|
SEPTEMBER
5 , 2003
<**MODERATOR**>
AMBER N ALABAMA YOU HAVE THE FIRST QUESTION FOR OUR GUEST TONIGHT:)
<Amber_N_Alabama>
i have tmj (lockjaw) and can only open my mouth so far without my joints
popping...last year when i had surgery ..the anesthesiologist...was afraid
to put me to sleep because of my jaw....is this going to create a problem
with gastric bypass surgery?
<Dr.
Simpson> Well you do have to open your mouth to put that breathing
tube down....
<Dr.
Simpson> so, being able to control your airway is critical to an operation...
<Dr.
Simpson> unless you can live without oxygen for a prolonged period
of time...
<Amber_N_Alabama>
I can open it..but it pops...
<Dr.
Simpson> but the only ones that can do that are people who are my relatives...
<Dr.
Simpson> but they don't think to clearly....
<Dr.
Simpson> but that is another story.....
<Dr.
Simpson> so, I would probably say you should have a consultation with
an anesthesiologist regarding your mouth and what they and you can do
with it...
<Dr.
Simpson> because your airway is critical during surgery -- honest,
you do want the anesthesiologist to breathe for you.
<Dr.
Simpson> good luck.
<**MODERATOR**>
TERRI YOU HAVE THE NEXT QUESTION:)
<Terri> Terri
from Ft. Kxox, Ky. I had an RNY in 1987, I became pregnant 4 months later.
Through the years I gained all the weight back. I am getting ready to
have an open BPD, but the Doctor cannot perform a DS with the BPD. I am
58 inches tall and my BMI is 46, I cannot find anyone who has had this
surgery in any of the WL groups. Can you please tell me how the success
rate is with this surgery being a revision. I have been told that it is
only 50/50. Do you feel that the weight loss success can be better than
this?.
<Dr.
Simpson> wow, everyone is so quiet. Hi Terri. --- Why cannot the doctor
do a DS????
<Dr.
Simpson> A revision is a more tricky operation than having fresh tissue,
but we can revise a RNY to a DS,a although;....
<Dr.
Simpson> it isn't an easy thing to do, it certainly is something that
some experienced DS types can do -- and if you do have this revised...
<Dr.
Simpson> I think that you can have some success. The second question
is why did the RNY fail-- there are a number of reasons.
<Dr.
Simpson> Well, RNY can be revised to a DS -- and it isn't that difficult--
but it is something which can be done. The BPD can work also, or revision
to a longer limb RNY
<Dr.
Simpson> there are some surgeons who are pretty good at revisions,
and you might need to find someone who does that as a matter of course...
<Dr.
Simpson> I think Dr. Hess in Ohio would do well, or Dr. Rabkin in California
---- ...
<Dr.
Simpson> Dr. Simpson only works out of Arizona but I hear he is not
too bad either.
<Terri> How
is the success rate. There are no Doctorrs in Ky, that do revisions
<Dr.
Simpson> he doesn't take out of state though -- damn him. Good luck.
<**MODERATOR**>
LAURA YOU HAVE THE NEXT QUESTION PLEASE:)
<Laura> I had
surgery one year ago. My B-12 level is barely above the normal range-I
began taking B-12 tablets today. Will this increase my energy level, and
what are dangers of low B-12
<Dr.
Simpson> B12 can cause anemia -- which means you won't make enough
blood cells, and that...
<Dr.
Simpson> will make you tired, and have a lack of energy, and so forth....
<Dr.
Simpson> the B12 pills are not as effective as the shots, or the B12
which goes under the tongue, so it is something that...
<Dr.
Simpson> you should have your primary care doctor monitor levels of,
and have treatment according the the levels....
<Dr.
Simpson> it is worth watching-- because you don't want to become anemic.good
luck.
<**MODERATOR**>
MONICA YOU HAVE THE NEXT QUESTION:)
<MONICA> Hair
loss, how bad is it, and what can you do to either prevent it or lessen
it? Do you know of any good bariatric surgeons in wisconsin? How do I
find out if they are any good?
<Dr.
Simpson> Hair loss is only in about 30 per cent of people in most practices
and 100 percent of people who go on the internet....
<Dr.
Simpson> so computers are bad for the hair....
<Dr.
Simpson> there is nothing you can do to lessen it, but there are things
you can do to make it worse: you can...
<Dr.
Simpson> color your hair during that time, get a perm -- and you can
make it worse if you don't have enough protein or zinc....
<Dr.
Simpson> but taking protein, biotin, or some weird shampoos, or other
nonsense won't prevent it at all. IN terms...
<Dr.
Simpson> of good bariatric surgeons, the way to find one is to check
the physician index online here at obesityhelp.com and...
<Dr.
Simpson> talk to some of their patients, and see how they do. If they
are good is sometimes subjective, and there are no...
<Dr.
Simpson> objective measurements of good bad or ugly ....
<Dr.
Simpson> good luck
<**MODERATOR**>
TINA YOU HAVE THE NEXT QUESTION:)
<tina> I have
a bmi of 56, also suffer from IBS which requires librax, and have PSVT,
no medication taken for that, just adenocard in ER during episodes, with
these problems would I still be able to have bariatric surgery?
<Dr.
Simpson> IBS is not going to be an issue with this surgery....
<Dr.
Simpson> having PSVT is also not an issue-- although your surgeon and
anesthesiologist will want to know what you are having...
<Dr.
Simpson> and might want you to have some preliminary work up by the
cardiologist before the surgery, or even..
< tina> that's
wonderful to hear
<Dr.
Simpson> some work by the electrophysiologist. Otherwise, no, that
isn't an issue that you need to worry about. The only thing you need to
worry about is....
<Dr.
Simpson> buying all those new clothes. That will be a big problem.
Good luck
<**MODERATOR**>
DENISE YOU HAVE THE NEXT QUESTION FOR DR. SIMPSON:)
<Denise(sept 25th
RNY> My surgery is coming up Sept 25th, is there anything I can do
to prepare myself for it while I am waiting?
<Dr.
Simpson> Walk, walk, walk,walk, walk ----
<Dr.
Simpson> and then start walking some more. Start taking a vitamin daily....
<Dr.
Simpson> start walking (did I say that)....
<Denise(sept 25th
RNY> get off the computer right....lol
<Dr.
Simpson> and don't forget
<Dr.
Simpson> walk.
<Dr.
Simpson> good luck.
<Denise(sept 25th
RNY> thank you
<**MODERATOR**>
KATHY NC YOU HAVE THE NEXT QUESTION PLEASE:)
<Kathy NCpost-op3wks>
I am 3 weeks out from R N Y and have had hives since I came home from
the hosp. No one know where it is coming from. I am on Benadryl 4 times
aday.I have a msg allergy. I stopped taking all vitamins they dont say
they have msg in them?I look like I have a bad case of chicken pox. My
docs are confused? Have you had a patient like me before?
<Dr.
Simpson> There are a lot of reasons you can have hives -- and probably
it is related to one of the medications that you had while you were in
the hospital....
<Dr.
Simpson> sometimes they perpetuate themselves quite a bit, and if they
do then you need to occasionally have a bit of steroids....
<Kathy NCpost-op3wks>
morphine I bet it gave me indigestion so bad
<Dr.
Simpson> which have their own set of problems. Yes, I have had patients
with hives before, and it is a rotten state to be in....
<Dr.
Simpson> but there are worse states to be in -- for example, Delaware.
good luck.
<Kathy NCpost-op3wks>
oh ok thanks
<**MODERATOR**>
BKS YOU HAVE THE NEXT QUESTION PLEASE:)
<bks> Hi Doc,
I am now 7 mths post op from having rny and wondering how many calories
a day should I be eating and how often?, cuz I know now at this stage
I am able to eat alot more, also I am down 106# from 322 to 216 is that
a good weight loss so far I am 5'7" thanksyou!
<Dr.
Simpson> That is a great weight loss and I will now stand up and clap
for you....
<bks> ty
<Dr.
Simpson> try to keep the calories to less than 1000 per day, and fill
yourself with good stuff, measure twice eat once...
<Dr.
Simpson> do not stretch it, do not test it--- do not skip meals....
<bks> okay ty
<Dr.
Simpson> and make sure you have some good snacks, and one more thing
(anyone can put in here and you won't be booted)...
<Dr.
Simpson> (was no one paying attention?_)
<Dr.
Simpson> walk
<Dr.
Simpson> then walk some more
<Dr.
Simpson> walk like a cop getting a donut
<**MODERATOR**>
MDL YOU HAVE THE NEXT QUESTION:)
<MDL> What will
happen if I do not quit smoking in the thirty days prior to surgery? I
smoked just prior to old fashioned gallbladder surgery. I know its bad,
but is there a DIRE consequence of this particular surgery?
<Dr.
Simpson> yes -- if you smoke you will regret it.
<Dr.
Simpson> first, when they took out your gallbladder they didn't get
into any intestine...
<Dr.
Simpson> they didn't cut it and sew it together and hoped it would
heal....
<Dr.
Simpson> and they just put a clip or two on the duct once they removed
the gallbladder -- nothing to leak...
<Dr.
Simpson> and since the surgery was shorter, they didn't worry too much
about lung problems....
<Dr.
Simpson> so, now someone will rearrange your guts, and hope and pray
that what they sew together will stay that way...
<Dr.
Simpson> and every cigarette you smoke will interfere with healing,
and if you spring a leak...
<Dr.
Simpson> you might end up spending weeks in the hospital instead of
days...
<Dr.
Simpson> and that is one way to quit smoking. Of course, you could
quit now, and have no complications. Your choice. Good luck.
<Dr.
Simpson> but I have no opinion.
<MDL> Guess
I will QUIT 30 days prior then!! Thank You.
<**MODERATOR**>
DAVE W YOU HAVE THE NEXT QUESTION PLEASE:)
<DaveW/SoCal/17dPost>
Hi doc, I'm 17days post from open rny, my incision was closed with skin
glue/steristrip on surface, I assume sutures below, it's healing well.
However, yesterday I started having some pain about 1in out on either
side of the incision and feels like tearing, is this an early sign of
hernia? I'm afraid that shifting around in bed has over stressed the incision.
<Dr.
Simpson> shifting around in the bed won't cause a hernia. ... get out
of the bed and start walking...
<DaveW/SoCal/17dPost>
I take several small walks cuz I have a back injury, but I do walk, and
walk, and oh yeah, walk :)
<Dr.
Simpson> sutures are inside, but walk more, the more you walk the better
you will feel
<Dr.
Simpson> the more oxygen you will breathe in --
<Dr.
Simpson> and the faster you will heal
<Dr.
Simpson> and the less chance you will have of a hernia
<Dr.
Simpson> and the better your back will feel
<Dr.
Simpson> and the better I will feel
<Dr.
Simpson> which is what is really important here
<DaveW/SoCal/17dPost>
:-)
<Dr.
Simpson> good luck.
<**MODERATOR**>
MIDLIFESTU YOU HAVE THE NEXT QUESTION PLEASE:)
<midlifestu 345/290>
Hi Dr. Simpson, so wonderful of you to share time here with us. I am wondering
why on earth I developed a stress ulcer at my pouch outlet one month postop.
It's taking so long to heal even on Carafate and just protein shakes.
My doc said as long as the pain was improving then it's healing. Is there
more I can do to help this along? And how common is this postop problem?
I had lap RNY proximal on 06/30/03. I've never had ulcers or GI problems
prior to this. Also, I would love to know why you decided to go into bariatric
surgery. :O)
<Dr.
Simpson> Ulcers in the stoma are not uncommon-- or to get rid of double
negatives, are common....
<Dr.
Simpson> and in terms of what you can do, I suggest the following :
measure everything you eat so that you don't overeat your pouch.. Dr.
Simpson> take more walks so you breathe deeper and get more oxygen
to that poor ulcer that needs to heal....
<Dr.
Simpson> take some acid reducing agent, like Pepcid or Prevacid....
<Dr.
Simpson> and I went into bariatric surgery because it is fun to see
patients change and watch their bodies melt away...
<Dr.
Simpson> but the real reason is I am terrified of global warming....
<midlifestu 345/290>
lol, I bet you are a riot in surgery, lol
<Dr.
Simpson> and if I get a lot of people to lose weight maybe the tides
won't take us all away into the ocean.
<Dr.
Simpson> good luck.
<midlifestu 345/290>
thanks
<**MODERATOR**>
MARIE/BOSTON YOU HAVE THE NEXT QUESTION:)
<MARIE (BOSTON>
HEY DRS FINALLY, CAn dumping syndrome happen the next day after some one
eats the wrong food Ihave been puking on and off for 2 weeks its either
the flu or eggs andIve been walking
<Dr.
Simpson> Hi Marie, and welcome to this side of the weight loss surgery
world!!!....
<MARIE (BOSTON>
THANKS
<Dr.
Simpson> early on the pouch is very tender, and can puke at the thought
or sight of some things...
<Dr.
Simpson> one day things will be fine and the next day that same bit
will cause a problem...
<Dr.
Simpson> basically, with rare exception, the first 12 weeks suck....
<Dr.
Simpson> so, measure what you eat-- and don't let your eyes fool you--
your eyes are literally larger than your pouch....
<Dr.
Simpson> and your mouth can hold more than your stomach....
<Dr.
Simpson> so measure twice, eat once, vomit never....
<Dr.
Simpson> finally -- if you are in a vomiting cycle, stop eating solids
for a while-- sip on water, about a teaspoon...
<Dr.
Simpson> every five minutes while awake-- that way you won't stretch
your stomach and cause a problem with vomiting, and you will keep hydrated...
<MARIE (BOSTON>
what about vitamins at this time ?
<Dr.
Simpson> take food slow and easy -- kind of like my sense of humor.
Good luck, and send that cream pie.
<Dr.
Simpson> chewable vitamins are important-- DON'T FORGET THEM
<**MODERATOR**>
DIANA VA YOU HAVE THE NEXT QUESTION FOR OUR GUEST PLEASE:)
<Diana VA> (Your
sense of humor is so refreshing! I love it!) NOW...for the question....I
have read some about the different types of surgery and it seems that
RNY is the most popular. My surgeon only does a combination of the vertical
banded and gastric bypass.....How are they different and which do you
recommend? and of course, why? Is one more "successful" than
the other?
<Dr.
Simpson> Do the surgery that your surgeon does-- don't make them do
something else-- there are a few variations on the theme....
<Dr.
Simpson> and we all have our own style, and the way we do things. Some
like the band around the pouch, some do not...
<Dr.
Simpson> but go with the surgeon that will bring you to the dance....
<Dr.
Simpson> in terms of what is best-- what is best is what your surgeon
is doing, and what you will commit yourself to follow...
<Dr.
Simpson> follow the program better than a religion--- and you will
be fine. You don't have to worship your surgeon...
<Dr.
Simpson> most of the time we accept a bow. Good luck.
<Diana VA> thanks......just
looking at the options..... :)
<**MODERATOR**>
RICH/RI YOU HAVE THE NEXT QUESTION:)
<Rich / RI>
What are your guidelines for accepting a patient for surgery? i.e. weight,
BMI, and age
<Dr.
Simpson> insurance
<Dr.
Simpson> cash
<Dr.
Simpson> oh-- sorry....
<Dr.
Simpson> We use the NIH criteria almost exclusively, which is a BMI
of 35 with comorbiditieis of diabetes, heart disease, joint problems,
sleep apnea,,,or...
<Dr.
Simpson> BMI of 40 and above. In terms of age-- we go from 16 to 63
-- sometimes we think of going higher, but mostly not...
<Rich / RI>
thanks
<Dr.
Simpson> although 63 is still young. I remember those days..
<Dr.
Simpson> yw
<**MODERATOR**>
EILEEN YOU HAVE THE NEXT QUESTION PLEASE:)
<eileen preop10/6>
I am excited and scared to death(death being the key word) over this surgery
as my date gets closer. I want and need it but was wondering what I can
to assure a speedy and successful recovery ? I want to be the perfect
patient. I have no comorbities bmi41. open rny 10/6 buffalo ny ?I mean
besides walking lol And I am a puker... I puke with all pain meds, ansthesia,
will this hurt a new pouch?
<Dr.
Simpson> you may not be a puker with your pouch, in fact you may be
just fine and better with that pouch...
<Dr.
Simpson> in terms of fear, well, that is normal -- I can tell you that
if we thought you wouldn't do well we would not be doing surgery on you...
<Dr.
Simpson> of course the Titanic was unsinkable, but that is another
story....
<Dr.
Simpson> the best thing you can do is walk. Then walk some more...
<eileen preop10/6>
thats encouraging
<Dr.
Simpson> walk from the recovery room to your hospital bed, and then
walk even more from there...
<eileen preop10/6>
ok
<Dr.
Simpson> do a lap around the nurses station once an hour...
<Dr.
Simpson> don't sit in bed. Start walking now and work up to a mile
a day in 15 minutes...
<Dr.
Simpson> go to the obesity walk on Sept 20th at www.walkfromobesity.com...
<Dr.
Simpson> so, keep working and walking. good luck.
<eileen preop10/6>
thanks
<**MODERATOR**>
KRISTEN IN WI YOU HAVE THE NEXT QUESTION PLEASE:)
<Kristen in WI>
Dr. Simpson, i was in the hospital in April for mastoiditis, and IV antibiotics.
While I was there they ended up giving me 3 units of blood in 4 hours
( said my H/H was 7 and 21...ended up being lab error) anyways it put
me into CHF and ended up with Pulmonary edema. My concern is that I have
heard that while in the hospital for RNY they over hydrate you intentionally.
I am concerned with going into CHF again. ( have had heart and lung tests
and everything is fine now) also.... i am taking progesterone right now
for a pre cancerous endometrial biopsy... should this be stopped pre op?
<Dr.
Simpson> The progesterone might need to be stopped, and in terms of
CHF that is something that you will have to be ...
<Dr.
Simpson> examined for, and checked out prior to surgery, and I am certain
they will be doing that...
<Kristen in WI>
ive had stress echo and that was fine
<Dr.
Simpson> the only concern I have is why you were so anemic-- hopefully
that is figured out now...
<Kristen in WI>
well.. it was a lab error.. i wasnt anemic!!
<Dr.
Simpson> good, nice to know-- so probably had CHF from the anemia,
that happens...
<Dr.
Simpson> oh my -=- that is a problem. Well, avoid that lab then...
<Kristen in WI>
NO ...blood 1 week prior was normal!!
<Dr.
Simpson> wow-- ok, well, that explains a lot.You should be fine. Go
for it.
<Dr.
Simpson> good luck.
<Dr.
Simpson> walk, though -- or I will come and get you by the ear and
make you.
<**MODERATOR**>
MRS. K YOU HAVE THE NEXT QUESTION FOR DR. SIMPSON PLEASE:)
<MrsK> I had
a polyp in my colon 5 years ago that was discovered via barium enema w/
air and then a colonoscopy. Much to the dr's and my surprise (I was 30yrs
old) the tip of the polyp was cancerous. Due to this I have to be check
every few years via endoscopy or colonoscopy. I have not had my WLS yet,
but am wanting Lap RNY. My question is what effect, if any, will RNY have
the ability to have a colonoscopy or the endoscopy procedures? I also
have IBS and early indications of diverticulitis, I saw earlier IBS wont
effect being able to have WLS, but what about the diverticulitis?
<MrsK> i was
really concerned about the colonoscopy
<Dr.
Simpson> otherwise, you should have no problem. Well, they will see
the whole thing, don't worry about the colon-- it will be there to have
and to hold until you get rid of it or part of it...
<Dr.
Simpson> if you get rid of part of the colon you have a semi-colon::::::;;;;;;
<Dr.
Simpson> good luck.
<MrsK> thanks
so much...didnt want to do something to risk not catching ny more polyps
<**MODERATOR**>
MARILYN NYC YOU HAVE THE NEXT QUESTION PLEASE:)LOL
<Marilyn-NYC>
Hi Dr. Simpson! Now that have lost 112 Lbs since my Lap Rny 3/20/03 I
feel less energized than before and I get tired so easily lately. Do you
think I should double my daily vitamin and protein intake?
<Dr.
Simpson> I think if you are feeling more tired, you need to have some
blood work done to make certain that...
<Dr.
Simpson> you do not have an anemia, and that is the next step....
<Marilyn-NYC>
ok
<Dr.
Simpson> if you are not taking enough protein or vitamins that is also
aproblem....
<Dr.
Simpson> as for me-- I want some steak.
<Marilyn-NYC>
me too
<Dr.
Simpson> oh, this isn't about me -- sorry. good luck.
<Marilyn-NYC>
thanks
<**MODERATOR**>
VON YOU HAVE THE NEXT QUESTION PLEASE:)
<von> Hi Dr.
can you tell me if using protein supplements b4 surgery help your body
in the recovery process
<Dr.
Simpson> Yes I can.
<Dr.
Simpson> and no it won't.
<Dr.
Simpson> unless you are deficient in protein, and if you are then there
is some more work which needs to be done...
<Dr.
Simpson> so, don't worry about those awful tasting things before surgery....
<von> other
than walking and vit is there anything else
<Dr.
Simpson> you can worry about them later. Me-- I prefer the real food--
like Chicken Marsala-- mmmmmm.
<Dr.
Simpson> good luck.
<**MODERATOR**>
CAROLINAGIRL YOU HAVE THE NEXT QUESTION
<carolinagirl24>
how noticable is the scar from open RYN? and is it as bad as a cecerain
section or not as bad?
<Dr.
Simpson> Well, I never had a C-section-- although if I keep eating
the donuts in the surgeon's lounge they might want to give me one....
<Dr.
Simpson> it depends on what you mean by noticeable---
<Dr.
Simpson> it is usually a six inch incision going from top to bottom...
<Dr.
Simpson> and I like scars on a person-- I think they are better than
tattoos, and they show character...
<Dr.
Simpson> scars are sexy-=- show them off, be proud---
<carolinagirl24>
yeah your right
<Dr.
Simpson> tell everyone that you earned them in a fight with a neighbor...
<Dr.
Simpson> and you took a bullet for mom.
<carolinagirl24>
lol
<Dr.
Simpson> make up a good story-- not that I ever would.
<**MODERATOR**>
GARIELLE YOU HAVE THE NEXT QUESTION :)
<gabrielle>
i have the option of storing my blood..whats the difference between a
unit of blood and a pint?..im concerned about needing blood if they knick
my spleen..im having my surgery laproscopically
<gabrielle>
and DOC..your really funny
<Dr.
Simpson> well, we talk about pints in England when we refer to a bit
of beer-- so...
<gabrielle>
lmao
<Dr.
Simpson> tell them you want beer instead of blood.
<gabrielle>
rofl
<Dr.
Simpson> you can store your own blood, but needing blood for this surgery
is fairly rare...
<gabrielle>
its 200$
<Dr.
Simpson> now that I have said that everyone this week will probably
need blood...
<Dr.
Simpson> banked blood, that is from anonymous donors-- is fairly safe,
and probably safer than your family's blood...
<Dr.
Simpson> certainly safer than my family blood....
<Dr.
Simpson> so, don't stress about it-- if you need some blood look at
it this way -- whenever there is a holiday--
<gabrielle>
difference between unit and pint?
<Dr.
Simpson> like St. Patricks' day, even if you are not Irish you can
say you have some Irish blood in you...
<Dr.
Simpson> or Leif Erickson day -- you should be so lucky as to have
Norwegian blood in you...
<gabrielle>
man im laughing so hard i cant type
<Dr.
Simpson> A pint is the old way we use to administer blood, before we
washed it and spun down the cells..
<Dr.
Simpson> commonly we call a unit a pint-- but really it isn't, but
it is in our vernacular....
<Dr.
Simpson> I personally like good old Italian Red,. good luck.
<**MODERATOR**>
ANNETTE YOU HAVE THE NEXT QUESTION PLEASE:)
<Annette> I
have a very large scar from my breast bone to my right hip due to open
cholecystectomy and appendectomy is it possible to still have a lap rny
or does that pretty much mean it will have to be open my pcp said she
doubted it could be lap due to adhesions? Also my husband is very concerned
about nutrional problems post op about how many patients actually have
these type of post op problems.
<Dr.
Simpson> Annette it is possible to have it done through a scope, and
that is a decision that you and your surgeon will have to make....
<Dr.
Simpson> in terms of nutritional problems, the answer is simple: eat
well and the right food, take your vitamins and supplements...
<Dr.
Simpson> tell your husband he will have to do housework for the next
two years....
<Annette> great
I am still waiting on the surgical consult
<Dr.
Simpson> and you'll be just fine. Good luck.
<**MODERATOR**>
PHATLEXUS YOU HAVE THE NEXT QUESTION:)
<Dr.
Simpson> Hi Lex
<Phatlexus>
I HAVE NO HEALTH PROBLEMS RIGHT NOW AND HAVE BEEN TAKING PHENTERMAINE
FOR A WEEK TRYING TO LOOSE SOMETHING BEFORE MY CONSULT WHAT RNY BE SEST
FOR ME. AND KNOW SHOULD I BE TAKING A B12 SHOTHOW MUCH DO YOU THINK I
WILL LOOSE AFTER SURGERY IS DONEALSO HOW MANY CALORIES SHOULD I BE EATING
A DAY ON THIS DIET.I WILL BE HAVING MY SURGERY DONE AT JOHNSHOPKINS HOSPITAL
BY DR. MAGNUSON BY THE WAY MY BMI IS 78.1. THANKS FOR ANSWERING MY QUESTIONS
<Phatlexus>
hELLO dr
<Phatlexus>
yOUR VERY FUNNY
<Dr.
Simpson> The more that you can lose between now and your surgery, the
easier the surgery will be for you, and for your surgeon .....
<Dr.
Simpson> so, for now get on a 1500 cal a day diet, or less, and in
terms of b12 shots, not unless you need them...
<Dr.
Simpson> Johns Hopkins is a good instutition, I am sure you will be
in good hands there. Good luck--- .
<**MODERATOR**>
STEPHIAZ YOU HAVE THE NEXT QUESTION PLEASE:)
<StephiAZ> Hey
Doc! Should I split up whenI take my multi-vitamin, my zinc pill and my
vitamin b pill? I try to remember through the day, but you know me I can
be forgetful and if it is ok would like to take them at the same time.By
the way down two more pounds since last week -136 now :-)
<Dr.
Simpson> Hi Stephi-- Stephe use to weigh 987 pounds....
<StephiAZ> WHATEVER
<StephiAZ> I
may have looked like it LOL
<Dr.
Simpson> you can take all of those vitamins at once, without a problem--
sorry gang, she didn't;/.///
<Dr.
Simpson> Stephi is one of my patients, who can share with everyone
that I am real...
<StephiAZ> Ok
cool. I am forgetful
<StephiAZ> He
is real
<StephiAZ> and
really makes you walk LOL
<Dr.
Simpson> Stephi is about one year out, and has done very well, and
we are all proud of her....
<StephiAZ> a
real 98 year old man
<StephiAZ> Thanks
Doc
<Dr.
Simpson> Steph, some days I feel that old, but really I am only 72
<**MODERATOR**>
CARL YOU HAVE THE NEXT QUESTION:)
<Carl> i have
a hernia that is why the Dr. is going to try lap first what is your recommendation
on this type of procedure also how much walking should i do before surgery
i haven`t been able to walk very much because of accident that caused
some back injury
<Dr.
Simpson> Hi Carl-- I think if they want to try lap first, that is a
good idea, and I think you should start walking now...
<Dr.
Simpson> and keep walking until the procedure. In fact start walking
to the hospital now.
<Carl> my surgery
is 10 days away
<Dr.
Simpson> Keep walking-- then go to the east coast and work your way
back. Good luck.
<**MODERATOR**>
LISA 3 MORE YOU HAVE THE NEXT QUESTION PLEASE:)
<Lisa 3more days!>
I am having open RNY Monday, my doc has me taking blood thinner meds 2
days before surgery. Is this common practice now, and does it help? I
am not at any greater risk for clots than anyone else, but i wondering
if you also prescribe this before and after surgery as a precaution? Yes,
i am preparing for 12 weeks of "suck: LOL, and I WAL
<Dr.
Simpson> I don't know, Lisa, why they have you on blood thinners before
surgery. I think that is mystery, there are some reasons...
<Lisa 3more days!>
scroll back
<Dr.
Simpson> if you have a predisposition to blood clots, but generally
that isn't for the average bear...
<Lisa 3more days!>
oh ok]
<Dr.
Simpson> in fact, the average bear is hard to operate because getting
the iv in is a hairy experience....
<Lisa 3more days!>
lol
<Dr.
Simpson> good luck Lisa, you will do fine.
<Lisa 3more days!>
okthankyou
<**MODERATOR**>
SARAH YOU HAVE THE NEXT QUESTION PLEASE:)
<Sarah> Dr.
Simpson - How amazing that you are willing to take time to answer our
questions.... I'm certainly ready to do my part to help abate global warming...
LOL I'd like to know more about a revision from a RNY to a Lap Band. I
had open RNY 2 1/2 years ago - I only lost about 35 lbs... the Dr. said
that he gave me a "generous" pouch, and wanted to do the lap
band revision then, but i wasn't ready for another surgery. I'm ready
now, however, but don't want to do anything without thinking it through.
Is there any "track record" of success/failure with this type
of revision? I still have about 100 lbs. to lose.I talked to the folks
at Inamed and they say this type of revision carries cautions, not warnings
or contraindications. Your thoughts? (by the way - i've got a tatoo next
to my scar.... double sexy? LOL)
<Dr.
Simpson> A lap band might be a nice additional procedure with the "generous"
pouch that your doctor left you...
<Sarah> yea
- about 8 ounces
<Dr.
Simpson> and it might give you the restriction that you need to lose
that last 100 lbs...
<Sarah> ::nodding::
hope so
<Dr.
Simpson> 8 ounces is pretty generous, that is more generous than I
am ....
<Sarah> so i've
heard...
<Dr.
Simpson> so, go for the lap band, read a lot about it-- it is a very
good surgery...
<Sarah> lol
<Sarah> okey
dokey - just didn't want to be so desperate to lose weight i did something
not smart.
<Sarah> thanks!
<Dr.
Simpson> better stingy than stinky
<**MODERATOR**>
MDL YOU HAVE THE NEXT QUESTION PLEASE:)
<MDL> Have you
ever performed surgery on someone with Hidradenitis Suppurativa? Did WLS
help to relieve it in the long run?
<Dr.
Simpson> The only good thing for that disease is getting rid of the
hair bearing areas, although certainly, weight loss surgery...
<Dr.
Simpson> will make it a lot better and easier to do that....
<Dr.
Simpson> so good luck.
<**MODERATOR**>
JUDITH E YOU HAVE THE NEXT QUESTION:)
<judith e> I
am 65 and I have had all the preop tests and insurance coverage. I am
waiting for the doctor to accept me for surgery. Why do doctors not want
to do this surgery on older patients. I am healthy and strong except for
obesity related health problems. I went through the tests with another
dr but couldnot get scheduled before Medicare came in to effct and he
didnt accept medicare, so I have found another dr. but i am afraid he
wont because of my age.
<Dr.
Simpson> Sometimes we think that the effect of obesity on the internal
organs has already been done, and the surgery might have less benefit,
although we don't know...
<judith e> I
have only been obese for the last 10 or so years
<Dr.
Simpson> but that should be done on a case by case basis, and most
people won't do that=-=== I think for someone who is 65 they might consider
a lap band...
<Dr.
Simpson> it is all individual, and it is hard to set policies and keep
them. Good luck. Get thin, but the problem will be...
<Dr.
Simpson> you will find some younger man and then you will be in trouble...
<Dr.
Simpson> so we need to protect those innocent ones.
<judith e> I
have had prioir surgery and was concerned about the adhesions
<Dr.
Simpson> adhesions are not a problem at all.
<judith e> If
they die they die doc but give me a chance
<Dr.
Simpson> It takes a few weeks to heal to where the sutures or the staples
are not the main thing holding them together....
<judith e> Thank
you
<**MODERATOR**>
JEREMYELISEO YOU HAVE THE LAST QUESTION TONIGHT PLEASE:)
<jeremyeliseo>
I was wondering if the RNY pouch is just held shut by the staples or does
it eventually heal and if so how long does it take to heal? Also I have
a common head cold will this effect my surgery? Also My Doc wants me on
a liquid diet 48 hours before surgery. is this common and why?
<Dr.
Simpson> yes, we do not do this when you have a cold, and some liquid
diets before surgery to clean you out...
<eileen preop10/6>
thanks doc
<DaveW/SoCal/17dPost>
THANKS DOC!
<James Cooper>
thanks
<Kristen in WI>
thanks Doc!!
<**MODERATOR**>
THANK YOU SO MUCH DR. SIMPSON FOR JOINING US TONIGHT!
|
