Re: Who Has Had BPD/DS Surgery Weighing Over 400 Lbs?

[Guest guest]

I am having " open " aaltho I'm under 400 lbs. My BMI is 69. My understanding

is that research from Dr. Gagner at Mt Sinai is showing people with BMIs 60+

are better off having open or 2 part lap.

From my point of view, I'm going to one of Gagner's team. I chose them

because of reputation. If that's the way they want to do it, then that's the

way I'm gonna have it. I have to trust their judgment or why did I choose

them?

I'd rather have lap but at this point I just want to get on with it as

safely as possible.

n

n Boden (maboden@...)

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[Guest guest]

Could you please explain " abdominal compartment syndrome " .

- In duodenalswitch@y..., " Montgomery " wrote:

> It might help if you post the name of the surgeon so that we can

understand

> who is restricting surgery based on your weight. We are seeing

more and

> more surgeons talking of a 2 stage surgery for some folks. I think

the

> inabdominal pressure post op for folks who already have abdominal

> compartment syndrome can be deadly. I suspect that the 2 stage

surgeries

> are being done to reduce the post op morbidity and mortality risks.

>

> However, Doug's recent post indicates that Dr Gagner does very MO

folks. He

> started at 500 lbs. And I think Dr G does lap for many of those

very MO

> folks.

>

> in Seattle

>

> ----- Original Message -----

> From:

> > I'm trying to find out who has had BPD/DS Surgery and weighed

over 400

> > lbs.

> >

> > A doctor I saw yeserday told me he could only do it open (not

lap) and

> > besides its being a complex operation (aren't they all?) it is

HIGHLY

> > risky since I'll be under on the table so long, yet a lap BPD/DS

is

> > the same amount of time. His point was he feels the cardiac and

> > pulmonary stress is higher on a person above 400 lbs. than on one

> > below and I'm trying to find out how true this feeling/statement

of

> > his is.

> >

> > For those over 400 that had this done, I'm trying to find out what

> > complications (if any) happened and who/where the doctor was that

yous

> > used. I'm willing to travel.

> >

> > The doctor I saw yesterday offered doing a lap BPD now and a lap

DS in

> > a year, but not only will that leave me losing just 100 lbs (not

the

> > 200+ I need to lose) but it subjects me to risks and pain that I'd

> > rather not repeat a year later. Plus, open has the advantage of

> > removing the gallblader, thus avoiding a future surgery to do so.

[Guest guest]

Here is an excellent snippet on this. Dr Sugarman is a highly respected

surgeon who does the RNY

http://members.nbci.com/diabetesm/advances_in_surgical_management_.htm

Dr. Harvey Sugerman[20] presented compelling data showing that morbidly

obese people have what he refers to as " chronic abdominal compartment

syndrome. " This syndrome of extreme central obesity leads to intra-abdominal

hypertension and is associated with all of the familiar comorbidities of

obesity such as hypertension, hypertriglyceridemia, type 2 diabetes, and

atherosclerosis. In addition, his data suggest that the abnormal abdominal

pressure leads to urinary incontinence, pseudotumor cerebri,

gastroesophageal reflux disease, venous stasis, abdominal hernias, and

obesity hypoventilation syndrome. In his studies, patients examined 34

months after gastric bypass surgery had lost 69% of their excess weight,

with a decrease in BMI from 52 to 33. In addition, urinary bladder pressures

and lumbar cerebrospinal fluid pressures had dramatically decreased.

----- Original Message -----

> Could you please explain " abdominal compartment syndrome " .

>

>

> - In duodenalswitch@y..., " Montgomery " wrote:

> > It might help if you post the name of the surgeon so that we can

> understand

> > who is restricting surgery based on your weight. We are seeing

> more and

> > more surgeons talking of a 2 stage surgery for some folks. I think

> the

> > inabdominal pressure post op for folks who already have abdominal

> > compartment syndrome can be deadly. I suspect that the 2 stage

> surgeries

> > are being done to reduce the post op morbidity and mortality risks.

> >

> > However, Doug's recent post indicates that Dr Gagner does very MO

> folks. He

> > started at 500 lbs. And I think Dr G does lap for many of those

> very MO

> > folks.

> >

> > in Seattle

> >

> > ----- Original Message -----

> > From:

> > > I'm trying to find out who has had BPD/DS Surgery and weighed

> over 400

> > > lbs.

> > >

> > > A doctor I saw yeserday told me he could only do it open (not

> lap) and

> > > besides its being a complex operation (aren't they all?) it is

> HIGHLY

> > > risky since I'll be under on the table so long, yet a lap BPD/DS

> is

> > > the same amount of time. His point was he feels the cardiac and

> > > pulmonary stress is higher on a person above 400 lbs. than on one

> > > below and I'm trying to find out how true this feeling/statement

> of

> > > his is.

> > >

> > > For those over 400 that had this done, I'm trying to find out what

> > > complications (if any) happened and who/where the doctor was that

> yous

> > > used. I'm willing to travel.

> > >

> > > The doctor I saw yesterday offered doing a lap BPD now and a lap

> DS in

> > > a year, but not only will that leave me losing just 100 lbs (not

> the

> > > 200+ I need to lose) but it subjects me to risks and pain that I'd

> > > rather not repeat a year later. Plus, open has the advantage of

> > > removing the gallblader, thus avoiding a future surgery to do so.

>

>

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

>

[Guest guest]

>

> I remember him mentioning such studies and research to me when I

went for my

> consult in November '99.

Woops, I meant my consult in November 2000... I did not wait an entire

year for my surgery! LOL

>

> all the best,

> teresa

> lap DS with gallbladder removal

> Dr. Gagner/DR. Quinn assisting/Mt. Sinai/NYC

> January 25, 2001

>

> pre-op: 307 lbs/bmi 45 (5'9 " )

> now: 263 lbs (it's still coming off! Yahoo! LOL)/bmi 4

[Guest guest]

The doctor I saw yesterday offered doing a lap BPD now and a lap DS in a year, but not only will that leave me losing just 100 lbs (not the 200+ I need to lose) but it subjects me to risks and pain that I'd rather not repeat a year later. Plus, open has the advantage of removing the gallblader, thus avoiding a future surgery to do so.

Sorry I don't know your name.

I am not over 400 lbs, however my surgeon Dr. Elariny strongly suggests doing the surgery in two parts in someone over 400 lbs.

He fully explained the reasons and I really agree with him.

I know that you will have to bear more than most of us going through two surgeries, but the risks will be much less for you and that is very important.

Dr. Elariny did this procedure recently on someone over 400 lbs and he is doing great, he had no complications and has lost about 65 lbs so far and will

go back in a year for the rest of the procedure.

If I was in this postition I would definitely do it this way.

Best wishes to you in your decision.

Kathy

June 7

BMI 50

[Guest guest]

I just wanted to let you know that I have a bmi of 65--weighed

399.6lbs when i completed my paperwork for dr inabnet--have lost

14.5lbs pre-op. Prior to my consult with dr inabnet at mt sinai, i

had myself convinced that i would be having an open bpd/ds, but at my

consult we discussed the 2 part surgery--both parts can be done

laproscopically..i realized during the consult that he knows what he

is doing & would not be recommending the 2 part process for me if he

thought the surgery could be completed in 1 procedure without

increased risk of complication. I know that i trust him as my

surgeon & he does have a personal interest in the healthy outcome of

my wls. the plan we have at this point is that i will have the

stomach restrictive portion of the surgery on may 11th--will return

home to lose about 100lbs & then in the fall, yes, the fall of this

year I will return for the 2nd part of my surgery. With a higher bmi

there appear to be increased risks when under anesthesia for extended

periods of time (i also have some health issues--chf, recent stroke,

sleep apnea that add an additional risk factor)

I know that I have to choose the surgeon that I believe is going to

respect my opinions, offer me options & still follow through with the

plan. I found that surgeon in dr inabnet.

It is a very personal thing, this patient/doctor relationship & it is

very important that you are comfortable with your choice & not 2nd

guess yourself or your surgeon. Just my opinion.

good luck in your pursuit of your new life..take good care

ogretta

pre-op

may 11, 2001

dr inabnet

mt sinai

> Hi:

>

> I'm trying to find out who has had BPD/DS Surgery and weighed over

400

> lbs.

>

> A doctor I saw yeserday told me he could only do it open (not lap)

and

> besides its being a complex operation (aren't they all?) it is

HIGHLY

> risky since I'll be under on the table so long, yet a lap BPD/DS is

> the same amount of time. His point was he feels the cardiac and

> pulmonary stress is higher on a person above 400 lbs. than on one

> below and I'm trying to find out how true this feeling/statement of

> his is.

>

> For those over 400 that had this done, I'm trying to find out what

> complications (if any) happened and who/where the doctor was that

yous

> used. I'm willing to travel.

>

> The doctor I saw yesterday offered doing a lap BPD now and a lap DS

in

> a year, but not only will that leave me losing just 100 lbs (not

the

> 200+ I need to lose) but it subjects me to risks and pain that I'd

> rather not repeat a year later. Plus, open has the advantage of

> removing the gallblader, thus avoiding a future surgery to do so.

>

> PLEASE HELP, Thanks!

[Guest guest]

Hi Ogretta,

I have my appt with Dr Herron on May 10th I wish it was the 11th so I could stop

by and say hi. I was interested to hear you are from Delaware since that is

where I am originally from and my family is still there. I will be having

surgery June 12th. Gwen

[Guest guest]

Gwen- Dr. Herron was my surgeon and I adore him. He is caring,

understanding and compassionate and always gets back to you. His PA is

who you will meet. Please send her my regards. She too is wonderful.

the nuitritionist is a knowledgeable and very good teacher. You will

be in the best hands. Ellen(Pam