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<MODERATOR> LEY -75, YOU HAVE THE FIRST QUESTION TONIGHT FOR
DR. SIMPSON.
<LEY(-75@15weeks)> Dr. Simpson I have a two part question...first
I have lost 75 lbs very rapidly and am afraid I am losing too fast...can
this be a problem? And second I went to the Dr today and was prescribed
some Lortab 7.5 for a toothache and they are giving me severe stomach
upset and heartburn..my surgeon has said its ok to take tylenol by pill
but are these not ok...or should I try taking half of one? I took one
at 11:30 today and STILL have heartburn even after 2 pepcids.
<Dr. Simpson> loosing weight is not a problem.
Lortab is OK, won't be a problem. Heartburn is another issue, not related
to this.
<LEY(-75@15weeks)> but it just started after the meds\
<Dr. Simpson> Lortab is not a drug which
causes stomach problems, it has Tylenol and it has some narcotic, you
might have a problem with the narcotic.
<LEY(-75@15weeks)> anything i can to to counteract that
<Dr. Simpson> No-- if it is a problem with
the narcotic then it will wear off with time. If it is something else
that is going on then you should see your doctor and go from there. Good
luck.
<LEY(-75@15weeks)> thanks dr simpson
<MODERATOR> POLLY 3 WKS, YOU HAVE THE NEXT QUESTION.
<Polly-3wksPO-25> i am 3wks PO can i take an anti-inflamatory
here
<Polly-3wksPO-25> now?
<Polly-3wksPO-25> they told me at first to stay away from aspirin
type medication right after surgery
<Dr. Simpson> Well it depends, some people
who have the RNY do not allow their patients to ever have non steroidal
anti inflammatory medications....
<Dr. Simpson> some have no problem with it,
but the issue is regarding the surgery and how those effect your stomach...
<Dr. Simpson> after the RNY you are no more
or any less prone to problems from NSAIDs (motrin, Aspirin, Aleve, advil)
<Polly-3wksPO-25> oh..i thought it was a clotting issue
<Dr. Simpson> than you would before the surgery.
There are two issues: the first is that they work in a systemic fashion,
that is...
<Dr. Simpson> the pills work by causing a
breakdown in the lining of the stomach, and they do not have to be in
contact with the stomach to do that...
<Dr. Simpson> they simply have to be in the
bloodstream. So, some surgeons do not like that you cannot see the other
side of the stomach with an endoscope after you have had an RNY....
<Dr. Simpson> So, they prohibit patients
from every having NSAID's. I am not like that, and for my RNY I do allow
them that, with the caveat that they need to take
<Polly-3wksPO-25> so...i may be able to get some kind of steroid
shot instead?
<Dr. Simpson> some proton pump inhibitor
(nexium, prevacid, protonix) at the same time, in order to decrease the
acid....
<Dr. Simpson> and go from there. Steroids
are not the answer to pain control, they are the answer for inflammation....
Dr. Simpson> so, I suggest you discuss with your surgeon what issues
he has with these things and go from there...
<Polly-3wksPO-25> thank you!
<Dr. Simpson> further, if you do take the
NSAID's then I think you should take them with the other medicines I said....
<Polly-3wksPO-25> yes sir!
<MODERATOR> SHEILA 9 DAYS PO, YOU HAVE THE NEXT QUESTION.
<SHEILA 9 days po> Dr S, How long will the pain and swelling last
after open RNY,? I have to take pain meds continuously.
<Dr. Simpson> Pain and swelling after open
RNY is common for a few days. You cannot get rid of all pain and you cannot
expect to ...
<Dr. Simpson> have pain medicines being taken
every four hours, you have to let go of them...
<SHEILA 9 days po> but what abouut the swelling?
<Dr. Simpson> if you are having abnormal
amounts of pain, and it is not getting better then you should see your
surgeon....
<SHEILA 9 days po> I doubt abnolrmal thouhg
<Dr. Simpson> if you have swelling, that
could be a number of things, it could be you have a red wound infection,
so you would need to see your surgeon...
<Dr. Simpson> it could be that you have a
lot of fluid on board after surgery, which will pass...
<SHEILA 9 days po> what is that?
<Dr. Simpson> some swelling and pain is normal
after surgery, and some is not. You have to judge that yourself...
<SHEILA 9 days po> I see him Monday
<SHEILA 9 days po> thanks
<Dr. Simpson> if you are having fevers that
is not a good thing, and you should call. Good luck. Surgery is painful,
it is not for the faint of heart --
<MODERATOR> JAIMIE, YOU HAVE THE NEXT QUESTION.
<Jaimie> I've read that a lot of people have excess skin after
surgery what would you say is the best thing to do to stop this or is
the chance for this happening really high? Another question I have is
that how do you decide if a surgery is done open or laproscopical? Thank
you
<Dr. Simpson> The best thing to do is to
get into an exercise program and use your muscles to tone your skin. Some
people will have the skin no matter what, it is a combination....
<Dr. Simpson> of genetics and other factors.
In terms of surgery how it is done, every surgeon has their own criteria....
<Dr. Simpson> some do all surgery laparoscopically,
and some only do selective cases, it is a matter of surgeon preference...
<Dr. Simpson> if you area asking for which
surgeon you should go to, you go to the one that your insurance plan recommends,
and see what they do and discuss those issues with him. Some surgeons
do no laparoscopic surgery.
<Dr. Simpson> open works as well as laparoscopic.
Good luck.
<MODERATOR> LORI, YOU HAVE THE NEXT QUESTION.
<Lori 2wk post> I am 2 weeks post and healing very well. I am
now having some pain over one of my incision sites. I am afraid I have
done too much at home and maybe a hernia. What are some signs of a hernia?
<Dr. Simpson> pain in an incision is normal
after surgery, and more normal as you increase activity. Hernias come
in when...
<Dr. Simpson> you have torn the underlying
gristle, or fascia, and have a hole, which allows the inside tissues to
bulge out...
<Dr. Simpson> so if you have a hernia, you
might feel a bulge. Otherwise, it might be strain in the incision, and
so that is something to watch for. Good luck. Keep walking, however, that
is good for you.
<MODERATOR> ROCKIN ROBIN, YOU HAVE THE NEXT QUESTION.
<??RockinRobin??> Hello, Doctor Simpson. How soon after surgery
is it safe to start a workout program. Such as water workouts? For someone
my size 400 pounds?
<Dr. Simpson> Depends on whom you will work
out and if they give you permission.....
<Dr. Simpson> in terms of water aerobics
that is a good thing which you can start as soon as your surgeon ...
<Dr. Simpson> clears you to get into the
water and move around-- that is, when the wound is healed well enough
for you to be baptized again, or in water...
<??RockinRobin??> i am having open RNY
<Dr. Simpson> In terms of non water stuff
with weights-- at least six weeks. Good luck...
<Dr. Simpson> and have a good time in the
water, it is a great exercise.
<MODERATOR> BECKY, YOU HAVE THE NEXT QUESTION.
<Becky> When diet has been Re-Evaluated and over the counter gas
aids have been tried- Is there a prescription medication that would aleviate
the very frequent and foul gas that seems to be a issue for me since having
Open RNY 9 months ago. This is a BIG Problem when working around others,
Even when excusing yourself - It comes back with you and lingers. This
post sugery is offensive
<Dr. Simpson> OK-- well these are always interesting
questions, so let me see.....
<Dr. Simpson> first, you have to eliminate
a few things in your diet and check out a few simple things....
<Becky> The foulness is the worst part
<Becky> The carbs are minimized
<Dr. Simpson> the first is lactose -- eliminate
it and make certain that isn't a problem...
<Becky> okay-
<Dr. Simpson> second, is to go through your
grease and high fat items, and see if they are a problem...
<Dr. Simpson> the next is to eliminate gluten
and see if that is a problem... these are things that you should do...
<Dr. Simpson> not all at once, but in a sequential
fashion. Most of my patients like Devrom, it seems to work rather well...
<Becky> Is that perscrition?
<Dr. Simpson> in fact it worked so well we
started stocking it n the office so they have a ready supply of it...
<Dr. Simpson> and, finally --- candles. Lots
of candles. Good luck.
<Dr. Simpson> Devrom can be purchased over
the Internet or at 800 453 8898
<Becky> Thanks
<MODERATOR> PAM MI, YOU HAVE THE NEXT QUESTION.
<Pam>MI> after seeing the internist yesterday, for my P.A.T
testing she may want a liver cat scan after some blood test results on
monday--do u feel they can get me scheduled and results back by surgery
next Friday the llth of April since you are a Dr., thought u might have
an insight on that
<Dr. Simpson> Point after touchdown testing?
<Dr. Simpson> sorry -- couldn't resist, it
is a while till football season, but we are excited in Arizona to have
Emmit Smith...
<Dr. Simpson> they can get the labs scheduled
and it shouldn't delay your surgery. Go bears.
<Pam>MI> ok, u think a cat scan results will be back by Friday
?
<Pam>MI> if I have the cat scan tues. or wed.
<Dr. Simpson> Yes, results will be back.
<Pam>MI> ok, thank u
<MODERATOR> VICKIE, YOU HAVE THE NEXT QUESTION.
<Vickie> I'm experiencing back aches 9 weeks post op
<Dr. Simpson> back aches are something that
happen a lot after surgery, usually from the bad beds in hospitals and
from...
<Dr. Simpson> not getting up and moving a
lot. If you still have them you may need to see your internist to make
certain you...
<Dr. Simpson> don't have some other back
pathology going on there-- perhaps a bulging disc, or some such thing...
<Dr. Simpson> but seeing a physical therapist
would help you stretch your back out a bit, and keep walking.
<Vickie> Thank you!
<Dr. Simpson> So -- water, walk, protein.
<MODERATOR> DEB B, YOU HAVE THE NEXT QUESTION.
<DebB> Do you find more insurance companies starting to cover this
surgery now that it is showing such a sucess rate and if not, why, when
it saves so much for the insurance companies in the long run?
<Dr. Simpson> well insurance companies do
not think of the long run because patients are not with them in the long
run...
<Dr. Simpson> insurance companies think of
their profits for this quarter and this year, so that is something that
you have to learn to live with....
<Dr. Simpson> it is something that is hard
to accept. More insurance companies are making it more difficult for patients
to have the surgery, by increasing the
<Dr. Simpson> requirements, such as physician
supervised diets, or not allowing some procedures like lap band or the
DS....
<Dr. Simpson> and that is all for the bottom
line, it is not for your health. They are not in the business of health
care, they are in the business of making money-- sorry to disillusion
you, just the way it is. Good luck.
<DebB> That is why my next job will tell me if they cover WLS before
I accept the job! Thanks\
<MODERATOR> AMYMAY, YOU HAVE THE NEXT QUESITON.
<amymay@101pds> i have had many bloonings done and still cant
eat right will this be a for ever thing i went down to 81 pds had a revision
all in one year had 15 bloonings done what can i do i do not see dr overcash
anymore im on my own now im woundering if you caouls help me on this
<Dr. Simpson> well sometimes there are strictures,
or narrowings which happen at the stoma, and sometimes they have to...
<Dr. Simpson> be opened up, or revised by
surgery. So it is a tough problem, and there is not too much to do, if
that part of the body will...
<Dr. Simpson> scar down to that point you
might need to have a revision to another type of surgery instead of the
one you have had....
<amymay@101pds> i had one
<amymay@101pds> already
<amymay@101pds> oo
<Dr. Simpson> but a dilation is something
that happens. What did they revise you to?
<amymay@101pds> they made my bowels bigger
<amymay@101pds> thats all i know
<Dr. Simpson> What I meant was from a RNY
to a VBG or to a DS. I don't know what you mean by bowels bigger...
<Dr. Simpson> that would be the next step,
is a revision to a different type of surgery -- and to find out what the
underlying cause is for the
<amymay@101pds> the dr said he mademe to small
<Dr. Simpson> strictures. As there are a
number of reasons. Well, if they re larger now it should be OK. Sorry
you are going through this, but it does happen to about ten per cent of
folks with the RNY...
<Dr. Simpson> good luck.
<amymay@101pds> thats why i lost so fast and so much
<amymay@101pds> thank you
<MODERATOR> JEAN, YOU HAVE THE NEXT QUESTION.
<Jean> How much time do you have to take off post op to return
to work? I have a very physically demanding job. Can I do light duty after
4 weeks? Thanks so much.
<Dr. Simpson> Ah Jean. Well, I think that
it is a good question, and sometimes people don't like my answer....
<Dr. Simpson> then again I am the one who
says they should walk from the recovery room to the floor,....
<Dr. Simpson> generally three weeks for a
non-physically demanding job, and you should resume lifting at six weeks
or more....
<Dr. Simpson> so it depends. A lot of my
patients return to work after three weeks-- but that is to sit in front
of a computer like I am doing....
<Dr. Simpson> only my fingers get tired....
<Jean> How much weight is too much to lift?
<Dr. Simpson> sorry DL----
<Dr. Simpson> ten pounds to fifteen pounds
for the first six weeks is all we recommend...
<Dr. Simpson> more than that you might develop
a hernia.
<Jean> even if the procedure is done laproscopically?
<Dr. Simpson> which gives we surgeons more
work to do!
<Dr. Simpson> Yes, hernias form from all surgeries,
not just open.
<Jean> Thank you Dr. Simpson.
<Dr. Simpson> you are welcome, Jean
<MODERATOR> JOAN NJ, YOU HAVE THE NEXT QUESTION.
<JoanNJ> Dr Simpson i've heard that many vitamins dont get dissolved
and get passed through which probably means they werent absorbed...which
vitamins should be used? thank you
<Dr. Simpson> Vitamins that get absorbed.
<JoanNJ> ;)
<Dr. Simpson> remember to take them out of
the plastic wrappings-- they hurt coming out otherwise.
<JoanNJ> to be recycled
<Dr. Simpson> chewables work well, such as
Flintstones, some of the ones in gel caps work well also, such as Vista
Vitamins...
<Dr. Simpson> who would want the recycled
ones?????
<Dr. Simpson> never mind-- HMO material.
<JoanNJ> do the flintstone vitamins have enough iron?
<Dr. Simpson> So, most vitamins do get absorbed
quite well, all of the common ones that you can purchase over the counter,
you do not have to spend a lot of money....
<Dr. Simpson> with those other vitamin companies
that will sell you very expensive ones. You might need to supplement the
iron you take, with some more, depending if you are still having periods--
or some of my ...
<Dr. Simpson> patients have such heavy ones
they call them !!!.
<JoanNJ> thank you
<Dr. Simpson> but most companies that sell
high priced vitamins will try to convince you that they are better, and
absorb better, but that is advertising and not based on scientific fact...
<Dr. Simpson> even though they try to convince
you of it-=- here, buy my vitamins, they are more expensive but we think
they are better----
<Dr. Simpson> so much bunk, but it is effective
advertising. Good luck
<MODERATOR> FATTY PATTY, YOU HAVE THE NEXT QUESTION.
<Fatty Patty> I am required to demonstrate 2 comorbid conditions
as I have a BMI of 48 and my insurance companiy requires a BMI of 50 with
no comorbids or if less than 50, two comorbids, one of which can be being
ortho. They want me to see an orthopedist who will document that I will
need joint replacement surgery if I do not lose weight. I see things mentioned
about the spine and load bearing but little seems to support the fact
that weight loss will help back poroblems. I have deg disc, facet arthropathy,
compresion fracture, herniated discs in the lumbar and thoracic spine
. In your opinion should these conditions qualify me and if so where can
I get objective ifnromation about this requirement? I also have low iron
levels and am takin giron. I want to donate blood for myself for surgery.
How do I go about arranging this? How long does the blood last?
<Dr. Simpson> Blood lasts for a month or
so-- and the blood bank has all the information about that.....
<Dr. Simpson> bmi of 50 is above what the
NIH recommends, so here is an insurance company making up new rules so
they don't have to pay out as much for surgery....
<Dr. Simpson> you have enough co morbid conditions
even if you had a bmi of 36 -- in my book, so go forward and sin no more.
Or something like that.
<Dr. Simpson> sorry you have an insurance
company that makes up science as it goes along.
<MODERATOR> ROCKINROBIN , YOU HAVE THE NEXT QUESTION.
<??RockinRobin??> Doc, you are very funny, too bad you are not
my doc, mine seems to have a corn cob wedged someplace....another question
on walking.. I am on my feet 8 hours per day 7 days per week and am walking
around a 5000 square foot werehouse at least 80 time per day. , I have
really bad burning pain in every joint right now after a long day at work.
I but the best shoes and change them around every three months when they
get worn down. Some have suggested a walking program i should start right
now pre op to go out and start walking on the pavement,( this sends shudders
down my spine).. I have told them that i really don't want to start anything
right now because i am worried about damanging my knees or ankles or back
or even have a heart attack along the road someplace. I want to wait until
i have lost at least 150 pounds or so. When i was in high school i was
a big kid but very active and was around 230 pounds i played bastket ball
volly ball, soft ball, and was a member of the track team
<Dr. Simpson> wow
<??RockinRobin??> sorry so long doc
<Dr. Simpson> what a question. OK-- let us
go from here
<Dr. Simpson> first of all-- I think that
you should begin by seeing a podiatrist and have your feet checked by
them to see if there is something they can offer you...
<Dr. Simpson> and I do not mean the candy
in their office candy dish either....
<??RockinRobin??> hehe
<Dr. Simpson> second, for exercise you might
consider water aerobics, as it would take the weight off the feet and
give you a good work out....
<??RockinRobin??> i have seen a foot doc .. i am just too big
for my tiny frame
<Dr. Simpson> finally, walking on the job
is not the same as dedicated walking time-- and there are a thousand places
you can walk, and the excuses I have heard before, because I use them
all....
<Dr. Simpson> so, water aerobics, get a pool,
an instructor -- preferably someone of the opposite sex to keep you coming
to the pool. Good luck
<MODERATOR> TAZZNTX, YOU HAVE THE NEXT QUESTION
<TAZZ IN TX> WHICH WLS DO U THINK IS THE BEST WAY TO GO AND WHY.AND
WHAT INSURANCE IS A GOOD INSURANCE WHICH ONE HAVE YOU HAD YOUR HIGHEST
SUCESS RATE WITH.. AND WHY IS THE GALL BLADDER USUALLY REMOVED. WHAT IS
THE FUNCTION OF THE GALL BLADDER AND IS THERE ANYTHING THE PATIENT CAN
DO TO PREVENT HAIR LOSS AND WE MISS EMMIT ALREADY IN DALLAS.. THANKS DR
SIMPSON
<Dr. Simpson> the best wls is the one which
your surgeon does, who has a good after care program.....
<Dr. Simpson> the best insurance is the one
which will allow you the most choices in terms of doctors to go to for
the surgery so that you can actually have a choice of DS or RNY or lap
band, and make an informed decision....
<Dr. Simpson> the gallbladder is an organ
put in by God, because she is a surgeon and feels that we (earth surgeons)
need it to pay our rent....
<Dr. Simpson> it is a storage unit which
holds bile, and secrets that bile in response to a fatty meal....
<JoanNJ> lol
<TAZZ IN TX> LOL
LEY(-75@15weeks)> ROFLOL
<Dr. Simpson> and as you lose weight the
gallbladder can develop stones, so some of us take it out at the time
of surgery because you are already open...
<Dr. Simpson> and so as long as we take out
the spark plugs we might as well clean em too-- -. And Emmit will do well
in Arizona.
<Dr. Simpson> But I still like Da Bears.
<TAZZ IN TX> thank u very much dr simpson
<Dr. Simpson> you are more than welcome and
thanks for Emmit.
<MODERATOR> MSBADGRL68, YOU HAVE THE NEXT QUESTION.
<msbadgrl68> Hello Dr. Simpson.... I am pre still waiting for
approval and would like to know is it normal that I have gained almost
15 lbs in 2 months ?And what could I be doing to make my lower back to
stop hurting so much ?
<Dr. Simpson> Gaining weight is not abnormal,
otherwise I wouldn't be in this business. IN terms of lower back, see
your physical therapist and your internist to make certain you don't have
some underlying back pathology which needs correcting. ...
<Dr. Simpson> walk, drink water, eat protein,
get the surgery.good luck
<msbadgrl68> TY Dr. Simpson
<MODERATOR> JENNIFER B, YOU HAVE THE NEXT QUESTION FOR DR.
SIMPSON.
<Jennifer B.> I have been experiencing very low energy levels
post op since my surgery 8 weeks ago. Is this normal this far out and
what if anything should I be concerned with causing this and howdo I try
to regain that energy?
<Dr. Simpson> The more you get up and walk,
the more energy you will get from getting out and walking. In other terms
you might need to see your internist or primary care physician and have
some blood tests done to see if you have ...
<Dr. Simpson> anemia, or low levels of B12.
But 8 weeks we still expect people to be a bit under the weather, it takes
a good 12 weeks before you start to feel like yourself...
<Dr. Simpson> until then you feel like someone
else. I feel like Cindy Crawford right now, but she isn't around.
<Jennifer B.> well my old self had no energy either lol ....thanks
:)
<MODERATOR> ANISSA, YOU HAVE THE NEXT QUESTION.
<Anissa> I'm having lap RNY on the 22nd and I keep hearing people
talk about hernias, what would make me get one?
<Dr. Simpson> hernias occur when you put
too much pressure on the incision by lifting something or pushing or pulling
something...
<Dr. Simpson> too big, over ten to fifteen
pounds for a while. So don't do that for six weeks.--uh oh, just got busted
for the Cindy comment.
<Dr. Simpson> another night on the couch
<Anissa> Thank You Dr. Simpson and I love your sense of humor
<MODERATOR> KIM, YOU HAVE THE NEXT QUESTION.
<Kim> I'm having a Lap RNY 4/21, How do I know if I have a leak
post-op? When I'm home from the hospital that is. Is that common after
going home? Is there anything I can do to prevent it, other than following
my surgeons diet? And when am I "out of danger?"+
<Dr. Simpson> You will get sick if you have
a leak post op, and you are probably out of danger a month after surgery...
<Dr. Simpson> in terms of preventing a leak
-- DO NOT OVEREAT--- do not over fill your pouch.....
<Dr. Simpson> it is very uncommon after going
home, and in terms of other things you can do-- I suggest walking.
<Kim> Thanks, Dr. S, you're sense of humor is wonderful!
<Dr. Simpson> Glad some people like it.
<MODERATOR> ASHLEY 29, YOU HAVE THE NEXT QUESTION.
<ashley29> I am a 28 yr old mother of three.....with joint and
heel problems, trouble sleeping.....leg swelling, and i weigh 269 pds.
I am contemplating the surgery and have my first appt. on Thursday. But,
my concern is that i've heard horror stories about people dying from this
surgery. Can you give me and my husband some reassurance please? We are
also worried that our insurance wont pay for the surgery!! :( Can you
give my husband and I some reassurance? Thank you--Ashley from Mobile
Alabama.
<Dr. Simpson> Husband-- be reassured.....
<ashley29> lol
<Dr. Simpson> Yes, it is surgery, it is major
surgery, there are real and terrifying risks of surgery....
<Dr. Simpson> bad things can happen, unless
you are a bad person, in which case you will live forever.....
<ashley29> lol
<Dr. Simpson> in terms of insurance, they
usually do pay for it although you might have to jump through a few hoops,
which is hard when you weigh 269 lbs....
<ashley29> lol....exactly
<Dr. Simpson> but the fear of dying, or having
a prolonged hospitalization and rehabilitation is REAL, and cannot be
denied....
<Dr. Simpson> and cannot be MINIMIZED-- it
happens, it happens to healthy young people, and it is something that
is a real and very very sad thing....
<Dr. Simpson> So -- do not take the surgery
lightly, do not dismiss your fears about it-- however, on the flip side,
there are alot of things...
<Dr. Simpson> which we can say about the
surgery-- it works, people have improved lives, and do quite well, but
like any surgery or any procedure...
<Dr. Simpson> IT IS REAL--so, your husband
is expressing love-- and for that you should give him a kiss and tell
him that you love him-
<Dr. Simpson> and fix him dinner.
<ashley29> tyvm dr simpson......you've been a great help!! And
your funny too
<MODERATOR> CHRISTINE, YOU HAVE THE NEXT QUESTION.
<Christine> How long are you in the hospital for,and how big of
a cut is it? and how long do you have to eat liquid foods,also how would
you rate theBaiatric Centers.Also how long after the surgery can I go
swimming,since summer is creeping up.And are you on a higher risk for
blood clots if you have vericose veins?
<Dr. Simpson> Varicose veins do not, in and
of themselves, increase risk of deep venous thrombosis, or blood clots,
unless...
<Dr. Simpson> there is an underlying deep
venous blood clot which caused the varicose veins, which can be checked
quite easily....
<Dr. Simpson> surgery usually means hospital
stay of three to five days, and in terms of the liquid to solid food all
of us have a different program so it would be impossible for us to tell...
<Dr. Simpson> in terms of the length of the
scar, again that is individual, and depends on what they find---for example...
<Dr. Simpson> since, people ask, when I do
an open procedure I measure the incision, and it is usually six inches
(measured, gang, I know what you are thinking)...
<Dr. Simpson> and sometimes i have to enlarge
the incision if there are other things happening, like a lot of adhesions
in the pelvis...
<msbadgrl68> lol
<Dr. Simpson> for laparoscopic it is usually
five port holes, one inch long at the most.....
<Dr. Simpson> sometimes we have to put in
an additional port, if we find something else we need to do. Good luck
<Christine> thank You
<MODERATOR> GRACE IN CA, YOU HAVE THE NEXT QUESTION.
<Grace in Ca.> HOW DO YOU BEST PREVENT BLOODCLOTS AFTER SURGERY?
I'M AFRAID.
<Dr. Simpson> For patients, the best thing
they can do is:
<Dr. Simpson> (fill in the blank gang)
<Garrison/Dallas, Tx.> walk? lol
<sara> walk
<Anissa> Walk
<msbadgrl68> WALK
<DebB> What about blood clots, will walking before surgery help?
Do blood thinners preop help?? What is the best thing to do to prevent
these before and after surgery besides walking?
<TAZZ IN TX> walk as soon as possible
<Dr. Simpson> walking will help a lot-- so
you walk
<Dr. Simpson> and you keep walking. The surgeon
will prescribe for you some medicine to prevent the clots and have some
other things to do that...
<Dr. Simpson> But you can start walking before
surgery and keep walking. Good luck. Ok Jaime, here I come...
<Grace in Ca.> Thanks Doc
<MODERATOR> JAIME, YOU HAVE THE NEXT QUESTION.
<Jaimie> Why do a lot of doctors feel that you have to be at least
18 to have the surgery? I'm in Alabama and you have to be 18 but I've
heard of other places doing it as young as 14 and I've been overweight
since I was like 6 but I have 2 months till my 18th b'day I know that
I'm not that old but I want to get out there and start living already!
<Dr. Simpson> Now, I know that at 17 years
old you think that two months is a long time to wait, and for you it is,
for me two months...'
<Dr. Simpson> is just another blonde hair
turned gray, so you can start your process now by seeing a surgeon, and
getting material together for the surgery....
<Dr. Simpson> I have no problem operating
on patients who are 16 years old, and some of my colleagues have operated
on younger patients....
<Dr. Simpson> but two months waiting, really--
it is not too bad-- although again, that is my old age perspective here--
<Dr. Simpson> being 72 years old I have a
few years on you. Good luck.
<Jaimie> thanks
<MODERATOR> SHEILA, YOU HAVE THE NEXT QUESTION.
<Shelia> I take celebrex for my painful knees. I am less then
2 weeks from surgery, April 14, should I stop taking this medication so
that my stomach might not be having problems from this medication. Also,
I have sleep apnea and require a c-pap machine. Is it norman for the surgeon
to place the post-op patient in ICU till the Barium swallow can be done
the next day.
<Dr. Simpson> Yes you should stop taking
the medicine, and it is not because of the stomach, but it does inhibit
blood clots, and you want blood to clot after the surgery.....
<Dr. Simpson> some patients do go to ICU
who have sleep apnea, everyone has a different way to monitor those patients....
<Dr. Simpson> and some do the swallow right
after surgery, some wait. SO, no problem. Stop the celebrex, take tylenol
-- according to instructions.Good luck.
<Dr. Simpson> wow that hour went by fast
<Dr. Simpson> who has the last question
<Shelia> Thanks
<MODERATOR> LEY, YOU HAVE THE NEXT QUESTION.
<LEY(-75@15weeks)> what about carbonaiton doc
<LEY(-75@15weeks)> what is your feel on it
<Dr. Simpson> in terms of carbonation-- I
don't mind it at all-- although some don't like it, and some like it after
a few weeks--
<Dr. Simpson> I like diet Pepsi== although
Brittany isn't doing the commercials anymore--
<Dr. Simpson> there I go again
<LEY(-75@15weeks)> roflol
<LEY(-75@15weeks)> so it wont stretch the pouch
<Dr. Simpson>Carbonation if you have an escape
route won't stretch the pouch-- if you gulp it and if you... keep
it down it can. So, views change on this from time to time-- wait a week,
we will give you another answer.
<MODERATOR> MARIE, YOU HAVE THE NEXT QUESTION
<marie> my pcp tells me I have a high liver function test and i
dont have any reason for it can it be fatty liver? is it safe to have
surgery with fatty liver??
<Dr. Simpson> Fatty liver is not a contraindication
to surgery-- but if you have elevated liver enzymes you should have them
worked up to see if that is the cause, and that you don't have hepatitis,
or some other issue...
<marie> I had a hpatitis test and its not that i also dont drink
<Dr. Simpson> good marie-- it probably is
NASH-- non alcoholic steattorrheic hepatitis-- fatty liver. It is not
a problem for surgery, it does make
<Dr. Simpson> laparoscopic a bit harder.
<MODERATOR> JOANNJ, YOU HAVE THE LAST QUESTION FOR DR. SIMPSON.
<JoanNJ> Dr Simpson what is the nicest jesture of appreciation
a wls patient has done for you?
<Dr. Simpson> they got better and told me
thank you
<TAMMY> THANK YOU DR. SIMPSON! THANK YOU MEMBERS! PLEASE
VISIT DR. SIMPSON AT: WWW.DOCTORSIMPSON.COM
<LEY(-75@15weeks)> ROFLOL thanks doc
<Dr. Simpson> thank you all for coming
<marie> thank you DR. S
<MODERATOR> THANK YOU DR. SIMPSON
<Christine> Good Night Dr Simpson, You Are "WONDERFUL"
:)
<sara> ty dr. simpson
<Dr. Simpson> good night Mrs. Calabash, wherever
you are
<TAZZ IN TX> thank uou dr simpson
<jane> Thank you, Dr. Simpson
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