Re: Re:Tom and 's dispute- my 50 cents..

[Guest guest]

Tom, much as I like you and your tenacity-- I think you may have to relinquish this position -- lap surgeries are generally easier on the patient than open ones -- just think of all the square inches of skin that the body DOESN'T have to knit back together.

What seems to have gotten lost is it extreme difficulty of doing lap surgeries on people with high BMI. And this is why: the lap surgery involves poking a few holes into the abdominal compartment and inflating the abdomen with gas. in the very MO, there simply isn't sufficient room to inflate that isn't already occupied by fat. My BMI is 71 on a 5'2" frame -- at USC in my first appointment, looks me up and down, and does the calculation a second time. She says something to the effect of "you don't look that big."

That is because I am solid pack -- there simply is no area of my body where I don't have fat stashed. If they tried to inflate my abdomen, they'd get maybe and inch of moving around room. If you have ever watched any of the surgery stuff they put on the health channel and what not, you can see that a "normal" weight person gets inflated to enormous proportions (say, MO proportions) because the skin is quiet elastic (think preggers bellies that deflate post delivery) so there is lots of room in there to poke around. Most of us MO folks are as inflated by fat as we can be.

Now down to personal opinion. I do agree with you that docs that do the lap on high BMI patients probably don't do as thorough an inspection of livers and guts as those who do it open. It is a simple issue of how much poking thru layers of fat which conceal lord only know what a surgeon is willing to risk. Hence, the development of doing the thing is two stages -- just doing the stomach and waiting to do the rest of the surgery until there is more room in there is a FINE idea, and one I would go for in a hot second! I am really interested in finding out what Dr. Anthone thinks about this development and will be watching all the available health news sites for info on the Bariatric surgeon's meeting in DC. If I get the chance to ask him about it before they are committed to knocking me out and hacking off my apron, I will. Hell, they can do a gastrectomy by endoscopy these days.

What a great way to loose 100 pounds before doing the switch thing.

The next question is, how does that effect long term weight loss? We know that neither surgery alone produces sufficient weight loss in the MO population -- does doing it in two stages mitigate that? Or do the two proceedures work in a synergistic way only when done together? That is probably a paper the East coast guys doing the two stage thing are working on for next year or the year after for their conference.

Okay, fire away you two (or three if Nick gets in on this) I am braced for it. Just be advised that I tend to use common sense, not citations for my arguments. and I am familiar with lawyer's tactics.

Nan E.