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Hey there... I am throwing in my thoughts on this subject... While I

think its ideal to have the most educated surgeon with a comprehensive

WLS program... I believe that no one should rely on *only* their

doctor or nutritionist for information. From what I've read, by &

large, most doctors are advocates of hi protein post op & the

flinstones chewables... but there are so many variances which aren't

only because of the type of surgery. Even educated doctors do their

best, but will still err... the information I've learned from my own

research & taking in from others has been far & beyond everything I've

learned from my doctor, nutritionist & support group. However, that

may be beacuse I really enjoy the research & seek out the

information... I think its most important that one of us seeks out

and gets information from more than one place, and that each one of us

takes some responsiblity for our own care rather than rely *soley* on

the surgeons program.

Trish

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To and El,

I may have been a little strident in my defense of my surgeon and in knocking

others who may not have as complete a program as we do. I do get concerned

abut those surgeons who just cut and run and leave the postop recovery to the

patient. Followup and support groups are vital, but of course they don't

replace our own ability to inquire and read and learn about who and what we

are and what the surgery will mean to us both physically and emotionally. As

you can see from all the different postings there are so many different types

of WLS and programs for preop and postops that at times we are comparing

apples to oranges. I just get upset when I read patient questions that should

be answered by the medical people rather than us lay persons (although I

think some of us have become more knowledgeable than some of the medical

staffs).

El, Your surgeon sounds like a wonderful person as well as a good surgeon. We

are lucky to have found surgeons like that.

Bob Altman

Biliopancreatic Diversion (A Very Distal RNY) on 10/8/98

214 Pounds Gone Forever, But Not Forgotten!

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--

My doc is unique in the respect that he is also willing to learn from his

patients, too. He's admittedly learned from me. I do know what you mean

about being looked down on by the medical profession. I've had my share of

doctors tell me that my only problem was that I needed to stop eating. All

my medical situations would go away if I'd only lose weight. Some of those

have since gotten fat--serves them right! Well, had my 3rd abcess lanced

this afternoon, I do hear my bed calling. Now if boy wonder could only stop

these!

--El

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Dear Bob--

I guess that with everything I've gone through, I've become incredibly close

to my surgeon. It's no gross exaggeration that he's saved my life more than

10 times in the past 2 yrs. And now, with all the abcesses I've been

developing, it looks like the ride's not over yet.

I've certainly been on the educating side of some of my local medical

community. Because mine is the only doc here who does any form of wls, none

of the hospital staff or er docs, etc really knew anything about what I had

been through or how to deal with the complications I suffered. This has

caused doc to become very overprotective of his wls patients. So I guess in

that respect, we're very lucky. With the limited pre-and post-op resources

he provides, I still think he does a great job. And I like getting the input

of so many different experiences from the folks on the lists. As everyone is

so different, all the experiences have been very helpful to me. And I've met

some great people, to boot. Anyway, we'll all continue to learn throughout

this experience. It is a lifelong change after all. Take care.

--El

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El-

I think you're lucky, too! Your doc is one who is willing to learn, from

books, from the medical journals, from his own experience. I think that's

FABULOUS!! Many will NOT learn. They do it their way, no matter how many

failures they have. To some, we're just a bunch of losers (in the not nice

sense) anyway, so no big deal if a procedure fails.

My doc has been doing this for about 35 yrs, only this. BUT he continues to

learn! Amazing.

** No matter what my mail says in the " from " ,

please reply to me at: vitalady@... **

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Re: WLS mill

>From: Elfeline@...

>

>--

>

>I know that my particular case is a little extreme, but I would stand by my

>doc til the end. I remember waiting in the ER for him to get out of

surgery

>until 1 in the morning as I had to have a central line placed one night

when

>the dehydration and electrolyte imbalance got viciously out of control.

The

>ER staff was all buzzing about this little kid, 6 yrs old, who came in with

>completely torn up liver after an atb accident. Everyone was amazed that

the

>boy was out of surgery and doing fine in recovery. My doc had literally

>pieced the liver back together again. Last time I asked, the kid was doing

>fine and was back to being a little boy.

>

>I'm convinced that it was that kind of life saving approach and well

>rounded-ness that doc uses that caused him to never give up. I owe my life

>to that man. And deep down inside, he knows more about nutrition than he

>lets on--it's just his way. I never had to spend a minute more in the ICU

>than I had to with all my infections and life threatening malnutrition, but

>none were ever related to my wls. There were no dramatic diets to follow

and

>no special time frames. He simply takes each case on an individual basis

and

>lets us proceed at our own pace. We are all doing fine with his approach.

>Though his practice with wls is limited so far, he's never had a fatality

>related to vbg or rny. And he's gaining a reputation for fixing failed

wls,

>not just mine, and has now done a number of conversions to rny. I don't

>know--I've read a lot of stuff on these lists, maybe I'm just feeling very

>lucky.

> --El

>

>

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At 08:05 PM 12/20/99 -0800, wrote:

>But for those who have drawn a bad card, or perhaps were issued one by their

>insurance companies, at least here you can see folks 1+ yrs down the line

>and see what has and hasn't worked, or at least to a degree.

>

>Yes? No?

I guess the point I'm trying to make (and perhaps would be better made on a

list with pre-ops)... is that we MUST be informed consumers in WLS (and in

the follow-up medical care we receive associated with WLS).

We cannot just take the words of the medical profession as truth. In the

US, doctors are godlike. That needs to be debunked. I know more about my

body than any doctor. We have to do our own research (both scientific and

anecdotal) and come to the doctors we are screening with a list of

questions and information about our specific health situations and needs.

That's the best way to choose a medical practitioner. It should be like an

interview on both sides. There should be a few interviews, so information

can be digested and new questions can be raised (on both sides). If a

doctor treats me like *I'm* the only one who has to qualify, he/she is out

of the running as my health care provider. That's how Dr. Vierra

disqualified himself. I know he couldn't give a care about my judgement of

him, so can have no impact on his behavior; however, I voted with my dollars.

It's tricky for us, because we come to this surgery desperate, frustrated,

and in fear for our lives... not the most clear-headed approach to a

research project. At my goal, I'm only now just beginning to be present

enough to really advocate for the fine details I need in my on-going care.

At my highest weight, I may have had the intellectual capacity to research

WLS, but my hopes and desperation clouded some of my decisions. My low

self-esteem got in the way too. Thank goodness I had a good local health

library and access to the Web.

---------------------------

Hillary M. Russak

Technical Writer

Stanford Linear Accelerator Center

hrussak@...

'97 R1100RT, DoD #2106

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Hillary--

I agree with you wholeheartedly. After all, we are purchasing the doc's

services just as we would make any other purchase. Only in this case, our

lives are on the line. It sounds to me like you made the right choice and

are intelligent enough to make the wisest decisions. Looks like you're doing

pretty well with the after care as well. Keep up the good work.

--El

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Bob,

My surgeon has the full service deal, too. That isn't to say they have ALL

the answers. They have staff with some wild ideas of their own and have had

over the years. I asked my doc about something his PA said and he sort of

wrung his hands. I guess they can't control their every single word. Sigh.

We MUST be informed about ourselves, cuz even the staff cannot be perfect

and one flip remark to a patient can change the whole course of the person's

wt loss and health. There've been some Medically Astute people on staff

over the years who are NOT People Persons and WHOA, the havoc they wreak

just by not explaining things in enough depth. One girl understood that to

take care of herself meant going out and buying a new car!!! Yeah, that

helped when she was on TPN. Sigh.

I consider my doc one of the best you can get, but not on operation is

perfect. I'm thankful my doc can keep learning. That's critical. I had a

nervous moment there when he was going to adopt the common idea that

carbonation stretches the pouch. Some docs forbid 'em for life, he'd only

forbid them for the first little bit. WHEW! He let that idea go! Hahah!

Spoken by a True Carbonation-a-holic, I assure you!

They learn, they grow, they learn their limitations and the full service

docs fill the void, the other good surgeons like Hil 'n El have, they refer

or learn new skills. It's the Bad Guys, cut 'n run as you put it so aptly,

that scare me. When you call with your problem, they don't refer you on,

don't say it's out of their league, they just tell you to " Quit obsessing "

or " Get counseling " !

Those of us with good docs may not even APPRECIATE what we've got til we

hear someone else's horror story of abuse or neglect! I'm quite thrilled to

hear the good stories, though! Even if they do stuff differntly from my

doc!

** No matter what my mail says in the " from " ,

please reply to me at: vitalady@... **

Thanks!

Please visit our web site at:

www.vitalady.com

Re: WLS mill

>From: RAltman813@...

>

>To and El,

>

>I may have been a little strident in my defense of my surgeon and in

knocking

>others who may not have as complete a program as we do. I do get concerned

>abut those surgeons who just cut and run and leave the postop recovery to

the

>patient. Followup and support groups are vital, but of course they don't

>replace our own ability to inquire and read and learn about who and what we

>are and what the surgery will mean to us both physically and emotionally.

As

>you can see from all the different postings there are so many different

types

>of WLS and programs for preop and postops that at times we are comparing

>apples to oranges. I just get upset when I read patient questions that

should

>be answered by the medical people rather than us lay persons (although I

>think some of us have become more knowledgeable than some of the medical

>staffs).

>

>El, Your surgeon sounds like a wonderful person as well as a good surgeon.

We

>are lucky to have found surgeons like that.

>

>Bob Altman

>Biliopancreatic Diversion (A Very Distal RNY) on 10/8/98

>214 Pounds Gone Forever, But Not Forgotten!

>

>

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Hil,

Amen to that. I knew NOTHING when I had my surgery. NOTHING. I fell into

the best situation for me. I came THIS close to a VBG which would've been

disastrous for me.

I was years away from being able to research anything. I'd heard of ONE doc

who did this. Mine. AS far as I knew, he was the only one in the state!

Whew! Now, I just think he's the BEST in the state!

You guys who had the net available and these groups are SO lucky to have

known in advance what you were getting. I TOTALLY lucked out. But no one

could answer my nutritional questions to my satisfaction, so the range of

products was NIL in 1994. That's WHY I do what I do. Self defense!

But yes, you DO vote with your dollars. Many get an idea that this or that

surgery is what they want because they've been sold a bill of goods by a doc

whose ideas are slanted. We have a local doc that promises 80% of excess

lost with a VBG, and claims NO staple line disruptions. His 80% claim,

though, only holds true if you run as many miles a day as he does. That's

kinda difficult for a 450 lb person with failing knees or ankles, huh? So,

in researching, I think it critical to talk to pts 2+ yrs out and see where

they REALLY are, how hard they must work to maintain and how their heads

are.

Yes?

** No matter what my mail says in the " from " ,

please reply to me at: vitalady@... **

Thanks!

Please visit our web site at:

www.vitalady.com

Re: WLS mill

>From: hrussak@...

>

>At 08:05 PM 12/20/99 -0800, wrote:

>

>>But for those who have drawn a bad card, or perhaps were issued one by

their

>>insurance companies, at least here you can see folks 1+ yrs down the line

>>and see what has and hasn't worked, or at least to a degree.

>>

>>Yes? No?

>

>I guess the point I'm trying to make (and perhaps would be better made on a

>list with pre-ops)... is that we MUST be informed consumers in WLS (and in

>the follow-up medical care we receive associated with WLS).

>

>We cannot just take the words of the medical profession as truth. In the

>US, doctors are godlike. That needs to be debunked. I know more about my

>body than any doctor. We have to do our own research (both scientific and

>anecdotal) and come to the doctors we are screening with a list of

>questions and information about our specific health situations and needs.

>That's the best way to choose a medical practitioner. It should be like an

>interview on both sides. There should be a few interviews, so information

>can be digested and new questions can be raised (on both sides). If a

>doctor treats me like *I'm* the only one who has to qualify, he/she is out

>of the running as my health care provider. That's how Dr. Vierra

>disqualified himself. I know he couldn't give a care about my judgement of

>him, so can have no impact on his behavior; however, I voted with my

dollars.

>

>It's tricky for us, because we come to this surgery desperate, frustrated,

>and in fear for our lives... not the most clear-headed approach to a

>research project. At my goal, I'm only now just beginning to be present

>enough to really advocate for the fine details I need in my on-going care.

>At my highest weight, I may have had the intellectual capacity to research

>WLS, but my hopes and desperation clouded some of my decisions. My low

>self-esteem got in the way too. Thank goodness I had a good local health

>library and access to the Web.

>---------------------------

>Hillary M. Russak

>Technical Writer

>Stanford Linear Accelerator Center

>

>hrussak@...

>'97 R1100RT, DoD #2106

>

>

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El,

I know how you feel. I too had serious complications with the WLS and again

just recently with my hernia repair and tummy tuck. I bleed and use up all my

clotting factors. Nearly bled out 3 times in the 2 surgeries (I am going to

s Hopkins to find out why I bleed so much). After last year's WLS I

ruptured an artery and spent 3 weeks on life support and was not expected to

live. I fooled them. I lived because of the many docs including my surgeon

who would not give up on me. My surgeon held my ruptured artery for a long

time until they could find the source of the bleeding and then fix it and

remove my spleen. he had given me my life back many times and I feel very

close to him and his staff. He comes to our support group meetings and then

we all go to dinner after each meeting. When you break bread with your

surgeon he becomes more than just your doc. He is a friend in whom we trust

our lives.

Hope your complications improve and you feel better. You know, I would have

the WLS again in a heartbeat even knowing that I would have all the same

complications. All that matters is that I am finally thin. I can deal with

all the rest. I have control over my life now and it is great.

Have a great holiday and wonderful new year. 2000 is our year!!!

Bob Altman

Biliopancreatic Diversion (A Very Distal RNY) on 10/8/98

214 Pounds Gone Forever, But Not Forgotten!

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To Curran,

We are lucky to have such great docs. Our support groups are run by the

patients and we are involved in talking to new patients and helping many who

have complications. This is very complicated and serious surgery and

complications occur often. Many are the result of patents ignoring what they

are told (like drinking Gatorade a week after surgery, or eating pea soup in

the hospital and getting sick). We try not to blame the patient, but

sometimes you just want to slap some upside the head and yell " Aren't you

listening? " We joke that Dr. Marcus didn't operate on our brains, just our

stomachs. We all have done dumb things with food even those of us more than a

year postop.

I'm rambling. Time to go to bed. Take care. Have a great Holiday.

Bob Altman

Biliopancreatic Diversion (A Very Distal RNY) on 10/8/98

214 Pounds Gone Forever, But Not Forgotten!

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Dear Bob--

I followed your most recent difficulties with amazement that you could come

through so much. I don't know, but with everyone telling me how much I've

been through, I still feel so lucky when I read stories like yours. I too

almost died more than 10 times in the past 2 years, not from the bleeding

episodes you experienced, but through systemic infections. In my case they

know what caused my problems: a sloppy nurse infected me after withdrawing a

needle out of a central line and then reinserting it without wiping off the

needle or the port. It didn't take too long for my temp to skyrocket to

105-106 and, of course, the ICU followed. All this was made worse by my

compromised nutritional status due to the failed vbg, and I'm sure adds to

the problems I'm encountering now with these seemingly endless abcesses.

You're right--all of this has drawn my surgeon and I extremely close. We

haven't had the luxury of " breaking bread " together as I am just now able to

eat after 2 years, but it seems that all it takes is one look and he knows

when something is wrong. I saw him yesterday for a regular checkup and he

instinctively knew I wasn't just right--he put his arm around my shoulder and

gave me a hug when he came in the room and asked what was wrong. It turned

out to be yet another abcess which had to be lanced and packed. Urgh--will

it never end? My system seems to be becoming resistant to more and more

antibiotics after this whole ordeal. And I'm afraid that eventually I will

die from an infection that they just won't be able to treat.

I agree with you that there is nothing like being thin! I too would go

through it all over again, with all the complications and 5 surgeries, if I

had to. And I haven't even begun the plastic surgery yet!--I haven't been

stable enough--so I really can't wait to see what I'm going to look like with

a figure. I've never in my life had one as I've been extremely overweight

since childhood.

Happy holidays to you as well. This has to be our year, doesn't it?--after

all, it can only get better when you've hit the bottom.

--El

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