enough. Also, do
not, do not, do not, do not-- compare yourself to others, which is common
in this business....
<Dr. Simpson> enjoy the success that some
have-- but if you start out high, and have 500 lbs to lose, you will lose
a lot of it in a month or two, so it is apples and oranges...
<Dr. Simpson> we like patients to have lost
about ten per cent of their weight at six weeks. <MODERATOR> PAM
YOU HAVE THE NEXT QUESTION:)
<Dr. Simpson> but for now-- walk, walk, walk.
45 minutes per day, at a vigorous pace. No carbs, No sodas, no ice cream.
<Dr. Simpson> good luck.
<Angie-29> ok thank you
<MODERATOR> PAM YOU HAVE THE NEXT QUESTION:)
<Pam> Does or can the surgery cause any permanent bowel changes?
<Dr. Simpson> Sure it can cause permanent
bowel changes--- we staple, we sew, we make openeings where God didn't
want them....
<Dr. Simpson> we move things around, and
to move them back is like remodeling a house-- you can do it, but it will
never be the same....
<Pam> So its a frequent occurence?
<Dr. Simpson> some patients end up with diarrhea,
some with constipation, some have gas, some don't-- so there are changes
which happen when we rearrange guts....
<Pam> I dont want to suffer with loose stools forever ya know
what I mean!
<Dr. Simpson> but, the goal is weight loss,
and that will happen if you follow the program, and we have medicines
for lose stools,,,,
<Dr. Simpson> it is easier to get rid of
wind than weight. Good luck.
<MODERATOR> PAMELA YOU HAVE THE NEXT QUESTION:)
<Pamela> I have heard that really smelly gas may be a result
<Dr. Simpson> There are a few things you
can do about gas, and not everyone has that problem....
<Pamela> I just want to keep my friends!
<Dr. Simpson> gas comes from air that you
swallow, and also bacteria which break down some of the food....
<Dr. Simpson> things which cause excess gas
include, beans, high carbohydrate foods, and ....
<Pamela> I use a bypap which also seems to add to my gas
<Dr. Simpson> carbonated beverages. In addition
to the obvious other sources....
<Dr. Simpson> try Devrom, which will help
as an internal deodorizer-- you can get it from the internet at...
<Dr. Simpson> www.parthenoninc.com
<Dr. Simpson> good luck. Light a candle --
now we know why those priests lit those candles...
<Dr. Simpson> now I know why my dates liked
candlelight...
<Pamela> Thanks
<MODERATOR> TCLAXTON YOU HAVE THE NEXT QUESTION:)
<tclaxton> Would there be major complications if you were to get
pregnant after having surgery?
<Dr. Simpson> You would have a kid
<Dr. Simpson> they would want an allowance.
<Dr. Simpson> they would ruin your life.
<Dr. Simpson> --- none, many become pregnant
after surgery without problem... Dr. Simpson> you have to watch your
nutrition, and take your vitamins, but the children will grow up and...
<tclaxton> yes, I have one, but I want to have the surgery I am
only 27
<Dr. Simpson> make their parents insane,
as every child does. Good luck.
<MODERATOR> MARY YOU HAVE THE NEXT QUESTION:)
<Mary> How do you recognize what type of pain is normal and how
many days on average until you feel better?
<Dr. Simpson> Pain isn't normal unless you
are a masochist....
<Mary> haha
<Dr. Simpson> in terms of post operative
pain, we expect that you will continue to improve over time,
<Dr. Simpson> so that if you look at yourself,
you feel better today than three or four days ago, and if you've a bad
day...
<Dr. Simpson> you might have done a little
too much. Pain isn't something we expect too much of, and it is something...
<Dr. Simpson> that might want to talk to
your surgeon about. Good luck.
<Mary> Ok, thank you. :)
<MODERATOR> FEB 10 YOU HAVE THE NEXT QUESTION:)
<Feb 10> Should a patient with sleep apnea (BiPAP @ 14) be in ICU
immediately after surgery?
<Dr. Simpson> Some surgeons place all patients
with sleep apnea in the ICU post op and some surgeons....
<Dr. Simpson> don't, it is something to discuss
with the surgeon and with the pulmonologist who is taking care of you,
and...
<Dr. Simpson> it is something which we reserve
the right to change our mind about, there are things which will make us...
<Dr. Simpson> put you in the ICU - such as
if you have a hard time waking up after surgery, or need extra pain medicine...
<Dr. Simpson> but not everyone needs to be
in the ICU-- although the nurses are usually pretty nice there.
<Feb 10> My surgeon does not. I worry about not breathing when
heavily medicated.
<Dr. Simpson> then don't medicate yourself
heavily, get up and walk after surgery and keep walking.
<Dr. Simpson> good luck. Walk, walk, walk.
<MODERATOR> MID YOU HAVE THE NEXT QUESTION PLEASE:)
<mid> What is your opinion on LAGB procedure? There seems to be
a shorter wait list for this procedure. Why would that be?
<Dr. Simpson> well, it is a good procedure
for some circumstances, but if you have morbid obesity and are an adult...
<mid> I am
<Dr. Simpson> then you might as well have
a gold standard procedure like the RNY as opposed to having a piece of...
<Dr. Simpson> plastic which can move, needs
adjustments, and has the same risks as RNY without the same good results....
<Dr. Simpson> good luck.
<mid> thank you
<Dr. Simpson> you are more than welcome.
<MODERATOR> MELANIEV4 YOU HAVE THE NEXT QUESTION:)
<Dr. Simpson> V4-- could have had a V8
<Dr. Simpson> Guess Melanie didn't like the
joke.
<MODERATOR> SHELBY YOU HAVE THE NEXT QUESTION
<shelby> how long does surgery usually last for an RNY also what
is consider medical nessessity by medicare
<Dr. Simpson> Medicare goes by the NIH guidelines,
as a rule, so BMI of over 40 without comorbidities...
<Dr. Simpson> or 35 with sleep apnea, hypertension,
heart disease...
<Dr. Simpson> surgery for an RNY varies from
surgeon to surgeon-- open can be an hour and lap can be two hours, or
longer depending on a lot of factors. Good luck.
<MODERATOR> SHERRI YOU HAVE THE NEXT QUESTION:)
<Sherri> I have fibromyalgia and I take vioxx and cyclobenzaprine
will I be able to take these meds after surgery?
<Dr. Simpson> It depends on the surgery that
you will have, some of the surgeries do not like you taking vioxx, and
some do not...
<Sherri> open RNY
<Dr. Simpson> in addition, most of my patients
who have had fibromyalgia seem to have no problem with it after the surgery...
<Dr. Simpson> don't know why that is, but
it is a nice side effect....
<Dr. Simpson> perhaps it really does come
from the gut....
<Sherri> Thank you so much
<Dr. Simpson> good luck.
<Sherri> surgery on 1/27
<MODERATOR> CHRISTINE YOU HAVE THE NEXT QUESTION:)
<Christine> you just mentioned that the lapband has the same risks
as the RNY...that is the first I have heard that. From everyhting I have
read, the mortality rate on the band is only 1 in 10,000 and on RNY one
in 200. Am I wrong? Do you personally perform lapband surgeries?
<Dr. Simpson> the rate of death is one in
200 for all procedures on the abdomen, and the other statistic you site
is bunk....
<Dr. Simpson> the cause of death for most
surgeries has to do with a pulmonary embolus, and not the surgery itself...
<Christine> so I get a filter ;)
<Dr. Simpson> so, the rate of death is related
to something other than what you do in the abdomen, and just having surgery...
<Dr. Simpson> we discussed filters earlier,
they are not for everyone, and they have their own risks involved in them....
<Christine> i know
<Christine> ty
<Dr. Simpson> if you can be heparinized you
do not need a filter. Good luck.
<MODERATOR> ANNA/VEGAS YOU HAVE THE NEXT QUESTION:)
<Anna/Vegas(-140#@5mo> Dr. Simpson...another question. My surgery
(open RNY) lasted 4 1/2 hours (from going under to when I was rolled out
of surgery into recovery room) and was $71,000 total billed. It was done
by Dr. Papoola at Los Angeles Metropolitan. My incision is approximately
5 inches long. Does that sound too long to you? How would I go about ordering
a copy of the "surgery report"? Or am I allowed to even see
something like that? All my doc ever said was "everything went fine.
<Anna/Vegas(-140#@5mo> too long maning the time it took...
<Dr. Simpson> well the bills that you get
are fantasy, and don't worry about that. Taking time in the OR can happen
for a lot of reasons....
<Dr. Simpson> and it is difficult to say.
A five inch scar is a great result...
<Anna/Vegas(-140#@5mo> maybe doc went to the bank or something?
LOL
<Dr. Simpson> you can ask your surgeon for
a operative report, they will be happy to give one to you...
<Anna/Vegas(-140#@5mo> okay - thanks
<Dr. Simpson> went to Vegas-- gambled a bit...
<Anna/Vegas(-140#@5mo> lol
<Dr. Simpson> if you are doing well then
great. Good luck. Walk.
<Anna/Vegas(-140#@5mo> I do
<MODERATOR> FEB 10 YOU HAVE THE NEXT QUESTION:)
<Feb 10> I have type II diabetes. If I don't eat my blood sugar
drops, I get shaky & dizzy, etc. After surgery, won't I be feeling
like that all of the time?
<Dr. Simpson> No, you won't feel like that
ll the time, and you will probably have less fluctuation in the blood
sugar after surgery than you do now...
<Dr. Simpson> so, go for the surgery, and
good luck.
<Feb 10> Can't wait! Want to be healthy. Thanks!
<MODERATOR> TCLAXTON YOU HAVE THE NEXT QUESTION:)
<tclaxton> What is the least amount of time you have to take off
work post-op? I am a Nurse and sit at a desk??
<Dr. Simpson> Three weeks is about average
-- ...
<Dr. Simpson> I had one patient who went
to work a week later after an open DS, so ...
<tclaxton> ok...I hope I can just take a few days...lol
<Dr. Simpson> there are all sorts of crazy
people, some take weeks off ...
<Dr. Simpson> hey, you have one chance to
recover-- take it and recover well. Good luck.
<tclaxton> thank you...
<MODERATOR> MINDY83 YOU HAVE THE NEXT QUESTION:)
<mindy83@5months> I was just wondering why at 5 months I am starving....
I want to eat at night alot... al
<Dr. Simpson> Mindy?
<Dr. Simpson> I doubt you are starving. Perhaps
you are, if you live in Rawanda you might be starving...
<Dr. Simpson> if you mean that you are hungry
all the time, in spite of eating some food there are several reasons for
that...
<mindy83@5months> i feel like I can eat alot more now then ever
<mindy83@5months> am I already stretched out.. i am 30 pounds
from goal
<Dr. Simpson> one reason might be that you
have stretched your pouch, which means that you didn't watch your portions
and you overate over a period of time...
<Dr. Simpson> the other reason might be that
you might have a connection between your upper and lower stomach....
<Dr. Simpson> if they didn't transect the
two-- if you had it done open as opposed to through the laparoscope...
<mindy83@5months> i need to check with my surgeon? I had open
<Dr. Simpson> another reason may be that
you are drinking while eating, and pushing food through the pouch into
the intestine...
<mindy83@5months> i havent eaten barely at all for 4 months..
<Dr. Simpson> so stop eating and drinking
at the ame time.....
<mindy83@5months> I don’t
<Dr. Simpson> so, eat a high protein diet--
and that will allow you to keep full for a while, one other reason is
that the anstomosis between the stomach and...
<Dr. Simpson> intestine may have become wider,
allowing food to pass through it, so there are a number of reasons...
<Dr. Simpson> I suggest you get a test called
an Upper GI, which will allow the surgeon to see which of those might
be the case...
<mindy83@5months> alright.. I wll thanks
<Dr. Simpson> you drink some nasty tasting
stuff and it is all over in a few minutes, but it will give an idea of
what is going on. Good luck. Walk.
<MODERATOR> MARY YOU HAVE THE NEXT QUESTION FOR OUR GUEST PLEASE:)
<Mary> What exactly is the dumping affect?
<Dr. Simpson> Dumping happens when carbohydrates
hit the small bowel. The small bowel isn't ready for those concentrations...
<Dr. Simpson> of carbohydrates so it responds
by putting a lot of fluid into the bowel, and thus patients can feel faint...
<Dr. Simpson> they can feel nausea, they
can have cramping and diarrhea, only 60 per cent of folks with RNY get
this, so it is not...
<Dr. Simpson> something that everyone will
have. But it is not fun, further-- dumping has nothing to do with weight
loss....
<Mary> if you are one of the 60%, does it last forever?
<Dr. Simpson> you can gain weight and still
dump. So avoid the carbs and you won't dump, and you won't gain weight.
Good luck.
<Mary> ok, thank you!
<MODERATOR> SHELBY YOU HAVE THE NEXT QUESTION:)
<shelby> i have a BMI 53 sleep apnea, chronic leg pain, herniated
disc & high cholestrol do you think MEDICARE would approve me for
RNY if dr. said it is medical nessity thanks!
<Dr. Simpson> Shelby, Medicare will probably
approve you for it just with the BMI alone, so I think you will do just
fine...
<Dr. Simpson> so, find a nice surgeon who
will take Medicare and go for it. Good luck.
<shelby> thank you
<MODERATOR> ANNA/VEGAS YOU HAVE THE NEXT QUESTION PLEASE:)
<Anna/Vegas(-140#@5mo> Dr. Simpson...another one...lol...What
should be the most we EVER eat at one time. I still limit to 2 oz and
no liquid for 45 minutes after? Someone told me THEIR doc said we could
do up to 8 ounces!!! That sounds like alot to me. I'm VERY worried about
stretching my pouch...P.S. I never drink anything carbonated. :-)
<Dr. Simpson> Well some of us don't mind carbonation,
and some do, but you go with what your surgeon tells you...
<Anna/Vegas(-140#@5mo> okay - thankyou
<Dr. Simpson> in terms of what you should
eat-- you should eat what it takes to make you full. Start with two ounces
and wait a while and see if you ...
<Dr. Simpson> feel full after you have that...
<Anna/Vegas(-140#@5mo> I never feel hungry - let alone full
<Dr. Simpson> sometimes things pass quickly,
but most of the time it takes a bit and then you will realize it...
<Anna/Vegas(-140#@5mo> Ever since surgery, I've always hurt a
little when I eat anyway
<Dr. Simpson> so, if you don't feel empty,
just keep watching your portions and you will do fine.
<Anna/Vegas(-140#@5mo> thankyou so much
<MODERATOR> MID YOU HAVE THE NEXT QUESTION:)
<mid> I live in Ontario, Canada, and the wait for surgery can
be long!!! I have an opportunity to see a specialist, however, he may
be retiring now and 5 months have gone by!!! Do you know anyone in Ontario
who you would recommend who does the Duodenal Switch?
<Dr. Simpson> I don't know surgeons in our
northern provinces, sorry. Then again..
<Dr. Simpson> it is too cold up there to
have surgery. Come to America, it is nice here.
<MODERATOR> HEATHER YOU HAVE THE NEXT QUESTION:)
<Heather> Hey Doc! What WLS procedure do you personally prefer
and why? (you may have already covered that.. but I came in late)
<Dr. Simpson> Well, I prefer the one which
your surgeon does, the surgeon who you like, who has done a lot of them...
<Dr. Simpson> all of the procedures have
benefits, and all of them have issues...
<Dr. Simpson> so, find a surgeon with a good
support group, and that procedure will be the right one for you....
<Heather> I already made up my mind... I just wanted to know your
personal opinion
<Dr. Simpson> otherwise, I personally like
thea ;alsdkfj; alsdjf;aldjfa
<Dr. Simpson> oh-- I like the one my surgeon
does.
<Heather> hehe.. a little CYA never hurt... thanks anyway!
<Dr. Simpson> hey, it isn't my a that needs
covering here.
<MODERATOR> SUSANLYON YOU HAVE THE NEXT QUESTION PLEASE:)
<susanlyon> i am at almost 8 months is celery ok with peanut butter-is
sugarfree hot chocolate ok it has nutrisweet in it
<Dr. Simpson> Yes, susan-- those are all
things which are ok. Some celery can get caught up in the pouch and form
a little
<Dr. Simpson> hair ball, like cats get. So,
if you find yourself wanting to chase a ball, or liking catnip you should
...
<Dr. Simpson> worry about coughing up a hairball.
Seriously, with the RNY, stringythings can form a little ball of matter,
<susanlyon> could that be why i havew a little cramoing in my
belly
<susanlyon> you are so funny
<Dr. Simpson> which we call a bezoar, and
it is very much like a hair ball. SO, take off the stringy stuff. Good
luck,
<Dr. Simpson> here kitty kitty (they are
good protein).
<susanlyon> thanks
<susanlyon> hahaha
<MODERATOR> CANDACE YOU HAVE THE NEXT QUESTION:)
<Candace> What can you do if you have a wide opening to your intestine
you called it Anastomosis
<Dr. Simpson> If you have a wide opening
from the stomach to the intestine then you have a chance that you will
eat..
<Dr. Simpson> more than you should. With
that, there is nothing you can do, and instead you'll probably have to
<Dr. Simpson> have surgery to revise it,
if that is a problem. Good luck.
<MODERATOR> STEPHI AZ YOU HAVE THE NEXT QUESTION:)
<StephiAZ(5mo/-94)> My question is my weight is falling off very
slow now, but the inches are flying off. What causes this to happen? I
thought I would at least see the scale move while the inches go.
<Dr. Simpson> Weight shifts a lot, and when
that happens it is good to have the inches to remind yourself that...
<Dr. Simpson> you really are reforming your
body, and things are moving in the right direction...
<Dr. Simpson> I have the opposite problem,
after the Christmas season, when I was off my diet for a bit...
<Dr. Simpson> my weight went up, well, now
I am down five or six pounds that I wanted and ...
<Dr. Simpson> my pants are still tight--
guess I better diet some more. So, Steph-- walk more than you are walking
now...
<Dr. Simpson> and you also need to go to
your support group meetings....
<StephiAZ(5mo/-94)> Sorry I missed ya last night. 3am comes awful
early
<Dr. Simpson> good luck.
<StephiAZ(5mo/-94)> Thanks
<Dr. Simpson> Stephi is one of my patients---
I was giving her a hard time.
<MODERATOR> HEATHER YOU HAVE THE NEXT QUESTION PLEASE:)
<Heather> Do you have a foods list online.. or know of some good
websites that can provide low-carb/no sugar meals?
<Dr. Simpson> the Atkins Center website does
a nice way...
<Dr. Simpson> I will have a book out shortly
which will have a list of them, and there are two cookbooks....
<Dr. Simpson> which are coming out which
will have those good meals in them, watch this website and you will see
<Heather> great! will do... Thanks!
<Dr. Simpson> their announcement coming---
should be a good cookbook. Good luck.
<MODERATOR> JESSICA YOU HAVE THE LAST QUESTION FOR OUR GUEST
TONIGHT:)
<jessica> hi, i need to know where to start...
<Dr. Simpson> Jessica to start with you talk
to your primary care doctor and they will refer you to a surgeon who
<Dr. Simpson> does this surgery for a living....
<jessica> what about methods of payment?
<Dr. Simpson> a bariatric surgeon, then you
meet with them and decide if that is what you want to do. The cost of
the surgery...
<Dr. Simpson> varies from place to place,
but often it is anywhere from 17 thousand to 25 thousand dollars if you
pay cash...
<Dr. Simpson> and some surgeons and hospitals
have payment plans, but most want the money upfront...
<Dr. Simpson> so, good luck.
<Dr. Simpson> thank you all for a fun evening
<Dr. Simpson> good night
<jessica> thanks doc..
<MODERATOR> THANK YOU DR. SIMPSON! THANK YOU TO OUR
MEMBERS! HAVE A GREAT NIGHT!
<Tammy> THANK YOU DR. SIMPSON! THANK YOU MEMBERS! Visit Dr.
Simpson WWW.ARIZONABARIATRICCENTER.COM
<Dr. Simpson> www.doctorsimpson.com
<Heather> Thank you!!!
<Dr. Simpson> the new website
<Candace> Good night
<Dr. Simpson> it shows the same place, but
we are slowly changing
<tclaxton> thank you
<Dr. Simpson> same website
<Dr. Simpson> new name
<Dr. Simpson> new features coming
<Dr. Simpson> fun stuff
<SuzyQ(pre-op)> g'nite thanks
<Dr. Simpson> free horse rides
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