|
<**MODERATOR**> CUDDLYANGEL YOU HAVE THE NEXT QUESTION:):)
<CuddlyAngel> My Question
is .....If the pyschciatrist says you meet the criteria ....for medically
necessary ...is it likely that i will be approved? [
<Dr. Simpson(Chicago)> It means that you
don't hear as many voices as you normally tell them...
<Dr. Simpson(Chicago)> the approval process
is from several angels..
<Dr. Simpson(Chicago)> the insurance company,
the surgeon, nad you./...
<Dr. Simpson(Chicago)> you have passed the
psychiatrist, which means you don't have a disorder which needs medicaiton...
<CuddlyAngel> He said due to my weight bmi and co morbids as well
as my mentality
<CuddlyAngel> He said due to my weight bmi and co morbids as well
as my mentality
<Dr. Simpson(Chicago)> now you need to see
if you fit into your insurance criteria and then if the surgeons says
its a go and the insurance approves...
<Dr.
Simpson(Chicago)> you willl have a new scar on your belly. Good luck.
<**MODERATOR**> LYNNDATESCHEDOHIO YOU HAVE THE NEXT QUESTION:)
<LynnDateSchedOhio> Dr Simpson, I have mitral valve prolapse and
a heart murmur that sometimes causes an extra beat or two of my heart under stress. I do not take medication for
either condition. Will either of these conditions stop me from having
surgery?
<Dr. Simpson(Chicago)> Lynn, mitral valve
prolapse is common in people and is not prohibitive from any surgery....
<Dr. Simpson(Chicago)> My patients tell me
I don't have a murmer because I don't have a heart....
<Dr. Simpson(Chicago)> but that is another
story....
<LynnDateSchedOhio> lol<
Dr. Simpson(Chicago)> you will need some antibiotics
specifically for your murmer, and your surgeon will know those or ...
<Dr. Simpson(Chicago)> your anesthesiologist.
Good luck. Save your heart, start walking.
<**MODERATOR**>
CRYSTAL YOU HAVE THE NEXT QUESTION:)
<Crystal> I was diagnosed with Chrohns and it was active for one
year, I took meds for it and then it went into remission. I was obese
through it all. Can I still
have an RNY? I have been in remission for about 3 1/2 years.
<LynnDateSchedOhio> Yes, sir... I have.. thank you.
<Dr.
Simpson(Chicago)> Crohn's disease is not a specific contraindication
to any of the surgeries....
<Dr.
Simpson(Chicago)> it might make future care a bit difficult, but it
is not something that would prohibit you from having this...
<Crystal> thank you
<Dr. Simpson(Chicago)> glad it went into
remission...
<Dr.
Simpson(Chicago)> now get the surgery. Good luck.
<Crystal> me too
<**MODERATOR**> ALISON IN ALASKA YOU HAVE THE NEXT QUESTION:)
<Alison in Alaska> Dr. Simpson, do you still require your patients
to lose 10# prior to DS? If so,
I was wondering why?
<Dr.
Simpson(Chicago)> I do require weight loss, as a numbe rof surgeons
do....
<Dr. Simpson(Chicago)> the reason is fairly
simple....
<Dr. Simpson(Chicago)> DS is a surgery which
demands compliance after the surgery....
<Dr. Simpson(Chicago)> and if you cannot
follow things before the surgery, then doing the surgery does no good
for the patient...
<Dr. Simpson(Chicago)> and can make them
ill, especially if they eat a high carb diet and avoid protein....
<Dr. Simpson(Chicago)> by going on a diet
similiar to post op, they will lose weight, and they demonstarte compliance....
<Dr. Simpson(Chicago)> if they have not lost,
then we cancel their surgery until they do...
<Dr. Simpson(Chicago)> that is the reason.
Plus I am cruel.
<Alison in Alaska> that is going to be my only down fall, carbs!
<Alison in Alaska> yah.. we knew THAT
<**MODERATOR**> KELLY YOU HAVE THE NEXT QUESTION PLEASE:)LOL
<Kelly> HI! Dr. Simpson what
can I do about increased mmmm gas every
time I eat or drink I belch for
hours
<Dr. Simpson(Chicago)> Well Kelly, you should
become a Bears fan and go to football games....
<Dr.
Simpson(Chicago)> there are several things which cause gas....
<Dr. Simpson(Chicago)> the first one is the
air which you swallow during the course of the day
<Dr.
Simpson(Chicago)> the second is some foods cause more gas than others....
<Dr. Simpson(Chicago)> such as beans (big
surprise),,,
<Dr. Simpson(Chicago)> and the third thing
is to decrease carbohydrates and ....
<Dr. Simpson(Chicago)> medicines which work
include Devrom, which has an 800 number....
<Dr. Simpson(Chicago)> pepto bisomol...
<Dr. Simpson(Chicago)> and a cork. Good luck.
<Dr. Simpson(Chicago)> www.devrom.com
<Kelly> ty
**MODERATOR**> ANGLE76 YOU HAVE THE NEXT QUESTION:)
<angel76> I have low blood sugar but it stays in line on a 1200
cal diet pcp thinks it would be ok to have surgery
<angel76> insurance has already approved and see surgeon next week
will my sugar be ok
<Dr. Simpson(Chicago)> Yes, it would be just
fine to have surgery, but low blood .sugar isn't a contraindication for
the surgery,
<Dr. Simpson(Chicago)> and in fact, you don't
need that many calories to regulate your sugar after the surgery
<Dr. Simpson(Chicago)> good luck.
<angel76> they say now eat carbs what do i do then
<Dr. Simpson(Chicago)> protein, not carbs,
carbs will actually decrease sugar in the long run.
<**MODERATOR**> BBWSKN YOU HAVE THE NEXT QUESTION PLEASE:)
<bbwskn> I want to know
how long the recovery process is for bariatric (laproscopic) and how long
do you have to be out of work?
<Dr. Simpson(Chicago)> Recovery for bariatric
surgery, lap and open , is the same....
<Dr. Simpson(Chicago)> typically three to
four days in the hospital, three weeeks off of work...
<Dr. Simpson(Chicago)> unless, of course
you have comlications, in which case it might be longer....
<Dr. Simpson(Chicago)> and my friend here,
tells me that it should be longer...
<Dr. Simpson(Chicago)> but that is another
story. GOod luck.
<Dr. Simpson(Chicago)> Oh, no sex for 17 years after surgery.
<bbwskn> lol
<bbwskn> I don't want children
<bbwskn> thanks..time to go
<**MODERATOR**> TONI YOU HAVE THE NEXT QUESTION:)
<Toni (12/16/02)> Thanks! I am only 22 and it is so difficult to
find long term post-ops - how long is the longest post-op you know of?
Do you forsee any long-term ill effects of surgery
on someone my age?
<Dr. Simpson(Chicago)> at age 22, well you
should do just grat -- long term
<Dr.
Simpson(Chicago)> well, my longest is ten years, and he is doing great....
<Dr. Simpson(Chicago)> I have someone in
my practice, from another state who is 22 years out, and she is doing
well
<Dr. Simpson(Chicago)> the registry has even
longer ones out, so you should do fine. Better to have this than obesity.
<Toni (12/16/02)> thanks
<**MODERATOR**> JAMIE YOU HAVE THE NEXT QUESTION:)
<Jamie> Good evening. My
surgeon has explained to me that he does open RNY using lap intruments.
Ever hear of this? Does this mean the
incision will be smaller?
<Dr. Simpson(Chicago)> Well, there are some
lap instruments we all use because of their configuration.... [
<Dr. Simpson(Chicago)> but that does not
mean a smaller incision. An incision heals from side to side not up and
down
<Dr. Simpson(Chicago)> open or lap -- incisions
heal the same way. You want your surgeon t osee and operate well.
<Dr. Simpson(Chicago)> I need glasses, and
do my patients hate it when I forget them.
<**MODERATOR**> LISA CHINO HILLS YOU HAVE THE NEXT QUESTION:)
<Lisa Chino Hills, CA>
Hi Dr...What is your feeling about N/F milk after surgery (4 mths) I used
to hate milk and now crave. Is is ok? What is
too much
<Dr. Simpson(Chicago)> I think non fat milk
is simply blue water. Well, anything in moderation is ok, and that is
somethign you have to decide....
<Dr. Simpson(Chicago)> So, I would suggest
you check the carbs of what you are drinking and keep it to a minimum....
<Lisa Chino Hills, CA>
You sound like a great guy...thanks
<Dr. Simpson(Chicago)> that is, total daily
carbs to 40 grams a day...
<Lisa Chino Hills, CA>
ok....got it
<Dr. Simpson(Chicago)> while losing, 60 grams
to maintain.. I am not nice.
<Lisa Chino Hills, CA> I know... but at least you have a sense
of humor!
<LynnDateSchedOhio> A pretty good one too.
<**MODERATOR**>
APRIL YOU HAVE THE NEXT QUESTION:)
<april> im am 200lbs and 5'2. My dr. says based on family history
i can have this surgery. What do you think? [
<Dr. Simpson(Chicago)> That is a BMI which
is less than 40, although I cannot calculate it quickly right now....
<Dr. Simpson(Chicago)> It depends on your
insurance company and your co morbidities and what they require.
<Dr. Simpson(Chicago)> good luck.
<**MODERATOR**> SALLY YOU HAVE THE NEXT QUESTION:)
<Dr. Simpson(Chicago)> Hi sally
<**MODERATOR**> LYNNE YOU HAVE THE NEXT QUESTION PLEASE:)
<Lynne> have you performed a reversal of the original intestinal
bypass and then followed with the newer surgery
<Dr. Simpson(Chicago)> Well, Lynne, I have
done a number of reversals and revisions, so it is possible
<Dr. Simpson(Chicago)> there are a few things
which I have not reversed yet, but I am certain they will come around...
<Lynne> do the unused intestines
go back to working ok?
<Dr. Simpson(Chicago)> they do, they plump
up just fine. For those who had the jejuno ileal bypass...
<Dr. Simpson(Chicago)> that comes back.
<**MODERATOR**> TEDRA YOU HAVE THE NEXT QUESTION:)
<Tedra> Hi Doc.... do you know of any programs that help pay for
this surgery for those of us who have insurance with exlusions??
<Dr. Simpson(Chicago)> No, I don't know of
any programs...
<Tedra> thanks
<Dr.
Simpson(Chicago)> there are some patients who have put together things,
but the best is to save...
<Dr. Simpson(Chicago)> and good luck.
<**MODERATOR**> MG 4 WKS YOU HAVE THE NEXT QUESTION:)
<MG 4 wks post-op> I am 4 wks post - first week -10 lbs, 3weeks
no weight loss, I'm drinking water, exercising, and having the right amount
of protein. Have you ever heard
about this long of a plateau at the begining?
<Dr.
Simpson(Chicago)> I think that you have to realize that the first thing
you do is lose inches...
<Dr.
Simpson(Chicago)> the second thing that you do is to lose weight....
<Dr. Simpson(Chicago)> so measure inches
first...
<MG 4 wks post-op> so you've had a patient who hasn't lost lbs
for this long?
<Dr. Simpson(Chicago)> next, keep some of
the carbohydrates down....carbs are the eney..
<MG 4 wks post-op> I have lost inches, i just want to make sure
i"m not defective!
<Dr. Simpson(Chicago)> Yes, MG, some don't
at first, but keep up with the program, it will be fine...
<Dr. Simpson(Chicago)> well, MG check your
original packaging for the manual. Good luck.
<MG 4 wks post-op> thanks I will!
<**MODERATOR**> PAMTN YOU HAVE THE NEXT QUESTION:)
<PamTN> I have diabetes. I had hysterectomy 6 yrs ago. have large
scar and hernia. how will this affect my chances of getting to have surgery??lf ew
<Dr. Simpson(Chicago)> Here I am in beautiful
downtown Naperville Illinois-- miles from the great city of Chciago and
spending my time with you.....
<Dr. Simpson(Chicago)> THe diabetes is not
a contraindication, nor is the scar or the hernia.... i
<Dr. Simpson(Chicago)> it is more up to your
insurance and surgeon, than those factors....
<PamTN> thanks very much
<Dr. Simpson(Chicago)> in fact, I would say
that having diabetes is a reason to have this surgery....
<PamTN> so do i
<Dr. Simpson(Chicago)> this may be one of
hte few real good cures for diabetes-- not all of course, and you will
still have that predisposition...
<Dr. Simpson(Chicago)> but the weight loss
will decrease insulin resistence...
<Dr. Simpson(Chicago)> and you will be fine.
<Dr.
Simpson(Chicago)> good luck.
<PamTN> appreciate you
**MODERATOR**> MINDY IN MIAMI YOU HAVE THE NEXT QUESTION:)
<MINDY IN MIAMI> I have a bubble type lug exercise machine from
a previous surgery. Would it help to use it pre-op for my lungs?Also is it ok to have a PPD required for work. Thanks
for helping us.
<MINDY IN MIAMI> lung <blanca>
hello i'm 24 years old and i have pseudotumor do you think this will help
me
<Dr. Simpson(Chicago)> Miami, there is a
city I have never been too. Great looking
beaches... The machine is still good...
<Dr. Simpson(Chicago)> walk instead of this
machine, but use it and get in shape
<Dr.
Simpson(Chicago)> ppd isn't a problem at all. Good luck. Send me some
sand.
<MINDY IN MIAMI> it's in the mail come visit
<**MODERATOR**> LYNNDATESCHEDOHIO YOU HAVE THE NEXT QUESTION:)
<LynnDateSchedOhio> Doc, if you are allergic to codiene (even the
artificial kind) will morphine be a problem? Both regular and artificial codiene make me very ill.
<Dr. Simpson(Chicago)> Morphine and COdein
are not terribly related although both are narcotics...
<Dr.
Simpson(Chicago)> but some narcotics are hard to tolerate, and others
are not...
<Dr. Simpson(Chicago)> codeine is hard for
some people, although it did great when my wisdom teeth came out...
<LynnDateSchedOhio> Um, should I get a test run?
<Dr. Simpson(Chicago)> which apparently is
my wisdom, cause it is gone too...
<LynnDateSchedOhio> lol
<Dr. Simpson(Chicago)> no test runs needed,
they will see...
<Dr. Simpson(Chicago)> you should be fine.
Good luck.
<LynnDateSchedOhio> Thanks
<**MODERATOR**> LYNNE YOU HAVE THE NEXT QUESTION PLEASE:)
<Lynne> What are the results
after a reversal of the jejuno ileal bypass and then followed by the new
surgery? Any additional complications?
<Dr. Simpson(Chicago)> Lynne, with revision
surgery the risks are six times as much as the risks of a non revision
surgery....
<Lynne> what risks?
<Dr. Simpson(Chicago)> there is an increased
incidence of all forms of complications, nevertheless....
<Dr. Simpson(Chicago)> patients do well.
The risks include increased leak rate after surgery, increased abscess
rate, increased rate of ...
<Dr. Simpson(Chicago)> other usual complications
of surgery. But a jejuno ileal bypass SHOULD be taken down,...
<Dr. Simpson(Chicago)> because it has a risk
of cirrhosis, which is a very bad thing to get. Although, if I can get
out of my class tonight... <Lynne> that is what i have been reading
<Dr. Simpson(Chicago)> I would like to have
a drink....
<Lynne> but I am nervous about doing it
<Dr. Simpson(Chicago)> my behind is a bit
sore. Oh, I am here taking a class. Lynne, reversal is better and easier
on you...
<Dr. Simpson(Chicago)> than having cirrhosis.
So, get it reversed if nothing else.... [
<Dr. Simpson(Chicago)> There is af amous
surgeon who spent the first half of his career doing the jejuno ileal
bypass and the second half
<Dr. Simpson(Chicago)> taking them down.
<**MODERATOR**> KRISTY IN VA YOU HAVE THE NEXT QUESTION:)
<KristyInVA-144> how much does one
of your patients thats 10 months out get in as in calories, protein,
carbs, all that good stuff?
<Dr. Simpson(Chicago)> I don't care about
calories specifically, I want them to have 60 to 80 grams of prtoein,
cause I do a distal type procedure
<Dr.
Simpson(Chicago)> and no more than 60 grams of carbs until they reach
goal, then introduce as needed and weigh daily....
<Dr.
Simpson(Chicago)> I eat the other stuff for them. Good luck.
<KristyInVA-144> ty
<**MODERATOR**> blanca YOU HAVE THE NEXT QUESTION PLEASE:)
<blanca> i'm 24 years old and i have pseudotumor do you think this
can help me
<Dr.
Simpson(Chicago)> Losing weight through WLS is somethin which has helped
a lot of patients wtih this...
<Dr. Simpson(Chicago)> specifically, pseudotumor
cerbri, so it is one of the indications for the surgery
<Dr.
Simpson(Chicago)> SO I would suggest it would be a good thing for you.
GOood luck. THere is someone who comes in the chatroom
here late at night...
<Dr. Simpson(Chicago)> Kathi From Hawaii,
who had that disease and had the surgery... [
<Dr. Simpson(Chicago)> she is someone you
should seek out and talk to. Get a referral to a surgeon. GOod luck.
<**MODERATOR**> SUNNY ALBERTA YOU HAVE THE NEXT QUESTION PLEASE:)
<sunny alberta> when i had my gallbladder out i thru up alot in
recovery is there anything i should tell the anasthesoligist to help this
not happen again and if there
isn't will it be a problem for my staples i'm having rny, thanking you
in advance
<Dr.
Simpson(Chicago)> Well, yes, talk to your anesthesiologist....
<Dr. Simpson(Chicago)> there are a lot of
new drugs which they can give, and some which they can avoid...
<Dr.
Simpson(Chicago)> we like patients not to vomit, although some patients
seem to vomit more than ...
<Dr.
Simpson(Chicago)> Ally McBeal, and that is one way to lose weight --
works with hollywood types.... [
<Dr. Simpson(Chicago)> so, talk with the
docotrs and they should be able to help you. For tyou, walk. and wlak
a lot ofter surgery.
<Dr. Simpson(Chicago)> my computer keyboard
is whacky tonight.
<**MODERATOR**> LADYROSE YOU HAVE THE NEXT QUESTION PLEASE:)
<Ladyrose> I am a 52 y/o woman, 232 pounds, 5'2", BMI 42,
on 2 antihypertensive medications ..in your opinion would that make me
a good candidate. Also have fibromyalgia.
<Dr. Simpson(Chicago)> Fibromyalgia isn't
a factor or co factor, but you fit the criteria, and the `hypertension....
<Dr. Simpson(Chicago)> is not going to get
better with obesity....
<Dr. Simpson(Chicago)> so, you would be a
great candidate --- sign at the bottom of the page and I will see you
next week.
<Dr. Simpson(Chicago)> good luck.
<**MODERATOR**> TONI YOU HAVE THE NEXT QUESTION PLEASE:)
<Toni (12/16/02)> Me again:) The morphine question triggered my
memory lol - My dad is allergic to morphine, but I've never had it, should
i tell the surgeon this? Can
that allergy be passed down to me? Should I ask for something like demerol
instead?
<Dr. Simpson(Chicago)> Toni --- demerol is
a fine alternative.
<**MODERATOR**> SKIPPER YOU HAVE THE NEXT QUESTION:)
<skipper> 6 months post. When I eat popcorn. I get a pain that
last 3 or 4 days. Whats up?
<Dr. Simpson(Chicago)> don't eat popcorn.
<skipper> thanks
<Dr. Simpson(Chicago)> too many carbohydrates,
if you don't chew it then it will get stuck...
<Dr.
Simpson(Chicago)> and someone like a GI person might have to pull it
out...;
<Dr.
Simpson(Chicago)> instead of popcorn, have a steak.
<skipper> yuk
<Dr. Simpson(Chicago)> ok, have some tuna
<Dr. Simpson(Chicago)> how about a nice grilled
salmon?
<Dr. Simpson(Chicago)> sausage?
<Dr. Simpson(Chicago)> bratworst -- and why
isn't it bratbest?
<**MODERATOR**> MS-SKI@GOAL YOU HAVE THE NEXT QUESTION:)
<Ms-Ski@goal> Hi- I wasnt
Transected just 4 rows of staples- should i be worried later on about
a staple disruption?( sorry about my spelling)
is there anything i can do to prevent a staple line disruption?
<Dr. Simpson(Chicago)> Yes, do not over eat
your pouch
<Dr.
Simpson(Chicago)> watch your portions carefully...
<Dr. Simpson(Chicago)> wash your hands after
and before eating...
<Dr. Simpson(Chicago)> chew your food well....
<Ms-Ski@goal> How do i know if im over eating???
<Dr. Simpson(Chicago)> and don't eat if you
are full. Good luck. ...
<Dr. Simpson(Chicago)> watch your portions
and feel if you are full...
<Dr. Simpson(Chicago)> although usually we
find that patients don't reaquire more than a day or so of the medicine....
<Dr. Simpson(Chicago)> and go to orals quickly....
<Dr. Simpson(Chicago)> and usually tylenol
works great by day three or so...
<Dr. Simpson(Chicago)> or we give a prescription
for silver bullets.
<**MODERATOR**> KANDI YOU HAVE THE NEXT QUESTION:)
<kandi> is there any advise on what you should do to prepare for
surgery
<Dr. Simpson(Chicago)> Yes kandi there is
a lot of advice which I would give....
<Dr. Simpson(Chicago)> first is to start
a walking program, and begin before surgery and work your way up to 45
minutes...
<Dr. Simpson(Chicago)> second, start reading
labels for the food you are eating and write it down....
<Dr. Simpson(Chicago)> or join fitday.com
and let htem calculate it for you....
<Dr. Simpson(Chicago)> finally, begin to
watch your portions before surgery and see ifyou can guess how much you
are eating and how little you will be after the operation...
<kandi> thank you - that
helps a lot
<Dr. Simpson(Chicago)> finally, be sure to
send your surgeon a thank you card when you are done, cause we like that.
<**MODERATOR**> MS-SKI@GOAL YOU HAVE THE NEXT QUESTION:)
<Ms-Ski@goal> can I re-shrink
my pouch? to like in the beginning so i can eat less?
<Dr. Simpson(Chicago)> Well` yes and no.
<Dr. Simpson(Chicago)> the pouch normally
willincrease to ten ounces after a couple of years,...
<Dr. Simpson(Chicago)> but that does not
interfer with wight loss....
<Ms-Ski@goal> Im one yr and i can do 8 oz
<Dr. Simpson(Chicago)> and to re shrink is
hard, if it is an acute enlargement, it will go back....
<Dr. Simpson(Chicago)> 8 oz is ok, just watch
what you put in it. I have a patient who is years out from their RNY...
<Dr. Simpson(Chicago)> and her pouch is still
4 oz, and she is at goal and antoerh who has about a 12 oz pouch who is
still at ogal.
<Dr. Simpson(Chicago)> learn some new habits,
and good luck.
<Ms-Ski@goal> Thats not
8 oz of steak tho:-)
<Dr. Simpson(Chicago)> Ski, I will have your stake.
<**MODERATOR**>
ANTHONY YOU HAVE THE NEXT QUESTION:) >
<Anthony> What do you recomend for exercise for a brand new postie
<Dr. Simpson(Chicago)> walking, anthony,
and then walking some more, and when you are done with that....
<Dr. Simpson(Chicago)> walk some more. Finally
I recommend walking.
<Dr. Simpson(Chicago)> 45 miunutes per day,
four days per week, and a fast pace...
<Dr. Simpson(Chicago)> not like when I walk
my beloved doggies.
<Dr. Simpson(Chicago)> gotta get that stickem
stuff
<**MODERATOR**> KANDI YOU HAVE THE NEXT QUESTION:)
<kandi> how fast do people usually lose wt.
<Dr. Simpson(Chicago)> the average is 10
to 15 lbs per month for the first six months...
<Dr. Simpson(Chicago)> although in six weeks
usually ten per cent of weight...
<Dr. Simpson(Chicago)> it changes and it
varies with your starting weight also....
<Dr. Simpson(Chicago)> so don['t be discouraged
when someone loses faster than you....
<Dr. Simpson(Chicago)> but you should be
thinkin gof getting to goal as soon as you can, and with a lot of discipline
you can do it...
<Dr. Simpson(Chicago)> of course if it was
easy God would not have invented cookies.
<**MODERATOR**> KANDI YOU HAVE THE NEXT ONE
<kandi> how soon are people usually up and around - i have a 1
and 2 year old that are extremely active that i love to chase
<Dr. Simpson(Chicago)> give me a can of paint,
I will mix it up in a second. Well, as long as you don't lift them for
about six weeks...
<Dr. Simpson(Chicago)> then you should be
up and around within a couple of weeks, and walking after them would be
good...
<Dr. Simpson(Chicago)> BMI of 43 is good
enough for most of us.....
<kandi> definately 6 weeks - no exceptions
<Dr. Simpson(Chicago)> six weeks, is fine,
and there are no exceptions, unless you like to have your favorite surgeon
... [
<Dr. Simpson(Chicago)> fix a hernia for you.
Which we like to do, but
<Dr. Simpson(Chicago)> ok gang, thank you
for joining me. I have to make aphone call and get my dunce cap back one..
<TAMMY> THANK YOU DR. SIMPSON! THANK YOU MEMBERS! PLEASE VISIT
DR. SIMPSON AT: WWW.ARIZONABARIATRICCENTER.COM
<Dr. Simpson(Chicago)> I need a new pillow
for my skinny backsinde
<**MODERATOR**> THANK YOU EVERYONE AND DR. SIMPSON!
|
