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<**MODERATOR**> JOYCE YOU HAVE THE FIRST QUESTION:)
<Joyce (pre-op)> Please discuss the possibilities of damage to
organs long term due to the rapid weightloss. I am very worried about
that at this point in my research. (love your sense of humor by the way!)
<Dr. Simpson> rapid weight loss isn't really
a problem. The organs are happy to be living without so much around them....
<Dr. Simpson> it is a stress to the body,
however, it is something which needs to be done, and most paints enjoy
it and are quite healthy during this time period....
<Dr. Simpson> in the old surgeries, such
as Jejuno-Ileal bypass, there was damage to the liver, and some had liver
failure...
<Dr. Simpson> but that was due to bacterial
overgrowth of the bypassed segment, something which does not happen in
toady's world of surgery....
<Joyce (pre-op)> so i won't regret it in 10 or 20 years?
<Dr. Simpson> so, the faster you get to lose
it, the more likely you will be around in 10 to 20 years to enjoy it.
<Dr. Simpson> unless, of course, you are
shot by a jealous lover.
<Joyce (pre-op)> lol.. thx
<**MODERATOR**> TESS YOU HAVE THE NEXT QUESTION PLEASE:)
<tess> Hello Dr.- I have a BMI of 35.5 with rheumatoid, HTN---rheumatoid
very bad ---many bouts with steroids an surgery on right foot--------what
areyour thoughts on Ins approval?--
<Dr. Simpson> Joint conditions, which are
exacerbated by obesity are one of the reasons or co morbidities cited
by the ...
<Dr. Simpson> NIH in their study in 1997.
So, most insurance companies do follow those guidelines, unless they...
<Dr. Simpson> are trying not to pay for the
surgery in general. So, I would imagine it shouldn't be a problem with
a reputable insurance company. Good luck.
<**MODERATOR**> MARY YOU HAVE THE NEXT QUESTION PLEASE:)
<Mary> I had gall bladder surgery years ago but I had a severe
attack of all the symptoms, the doc said I wass passing stones through
the biliary ducts, can anything be done about avoiding further attacks??
it has been 18 months since my surgery, are there any chances of complications
of the surgery ??
<Dr. Simpson> Well, Mary you are far enough
out that the complication rate is almost zero...
<Dr. Simpson> in terms of your biliary colic,
you probably need to have a study to see if there are stones in your bile
duct...
<Dr. Simpson> a HIDA scan might do it, so
check with your surgeon, because if you still have some, they might need
to come out....
<Dr. Simpson> in terms of other complications,
well, I think you need to keep walking, drink lots of water, and eat some
protein, then you would be just fine. Good luck.
<**MODERATOR**> SHV YOU HAVE THE NEXT QUESTION:)
<shv> I'm having the Lap and not the open. Is one surgery safer
then the other? Should you go on a diet to shrink your liver before surgery?
<Dr. Simpson> Well, safe is what your surgeon
does. If your surgeon does the lap, then that is the safest for you...
<Dr. Simpson> in terms of having an enlarged
liver from fat, a condition called NASH-- or non alcoholic
<Dr. Simpson> steatorrhic hepatitis, that
is something that will shrink after your surgery, far more than before
the surgery...
<Dr. Simpson> although some laparoscopic
surgeons like it shrunk a bit before the surgery. You should do just fine.
Go and sin no more.
**MODERATOR**> DENA YOU HAVE THE NEXT QUESTION:)
<DENA> DOES THE OPEN RNY HAVE ANY EFFECTS ON THE SECRETION OF
DOPAMINE AND SERATONIN, IF SO WHAT?
<Dr. Simpson> well dopamine and seratonin
are secreted in a number of places in the brain, and in the....
<Dr. Simpson> periphery, and they have a
number of effects, both as neurotransmitters....
<Dr. Simpson> and in addition, they have
almost opposing effects in different locations, so over all there is not
a broad effect that you can name...
<Dr. Simpson> there is, once you eliminate
some excess weight, a slight decrease then an increase in the seratonin
secretion...
<Dr. Simpson> in the hypothalmus of the brain,
and there is an initial drop and then increase in dopamine in the...
<Dr. Simpson> substantia nigra of the brain,
but we do not know if those effects are long term or not...
<Dr. Simpson> that is quite a question for
a Friday.
<DENA> THANKS
<Dr. Simpson> The drop in Seratonin secretion,
may be a reason for some post op depression, by the way.
<**MODERATOR**> GLORIA IN AK YOU HAVE THE NEXT QUESTION:)
<gloria in ak> while in regular chat earlier a ladysaid her doc
had her stop taking birth control pills to lessen the chance of blood
clots, (my doc didnt tell me to do that) is that something i should be
concerned about ?
<Dr. Simpson> Birth control pills do increase
the risk of blood clots in everyone. ...
<Dr. Simpson> Since I do the duodenal switch,
birth control pills don't work too well after the surgery....
<Dr. Simpson> for the first year or so, so
I have patients stop those as well as any who might be on ...
<Dr. Simpson> estrogen replacement therapy,
such as Premarin, to decrease the risk of blood clots....
<Dr. Simpson> not everyone does that, but
it is something that we advise all patients who are undergoing surgery...
<Dr. Simpson> of course, you have to take
other birth control precautions...
<gloria in ak> and does that include all forms of birthcontrol?
pills etc?
<Dr. Simpson> there are some things worse
than blood clots. Having a new child might be one of them.
<Gloria in AK> no kidding
<Dr. Simpson> no, just hormonal birth control.
The use of....
<Dr. Simpson> mechanical birthcontrol is ok.
<Gloria in AK> thanks
<**MODERATOR**> KRISTYN HODGES YOU HAVE THE NEXT QUESTION PLEASE:)
<Kristyn Hodges (-85> Can a post op or work out too much? and
are abdominal excersizes (crunches) ok to do soon after surgery especially
open DS?
<Dr. Simpson> After six weeks there is no
problem doing that.....
<Dr. Simpson> so, after six weeks, you are
healed well enough that you can exercise, and I would like it if you did...
<Dr. Simpson> because then, Kristyn, you
will think all of your weight loss is my fault, and you will send me many
gifts...
<Kristyn Hodges (-85> I am
<Dr. Simpson> and name government buildings
after me.
<Dr. Simpson> Perhaps a mountain or two.
<Kristyn Hodges (-85> thanks
<Dr. Simpson> So, keep on exercising, and
it will be just fine. Good luck, Kristyn -- you are doing great.
<Kristyn Hodges (-85> thanks...love ya babe
<**MODERATOR**> FRANKIE CA YOU HAVE THE NEXT QUESTION PLEASE:)
<Frankie-CA 10wks PO> I have been refused an edg by the insurance
co...already had the upper gi..I need a scoping what can I do to make
myself comfortable in the interim?
<Dr. Simpson> why you think you need an EGD....
<Frankie-CA 10wks PO> I was told by the surgeon that I need one..constant
diarrhea, vommitting 11 weeks PO...
<Dr. Simpson> Frankie-- then your surgeon
will have to appeal that, and work with a gastroenterologist to see why
you have that...
<**MODERATOR**> JANEFROM CANADA YOU HAVE THE NEXT QUESTION:)
<janefromcanada> I'm having lap-band surgery in march - I'm wondering
about a slow-down in metabolism due to rapid weight loss - also concerned
about energy level as I'm a middle school teacher and I plan to return
to work 11 days post-op
<Dr. Simpson> Jane, there is a slow down
with weight loss, but it can be overcome with a lot of walking,...
<Dr. Simpson> which is why I push it so much.
So, I want you to walk a lot and then you will not have that...
<janefromcanada> but what about energy level
<Dr. Simpson> the energy level will increase
as you increase your activity...
<Dr. Simpson> you won't feel like walking,
but the more you do, the better you will feel the following day...
<janefromcanada> so you think 11 dyas post op will be ok?
<Dr. Simpson> it is hard to get into that...
<janefromcanada> As long as I start walking right away?
<Dr. Simpson> 11 days post after a lap band
should be just fine.
<Dr. Simpson> keep running after those kids...
<janefromcanada> I will be!!!
<Dr. Simpson> if you have kids like I was
when I was in school you will be quite busy.
<janefromcanada> they're 6th graders!!
<**MODERATOR**> BETH YOU HAVE THE NEXT QUESTION:)
<Beth> what vitamins do you recommend? Someone mentioned prenatal..is
that okay? And also, how many a day?
<Dr. Simpson> Prenatal is just fine, as are
Flintstones, as are Vista Vitamins, which are advertised here...
<Dr. Simpson> as are baritec, and an assortment
of other vitamins. They are something you need, and the standard one a
day or two a day will do you just fine...
<Beth> How many do you receommend
<Dr. Simpson> I think you should get Dr.
Simpson's special vitamins, which I haven't formulated yet, but I will
if you pay enough for them...
<Beth> Okay..that is great! I just want to be as healthy as possible
<Dr. Simpson> essentially, you need one vitamin
a day
<Dr. Simpson> stay healthy. WALK!
<Beth> Why do other docs differ so much
<Beth> Some people take 12 a day!
<Dr. Simpson> because they are wrong.
<Beth> Thanks so much!!!! I appreciate this info
<**MODERATOR**> CINDY S YOU HAVE THE NEXT QUESTION:)
<Cindy-surgery soon> Do you recommend somebody sleep in a recliner
right after surgery? or is the bed ok? does it have to do with comfort
level or possiblitity of opening the incision? i'm having OPEN RNY (i
don't own a recliner at the moment but might be able to purchase one if
its nessessary)
<Dr. Simpson> The recliner is more comfortable
for a lot of people after surgery, so that is something you might think
about buying...
<Dr. Simpson> in addition to getting a hand
held shower apparatus, as well as a J-hook, and some baby wipes....
<Cindy-surgery soon> whats j hook?
<Dr. Simpson> Something that will reach your
back end when you have an incision on your front...
<Dr. Simpson> and cannot clean yourself.
Some medical supply places have them.
<Cindy-surgery soon> oh ok........thanks........
<Dr. Simpson> or a long pair of salad tongs--
which you don't need anymore.
<**MODERATOR**> KOLLADY YOU HAVE THE NEXT QUESTION:)
<kollady 3days till s> Dr.S Hello! I'm 5'9 280 and having surgery
on Monday. I have heard from others that the smaller u the slower u lose
ur weight, and the bigger the faster. Is this true?
<Dr. Simpson> Well, yes and no. You have
to remember that if you weigh 500 lbs going to 400 lbs is only losing
20 per cent of your weight...
<Dr. Simpson> so, they can do that in three
months or so, and you will lose twenty per cent in that period of time
also, but it wont be as much...
<Dr. Simpson> but trust me, the person who
weighs 500 lbs wishes they weigh 280. So, don't worry about it. But...
<kollady 3days till s> ok thank you
<Dr. Simpson> if you want to lose more weight---
WALK
<Dr. Simpson> oh, did I tell you to walk?
<kollady 3days till s> lol
<kollady 3days till s> Thank You
<Dr. Simpson> you are welcome
<**MODERATOR**> STACY LYNN YOU HAVE THE NEXT QUESTION:)
<Stacie Lynne> What percentage of people need blood transfusions
during surgery? I'm hoping to have open rny in Feb. Thanks (And I love
your humor-I thought you would say a J-hook was a Globe Trotter trick
shot)
<Dr. Simpson> Stacie it depends on a lot
of factors, I have had months of patients who never needed a transfusion,
then in one week I had two...
<Dr. Simpson> so usually we don't need blood
for this surgery, and about 5 per cent of the time it is a good idea to
have a little Italian Red...
<Stacie Lynne> are there any factors that make it more likely?
<Dr. Simpson> if you are anemic to start,
if you have some liver disease, if you have had a lot of previous surgery...
<Dr. Simpson> if you are blond. Lots of reasons.
<Stacie Lynne> Okey dokey... thanks....lol I'm not so I'm set
<Dr. Simpson> good luck, Stacie
<*MODERATOR**> KAREN YOU HAVE THE NEXT QUESTION:)
<Karen> Karen< I was wondering if a higher bmi makes the surgery
more dangerous are is it the same for everyone
<Dr. Simpson> A higher BMI does add morbidity
to the operation.....
<**MODERATOR**> BONNY YOU HAVE THE NEXT QUESTION
<Bonney> I would like to know if I will have to discontinue social
parties and drinking for the rest of my life after I have the sugery?
<Dr. Simpson> and in terms of social parties,
there is drinking after surgery.....
<Dr. Simpson> but you need to get to goal
first, then have a glass of whatever...
<Bonney> yeah
<Dr. Simpson> start with water.
<Bonney> how will I control the sickness at work?
<Dr. Simpson> Sickness is something which
you might not have, or you might....
<Dr. Simpson> so, you have to see how you
do.
<Dr. Simpson> If it is diarrhea, then you
have some things that you can do.
<Bonney> so will I have to half a trash can beside me?
<Dr. Simpson> No, Bonney, you don't
<Bonney> thanks
<**MODERATOR**> THERESA YOU HAVE THE NEXT QUESTION:)
<Theresa> how common is it to have post op complications and how
long out of post op contribute to death
<Dr. Simpson> Post op complications are something
that can happen....
<Dr. Simpson> and it depends on the extent
of what you are talking about...
<Dr. Simpson> in terms of wound infections,
they happen to about 10 per cent of WLS patients..
<Dr. Simpson> hernias to about 15 per cent
of patients.....
<Theresa> the connection of stomach to intestine
<Dr. Simpson> others are less, leaks about
1.5 per cent...
<Dr. Simpson> 1/200 for pulmonary embolus
leading to death...
<Dr. Simpson> so, there is a fair number
of complications, but it isn't too bad....
<Dr. Simpson> so go for it. Good luck.
<Theresa> it is the same for all surgeries
<Dr. Simpson> More with some bariatric patients.
<Theresa> thank you
<**MODERATOR**> JOYCE YOU HAVE THE NEXT QUESTION:)
<Joyce (pre-op)> RNY still has me a little scared due to the fact
that it alters my anatomy... I've never so much as broken a bone, had
stitches, had tonsils out, etc. I've heard the Lap Band is not nearly
as effective. What are your thoughts?
<Dr. Simpson> Lap band isn't as effective,
and it can also lead to other problems.....
<Dr. Simpson> the RNY has a better success,
and it is something which if you are going to go through surgery...
<Dr. Simpson> you might as well have something
which is more effective and something....
<Dr. Simpson> which will last and keep you
ok....
<Dr. Simpson> obesity also changes things
in your life, and things in your internal organs...
<Dr. Simpson> which you don't think about,
which are deadly, and which you don't need...
<Joyce (pre-op)> how can i get over the fear of it? i really need
the surgery!
<Dr. Simpson> so, better to have the RNY.
You cannot be over the fear of things...
<Dr. Simpson> that is the fun of it, like
jumping of the bridge with a long cord, but not too long....
<Dr. Simpson> we would worry if you were
not scared. Then we would be very worried...
<Dr. Simpson> we would think you were weird.
So, just look at what is going to happen without the surgery...
<Joyce (pre-op)> wow, i'd never jump off a bridge!!! Scardey cat
here!
<Dr. Simpson> and keep thinking about how
you want to dance at your grandkids wedding...
<Dr. Simpson> then go for it.
<**MODERATOR**> DIANE YOU HAVE THE NEXT QUESTION FOR OUR GUEST:)
<diane> I have arthritis in my knees and hips. when i'm postop
is there other exercise to do right away instead of walking?
<Dr. Simpson> Water aerobics, water aerobics.....
<Dr. Simpson> and water aerobics.......
<diane> thanks!
<Dr. Simpson> find the YMCA(background song
please)... or get a pool, come use mine....
<Dr. Simpson> good luck.
<**MODERATOR**> CINDY SURGERY SOON YOU HAVE THE NEXT QUESTION
FOR OUR GUEST:)
<Cindy-surgery soon> Anything you reccamend for pre ops to start
doing now?? my dr hasn't really suggested anything but other peoples doctors
have suggested starting protein, walking and multivitamins....Any advice?
And thanks for taking the time to talk with us!! oh yeah and How soon
post op can i go in a hottub?
<Dr. Simpson> Two weeks after surgery for
the hottub...
<Cindy-surgery soon> k
<Dr. Simpson> yes, starting water, walking,
and protein are good, as well as the vitamins...
<Dr. Simpson> the better shape you are in
when you go to surgery, the better you will be when you have the surgery...
<Dr. Simpson> and the better you will do
during surgery....
<Cindy-surgery soon> ok thanks :)
<Dr. Simpson> well, we all have those plateaus,
even those of us who have not had the surgery....
<Dr. Simpson> so, walk, and walk some more.
<Dr. Simpson> good luck
<**MODERATOR**> PAM YOU HAVE THE NEXT QUESTION PLEASE:)
<flamingo> is weights better than aerobics?
<Dr. Simpson> aerobics are better.
<Pam> I am 55 and Post Polio parapelgic.
<Dr. Simpson> love arobics.
<Pam> What exactly is RNY and how will not walking affect outcome
<Dr. Simpson> Not walking isn't a problem......
<Dr. Simpson> there are other things that
you can do to exercise.....
<Dr. Simpson> and I have operated on parapelegics
and they have done quite well...
<Dr. Simpson> motoring around in their wheel
chairs....
<Pam> What is RNY--stomach and intestine
<Dr. Simpson> so, the RNY is Roux En Y gastric
bypass, where a piece of intestine is hooked up to a small stomach pouch...
<Dr. Simpson> see my diagrams or the one
on this site....
<Dr. Simpson> it will be a good thing. Go
forth and surgerize.
<Pam> My dr says it will take 30-60 minutes is that right?
<Dr. Simpson> Well, Pam, that is a fast doctor,
usually the RNY takes about 2 hours, 3 hours for DS
<Pam> He says divides stomach and there is a small whole in the
smaller stomach that goes to the lower stoamch?
<Dr. Simpson> Pam, that is a vertical banded
gastroplasty, or a lap band...
<Dr. Simpson> and that will take 30 to 60
minutes.....
<Dr. Simpson> and see what you like. Good
luck.
<Pam> Thanks
<**MODERATOR**> JANEFROM CANADA YOU HAVE THE NEXT QUESTION:)
<janefromcanada> I'm wondering about the
port involved in the lap band surgery - I have a very rambunctious 4 year
old and a 15 month old - what if they jump on my stomach? Also what about
sex?? can your partner affect it? Oh geez - just saw your post on lap-band
haveing other problems? what are they? there's a very very long waiting
list for RNY in Canada....lap band is pretty much the only option here
if I want surgery in the next 3 years...
<janefromcanada> sorry for the multiple questions
<Dr. Simpson> No sex after surgery ever again.
<janefromcanada> WHAT?????
<janefromcanada> LOL
<Dr. Simpson> No, the port will not be a
problem, nor will rough housing...
<Dr. Simpson> and if that is the only option
you have then that is the only one you have....
<Dr. Simpson> then go for it.
<janefromcanada> well - I could wait about 3 years
<janefromcanada> for the RNY
<Dr. Simpson> you could, or you could come
to America.
<janefromcanada> what are the other complications involved
<Dr. Simpson> land of the free, home of the
brave....
<janefromcanada> how much for an RNY in US
<janefromcanada> ?
<Dr. Simpson> lap band have a high revision
rate, much higher than RNY...
<Dr. Simpson> and the cost of RNY varies from
about 15k on up...
<Dr. Simpson> good luck.
<janefromcanada> my lap band is costing me 15k Canadian
<janefromcanada> ack! what kind of revisions?
<janefromcanada> it's not successful?
<Dr. Simpson> they have to move the lap band
around, and refill and underfill, and move it, etc. Good luck
<Dr. Simpson> not as the RNY
<Dr. Simpson> RNY is better
<**MODERATOR**> STACIE LYNN YOU HAVE THE NEXT QUESTION:)
<Stacie Lynne> (Y-M-C-A it's fun to lose at the Y-M-C-A... great,
now I got that song stuck....) Me again, do you have any useful info to
reduce hair loss, I have very thin fine hair to begin with....
<Dr. Simpson> Hair loss does not happen to
all people, only about 30 per cent of folks....
<Dr. Simpson> and there is nothing you can
do to really prevent it. If you have some deficiencies in protein or zinc...
<flamingo> is "stapled and divided" mean transected?
<Stacie Lynne> didn't know that, I hear alot about it though.
<Dr. Simpson> it will make it worse, but
if you don't then it will just come and go
<Stacie Lynne> k, thanks again
<Dr. Simpson> I am lost with these question.
Moderator-- help...
<**MODERATOR**> HEATHER YOU HAVE THE NEXT QUESTION:)
<Heather> Dr. Simpson, what appears to be the revision rate from
earlier bypasses?
<Dr. Simpson> Revision rate from bypass--
if you have a jejuno-ileal bypass you will need to have the thing revised...
<Heather> Sorry Dr. Simpson, what are the rates of revisons from
past surgeries?
<Dr. Simpson> that is recommended because
of the high complication rates including liver failure...
<Dr. Simpson> in terms of old stomach stapling
surgery, there is a high rate from the horizontal stapling, and ....
<Dr. Simpson> lower from vertical banded,
the RNY has a small revision rate...
<Heather> I worry because Ive been revised RNY but have no dumping
<Dr. Simpson> but the key is that if you
have a revision, it is usually because something went wrong with the surgery...
<Dr. Simpson> not if you out eat your pouch..
<Dr. Simpson> So, rates are variable. Good
luck. Next???
<Dr. Simpson> that is for themoderator
<Heather> I wish they could explain, no disruption
<**MODERATOR**> GLORIA IN AK YOU HAVE THE NEXT QUESTION:)
<gloria in ak> I sauna a LOT 3/4 times a week, after surg, if
i sauna, will i have to increase the amount of water i would normally
drink?have to pretend i am in the sun lol:)
<Dr. Simpson> ok, Gloria.... my fellow Alaskan.
Yes, you will have to increase the water you drink....
<Gloria in AK> thank you sir
<Dr. Simpson> it is important to keep hydrated.
<Dr. Simpson> so drink, lots of water, lots
of it, and keep drinking it.
<Gloria in AK> aye aye sir :)
<**MODERATOR**> POCO YOU HAVE THE NEXT QUESTION PLEASE:)
<Poco 9/24/02> Hi Dr.Simpson.....what would you say makes some
peoples hair fall out after surgery and how can you prevent it or slow
it down? Thanks.... Oh someone just asked a question about hair so for
get this question, but thanks anyway
<Dr. Simpson> You are welcome POCO=== hair
today, gone tomorrow
<Dr. Simpson> use super glue, it will keep
the hair on.
<Poco 9/24/02> lol
<**MODERATOR**> ERIN YOU HAVE THE NEXT QUESTION PLEASE:)
<Erin> I was told I have a fatty liver and they are going to test
it further when I have my surgery. What is it they are testing exactly
or what are they looking for?.
<Dr. Simpson> What they will do is take a
small biopsy of the liver and see if you have cirrhosis, ...
<Dr. Simpson> that is what they will do.
The fatty liver will get better with time after your surgery..
<Gloria in AK> pm the moderator for ???
<Erin> and if I have it what is the treatment
<Dr. Simpson> the treatment for fatty liver
is having weight loss surgery and losing weight and avoiding carbohydrates
which cause it in the first place.
<Erin> I see thank you
<**MODERATOR**> MT YOU HAVE THE NEXT QUESTION PLEASE:)
<mt> Is the duodenal swithc better than the RNy?
<Dr. Simpson> The surgery which is best for
you is the surgery which your surgeon does....
<Dr. Simpson> a lot of people have the RNY
and do very well by it, and about 8 per cent of bariatric surgeries are
the DS...
<mt> <I have heard the DS does not give you dumping problems
<Dr. Simpson> and people do quite well with
that surgery also, it does depend....
<Dr. Simpson> dumping is not a problem, usually,
with the duodenal switch, although about five per cent of people will
have it...
<Dr. Simpson> in spite of what they say.
But DS does allow you to eat a few more things, and have a bit more normal
a life...
<mt> Do you know any doctors in TX who do the DS I think I am
more interestedin it than RNY
<Dr. Simpson> but you can overcome any surgery
with grazing and high carbohydrate dies....
<Dr. Simpson> I don't off hand...
<**MODERATOR**> LAWANDA YOU HAVE THE LAST QUESTION:)
<lawanda> would you say that a person who has the RNY has the
same life expectancy as someone who has never had bypass surgery? also
excess protein makes me have blood in my urine can a modified diet of
protein and carbs be as effective to control this problem?Dr. Simpson>
I don't know why excess protein would make you have blood in your urine,
however....
<Dr. Simpson> you can expect that you will
need to have a higher protein diet after the surgery....
<Dr. Simpson> and in terms of life expectancy,
you have to take in to account the following:
<Dr. Simpson> there is a risk of death from
surgery of about one in two hundred, and those people do not have ...
<Dr. Simpson> a normal life expectancy....
<Dr. Simpson> and there is also a risk of
death 12 times that every year for someone who is morbidly obese.,...
<Dr. Simpson> so that is another factor, All
in all, people who have morbid obesity are better off
<Dr. Simpson> to have the surgery than not,
so go for it and good luck. Good night everyone
<**MODERATOR**> THANK YOU SO MUCH DR. SIMPSON FOR JOINING US
TONIGHT, AND THANK YOU MEMBERS AS WELL!:)
<TAMMY> THANK YOU DR. SIMPSON! MEMBERS! PLEASE VISIT DR. SIMPSON
AT: WWW.ARIZONZBARIATRICCENTER.COM
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