Re: Your assistance please

[Guest guest]

Sounds like possible symptoms of dehydration. How's her oral fluid intake?

-----Original Message-----From: [mailto: ]On Behalf Of arrigonkSent: Tuesday, June 21, 2005 3:02 PM Subject: your assistance pleaseI have a patient who admitted for observation who had a Roux-en-Y in February of this year. We do not do surgery here, but I do see some patients pre and post op. About a month after surgery she began having problems with vomiting. She was not eating large amounts of food or eating too fast. She has been able to tolerate fewer and fewer foods over time. She recently had a dilitation. She is eating a small amount of food (she tolerated 1/8 cup of applesause at lunch), but continues with nausea, dizziness, dry heaves and a head ache. She has not had good luck with tolerating protein supplements in the past, so she is declining them now. She did agree to try some milk with beneprotein this afternoon. Her lipase and amylase are elevated. Any ideas?

[Guest guest]

Does she have an ulcer?

your assistance please

I have a patient who admitted for observation who had a Roux-en-Y in

February of this year. We do not do surgery here, but I do see some

patients pre and post op.

About a month after surgery she began having problems with vomiting.

She was not eating large amounts of food or eating too fast. She has

been able to tolerate fewer and fewer foods over time. She recently had

a dilitation. She is eating a small amount of food (she tolerated 1/8

cup of applesause at lunch), but continues with nausea, dizziness, dry

heaves and a head ache. She has not had good luck with tolerating

protein supplements in the past, so she is declining them now. She did

agree to try some milk with beneprotein this afternoon. Her lipase and

amylase are elevated.

Any ideas?

[Guest guest]

She should be evaluated medically to rule out an ulcer, stricture or internal hernia. Internal hernias often present with nausea, though depending on location, there might not be any actual vomiting. There may be defects -- either those created by the surgeon such as a 's defect or a mesocolon defect, or those that occur as weight loss progresses and with adhesions. If hernias became incarcerated or an actual obstruction occurs, it can be life threatening. Nonetheless, she needs a full work up including an upper GI, EGD and CT.

If she is unable to consume adequate nutrition po, you have to consider alternative approaches. Some of her syptoms could be secondary to dehydraton.

Jeanne Blankenship, MS RD

-------------- Original message from "arrigonk" <arrigoni.karla@...>: -------------- I have a patient who admitted for observation who had a Roux-en-Y in February of this year. We do not do surgery here, but I do see some patients pre and post op. About a month after surgery she began having problems with vomiting. She was not eating large amounts of food or eating too fast. She has been able to tolerate fewer and fewer foods over time. She recently had a dilitation. She is eating a small amount of food (she tolerated 1/8 cup of applesause at lunch), but continues with nausea, dizziness, dry heaves and a head ache. She has not had good luck with tolerating protein supplements in the past, so she is declining them now. She did agree to try some milk with beneprotein this afternoon. Her lipase and amylase are elevated. Any ideas?

[Guest guest]

Hi. Congratulations on making this life changing decision. Personally, I was turned down by two other 'Mexico' WLS Drs. ...then I found Dr. Aceves. Dr. A does quite a few 'high risk' patients - those that others won't. To say that Dr. A is the best of the best is an understatement! He and his whole team are one in a Million. The hospital is better than most here and the care is top notch. I live in the S. Ontario/Chino area."jillie.diane" <jillie.diane@...> wrote: I've made up my mind that I am going to do this. How did you all decide which Dr to choose? I'm in Palm Desert CA. Anyone in my area?

Never miss a thing. Make your homepage.

[Guest guest]

A friend of mine is a surgeon in Mexico (trauma, not bariatrics) and he helped me do the research. After we were pretty sure we had decided on Dr. Aceves called several of his MD friends throughout Mexico. He asked his MD friends if they were going to have bariatric surgery or if their family members were going to have surgery, which doctor would they go to? They ALL said Dr. Aceves. There was no question about it. They all knew him or knew of him and without exception, they all said they would go to Dr. Aceves.

It was kind of a no brainer at that point. ;o)On Feb 12, 2008 4:38 PM, Jane Moss <joy4jane66@...> wrote:

Hi. Congratulations on making this life changing decision. Personally, I was turned down by two other 'Mexico' WLS Drs. ...then I found Dr. Aceves. Dr. A does quite a few 'high risk' patients - those that others won't. To say that Dr. A is the best of the best is an understatement! He and his whole team are one in a Million. The hospital is better than most here and the care is top notch. I live in the S. Ontario/Chino area.

" jillie.diane " <jillie.diane@...> wrote:

I've made up my mind that I am going to do this. How did you all decide which Dr to choose? I'm in Palm Desert CA. Anyone in my area?

[Guest guest]

Thank you so much for answering me. I need the reassurance. Why were you turned down? Hope that is not too personal to ask. How long have you had your band? Are you happy with it? Are you loosing weight? Any info that you are willing to share will be greatly appreciated.

Re: Your assistance please

Hi. Congratulations on making this life changing decision. Personally, I was turned down by two other 'Mexico' WLS Drs. ...then I found Dr. Aceves. Dr. A does quite a few 'high risk' patients - those that others won't. To say that Dr. A is the best of the best is an understatement! He and his whole team are one in a Million. The hospital is better than most here and the care is top notch. I live in the S. Ontario/Chino area."jillie.diane" <jillie.diane> wrote:

I've made up my mind that I am going to do this. How did you all decide which Dr to choose? I'm in Palm Desert CA. Anyone in my area?

Never miss a thing. Make your homepage.

Never miss a thing. Make your homepage.

[Guest guest]

I made a spreadsheet of pros and cons on the Mexico Dr.'s, I had it down to 3 docs. One was in Monterey - too far away, one was Tijuana - while my family was NOT supportive of Mexico my sister who lives in San Diego FREAKED about me going to TJ. She told me I wasn't allowed to get a t'shirt from TJ much less surgery. And that left Dr. Aceves. The TJ dr was cheaper but he did surgery in a clinic, not a hospital. Dr. A does surgery in a hospital, I got a funny feeling when I talked to the pt coordinator at the TJ clinic, I loved from Dr. A's office the first time I talked to her. Things like this I "mapped" out and went with Dr. Aceves. I also asked for his referral list and called about 20 people on his list. I needed to talk in real life to people that

had gone to him. I thought websites and groups like this can all be made up but real people can't I actually called a gal and she happened to be in the van with Ernesto going to Dr. A for a fill and she was bringing her daughter and daughter in law for surgery! Can't get much of a better referral than that Please feel free email me privately if you would like my phone number to talk to a real person Good luck with your decision. Cyrena WeeksDOB: 1/19/07240/144/145start/current/goal Your assistance please

I've made up my mind that I am going to do this. How did you all

decide which Dr to choose? I'm in Palm Desert CA. Anyone in my area?