Letter to my PCP: In response to his email about the DS surgery. Fw: surgery

[Guest guest]

>

> surgery

>

>

> > Ms. Whitlow,

>

> Hello Dr. McClure..

>

> > Thank you very much for the information you provided regarding

> obesity

> > surgery.

>

> You are welcome.. thank you for taking time to check into it for and with

> me. I feel confident that you will see that this is a viable procedure,

as

> well as the best answer for my health related problems. Most of which are

> related in some way to my weight. I have tried so many diets in my

> lifetime, and if I lose some weight, it all comes back plus more.. I was

> resigned to be obese for the rest of my life, until I started researching

> this option.

>

> For once in my life, I have *hope* in this procedure/surgery. I have been

> large for most of my life, due to severe emotional trauma and emotional

> abuse during my childhood/young adult life. It was only after 1 1/2 years

> in a 12 step program for adult children of alcoholics that I finally

learned

> it wasn't my fault.. I also attended an intense workshop for 16 weeks

> titled.. " 12 step program for damaged emotions " It was there that I

> revisited much of my pain that had been suppressed for most of my adult

> life. I know you probably don't have time to hear about my heartache and

> pain that put this weight here, and caused me to find comfort in food..

> However, it is the cause of it. Emotional abuse could have killed me, had

I

> chose the path that led to drug abuse and alcohol abuse.. However, I

didnt'

> do that.. I turned to food.. I am a current member of OA, and ACOA.. and

do

> continue to work on my issues with food. the compulsive eater is in the

> past. Now, I just want to get rid of the last part of the cycle of pain.

> that is this weight.

>

> >I have read it and need to do further research.

>

> How can I help you, Dr. McClure? here are some URL's that you can use to

> aid in your research.. these are what led me to this decision. Also, I

have

> included the doctor's email in Georgia, so that you can communicate with

him

> as well. He will most likely welcome any questions you may have. He will

> respond, altho, it does take him a while.. due to his surgery schedule. It

> is reported that he reads his email in the early morning hours before his

> day begins, and answers accordingly. Of course, he is also available by

> phone, too. His website is also included at the bottom of the page.

>

> As I mentioned to you, Duke's Dr. Grant wants me to do the unthinkable. I

> will stay obese the rest of my life, before I will allow him or any doctor

> to further cut my quality of life by sticking a catheter in my chest, for

> *nutritional* feeding for 10-14 hours a night..for as long as two (2)

years!

> I know, and you do too.. that the HS will flare up whereever a foreign

> obeject is stuck in my body.. there IS NO way.. Not to mention that

Medicaid

> will not pay close to $800,000.00 for this. Smart people, if you ask me.

> It is also still experimental. Dr. Grant developed it, and has not had

that

> many patients according to his website.. He has no updated reports

available

> either. I have asked him.. that report on his site is from 1994. I would

> like to talk to the woman that did this surgery, if she is still alive..

> Yes, I am very disillusioned with him and his *so-called safe*

procedure..He

> had no regard for the fact that I have HS, either. that really bothered

me,

> the way he acted as if every other person deals with HS.. Goes to show how

> much learning he has done.. Not to mention the fact that he point blank

told

> me in my consultation with him that the nutritional feeding is how he

makes

> his money. Also, he will not even consider learning the duodenal

> procedure.. His exact words were that he didn't need to learn anything

new.

> IMHO, when a Doctor stops learning, his patients begin to suffer.. But

this

> is just My Opinion..

>

> I have given you both his printout, and the duodenal patient brochure. On

> the duodenal switch site.. (www.duodenalswitch.com) there is a report

there

> by the founding physician called the Hess report. It is a study of 10

> years, that has 440 patients mentioned, and how the success of the

procedure

> has charted over the years.. Most of the patients were considered morbidly

> obese.. this procedure has high success rates for MO people. Most

patients,

> if not all of them, reach the weight that they are supposed to be w/in 1

to

> 2 years. They can eat normally, have a normal portion, and be just

> fine!..The co morbidities of the people involved were decreased or

absolved

> completely with the loss of weight..

>

> the link for Dr. Hess's report, as well as 2 other medical journal reports

> on the surgery are:

>

> http://www.duodenalswitch.com/Procedure/1998Hess/1998hess.html

>

> http://www.duodenalswitch.com/Procedure/1998BPD/1998bpd.html

>

> http://www.duodenalswitch.com/Procedure/93Marceau/93marceau.html

>

> The BPD/DS procedure reduces the stomach along the greater curvature,

> effectively restricting its capacity while maintaining the its normal

> functionality. Unlike the BPD and the RNY procedures, which employ a

gastric

> " pouch " and bypass the pyloric valve, the DS keeps the pyloric valve

> intact -- a main benefit of which is the elimination of dumping syndrome,

> marginal ulcers, stoma closures and blockages. Unlike the BPD and the RNY,

> the DS keeps a portion of the duodenum in the food tract of the small

> intestine, enabling more-normal absorption of many nutrients, including

> calcium, iron and vitamin B12.

>

> > I will try to contact

> > you within the next 2 weeks regarding my final decision on whether or

not

> to

> > refer you to Georgia.

> Considering that I have only been checking into this for about 2 months, I

> believe that I have a vast amount of information on this procedure.. It

is,

> in my mind and heart, the answer for me.

>

>

>

> On a more heartfelt level.. I can't explain to you how the weight, the

> edema, the Hidradenitis Suppurativa, and the sleep apnea affect my self

> esteem. My legs are hideous to me now, because of the leg ulcer scarring,

> and the deep scarring left from the cellulitis. Over the years, I have

> resigned my mind to accept what I can't change.. also to have the courage

to

> change the things that I can.. and I CAN change the rest of my life. with

> this surgery, Dr. McClure. You have been very caring and also blunt with

me

> since you have been my Doctor.. you have told me how afraid you are that

my

> weight will cause me further harm that it has already.. *ie. possible

> diabetes, heart problems, et al.. * I have heard you loud and clear..

> Betcha didnt' think I was listening, did you? It has hit me square in the

> face this past year, with all the trips to Duke for various doctor

visits..

> having my legs wrapped in Duke Unna Boots, and having to deal with the

> terrible swelling, and excruciating pain if I chose not to wear them.

Which

> I won't.. I just want my life back, Dr. McClure.. Is that too much to ask?

> Do I have to deal with all of this pain forever? Can't I have a life free

> of the vast majority of it? Do I not deserve this? I must admit to you,

> that even tho I believe in my heart that you will support my decision, and

> refer me to see Dr. in Georgia, there is also a huge part of me that

> is scared to death that you will not. and If you don't, what other

choices

> are available to me? I must have a referral from my primary care

physician.

> I need a committment from you to do my followup care after the procedure

is

> done, and while I am losing weight.. to make sure that I am keeping my

> vitamin levels up, as well as my protein levels.. I need an internist..

that

> is you. .and honestly, I would rather have you as my follow up physician..

> because you are very familiar with my history.. Plus, would it not be

**WAY

> COOL** to see me drop the weight, and experience my excitement with each

> block of weight that comes off? I tell you, I will want to throw a party

> when it is over.. I honestly can't imagine myself any smaller than 365,

> cause that is where my memory stops.. I don't remember being too much

> smaller than that.. I can't fathom being my goal weight of 175. the last

> time I weighed that, I was probably 13. I can't say for sure tho.. that

> period in my life was hell for me. I remember having a late start on my

> monthly cycles.. I wonder now if that wasn't related to my weight as well?

>

> Lastly.. I am getting married.. I have, at long last, finally found a man

> that loves me just like I am.. but ya know what? I want children with

this

> man.. Can you tell me that getting pregnant at this weight will not

> adversely affect me? I dont' think so. I want to be able to raise my

> children, and go play with them in the park.. I want to be abel to get on

> the floor and play with them, in their formative years.. I want to be able

> to learn to roller skate with them, ride a bike with them.. Go camping..

> sleep in a tent, on the ground for heaven's sake. I want to be able to go

> to the grocery store, and not have to use an electric cart to get around

the

> store, cause I cant' walk it. I want to stop the progression of the HS as

> much as I can.. I want to wear normal *feminine* shoes.. instead of

athletic

> shoes, cause nothing else fits and supports my feet. I want to be able to

> attend my future children's plays, and recitals, and school functions

> without worrying whether or not I will be able to *FIT* in the school

> auditorium seating. I don't want my children being ridiculed by the other

> kids at school because their mom is a fat cow.. I know that will happen

> too.. my memory still burns with the names that I was called in school..

I

> want to be able to go to the amusement parks and RIDE the rides.. not

> worrying about whether the bar will lock in place over my tummy.. or be

> mortified when the person there tells me that I can't ride the ride, cause

I

> can't be held in due to my weight or inability to secure myself. I want

to

> be able to stand in my kitchen and cook a meal without being in pain from

> standing too long.. I want to be able to have the energy to clean my

house,

> for crying out loud..I want to be able to hold my head up high, not afraid

> to speak out for what I believe in.. I want to be able to be proud of me

> again.. I was once.. I haven't been for a really long time.. Society shuns

> the large/obese person.. Stereotypical reasoning leads the average thin

> person to believe that fat folks are like that, because they eat too much,

> or because they are lazy.. that is so not true.. Having mobility is a

dream

> that I have often these days. it is very hard for me to just walk from

the

> parking lot into a store.. so I dont' go. unless I must.. When I come to

> see you, I can't check in if the line is long, cause I can't stand there

> while Beth or the other people there check others in first. I can't sit

in

> those chairs in the waiting room, cause I dont' freaking FIT. It is so

Damn

> unfair that society judges the Obese American. It is even worse that

there

> isnt' a surgeon in this state that does the DS. there is a whole BUNCH of

> them that do the VBG, the RnY, the Gastric Bypass, stomach staple.. et al.

>

> I know this has been a really long email, and I apologize for the length

of

> it. I wanted to say these things to you when I saw you the other day, and

> time restraints didnt' allow me to. there is soo much riding on this

> decision.

>

> I said above that Dr. Grant's procedure is on my No Way list. I should

> probably say the RnY is as well.. I dont' want to risk having that stoma

> close up, and having to have an endoscopy at any given time in my life,

for

> the rest of my life, so that I will be able to digest my food. I dont'

want

> to run the risk of not knowing if I will throw up my food in a dumping

> syndrome.. I don't like throwing up.. I never have been one to do a lot of

> that normally.. I also don't want to run the risk that the pouch will come

> open, and then my stomach will return to it's regular size, and I will be

> once more be obese. Also.. in all of the research that I have done on the

> RnY, most patients are no more than 300 when they do this RnY.. and the

> studies all say that the RnY Patient will lose about 100 pounds.. well

that

> would put me at 325.. still Obese.. why go thru something this major if I

> won't be able to lose it all? .

>

> I dont' have those risks with the duodenal switch.. I have different ones,

> that is true.. smelly flatulence, I am told. flatulence smells anyway,

> doesnt' it? LOL.. From what I can tell from the people that have had the

DS,

> the complications are few and far in between. if at all. I know that

> exercise is vital as well as taking vitamin supplements. I am committed

to

> *ME*, meaning that if that is what I must do, then do it I will. I know

> that my edema will all but go away.. I know that my sleep apnea will be a

> thing of the past. I know that the HS will be almost non existant,

because

> there will be no place for it to develop, w/out extra skin folds.. I dont'

> expect the HS to dissipate, but even Dr. Levin believes that it will be

tons

> better.. He supports the WLS. he is the one that sent me to Dr. Grant.

He

> has also committed to doing any tummy tucks, butt tucks, arm tucks, groin

> tucks, back tucks.. whole body tucks that need to be done once the weight

is

> lost. I think that alone stands as a viable physician support.. Cause he

> would not do that, if he didnt' believe in WLS..

>

> Point being that I will have my quality of life restored to me, Dr.

McClure.

> Ya know, when you sent me to Dr. Letteiri for the HS surgery.. the

statement

> you made on your referral slip for the plastic surgery was to give the

> patient a higher quality of life.. You can do that with your support and

> referral for this surgery..

>

> I would be forever grateful for your supporting me in this matter.. If

there

> is anything else that I can do to further aid your decision making

process,

> please do not hesitate to email or call me at .. I need your

> support..

>

> I will shut up for now.. *aren't you glad*

> I will follow up with you in a few days to make sure that you got this

> email. I also copied Dr. on this email as well, so that if you did

> choose to contact him, he would be familiar with your name and your

hospital

> affliation.

>

>

>

>

>

>

> >Who is the Surgeon you want to be referred to?

> >

> >

> > Sincerely,

> >

> > McClure, MD

> >

>

>

> This is the most current list of known Duodenal Switch surgeons, along

with

> their contact information, if available.

> Surgeons indicated with an asterisk (*) offer the procedure

laparoscopically

> for appropriate candidates. Consult with the surgeon for more information

on

> whether you might qualify for the lap procedure.

>

>

> GEORGIA

>

> Marietta

>

> * Dennis C. , Jr., M.D., F.A.C.S. (photo)

> E-mail: drdennissmith@...

> Phone:

> Fax:

> Advanced Surgical Group

> 800 Canton Road

> Marietta, GA 30060

> http://www.mini-surg.com

> http://www.ObesitySurgeryCenter.com

>

> The USC Approach to Obesity Surgery - Dr. Anthone

> http://www.surgery.usc.edu/foregut/bariatric/

>

> The Pacific Institute - Dr. Rabkin

> http://www.pacificsurgery.com

>

> Mt. Sinai Medical Center - Dr. Gagner

> http://www.surgicallyslim.com

>

> Central Valley Bariatric - Dr. Keshishian

> http://www.gr-ds.com

>

> New Life Surgery Center - Dr. Maguire

> http://www.newlifesurgery.com/

>

> Dr. Picard Marceau, Laval, Quebec, Canada

> http://obesity.chair.ulaval.ca./associates.html

>

> Dr. Aniceto Baltasar, Alcoy, Alicante, Spain

> http://www.drbaltasar.com

>

> Advanced Surgical Group - Dr.

> http://www.mini-surg.com

>

>

> thank you again for all that you do and will do for me, to restore my

> quality of life..

>

> Sincerely

> Whitlow

>

>

>

>

>

>

[Guest guest]

Cia....That was such a beautifully written letter. It's hard to imagine

how your doctor would not give you a referral after reading what you

wrote and checking out your research. Good Luck!

That " nutritional feeding " is a new concept and term to me.....sounds

like that doctor is trying to pay off his new mansion! And it sounds

absolutely ridiculous compared to a DS. I am not real clear on what it

involves but I got this image of a poor, trusting patient lying in a

hospital bed with a tube in their chest for a couple years????? Wonder

what insurance companies approve that sort of medieval torture?

=====

H

Dr. Keshishian/surgery 11-21-2000

San Francisco Bay Area

mailto: hillsmith2000@...

__________________________________________________

[Guest guest]

> > ,

I had explored the nutritional feedings in my research. You are

correct that is not the way to go. Some of these surgeons prey on the

desperation of the morbid obese. What Dr. Grant's program is, is

similar to the optifast but it is he's own concoction. The taste is

not tolorated so it is put in through a tube into the stomach for up

to two years. Then he performs a RNY AFTER the patient loses all the

weight. The last I heard he had a study of 7 patients and that two

had died of unrelated causes. I am sure that he believes that his

program works and something that drastic does work, but I think it is

overboard. In the end you end up with weight loss surgery anyway. He

is not doing anything new, he is just making things harder, more

complex and more expensive. If you just had the DS I think you would

be at the same weight in two years on your own.

I had to laugh thinking about if I were to go that way. I can picture

me out on a dinner date. Oh excuse me I just need to insert this bag

of glop into my chest, yes it does smell like ten day old fish, but

after a few more dates you'll get used to the smell Darling......