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<Dr. Simpson> Good Friday to everyone
<**MODERATOR**> LS YOU HAVE THE FIRST QUESTION TONIGHT, FOR
DR. SIMPSON
<LS> Hi Dr.- I am at my goal weight and I am 8 months post. My
blood work is really great. I know I have to take my vitamins and supplements
for the rest of my life , but how long do I have to eat all this meat
for?
<Dr. Simpson>Well, LS- you don't have to
eat meat, but you have to get the protein in...
<Dr. Simpson>protein is important, and with
the DS you need to get 70 grams, or so, in a day...
<Dr. Simpson>there are a lot of places of
protein.
<LS> 90 for the rest of my life??
<Dr. Simpson>the rest of your life, You need
it.
<LS> grams
<LS> OK
<Dr. Simpson>yes, forever.
<LS> thanks Dr.
<**MODERATOR**> BING YOU HAVE THE NEXT QUESTION PLEASE:)
<bing(6 weeks postop> (My open RNY G Bypass was on March 6) I
want to know what is malabsorbed and to what extend with the RNY, eg.
fats, sugar, and vitamins/minerals. Why is malabsorption a good thing
when you lose out on nutrition from the bypass of your intestines. I get
about 900 calories per day, 60+ grams protein per day.
<Dr. Simpson>Well, I don't think that malabsorption
is the correct word------
<Dr. Simpson>in fact, I think that you have
some of the intestine which is bypassed, and if you have some of it bypassed,
then you don't absorb food through that....
<bing(6 weeks postop> dr. that is what my doctor calls it i think
<Dr. Simpson>I know, a lot of people say
that, the issue isn't malabsorption -- the real issue is how much is there
to absorb...
<Dr. Simpson>we don't do anything to cause
you to not absorb food-- we instead bypass some intestine, and the percent
of intestine which is bypassed
<Dr. Simpson>is not always the amount that
you will not have to be concerned about for ....
<Dr. Simpson>that is-- if 100 cm is bypassed,
then you don't miss out on 1/6th of the absorption....
<Dr. Simpson>so--- basically -- learn to
eat well, keep carbohydrates out of it, eat protein first....
<Dr. Simpson>and walk a lot.
<Dr. Simpson>good luck
<bing(6 weeks postop> ok, i don't get it, but i'm doing what the
doc says, and that's going to have to do for now
<bing(6 weeks postop> thanks
<**MODERATOR**> KS SUNFLOWER YOU HAVE THE NEXT QUESTION PLEASE:)
<KS Sunflower> hi Dr Simpson, good to speek to you, have heard
nice things about you, i was wondering if you have any suggestions on
how to get thru the plateau i'm in, i do the protein, walk, drink 60-80
oz water day, i'm 7 1/2 mo. post op. open RNY
<Dr. Simpson>Plateaus work out themselves,
because you will lose weight. However, if you are having carbohydrates....
<Dr. Simpson>you will put on weight, or slow
weight loss, so you have to moderate those a bit, and that is the best
way to get the plateau...
<Dr. Simpson>so, sometimes plateaus happen,
and when those plateaus do happen then it is OK.
<KS Sunflower> thank you DR.
<**MODERATOR**> DEBBIE B YOU HAVE THE NEXT QUESTION:)
<Debbie B> For a relatively active person, what is the average
recovery time before returning to work after RNY surgery?
<Dr. Simpson>Three weeks on the average---
and sometimes a bit more if you have a tough job. Such as a surgeon.
<Debbie B> for a desk job?
<Dr. Simpson>Three weeks-- although you will
be a bit tired.
<**MODERATOR**> BASSETT MOM YOU HAVE THE NEXT QUESTION:)
<Basset Mom> Hello Dr.,Will This Surg. Help Elevated Lft's and
in return help a fatty liver?
<Dr. Simpson>Fatty liver is something which
a lot of people have who have obesity, and is caused from a problem with
carbohydrate metabolism in the liver....
<Dr. Simpson>and weight loss surgery is one
of those things that does help do that.
<Dr. Simpson>So, it is a good thing. You
also need to have a liver biopsy...'
<**MODERATOR**> LINDA 21249 YOU HAVE THE NEXT QUESTION:)
<Linda 21249> How long after surgery can i swim?
<Dr. Simpson>You can swim in surgery following
a week or two.
<**MODERATOR**> GLORIAINSOCAL YOU HAVE THE NEXT QUESTION:)
<GloriaInSoCal> Hello Dr Simpson, I want to know how you advise
your patients on how to get thru the fist few weeks of the liquid diet
monotony...its becoming really frustrating for me, to the point of tears
<Dr. Simpson>well, I don't use liquid diet
the first few weeks, and the only way to put up with it is to realize
that you can do anything for a time, and ....
<Dr. Simpson>and find new liquids to try--
like radish juice, or put a cat in a blender....
<janet h> mmm
<Dr. Simpson>or perhaps find a new source
of iron-- such as old nails in a blender-- need strong blades.
<GloriaInSoCal> lol my cats dont like blenders...already tried
<JimGA> hey don't knock it!!!
<Linda 21249> yummy
<Dr. Simpson>Possum is good
<KS Sunflower> YUMMY
<beach/va> ewwwwwwwwwww
<Jenny~26#> LOL!
<muffy> cats =protein?
<Dr. Simpson>yes cats are good protein.
<NIKKI> <--------hides cats
<**MODERATOR**> LISAANN YOU HAVE THE NEXT QUESTION:)
<Lisaann> I went shopping after going from store to store .. I
started dropping things .. tripped on way out tripped again started weaving
while walking my friend said I looked bad.. While she went to the car
I say felt dizzy out of it. On way home my leg felt strange then I was
so out of it wanted to sleep ... my friend said I slurred my words.
<Dr. Simpson>You need to see your doctor
ASAP -- simple as that, not here on the Internet-- GO.
<Dr. Simpson>Get labs done.
<Lisaann> I slept three hours at home still feel out of it
<Dr. Simpson>GO
<Dr. Simpson>See Doctor
<Dr. Simpson>my office is open.
<Lisaann> Ok
<**MODERATOR**> BUBBLES YOU HAVE THE NEXT QUESTION:)
<Bubbles> Where are you perforrming the surgery at and do you
except Tricare Prime Ins?
<Dr. Simpson>I accept TriCare and I like
cats------
<Dr. Simpson>boiled
<Bubbles> LOl
<Bubbles> Where are you at DR
<Dr. Simpson>PHOENIX
<beach/va> run kitties, run
<muffy> <loves dogs .:)
<**MODERATOR**> LS YOU HAVE THE NEXT QUESTION:)
<LS> Dr. another question- I have always eaten some carbs throughout
my weight loss- and never even hit a plateau- will I start to gain weight
after my 18-24 month weight loss window? I am pretty careful about eating
healthy and staying active. I am at my goal weight. Thank you Dr.
<Dr. Simpson>You can eat some carbohydrates,
and some carbs are always necessary ---- the 18-24 month loss is good
for some, some can earlier than that.
<Dr. Simpson>SO, keep on losing--- you can
gain weight.
<LS> Keep losing- I am at goal
<LS> ??
<LS> Dr. sorry- did you mean for me to go below my goal weight??
<**MODERATOR**> MUFFY YOU HAVE THE NEXT QUESTION:)
<muffy> HI DR:) when do most of the complications happen?
<Dr. Simpson>Most complications occur in the
first week or so....
<muffy> ie ...leaking? how do you know?
<Dr. Simpson>leaks in the first few days
to three weeks----
<Dr. Simpson>if you leak you get sick, and
if you get sick then you will come see us, and we will do that.
<**MODERATOR**> LISA YOU HAVE THE NEXT QUESTION
<lisa> Hello Dr, are there studies showing the success rates 10
- 20 years out?
<Dr. Simpson>Well-- you can get below your
goal weight, or you cannot-- that is hard to say. But until you get to
that point, then you have to figure out what to do. Don't worry about
it before. ..
<Dr. Simpson>Success depends on the surgery...
<lisa> RNY
<Dr. Simpson>50-75 percent with the RNY ....
<lisa> is that from patient not doing as they should or just in
general
<lisa> as in it sometimes happens
<Dr. Simpson>that is hard to know, and difficult
--- for example, some people, through no fault of their own......
<Dr. Simpson>can have a technical problem
with the surgery and those individuals can regain, through no fault...
<lisa> ok, thanks, its my last deciding factor in getting the
surgery
<Dr. Simpson>but if you follow the program,
it is unlikely.
<lisa> ok thanks
<**MODERATOR**> DJ YOU HAVE THE NEXT QUESTION:)
<DJ> Hi Dr. Simpson, I wanted to discuss lapband surgery. How
successful is it and do you find that most insurance companies will pay
for it?
<Dr. Simpson>DJ-- the lapband is not covered
by a lot of insurance companies, because it is about 3 grand.....
<Dr. Simpson>and its rate of success in this
country is now 60 per cent.....
<Dr. Simpson>so lap band is not something.
<Dr. Simpson>that I would recommend as a
primary weight loss surgery except in certain circumstances.
<**MODERATOR**> SALLY YOU HAVE THE NEXT QUESTION:)
<sally> how long after surgery can you eat fruits?and what kinds?
<Dr. Simpson>Depends on which fruits that
you have and which operation that you undergo-- for example, .....
<sally> i had open rny
<Dr. Simpson>if you have the RNY, ....You
cannot have pulpy fruit or...
<Dr. Simpson>fibrous vegetables, and a few
things like that-- so the answer is NEVER...
<Dr. Simpson>the reason is that they form
a ball of undigested matter in your pouch, much like a cat hair ball....
<Dr. Simpson>and I hate having cats for dinner
with the hairball in them, it ruins the barbecue....
<sally> lol
<Dr. Simpson>in terms of other fruits, you
have to moderate them according to their glycemic index and carbohydrate
content, and load. Good luck.
<**MODERATOR**> BASSETT MOM YOU HAVE THE NEXT QUESTION:)
<Basset Mom> What are the current mortality rates on laproscopic
vs open surgery? Is there a greater risk of infection with the open surgery?
<Dr. Simpson>There is no greater risk of
infection with open surgery, and there is a slightly higher risk of leaks
with laparoscopic surgery, although that rate is going down with the improved...
<Dr. Simpson>equipment and experience of
laparoscopic surgeons.....
<Dr. Simpson>the mortality rate is still
1 in 200 and the majority of those are from blood clots which travel from
the legs or pelvis and go to the lung (pulmonary embolus)....
<Dr. Simpson>leak rate is 1.5 per cent for
open 3 per cent for laparoscopic, although it is less in certain laparoscopic
centers.....
<Dr. Simpson>hernia rate is the same, but
adhesions are less with laparoscopic....
<Dr. Simpson>I would imagine in the next
ten years there will be fewer open surgeries performed.
<Basset Mom> Thank you so much Dr.
<**MODERATOR**> WANDA OLGUIN YOU HAVE THE NEXT QUESTION:)
<wanda olguin> my surgery is 6/25 and they not ask for pre test
yet my first appointment will be a month before surgery, they will ask
me for that test then, i am very worry about, because i'll be doing a
lot of research and every body will be doing pre test and they did not
told me nothing yet, i want to know if they
<wanda olguin> ask for that test in that app.
<Dr. Simpson>well I am not certain what the
pre test will be other than some blood work, and perhaps a psychiatric
evaluation....
<Dr. Simpson>the psych evaluation is merely
another way to see if you understand what you are getting into,
<Dr. Simpson>and if you still hear voices....
<wanda olguin> what do you mean with that
<Dr. Simpson>well, in the psychiatric evaluation
one of the things they wish to know is if you really understand that this
is a life altering experience,
<Dr. Simpson>and do you understand that,
and are you willing to go forward with it, they also need to determine
if you have any underlying disorder which might be best treated...
<Dr. Simpson>with medicines, such as some
compulsive behaviors, or some depression, or psychosis....
<wanda olguin> i don t think i will need that
<Dr. Simpson>so, it is a good thing to go
through, and it is another way for we surgeons to find out if the patient
is really motivated to do this, or if they consider it just another....
<Dr. Simpson>fancy diet with a scar.
<wanda olguin> thanks doctor.
<**MODERATOR**> DEBBIE B YOU HAVE THE NEXT QUESTION:)
<Debbie B> How long after surgery can I begin resistance training?
weight training/lifting? (hiding cats from doc)
<Dr. Simpson>Never hide the cats-- if they
weigh more than 15 pounds you shouldn't lift them for six weeks, because
your incision still is healing inside...
<Dr. Simpson>and you could develop a hernia.
So I would walk right away, and begin the other training later, but you
can start walking now-- you can even run after the cat. Here kitty, kitty.
<Debbie B> lol
<Dr. Simpson>We call it urban hunting.
<**MODERATOR**> GLORIAINSOCAL YOU HAVE THE NEXT QUESTION PLEASE:)
<GloriaInSoCal> why is GAS so much worse after WLS...and by worse
I mean in volume, pain, and sound...I am 10 days out OPEN RNY. AND I KNOW
THIS MAY SOUND CRASS...but what are the time guidelines on sex and/or
masterbation after surgery
<Dr. Simpson>Gas is worse after weight loss
surgery because you have some undigested food which bacteria work on and
they create byproducts of their metabolism which smell.....
<Dr. Simpson>In terms of sex and whatever
other activities you do, you need to know that 17 years is the minimum...
<Sandy> are you really a doctor?
<Jenny~26#> LOL!
<Dr. Simpson>ok-- well, when you are comfortable,
and as long as you are not doing anything which causes you to exert more
than 15 pounds for six weeks....
<Dr. Simpson>you should be just fine. Yes,
I am a real doctor.
<**MODERATOR**> BLOSSEM YOU HAVE THE NEXT QUESTION:)
<Blossem> what should my pouch capacity be at 3 months post op?
<Dr. Simpson>The pouch should stay between
one and two ounces the first six months. Liquids go through very easily,
so you should not consider them to be a..
<Dr. Simpson>measure of what your pouch volume
is.
<Blossem> ok thanks
<**MODERATOR**> LAURA YOU HAVE THE NEXT QUESTION:)
<Laura (pre-op)> I'm having open RNY and my surgeon says there's
no need for protein drinks but it seems like everyone is drinking them.
What's your advice? Can I get all my protein through food? No cat kabobs
for me please!
<Dr. Simpson>Protein through food, not from
protein drinks. Protein drinks taste very very very bad....
<Dr. Simpson>they are like drinking sawdust
and the worst tasting vitamin ever....
<Dr. Simpson>and food is better, cheaper,
and more bio-available for a source of protein...
<Dr. Simpson>and so, get the steak instead
of the protein drink.
<Dr. Simpson>--- love steak.
<Dr. Simpson>cat is a bit tough.
<Dr. Simpson>but often you can get it fresh.
<Laura (pre-op)> cat steak?
<**MODERATOR**> KATHY N.C. YOU HAVE THE NEXT QUESTION:)
<Kathy N.C.> Dr I went to a seminar last night my surgeon said
1 in a 100 die from complication..for R.N.Y. surgery. I thought this change
to 1 in 1000 I thought this went up to 1 in 1000
<Dr. Simpson>the real figure is about 1 in
200, but it is close. So, I think that you need to realize surgery is
serious business....
<Kathy N.C.> thank you
<Dr. Simpson>while I am a bit glib about
it, this is something that people can die from, and normal healthy, but
obese people, can die from this surgery...
<Dr. Simpson>it is not something to be taken
lightly, and it is something that when you are out a few weeks take a
deep breath and thank the lord you are alive and on your way to good health...
<Kathy N.C.> is it from leaks mostly
<Dr. Simpson>no, it is from blood clots going
to the lung.
<Dr. Simpson>and if you are not alive, say
hi to my friends in the warm place.
<Kathy N.C.> yes plan to do that thank yo dr
<**MODERATOR**> BEACH/VA YOU HAVE THE NEXT QUESTION:)
<beach/va> When does the risk of blood clots diminish? How long
after surgery?
<Dr. Simpson>Well, several weeks, actually-
-- some people can have the clot, and it can form another clot on top
of it, so the more you walk the better you will do and the less likely
you will have a problem...
<beach/va> ty, i will chase the cat
<Dr. Simpson>the more you lay in the hospital
or home bed the higher the chance that you will have a blood clot which
will cause major problems, including death.....
<Dr. Simpson>leaks are not a major cause
of death, they are a pain in the neck for the patient, and may require
a few more surgeries, but they are not the major reason that people die
from the surgery...
<Dr. Simpson>we can fix some leaks, and not
others, but ultimately we get a handle on them.
<Dr. Simpson>chase the cat
<**MODERATOR**> HEATHER YOU HAVE THE NEXT QUESTION:)
<Heather> Hi Dr. Simpson, I am 3 weeks post-op and have purchased
a form of liquid protein, that I mix in water (comes out like juice not
a milkshake those are gross!!!) what do you recommend that I look out
for in a protein shake any specific vitamins or Amino Acids within the
liquid?
<Dr. Simpson>I recommend you look for a protein
shake that will help your plants grow so that when you are....
<Heather> ha ha
<Dr. Simpson>eating food you can do something
with the shake, or drink. In terms of amino acids....
<Dr. Simpson>don't worry, they should be
a good combination-- most protein drinks that are good are whey based,
or soy based....
<Dr. Simpson>whey is way better, and easier
to flavor....
<Heather> great thanks Dr. Simpson, if I don't like it I can feed
it to the plants
<Dr. Simpson>in terms of vitamins-- just
something they add to make it taste even worse. Otherwise, I like isopure.
<Heather> Isopure great thanks.
<Dr. Simpson>feed it to the cat. Soften them
up a bit.
<**MODERATOR**> GABBI YOU HAVE THE NEXT QUESTION:)
<Gabbi> back to leaks,please.. my biggest fear.. all in all if
a leak cannot be repaired, what is the ultimate outcome? I dont' have
shoes that match a colostomy bag..
<Dr. Simpson>sometimes we have to let mother
nature repair them and we put in a drain, and sometimes you need to have
tube feeds or tpn for a while (intravenous foods.....
<Gabbi> temporarily?
<**MODERATOR**> MUFFY YOU HAVE THE NEXT QUESTION PLEASE:)
<muffy> when is it safe to fly post lap rny? how much do you bypass
on female for lap rny and size of pouch? is there a standard # for bmi
or just what the surgeon does for all patients?
<Dr. Simpson>I keep flapping my wings, but
have not been able to fly yet.....
<Dr. Simpson>although after weight loss surgery
if you develop some of the bat wings we see you might be able to fly....
<muffy> lol
<Dr. Simpson>in terms of, flying after surgery
-- it is usually safe almost anytime. IN terms of lap RNY the pouch size
is between one half to one ounce, and the BMI is something...
<Dr. Simpson>that we do standard by the NIH
stuff. In terms of leaks-- you don't need a colostomy, as that is a bit
low....
<Dr. Simpson>so, go fly. Not a problem. I
like the aisle seat.
<muffy> NO, i meant how much do you bypass? is it decided by bmi?
<**MODERATOR**> ROBIN H YOU HAVE THE NEXT QUESTION:)
<Robin H> What's the scoop on "fatty liver"? What can
we do to 'de-fat' it prior to scheduled lap rny?
<Dr. Simpson>You cannot defat the liver,
it is something that will happen when you reduce carbohydrate intake and
improve the protein intake of your diet. IN terms of bypass size, every
surgeon has their own criteria.
<Dr. Simpson>High protein, low carbohydrate
diets are good to decrease the fattiness in the liver.
<Robin H> ty
<**MODERATOR**> LISAANN YOU HAVE THE NEXT QUESTION:)
<Lisaann> Will taking potassium presribed by doctor ause water
retention... I have been swollen for days I take a non potassium depleating
one.. but still feel swollen
<Dr. Simpson>potassium does not cause water
retention in any form. Potassium is something some people need, but sodium
causes water retention, not potassium.
<Dr. Simpson>being swollen after surgery means
either you are fresh or you do not have enough protein.
<Lisaann> Sorry my surgeon called me back just as I asked my question...
Thankyou Doctor for your answer
<**MODERATOR**> MARGARET YOU HAVE THE NEXT QUESTION:)
<Margaret> Dr. Simpson, I've at surgery about 5 months ago and
find that I can eat alot, alot more. Is this okay
<Dr. Simpson>You do eat more as time goes
on, but you should keep your portions tightly controlled, otherwise you
can stretch the pouch.
<Margaret> can you tell when you've stretched your pouch
<Dr. Simpson>You can tell when you have stretched
the pouch by doing a study to see if you have stretched it. Yes, you can
see the fatty liver on ultrasound, that is a simple test to check for
it, although the best test is a liver biopsy.
<**MODERATOR**> LS YOU HAVE THE NEXT QUESTION:)
<LS> Hi Dr. it's me again- OK I understand about the bacteia working
on the undigested stuff in the intestines-hence - the funk- does that
get better- I mean it has gotten better for me- but will there be a time
when it will be back tot the way it was prior to surgery? Why do RNY people
have to worry about stretching their pouch when DS poeple start with a
much larger stomach
<Dr. Simpson>OK--- well, LS-- let us go back
to what question you are asking-- does gas become better well there are
things for it, like Devrom, and that might help.....
<Dr. Simpson>and sometimes things to become
better. DS people, have a pylorus, and they cannot passively put food
through with water or liquids....
<Dr. Simpson>so they have a bit of an advantage
over RNY in that regard.
<Dr. Simpson>So that is why the size is a
bit larger for DS.
<LS> Thanks Dr.
<Dr. Simpson>Those who have DS can have more
cat.
<muffy> and more gas?
<Dr. Simpson>Sara, I am glad you are doing
better with the venison, and those meats which are less well done are
easier to digest than well done. Ice cream is good for me, so please send
me yours.
<LS> I don't get that much gas
<Dr. Simpson>Some DS have more gas, but wind
takes it away-- stay down wind.
<Dr. Simpson>We call it the sweet smell of
skinny.
<Gabbi> lol
<**MODERATOR**> GABBI YOU HAVE THE NEXT QUESTION:)
<Gabbi> someone last night said that had "fobi"?? surgery,
where they wrap the pouch in plastic so it cannot stretch. this is the
first time I have heard about this. DO you know anything about it?
<Dr. Simpson>Fobi put a silastic ring around
the pouch with the idea that it wouldn't stretch, and that is something
that sometimes works,...
<Dr. Simpson>it is his version, we all like
our little version of weight loss surgery and get our names in things,
or advertise as such.....
<Dr. Simpson>that is his version of things.....
<Gabbi> thank you
<Dr. Simpson>in terms of the silastic ring--
there is no evidence that his patients do any better than others.
<Dr. Simpson>it is a RNY with a twist. Sort
of a VBG plus RNY.
<**MODERATOR**> LAURA (PREOP) YOU HAVE THE NEXT QUESTION:)
<Laura (pre-op)> What vitamins and supplements do you recommend
after RNY?
<Dr. Simpson>First, any general multiple
vitamin is a good one, and if it is a female we also recommend a source
of iron to take twice a day...
<Dr. Simpson>we need to watch the various
bits of vitamins in the blood, and at six months, or earlier, we check
B12 levels....
<Dr. Simpson>sometimes they are needed to
supplement them. We also recommend calcium, in a calcium citrate form.....
<Dr. Simpson>but do not take calcium with
iron, and if you have a multivitamin with iron, make certain it has either
calcium or iron, but not both, as they will...
<Laura (pre-op)> any particular form of iron?
<Dr. Simpson>combine together and you will
not absorb either.....
<Dr. Simpson>which ever form is easy to digest
for you, some like ferrous sulfate, which is inexpensive, but some prefer
the gluconate, you have to see what you can tolerate.
<**MODERATOR**> ALI G YOU HAVE THE NEXT QUESTION:)
<Al G> Sorry, I came in late and may have missed this question.
I'm considering surgery. Is there a huge difference in the procedures
between open and laproscopic surgery-are the complication rates different,
is the healing time different, etc. Any differences long term, post-op.
<Dr. Simpson>Ali-- I think that you have
to find out what your surgeon does, and go with that, I wouldn't worry
too much about the differences between the two...
<Dr. Simpson>if your surgeon does all laparoscopic,
then go with that. If they do open, then go with that. If they are transitioning
between the two, then decide if you want to be one of their first laparoscopic
cases or not.
<Al G> Also, can hiatal hernia be taken care of at the same time
or shouldnt i be concerned
<Dr. Simpson>The RNY will take care of the
hiatial hernia problem.
<Al G> thank you
<Dr. Simpson>good luck.
<**MODERATOR**> MARGARET YOU HAVE THE NEXT QUESTION FOR DR.
SIMPSON:)
<Margaret> Dr. Simpson, I was wondering........Is it possible to
stop loosing weight once you've reached your goal. I'm now 5 months post
and am 27lbs *(maybe a little more) from my goal weight. Not that this
should be a concern, because my weight lose has extremely slowed down.
But was just wondering if weight loss can be controlled?
<Dr. Simpson>Weight loss can be controlled,
and you have proven it, so don't worry, I promise you will not go away
to nothing...
<Margaret> and, do you think that it is too soon for the weight
loss to slow down
<**MODERATOR**> WANDA K. YOU HAVE THE NEXT QUESTION FOR OUR
GUEST TONIGHT:)
<Wanda K.> I am looking into the Lap surgery. I weigh 210 at 5'4".
I have never had high blood or cholesterol, but my family history is pretty
bad with heart disease, diabetis, asthma, arthritis. I feel tired all
the time and i haved tryed every diet! i may lose a little and gain it
back and more. My question is do you think I would have a good chance
of getting approval for this surgery from a doctor?
<Dr. Simpson>Your BMI is about 36 and with
the lack of comorbidities it is a dealers choice....
<Dr. Simpson>so I think that is something
that you will have to deal with the insurance companies, some are quite
good and will allow you to have surgeries, some are not.
<**MODERATOR**> CINDY YOU HAVE THE LAST QUESTION FOR OUR GUEST
TONIGHT:)
<cindy> Dr would you do this surgery on your wife and feel safe
and what is ds? Do you know of Dr Speir in ohio?
<Dr. Simpson>It is unethical to treat one's
family, so I wouldn't do it on my wife, especially since her BMI is about
19 anyway....
<Dr. Simpson>but, yes, if a family member
needed this surgery then I would be happy to have them have it done, and
I do know of Dr. Spier in Ohio....
<Dr. Simpson>if you are in Ohio do you have
that great ice cream--Graters????
<cindy> would u approve of this surgery
<Dr. Simpson>and no, previous lap holes does
not interfere....
<Dr. Simpson>some do it routinely and some
do it if they suspect.
<Dr. Simpson>I approve of this surgery, I
do this surgery, and ds stands for duodenal switch and you can read about
that on my website.
<Dr. Simpson>www.doctorsimpson.com
<Woody> THANK YOU DOCTOR SIMPSON
<NIKKI> THANK YOU DR. SIMPSON. YOU CAN VISIT DR. SIMPSON'S
WEBSITE AT http://www.doctorsimpson.com
<Gabbi> thank you doctor for helping us.. Happy Easter
<**MODERATOR**> THANK YOU SO MUCH DR. SIMPSON AND A BIG THANK
YOU TO OUR MEMBERS!
<Dr. Simpson>thank you everyone.
<Dr. Simpson>happy Passover
<Dr. Simpson>happy Easter
<Dr. Simpson>happy Friday
<beach/va> THANK YOU!!!!
<anya> thank you
<Rose@Goal> bye Doc, take care and don't work so hard :)
<muffy> <is sending a cat as a gift")
<Bubbles> thanks
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