<**MODERATOR**> PLEASE DO NOT INTERRUPT OUR CHAT NOW IT HAS
BEGUN
<**MODERATOR**>
ANGEL YOU HAVE THE FIRST QUESTION FOR OUR GUEST:)
<Dr.
Simpson> Good afternoon everyone from the place on the planet that
is hotter than H#ll
<angel> my
friend had surgery on june 30th , She still has a burning feeling after
she tries soft foods. Any advice for her? thank you
<Dr.
Simpson> Sometimes the pouch is a bit tender after surgery -- and
she is a bit soon after surgery....
<Dr.
Simpson> so, there are a couple of reasons for burning-- first the
stomach was cut, and that kinda hurts...
<angel> ok
<Dr.
Simpson> second, some foods aggravate things more than others. If
she isn't on an acid reducer, like Pepcid, she should be...
<Dr.
Simpson> she can get Pepcid Complete from the store, it is over the
counter and is chewable...
<angel> ok
<angel> thank
you
<Dr.
Simpson> and to measure everything she eats -- so as to not overfill
herself. Good luck.
<**MODERATOR**> CINDERELLA YOU HAVE THE NEXT Question
<cinderella canton,oh>
DR how does the green filter work and where do they put it? And what
is protein deffincacy
<cinderella canton,oh>
protein c
<Dr.
Simpson> A greenfield filter is a filter they put in the large vein
which goes to the heart...
<Dr.
Simpson> the purpose of it is to collect any clots that are going
to the lung, and prevent pulmonary embolism...
<Dr.
Simpson> which is the leading cause of death from this surgery, it
does not prevent small clots, however...
<Cinderella canton,oh>
after u r asleep i hope
<Dr.
Simpson> it is put into a patient before surgery, usually by the
radiologist, and they either go through the vein in the leg or in the
neck...
<Dr.
Simpson> and protein C deficiency is a deficiency in a protein which
leads to patients having more clots than usual...
<Dr.
Simpson> in the lower extremity.
<Dr.
Simpson> So, that is a good reason to have a filter.
<Cinderella canton,oh>
my mom has that
<Cinderella canton,oh>
pass down yes?
<Dr.
Simpson> si, yes
<**MODERATOR**>
MS TEXAS YOU HAVE THE NEXT QUESTION:)
<MsTexas>
Why can you eat something one day and the next time you eat it.... it
makes you sick? I am running out of things to eat! smiles and hotter
then hell .... are you in Texas as well?
<Dr.
Simpson> I am in Arizona, and we go to Texas to cool off.....
<Dr.
Simpson> Yes, you can tolerate one thing one day, and the next day
it doesn't sit too well...
<Dr.
Simpson> take my mother-in-law....
<Dr.
Simpson> please....
<Dr.
Simpson> oh, sorry.
<MsTexas>
I got rid of mine already
<Dr.
Simpson> So, that is normal, take the food slowly, and if you can't
tolerate it one day then wait for a couple of centuries and try it again.
<**MODERATOR**>
DOODLEBUG YOU HAVE THE NEXT QUESTION:)
<DoodleBug>
I've lost 102 pounds in 8 months - is it true that we have a window
of opportunity for 16 mths or is that a myth? Fast fingers here too
Dr. Simpson....anywhere near Scottsdale?
<Dr.
Simpson> A bit west of Scottsdale, Arizona. Well, the greatest weight
loss occurs in the first 18 months, however, you ....
<Dr.
Simpson> can always use your new anatomy to lose weight later on....
<Dr.
Simpson> it is a tool -- and while the tool provides a great weight
loss initially it can be used the rest of your life...
<Dr.
Simpson> all you have to do is cut carbohydrates, drink lots of water,
and WALK.
<**MODERATOR**>
DANA YOU HAVE THE NEXT QUESTION FOR DR. SIMPSON:)
<Dana> Is
it true recovery time is shorter with Lap RNY vs. Open?
<Dr.
Simpson> Is there a 12 step for being a gymaholic? Recovery time
is an interesting question because...
<Dr.
Simpson> everyone has a different definition of that. For some it
is hospital days, for others it is return to work, for others it is
when they feel better...
<Dr.
Simpson> essentially, no matter how you look at it -- you will feel
better in 12 weeks, and be happy this is over with....
<Dr.
Simpson> but lap surgery has less scar, less adhesions, less hernia
BUT higher incidence of leak...
<Dana> Why
the higher incidence of leaks?
<Dr.
Simpson> so, something to think about. Laparoscopic is a bit easier
in terms of post op pain....
<Dr.
Simpson> probably higher leaks because while you can see the bowel
better with the scope....
<Dr.
Simpson> you cannot feel it, as you can with an open abdomen. Nevertheless,
the leak rate is coming down for that surgery.
<Dr.
Simpson> good luck.
<**MODERATOR**>
MISSY WV YOU HAVE THE NEXT QUESTION:)
<Missy*WV-100/7mo.>
Hi Dr. I was just wondering if you know the % of wls patients that actually
get to their "normal body weight" or "goal weight"?
Dr. Simpson> Well, that depends on if they get it and then gain back,
or not. It also depends on what you consider a success...
<Dr.
Simpson> for example, in surgery we consider a success if you lose
65 per cent of your excess body weight, if you lose more it is you,
not the operation....
<Missy*WV-100/7mo.>
Do a lot of people actually gain back?
<Dr.
Simpson> so, we have never seen a goal study done before, ....
<Dr.
Simpson> and in terms of getting to normal weight, it is probably
20 per cent or less. However, if you are 20 to 30 lbs over your ideal
body weight...
<Dr.
Simpson> it is still better than you were before the surgery. Most
people do gain weight back after surgery, not all the weight, but some
weight, and then level off.
<Missy*WV-100/7mo.>
Thank You :)
<Dr.
Simpson> Usually anywhere from 5 to 20 lbs.
<**MODERATOR**>
VIKKI-FL YOU HAVE THE NEXT QUESTION PLEASE:)
<Vikki-fl>
Hi Doc, I have recently been diagnosed with sleep apnea but don't have
my cpap yet. Will this cause my surgery (open rny) to be postponed or
delayed in nay way?
<Dr.
Simpson> Your surgeon can get CPAP for you in the hospital, if you
need it. So, while your surgeon might want you to get the CPAP before
surgery, it is something that you will have to work out with them. For
the rest of you...
<**MODERATOR**>
SARA LEE YOU HAVE THE NEXT QUESTION PLEASE:)
<Sara Lee>
Can we eat Venison ? I love it :)
<Dr.
Simpson> Everyone loves Sara Lee -- yes, Venison is good for you.
It is a good source of protein....
<Sara Lee>
great! TY Doc
<Dr.
Simpson> goes down easily -- I am sure you would agree --- and quite
a healthy food.
<**MODERATOR**>
SUE YOU HAVE THE NEXT QUESTION :)
<Sue> Thanks
for taking my question. Are there any exercises I can do to improve
lung function before my surgery? My surgeon won't operate on my until
I have better function. Sue> Thanks for taking my question. Are there
any exercises I can do to improve lung function before my surgery? My
surgeon won't operate on my until I have better function.
<Dr.
Simpson> To improve your lung function there are several things you
can do-- first, see a lung doctor...
<Dr.
Simpson> or pulmonologist, they may have a pulmonary rehab program
that you can enter to improve your lung function...
<Dr.
Simpson> that would be a good thing. Start a walking program, under
some supervision, and from there you can....
<Dr.
Simpson> work with your doctors with some fun machines they have
to help you out. Good luck.
<**MODERATOR**>
LISA MARIE YOU HAVE THE NEXT QUESTION:)
<LISA MARIE>
i was schedualed for surgery thursday and today the drs office called
to tell me he wouldnt do my surgery because one of my blood tests came
back positive to hepatitus c i have cried all day .. is there a cure
for this ? i have never used needles or had any blood transfusions i
swear i was so ready to start my new life and now this i am devasted
i think i am gonna die. the girls at the drs office were so cut and
dry and said that he will never do the surgery for me now
<Dr.
Simpson> Well that is an unfortunate attitude, because there are
a lot of things about hepatitis C that we can do something about...
<Dr.
Simpson> just because you have had it does not mean that you have
it actively, that is the first thing to know...
<Dr.
Simpson> second, there is treatment for hepatitis C, and you should
see a gastroenterologist who specializes in this and see if it is active,
and if it is then you should have treatment...
<Dr.
Simpson> once you have had treatment, if you need it, then you can
have surgery. So, it is a good thing to find out because you can do
something about it. Good luck, and I am sorry Dr. Simpson> that the
doctor 's office had a bad attitude.
<LISA MARIE>
thanks u
<**MODERATOR**>
VICKIE YOU HAVE THE NEXT QUESTION:)
<vicki> Does
everyone get the green filter during surgery ?
<Dr.
Simpson> No, very few people have a greenfield filter. It isn't always
needed. Talk it over with the surgery.
<**MODERATOR**>
KELL YOU HAVE THE NEXT QUESTION PLEASE:)
<kell> I have
a hard time getting in my protien amount, what is the best protein bar?
Also how much is to much sugar when buying protien bars? Liquids don't
seem to go down to fast unless it is a hot liquid, any suggestions to
getting my liquid intake up?
<**MODERATOR**>
OKAY, I WILL SLOW UP NOW*LOL SORRY GUYS
<Dr.
Simpson> there is no best protein bar or drink-- there is a lot of
good food that has protein , like venison, like meat, like tofu, the
best protein bar is a steak....
<Dr.
Simpson> in terms of looking for prtoein bars, I think that you should
strive to keep carbs per day total less than 60 grams, so figure that
in everything you eat and consume....
<Dr.
Simpson> in terms of liquids fast-- you don't want fast, you don't
want to eat fast, drink fast, or make love fast-- take it slow, everyone
likes it better that way.
<**MODERATOR**>
ALLY YOU HAVE THE NEXT QUESTION:)
<ALLY> do
u have any pts. with cigna ppo, im hearin horror stories about approvals
just wondering ty
<Dr.
Simpson> I do have cigna PPO patients, they are sometimes a bit slow
to approve, but they get there.
<**MODERATOR**>
LYNN2 YOU HAVE THE NEXT QUESTION:)
<Lynn2> Ciao
Doctor, I have been in deep discussion with my friend over RNY and Duodenal
Switch. Each has advantage and disadvantage. What are some of your thoughts
on the two procedures? Milli gracia!
<Dr.
Simpson> Well, everyone has an opinion, and there is a lot of information
out there about both operations, I do both operations....
<Dr.
Simpson> they both work well, and they both work well for all with
morbid obesity, I happen to like the DS because it allows...
<Dr.
Simpson> a more normal diet, however, the RNY works very well for
alot of people, and I have a lot of patients at goal with their RNY....
<Dr.
Simpson> So, find a surgeon who you like, and go with that surgeon's
choice.
<Lynn2> Good
Advice...thankyou again!
<**MODERATOR**>
JULIE FL YOU HAVE THE NEXT QUESTION:)
<julie fl>
if theres anything wrong with your heart will a ekg show something wrong
with you? i have heavy breathing all the time and my heart flutters..
i have had test done that shows everything is fine..
<Dr.
Simpson> I have heavy breathing too, but only when I am around Pam
Anderson......
<Dr.
Simpson> no, and EKG only shows some abnormalities with the heart,
it does not show all of them....
<julie fl>
ok thank you
<Dr.
Simpson> so, if you are concerned get a stress test and an echo cardiogram.
<Dr.
Simpson> Send Pam over.
<**MODERATOR**>
DOODLEBUG YOU HAVE THE NEXT QUESTION:) DoodleBug> I do not use fat
free products but I limit my carbs - also, I tolerate sweets pretty
well (but not often and only a small portion) - they cause me to be
lethargic for a short time is that part of dumping? I wish my surgeon
were more like you -he's much too stuffy! You wouldn't happen to have
a single brother, would you???
<Dr.
Simpson> I do have a single brother -- handsome fellow who lives
in Alaska.....
<DoodleBug>
age doesn't matter any longer
<DoodleBug>
long as he's healthy :)
<Dr.
Simpson> sweets and simple sugars can cause lethargy, and they can
also cause some joint problems --- he is healthy.....
<Dr.
Simpson> so that is normal-- stick with more complex, low glycemic
index carbs, like vegetables and fruits, and avoid the simple sugars....
<**MODERATOR**>
MARSHA YOU HAVE THE NEXT QUESTION:)
<Dr.
Simpson> his website is www.crnwrailway.com
<Marsha/2mpo/047>
Do you absorb the B12 pills the same as sublingual B complex. If you
do, then why do they suggest the sublingual. Thank you Dr. Simpson
<Dr.
Simpson> No, you don't absorb pills as well as the sublingual, in
fact pills are pretty much as useless as I am at housework...
<Marsha/2mpo/047>
ty
<Dr.
Simpson> the sublinqual (or under the tongue) is made to absorb a
lot better and works well. Forget the pills.
<**MODERATOR**>
DANA YOU HAVE THE NEXT QUESTION;)
<Dana> What
does the WLS patient take for constipation? What is safe?
<Dr.
Simpson> First I am going to tell you to drink more water, then you
are going to tell me you drink a lot of water, then I am going to tell
you that if you drink more water you wouldn't have constipation.....
<Dr.
Simpson> then I am going to suggest fiber, then you will tell me
you eat salads, then I will tell you they don't have enough fiber, then
you will say what should I take, then...
<Dr.
Simpson> I will tell you to take Citrucel. See-- whole dialog, all
by myself.
<**MODERATOR**>
SARAHK YOU HAVE THE NEXT QUESTION:)LOL
<sarahk> WHO
SETS THE WEIGHT GOALS US OR THE SURGEONS AND HOW DO WE FIGURE THE GOAL?
<Dr.
Simpson> Your goal should be a BMI between 19 and 24. So, go see
the charts and go from there-----
<Dr.
Simpson> I personally think a BMI of 19 is good, but I am crazy,
and have the papers to prove it.
<sarahk> OK
TY
< **MODERATOR**>
CINDERELLA YOU HAVE THE NEXT QUESTION:)
<cinderella canton,oh>
being prone to protein c deff from my mom should my dr take xtra percautions
<Dr.
Simpson> You should be tested for protein C deficiency, as well as
Protein S deficiency, and a few others, and have your doctor do that...
<Dr.
Simpson> there is a panel they can check. If you have it, then they
will do some other precautions before surgery.
<Cinderella canton,oh>
is that a normal blood work
<Cinderella canton,oh>
thank you
<Dr.
Simpson> No, it is highly specialized blood work. It isn't seen on
routine stuff, have to order it extra special.
<Cinderella canton,oh>
ok
<**MODERATOR**>
KIMBALINA YOU HAVE THE NEXT QUESTION:)
<**MODERATOR**>
RHONDA YOU HAVE THE NEXT QUESTION PLEASE:)
<ALLY> anyone
awake??
<Rhonda> Dr.
Simpson, I went to the ER night before last with excruciating pain right
below my breast bone and in my back on the right side. I have had this
attack two other times and thought I would die. I have had my galllbladder
removed over a year ago. by the way I am at goal with BPD/DS. The doctor
had me have a CT scan on the abdomen and pelvic area and they also injected
iodine thru I.V. I also had blood test. I have not heard back yet and
probably wont until Monday now. He mentioned the possibliiity of pancreatitis.
I read up a little on this and this sounds very serious? It even mentioned
having to be fed through a tube for treatment? YIKES! What are your
thoughts? I am very scared. Sorry this is so long. Oh yeah, where are
you located?.
<Dr.
Simpson> Well, first of all, if you have pancreatitis there is some
blood work for it, and second....
<Rhonda> is
pancreatitis common with wls?
<Dr.
Simpson> it is good that you are at goal. There are a lot of other
pains this could be, and so we should see..
<Dr.
Simpson> so, have the stuff sent to your primary care doctor.
<Rhonda> the
nurse mentioned by accident that it showed I had a soft tissue prominence
what is that?
<Dr.
Simpson> or your surgeon. Pancreatitis is not something that is common
with this surgery.
<Dr.
Simpson> Some days I feel like a 20 year old, and some days I cannot
find one....
<Rhonda> I
see on this sight that allot of people have pancreatitis after wls?
<**MODERATOR**>
MISSY IN WV YOU HAVE THE NEXT QUESTION:)
<Missy*WV-100/7mo.>
Dr, why is it that some days I couldn't care less if I eat or not, other
days I feel like I could eat all day?
<Dr.
Simpson> It is common to have different appetites as you go through
the post operative period....
<Dr.
Simpson> it is important that you do two simple things: do not over
eat, and measure everything, and make certain you get some protein in.
<Missy*WV-100/7mo.>
Thank You Dr.
<**MODERATOR**>
GRANNY/ROBIN YOU HAVE THE NEXT QUESTION PLEASE:)
<Granny/Robin>
Hi Dr. Simpson. Can you tell me why a surgeon would require a NUCLEAR
(as opposed to reg treadmill) cardiac stress test pre-surgery? I am
58 and weigh 300# and have TypeII diabetes..or do they require that
for everyone? and are you a "Stripperella" fan?
<Dr.
Simpson> Don't know what stripperella is. The nuclear scan can show
areas of ischemia, and can bemore sensitive than a treadmill, so it
is something that isn't too bad to order....
<Dr.
Simpson> it is simple to take and easy to use.
<Granny/Robin>
Babs A's cartoon series..
<NIKKI> DOC,
PAM ANDERSON IS STRIPPERELLA. :-)
<Granny/Robin>
ty :)
<Dr.
Simpson> Love PA
<**MODERATOR**> KELL YOU HAVE THE NEXT QUESTION
<kell> I have
been taking milk of magnesia for constipation, without it I don't go.
How long can I take this product safely?
<Dr.
Simpson> MOM isn't the best thing for constipation, there are other
things-- probably after surgery ...
<kell> and
is orange juice ok to drink?
<kell> why
is that?
<Dr.
Simpson> your anatomy will be a different configuration, and you
should get on something else for constipation-- if you have a long limb
bypass or a DS you probabl won't need anything for constipation.
<Dr.
Simpson> OJ has a lot of carbs.
<Dr.
Simpson> Nothing is BAD in terms of food--just bad quantities.
<**MODERATOR**>
RHONDA YOU HAVE THE NEXT QUESTION:)
<Rhonda> Dr.
Simpson, have you ever had to revise someone who had bpdDs because of
too much weight loss
<Dr.
Simpson> Nope --- for Rhonda -- it is much more rare these days with
the common channel at 100 cm, alhtough it can happen...
<Rhonda> I
had to be reivised when my wt got down to 102, i am 5'3. I had my common
cha nnel lengthened, but now I am regaining too much weight?
<Dr.
Simpson> Ah, well, there is always a price-- too much loss, too much
gain. You might need the stomach decreased in size a bit.
<**MODERATOR**>
CHRISTINE YOU HAVE THE NEXT QUESTION:)
<Christine>
Dr.Simpson ..what is an infection from a Bowel loop how does it occur?
<Dr.
Simpson> for Christine-- if you have a bowel loop which is partially
obstructed, like the limb which comes from the unused stomach...
<Dr.
Simpson> it can become overgrown with bacteria and have a problem.
<Rhonda> could
I simply have the common channel shortened a bit?
<Dr.
Simpson> Nope-- need to look at stomach size too.
<**MODERATOR**>
NIKKI YOU HAVE THE NEXT QUESTION:)
<Nikki> are
the chances better for getting approved if you have such co-morbidities
as OSA, hypertension, depression, anxiety, and osteoarthritis??
<Dr.
Simpson> Well, Nikki-- the co morbidities are counted IF you have
a BMI between 35 and 39 if it is over 40 then it isn't a problem.
<Nikki> I
am at 47 and I have all of those
<Dr.
Simpson> all insurance companies have different requirements, so
it is up to them. So, with that BMI you will probably be fine, it is
up to the insurance company and what they require.
<**MODERATOR**>
CINDY NY YOU HAVE THE NEXT QUESTION FOR DR. SIMPSON PLEASE:)
<Cindy in NY!>
I've woken up the last 4 mornings w/ bad cramps in my calves. Could
that be a sign of a potassium deficiency & what can I take to help
it. It's quite a RUDE awakening and I can think of a zillion other ways
I'd rather wake up! LOL
<Dr.
Simpson> Hi Cindy. Well, before you go talking potassium, I think
that you should get a blood test to see what your level is, and then
go from there. Are there better ways to wake up-- where is Pam?
<Dr.
Simpson> Coffee wakes me up.
<Cindy in NY!>
LOL.. ok.. I'll do that
<Dr.
Simpson> Well, there is a lot of misinformation that primary care
doctors have about weight loss surgery, and until they read my book,
which isn't out yet, it will probably continue to be that way....
<Dr.
Simpson> of course, keep watching this channel to see when the book
will be out-- I am certain to shamelessly tell you all about it, kind
of like now.
<Dr.
Simpson> I'll autograph it for you and your primary care doctor.
<**MODERATOR**>
CINDERELLA YOU HAVE THE NEXT QUESTION:)
<cinderella canton,oh>
can water arobics help the same as walking since my back really hurts
when walking
<Dr.
Simpson> Water aerobics are great -- keep on watering in the pool.
Just don't pee in it
<cinderella canton,oh>
ok lol thanks
<**MODERATOR**>
RHONDA YOU HAVE THE NEXT QUESTION:)
<Rhonda> Dr.
Simpson, back to the revision question, if they don't shorten the common
channell and only make the stomach smaller again, wont it just restretch
to a larger size again? Also, what state are you practicing in?
<Dr.
Simpson> I practice in the state of confusion, although sometimes
I am clear....
<Dr.
Simpson> the stomach sometimes will stretch, but often not-- so it
is something that is easy to revise. The real question is can you use
the tool you were given and get a good result.. leslie N.> oyvay
<Dr.
Simpson> the stomach sometimes will stretch, but often not-- so it
is something that is easy to revise. The real question is can you use
the tool you were given and get a good result....
<Dr.
Simpson> but you need to have an uupper GI to see the size of the
stomach and that will give you an answer as to if it should be revised
or not-- have them do both a lateral view and a front view of the tummy
with the contrast.
<Dr.
Simpson> Phoenix, Arizona is where I am, where it is so hot the fire
hydrants are signaling the dogs for relief..]
<**MODERATOR**>
NIKKI YOU HAVE THE NEXT QUESTION:)
<Nikki> I
love your sense of humor, doctors like you make it easier on patients
like me. I have terrible stomach problems already will they get worse
after surgery??
<Dr.
Simpson> Well, various stomach problems can improve after surgery,
or be made worse, it depends on a lot of things, so that is something
to go over with the surgeon...
<**MODERATOR**>
MARY YOU HAVE THE NEXT QUESTION:)
<Mary Mack>
Do many patients typically get off insulin after surgery?
<Dr.
Simpson> not all of them, but a number of them do, there are a lot
of factors involved in that, but many use less insulin, some get off
it entirely, and just to pills...
<Dr.
Simpson> some get off pills entirely. Rmember, skinny people get
diabetes too.
<**MODERATOR**> TW YOU HAVE THE NEXT QUESTION
<TW> For selfish
reasons (because I NEED this surgery and we have an insurance exclusion),
I want the hospital that I work for to add GSB. I would like to show
the profitability of this surgery. Any suggestions on where I can get
such information? Thanks.
<Dr.
Simpson> There is no profitability of this surgery. There is long
term data, but remember, we look at the short not the long term in insurance....
<Dr.
Simpson> so, get a different policy, or save your pennies.
<**MODERATOR**>
RHONDA YOU HAVE HE NEXT QUESTION:)
<Rhonda> Dr.
Simpson, back to the revision, and stomach size stuff, if it is found
that the stomach is too large now, what about the new adjustable lap
band? Is this an option after BPD/DS. I had that particular type of
surgery due to less chance of regain, first too thin, then too heavy?
<Dr.
Simpson> Some people have done that-- placed the lap band in after
this, and it might work, although it might be difficult to do in someone
who has had a few surgeries before....
<Rhonda> why
the difficulty?
<Dr.
Simpson> So -- first, get an upper GI, let us see what is going on,
then we can go from there. Lap band probably cannot be done througha
scope, because of the adhesions, or scar tissue from the previous surgery,
alhtough...
<Dr.
Simpson> it is possible that the small bowel has lengthened a bit,
so that is something to look at. Mary Mack> .3 Are there any web
sites you can suggest that I can find statistics and other information
on results of GPS for Type 2 diabetics? Thank you very much for providing
your answers.
<Rhonda> My
doctor is in NY and anot very accessible
<Dr.
Simpson> There are a number of studies looking at weight loss surgery
and diabetes-- I don't have them handy at the moment....
<Dr.
Simpson> but they are in most textbooks, or even check out the
asbs.org website.
<**MODERATOR**>
NIKKI YOU HAVE THE LAST QUESTION FOR DR. SIMPSON TONIGHT:)
<Nikki> my
mother had the surgery 17 years ago, and gained all her weight back
and then some, what advances have been made since then?? Thank you
again!!!
<Dr.
Simpson> Welll it depends on the surgery --- some surgeries that
were done then just didn't work that well, for example,
<Dr.
Simpson> the horizontal stapling didn't work that well, and that
can be revised to a RNY or to the DS without a problem...
<Dr.
Simpson> those surgeries work better, have longer lasting results,
and ....
<Dr.
Simpson> are new and improved since the previous surgeries. We do
revisions for those surgeries all the time...
<Nikki> she
had a gastric bypass
<Dr.
Simpson> gastric bypass is a generic term, which isn't specific enough
to know what was done...
<Dr.
Simpson> there are a lot of reasons that any weight loss surgery
has failed, and those need to be worked up to see ...
<Nikki> she
calls it stomach stapling
<Nikki> I
see thank you very much for your time
<Dr.
Simpson> if thereis an anatomical reason. Stomach stapling is also
too generic-- basically, you need to sit down with a surgeon who does
this and get an upper GI test, and her old operative
<Dr.
Simpson> reports to see if you can have some sense made of it,
then go through it, and probably thereis something better today that
we can offer her.
<Dr.
Simpson> Have a good weekend everyone.
<**MODERATOR**>
THANK YOU SO MUCH TO DR. SIMPSON AGAIN FOR JOINING US HERE TONIGHT!
IT IS ALWAYS A PLEASURE! AND THANK YOU TO OUR MEMBERS!
<NIKKI> TO
LEARN MORE ABOUT DR. SIMPSON, PLEASE VISIT HIS WEBSITE AT http://www.drsimpson.com
<**MODERATOR**>
GOODNIGHT EVERYONE!
<Dana> Thanks
Dr. S, GREAT sense of humor! Look anything like your bro?
<NIKKI> JOIN
US NEXT FRIDAY FOR ANOTHER CHAT WITH DR. SIMPSON
<Dr.
Simpson> Good night all.
<Dr.
Simpson> @@@@@@@@@@@@@Poooof@@@@@@@@@@@
