Re: How many with High BMI?

August 13, 2001

Jerry...I started with a BMI of 64. I am 5'8 and weighed 415 lbs. While I

couldnt walk far...I had no trouble walking. I just had my surgery and have

had no complications. Dr. B. gave me 5 days of heparin after surgery...I had

3 days of pain shots (they do everything the old fashioned way in Spain..LOL)

and was up and out of bed the same night of my surgery. I went in for surgery

at 3 and came out 110 minutes later. I was up and out of bed through the

next 4 days and then was released to a hotel nearby. I have had the usual

gas and tiny amounts of nausea...but really I consider myself a text book

case. I'm now 3 weeks post op and doing fine. I went to Dr. B. not only to

save money since I'm a self-pay but becuase he had lots of experience with

larger people and is considered one of the best! Hope this helps!

~~* AJ *~~

Post op 7/24/01 Open DS

self pay - Dr Baltasar -Alcoy Spain

07/24/01 BMI 64 - 415.1

08/06/01 BMI 59 - 390.2 -24.9 lbs!!!!!!!!!!~~~~

Check out the

Bellingham Support for WLS

WWW.WLSBellingham.homestead.com

August 13, 2001

In a message dated 8/13/01 5:49:21 PM Pacific Daylight Time,

chull1@... writes:

> Laprascopic techniques for BMI > 65 is dangerous. I would aviod it

> (even lap assisted). Dr. Gagner, , and Ren report a higher

> rate of complications with that high a BMI and the lap procedure.

>

Just to comment since I was a 64...I would never have done Lap...my own

personal opinion...when you are this big I think they do much better being

right in there. I have recovered fine in the incision area and I think the

shorter you're under the better if you are larger....less time being laid out

in one spot. I know you have to decide for yourself, but one of the beauties

to me about Dr. Baltasar is he has 2 other surgeons with him in the OR and

you're not even out 2 hours...I felt this was a very big benefit to going to

Spain and with my weight.

~~* AJ *~~

Post op 7/24/01 Open DS

self pay - Dr Baltasar -Alcoy Spain

07/24/01 BMI 64 - 415.1

08/06/01 BMI 59 - 390.2 -24.9 lbs!!!!!!!!!!~~~~

Check out the

Bellingham Support for WLS

WWW.WLSBellingham.homestead.com

August 13, 2001

In a message dated 8/13/01 6:38:53 PM Pacific Daylight Time,

donna_lee777@... writes:

> I was wondering if you actually LIVE in Spain or did

> you go there for the surgery? Also, is the price

> cheaper than in the US? Did insurance cover any of it

> for you?

>

> I know I'm nosy but inquiring minds want to know!

>

Hey be nosy...that's why I'm here...so I can share my experience and

hopefully help at least one other.

I live in WAshington State...up near the border by Vancouver. I flew to

Spain on 7/21 and had surgery on 7/24. I spent 5 days in the clinica and

then went to a hotel for another week before coming home. If I had my surgery

here in WAshington state with Dr. Heap...we figured the cost ran from $25,000

up depending on complications and how many days in the hospital. In

Spain...the surgery is on average 10,500 to 11,000. With the traveling and

hotels etc, I spent about 16,300 or somewhere in that neighborhood...so I

saved alot. I had an exclusion so I had no choice but to pay. I've heard of

some people getting reimbursed...but I'm not sure how or what insurance. I

know you have to pay upfront and then bill the insurance.

The clinica also had a extra bed (like a futon sorta) for a companion...so

when you're in the clinica..your husband or whoever can stay right there with

you...which is really helpful.

~~* AJ *~~

Post op 7/24/01 Open DS

self pay - Dr Baltasar -Alcoy Spain

07/24/01 BMI 64 - 415.1

08/06/01 BMI 59 - 390.2 -24.9 lbs!!!!!!!!!!~~~~

Check out the

Bellingham Support for WLS

WWW.WLSBellingham.homestead.com

August 13, 2001

In a message dated 8/13/01 9:51:10 PM, duodenalswitch writes:

<<

Laprascopic techniques for BMI > 65 is dangerous. I would aviod it

(even lap assisted). Dr. Gagner, , and Ren report a higher

rate of complications with that high a BMI and the lap procedure.

>>

Yes, this is why they are suggesting a two part lap procedure for those with

bmis over 60, I believe (or is it 65?). The conclusive results are not in

yet as to whether having a two part lap procedure greatly reduces the risks

involved, etc. but I think that people who have had it done this way are

doing great and feeling fabu!

The goal is to have the sleeve gastrectomy done, lose a certain amount of

weight and then go in for the intestinal portion at a much lower weight.

This is definately an option for anyone in the higher bmis if they would

prefer a laparoscopic surgery (I know I would hands down, but each case is

different). The downside is that you must be under anesthesia twice, etc.

even though I think it makes the recovery each time a little 'easier' and

less painful. I'll have to leave that to those who have undergone the two

parter, though.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

six months post-op and still feelin' fabu!

pre-op: 307 lbs/bmi 45 (5' 9 1/2 " )

now: 233.5 (ok - so 1/2 lb is gone again -- I want this plateau to end soon!

AGH!)

August 13, 2001

Hi Southern Gal

Wow that's great you're mobile!! I would investigate futher--have

some preliminary blood work done with clotting times ect...

You're on the border of 70 BMI, and if you really wanted an umbrella,

the doc probably wouldn't object. When you are heavy--it's not just

the mobility--but there is alot of tissue for blood to pool in and

get sluggish (more sticky) and prone to clotting. Being more

sedentary adds to that.

You can type in vena cava filter or Greenfield filter on the search

feature and you'll get alot of info you can sift through. There are

diagrams of the procedure and pics of the filters. Then with your

doctor you can come to a decision.

Let me know if there is something I can help you understand better.

Liane is a surgical nurse too and can help too.

Pammi

> I realize that Larry had a very high BMI. My BMI is 67 - 68. How

many

> others out there have had high BMI? Did you have the DS in one

part or two?

> Dr. Booth, MS suggested an assisted lap DS (in one part) for me .

My

> choice whether I wanted to use the " umbrella " to help stop blood

clots from

> getting to my lungs, heart or brain. He only insists on them for

patients

> with a BMI of 70 or above. What complications did you experience?

Though I

> have a high BMI, I do not need any assistance in walking. In fact,

Dr.

> Booth was alittle surprised when he say my BMI was so high. Please,

if you

> started with a BMI of 60 or above, share any information about your

surgery.

> Thanks.

> Jerry, southern gal

>

August 13, 2001

> Dr. Booth, MS suggested an assisted lap DS (in one part) for me .

Laprascopic techniques for BMI > 65 is dangerous. I would aviod it

(even lap assisted). Dr. Gagner, , and Ren report a higher

rate of complications with that high a BMI and the lap procedure.

I know if you were Dr. Anthone's patient he would have you do a panni

first and then do the DS. He also asks patients of that size to

loose 50-100 lbs before surgery.

If your weight is in the abdomen (like most men) then your risk with

Lap is really going to be high with BMI=68.

I am not saying that all patients with a high BMI and lap surgery

will have a bad outcome, or even the majority ... but maybe 1/3 will

have serious complications.

Jerry - I am taking what Tom LaRussa says to heart here. It really

is your decision, but I felt I should at least state my opinion. In

fact I would urge you to talk to Tom, as I think he was one of Dr.

A's first patients to do the panni thing first and then the DS.

Hull

August 13, 2001

I was wondering if you actually LIVE in Spain or did

you go there for the surgery? Also, is the price

cheaper than in the US? Did insurance cover any of it

for you?

I know I'm nosy but inquiring minds want to know!

Thanks!

--- lookn2bthin@... wrote:

> In a message dated 8/13/01 5:49:21 PM Pacific

> Daylight Time,

> chull1@... writes:

>

> > Laprascopic techniques for BMI > 65 is dangerous.

> I would aviod it

> > (even lap assisted). Dr. Gagner, , and

> Ren report a higher

> > rate of complications with that high a BMI and the

> lap procedure.

> >

>

> Just to comment since I was a 64...I would never

> have done Lap...my own

> personal opinion...when you are this big I think

> they do much better being

> right in there. I have recovered fine in the

> incision area and I think the

> shorter you're under the better if you are

> larger....less time being laid out

> in one spot. I know you have to decide for

> yourself, but one of the beauties

> to me about Dr. Baltasar is he has 2 other surgeons

> with him in the OR and

> you're not even out 2 hours...I felt this was a very

> big benefit to going to

> Spain and with my weight.

>

> ~~* AJ *~~

> Post op 7/24/01 Open DS

> self pay - Dr Baltasar -Alcoy Spain

> 07/24/01 BMI 64 - 415.1

>

> 08/06/01 BMI 59 - 390.2 -24.9

> lbs!!!!!!!!!!~~~~

>

> Check out the

> Bellingham Support for WLS

> WWW.WLSBellingham.homestead.com

>

> [Non-text portions of this message have been

> removed]

>

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

>

August 13, 2001

I am a 2-parter. My starting BMI was approximately 62. I had the sleeve

gastrectomy on July 17th by Dr. Gagner. I was back to work on day 8, sore at

the

end of the day but other than that OK. I am now 27 days out and feel great. I

have lost 26 lbs as of day 21. I will have part 2 after I loose about 100

lbs. Good luck, Pat

ruisha@... wrote:

> In a message dated 8/13/01 9:51:10 PM, duodenalswitch writes:

>

> <<

>

> Laprascopic techniques for BMI > 65 is dangerous. I would aviod it

>

> (even lap assisted). Dr. Gagner, , and Ren report a higher

>

> rate of complications with that high a BMI and the lap procedure.

>

> >>

>

> Yes, this is why they are suggesting a two part lap procedure for those with

> bmis over 60, I believe (or is it 65?). The conclusive results are not in

> yet as to whether having a two part lap procedure greatly reduces the risks

> involved, etc. but I think that people who have had it done this way are

> doing great and feeling fabu!

>

> The goal is to have the sleeve gastrectomy done, lose a certain amount of

> weight and then go in for the intestinal portion at a much lower weight.

> This is definately an option for anyone in the higher bmis if they would

> prefer a laparoscopic surgery (I know I would hands down, but each case is

> different). The downside is that you must be under anesthesia twice, etc.

> even though I think it makes the recovery each time a little 'easier' and

> less painful. I'll have to leave that to those who have undergone the two

> parter, though.

>

> all the best,

>

> lap ds with gallbladder removal

> January 25, 2001

> Dr. Gagner/Mt. Sinai/NYC

>

> six months post-op and still feelin' fabu!

>

> pre-op: 307 lbs/bmi 45 (5' 9 1/2 " )

> now: 233.5 (ok - so 1/2 lb is gone again -- I want this plateau to end soon!

> AGH!)

>

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

>

August 13, 2001

Jerry-

Depending on the BMI calculator used, I was either 59 or 60 at the

time of surgery. My biggest complication while in the hospital was

having an asthma attack in recovery and running fevers. However, I

will say that my fear of blood clots had me out of bed the first night

after surgery (about 2 hours out of recovery- I was too wobbly to

walk, but I stood up and took some deep breaths). I also walked every

AM when I first woke up, even on bad pain days, for the same reason.

I may have been luckier than many my size.. I don't know for sure.

Hugs,

Liane

> I realize that Larry had a very high BMI. My BMI is 67 - 68. How

many

> others out there have had high BMI? Did you have the DS in one part

or two?

> Dr. Booth, MS suggested an assisted lap DS (in one part) for me .

My

> choice whether I wanted to use the " umbrella " to help stop blood

clots from

> getting to my lungs, heart or brain. He only insists on them for

patients

> with a BMI of 70 or above. What complications did you experience?

Though I

> have a high BMI, I do not need any assistance in walking. In fact,

Dr.

> Booth was alittle surprised when he say my BMI was so high. Please,

if you

> started with a BMI of 60 or above, share any information about your

surgery.

> Thanks.

> Jerry, southern gal

>

> >From: cas07@h...

> >Reply-To: duodenalswitch@y...

> >To: duodenalswitch@y...

> >Subject: knowing the risks, and making our own

> >decisions...

> >Date: Sun, 12 Aug 2001 21:24:41 -0000

> >

> >i am so sorry to hear about the passing of any person having wls -

i

> >understand too well the desperation that drives each of us to make

> >our choices regarding surgery, whether it is in deciding which

> >surgery to have or even if we should have surgery. each one of us

> >has been through more than any person should ever have to deal with

> >in several lifetimes, let alone one.

> >

> >when i first decided 2 years ago that i wanted to have wls, i

thought

> >i knew which procedure i wanted, and where i wanted it done. then

i

> >did more research, and found what i really wanted and who i wanted

it

> >done by. i lived on this site for 18 months, reading every single

> >post, learning as much as i could from everyone, and making my

choice

> >for the doctor who would change my life. i went into the operating

> >room the morning of my surgery fully aware i had a good chance of

not

> >coming out alive. i had already given the pastor at my church

> >information about my services, what songs i wanted sung by the

praise

> >band i sing in and the scripture verses i wanted read. i also knew

> >that just making it out of the operating room was just the start -

> >that other things could happen, and i could even die from

> >complications. these were all risks i was willing to take - i

wanted

> >to be free from my obesity, and i knew that if the surgery didn't

> >kill me, my obesity would. today, i am thankful that at 3.5 months

> >out, i am alive and i am on my way to a healthier, hopefully longer

> >life with my children and my husband.

> >

> >larry knew the same odds, and larry decided to take the same risk.

> >since none of us were in the room when the decision was made, nor

> >when the surgery was performed, nor when larry died, i think that

to

> >second guess what happened, or blame it on an inexperienced surgeon

> >is irresponsible to say the least. experience has nothing to do

with

> >wound infections or pulmonary embolisms, and even the incomparable

> >doctors that we all had would tell us the same thing. it is also

> >irresponsible to accuse the members of this list - to say it is our

> >fault he died. larry made a choice to have weight loss surgery -

he

> >made a positive move to better his quality of life. whichever one

he

> >had (including the lap-band) could have resulted in the same

> >outcome. we will never know.

> >

> >i realize no one asked my opinion - but i am a pushy broad, and i

> >couldn't keep it in any longer. i am thankful to the members of

this

> >list, and doctors who are willing to give us a chance at a more

> >normal life.

> >

> >~amy~

> >ds - 4/13/01

> >dr. k

> >-85 pounds and counting

> >

>

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

-

> >

August 14, 2001

My BMI was 64 or something, and I had a laparascopic BPD/DS with Rapkin. He

said he does them on folks which much higher BMIs, so opinions apparently

vary. It's a one-stage deal with him, too.

- SC

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

> In a message dated 8/13/01 9:51:10 PM, duodenalswitch

writes:

> <<

> Laprascopic techniques for BMI > 65 is dangerous. I would aviod it

> (even lap assisted). Dr. Gagner, , and Ren report a higher

> rate of complications with that high a BMI and the lap procedure.

> >>

>

> Yes, this is why they are suggesting a two part lap procedure for those

with

> bmis over 60, I believe (or is it 65?). The conclusive results are not in

> yet as to whether having a two part lap procedure greatly reduces the

risks

> involved, etc. but I think that people who have had it done this way are

> doing great and feeling fabu!

>

> The goal is to have the sleeve gastrectomy done, lose a certain amount of

> weight and then go in for the intestinal portion at a much lower weight.

> This is definately an option for anyone in the higher bmis if they would

> prefer a laparoscopic surgery (I know I would hands down, but each case is

> different). The downside is that you must be under anesthesia twice, etc.

> even though I think it makes the recovery each time a little 'easier' and

> less painful. I'll have to leave that to those who have undergone the two

> parter, though.

>

> all the best,

>

August 14, 2001

Hi Jerry (and Chris):

> I know if you were Dr. Anthone's patient he would

> have you do a panni first and then do the DS.

<<snip>>

> In fact I would urge you to talk to Tom, as I think

> he was one of Dr. A's first patients to do the panni

> thing first and then the DS.

I'll take that as an invitation and just jump right in here...

I wrote all about my panniculectomy experience for the USC support

group, and several people from this list have emailed me asking about

it, so I've posted it in the Files section here as well. For the

full story go to the files section and look for the folder named

" Tom's Pre-DS Panniculectomy. "

You can get a lot of detail from my writeup, so I'll limit myself to

a few comments:

1. Why I didn't mind being one of the first

This is something I NEVER would have done for the DS, regardless of

the surgeon. There are several reasons why I was comfortable being

one of the first under these particular circumstances.

First, it's a really simple surgery, consisting of the removal of a

big wedge of fat and skin and the suturing of the two sides back

together, so there is no penetration of either the abdominal cavity

or even the abdominal muscles. Because of this, you need much less

anesthetic than for a more invasive procedure -- you don't need to be

under as deep, and you don't need to be paralyzed since they aren't

going near any interior organs or significant blood vessels.

Second, Dr. Anthone is an extremely well-trained, experienced,

skilled, and *CAUTIOUS* surgeon, so I knew I was in good hands, and

that Dr. Anthone wouldn't recommend the procedure unless it would be

a plus for me.

Third, USC University Hospital (USCUH) is an excellent facility. If

you have the US News & World Report issue on the best hospitals in

the country, look at each section under the category of patient

deaths. (It's listed as Los Angeles County/USCUH because USC's

medical school also staffs LA's biggest county hospital.) The death

rate at the combined facility is much lower than that of almost any

other hospital discussed in the magazine.

2. What's the " panni " all about?

It's best for folks who have a large amount of fat that hangs down

from their bellies. ( " Panniculectomy " is made up from the Latin word

" pannus, " which means " skirt, " plus the standard medical ending

describing the surgical removal of something.) It's not that it

removes a HUGE amount of weight -- about 20 to 50 pounds -- but that

it helps folks with hanging frontal " skirts " of fat be more mobile,

i.e., it's a heck of a lot easier to sit, stand, tie one's shoes,

maneuver, and generally walk without waddling so much after it's been

snipped off.

3. Losing weight before the DS

Dr. Anthone did not ask me to lose weight on my own prior to my DS

despite my BMI of 64+ because, except for super-morbid obesity, body

aches and pains, and relatively mild apnea and reflux, I was really

quite healthy. My blood pressure is usually 110/65 or slightly

lower, my heart and lungs are healthy, (I've never smoked), my blood

sugar's okay, all my organs do what they're supposed to, etc.

If anybody has any questions, just let me know.

Tom

Panniculectomy, Dr. Anthone, 11/10/2000

Open DS, Dr. Anthone, 03/30/2001

Goal: Lose 80% of Excess Weight

*******************************

* Starting Weight = 386 *

* " Ideal " Weight = 142 *

* =========================== *

* Total Excess Weight = 244 *

* 80% x Excess Weight = 201 *

* Goal Weight = 386-201 = 185 *

* =========================== *

* Total Needed to Lose = 201 *

* Loss To Date = 116 *

* =========================== *

* Remainder to Goal = 85 *

*******************************

Weight By Date:

11/10/2000 . . 386

03/30/2001 . . 360

04/19/2001 . . 338

05/03/2001 . . 328

05/18/2001 . . 316

06/03/2001 . . 301

06/15/2001 . . 299

06/25/2001 . . 293

07/03/2001 . . 286

07/16/2001 . . 278

07/23/2001 . . 276

07/30/2001 . . 275

08/06/2001 . . 272

08/13/2001 . . 270

USC DS Support Group: <http://groups.yahoo.com/group/ds_usc>

August 14, 2001

> My BMI was 64 or something, and I had a

> laparascopic BPD/DS with Rapkin. He said

> he does them on folks which much higher

> BMIs, so opinions apparently vary. It's a

> one-stage deal with him, too.

I think you missed Chris's point.

Chris's point is that Dr. Gagner, , and Ren report a higher

rate of complications when the DS is performed by lap on patients

with very high BMIs.

He didn't say that no surgeon performs the BPD/DS by lap on very high

BMI patients. Obviously, Drs. Gagner, , and Ren perform the

DS by lap on such patients, or they would not have been able to

publish an article on the subject.

The mere fact that Dr. Rabkin performs the DS by lap on patients with

very high BMIs in no way contradicts what said. His

complication rate for such patients having a lap DS may be the same,

higher, or lower than the rates reported by Dr. Gagner et al. We

simply have no way of knowing.

Tom

August 14, 2001

>

> > My BMI was 64 or something, and I had a

> > laparascopic BPD/DS with Rapkin. He said

> > he does them on folks which much higher

> > BMIs, so opinions apparently vary. It's a

> > one-stage deal with him, too.

A couple more things to be aware of. Rabkin does a laprascopic assist

procedure which is different from the true laprascopic procedure of

Gagner, , and Ren.

Please read their own articles at:

http://thinforlife.med.nyu.edu/operations/early_results_bpd_ds.pdf

There own conclusion is that the procedure seems to be more dangerous

for BMI > 65 !

Hull

August 14, 2001

AJ, You make a very good point about increased risk with longer time

under anesthesia. I was a revision from a VGB, and had other

previous abdominal surgeries. Dr Hess had 2 surgeons assisting him

too, Dr Hess Jr, and Dr Oakley. They had me out much sooner than

expected (didnt get the exact time, but my mother who was waiting for

me was afraid there was something wrong when they came to talk with

her so soon) I was up the same night of surgery, and have had an

uneventful recovery as well (knock wood)

Meli

Dr Hess, Hess and Oakley

June 21,01

-40lb

-- In duodenalswitch@y..., lookn2bthin@c... wrote:

> In a message dated 8/13/01 5:49:21 PM Pacific Daylight Time,

> chull1@s... writes:

>

> > Laprascopic techniques for BMI > 65 is dangerous. I would aviod

it

> > (even lap assisted). Dr. Gagner, , and Ren report a

higher

> > rate of complications with that high a BMI and the lap procedure.

> >

>

> Just to comment since I was a 64...I would never have done Lap...my

own

> personal opinion...when you are this big I think they do much

better being

> right in there. I have recovered fine in the incision area and I

think the

> shorter you're under the better if you are larger....less time

being laid out

> in one spot. I know you have to decide for yourself, but one of

the beauties

> to me about Dr. Baltasar is he has 2 other surgeons with him in the

OR and

> you're not even out 2 hours...I felt this was a very big benefit to

going to

> Spain and with my weight.

>

> ~~* AJ *~~

> Post op 7/24/01 Open DS

> self pay - Dr Baltasar -Alcoy Spain

> 07/24/01 BMI 64 - 415.1

> 08/06/01 BMI 59 - 390.2 -24.9 lbs!!!!!!!!!!~~~~

>

> Check out the

> Bellingham Support for WLS

> WWW.WLSBellingham.homestead.com

>

August 14, 2001

> The mere fact that Dr. Rabkin performs the DS by lap on patients with

> very high BMIs in no way contradicts what said. His

> complication rate for such patients having a lap DS may be the same,

> higher, or lower than the rates reported by Dr. Gagner et al. We

> simply have no way of knowing.

Dr. Rabkin's website has a breakdown of their results, including

complications:

(If this breaks to two lines, you'll need to cut and paste to get the

URL into your browser's address field):

http://www.pacificsurgery.com/Obesity_Surgery/Our_Results/our_results.ht

ml

This page hasn't been updated in a few months, but they do show results

through April 2001.

M.

---

in Valrico, FL, age 38

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

August 14, 2001

In a message dated 8/13/2001 5:49:23 PM Pacific Daylight Time,

chull1@... writes:

<< I know if you were Dr. Anthone's patient he would have you do a panni

first and then do the DS. He also asks patients of that size to

loose 50-100 lbs before surgery.

>>

I don't think Dr. A would recommend panni removal in all patients with high

BMI. I started with a BMI of 69, and was/am able to get around okay. I think

mobility is a big factor in his recommendation. Luckily, I didn't need it. I

do agree with you, however, in the risk factor with lap procedures on higher

BMI's. I had a friend that had MAJOR complications, and with all her weight

in front, as an after thought, her surgeon said she was probably too large to

do the procedure lap. She will have brain damage for the rest of her life due

to her serious complications. Needless to say, there is a major law suit

going on because of his negligence. I know more and more surgeons are

willing to perform lap procedures on higher BMI's and alot of them are very

successful. A different set of problems for each surgery I suppose. It's a

tough decision for some, but after what I saw my friend go through, I would

much rather opt for the longer recovery time.

Kim

Dr. Anthone

4/18/01-DGB/DS open

-88 lbs

August 14, 2001

My BMI was 61 and I had the surgery done all at once. I didn't have

any complications other than being allergic to something in the

hospital and getting an itchy rash. I'm recovering nicely, swimming

every day now, and am very glad I did the surgery.

Also, I had a family history of blood clots and they gave me a few

shots of heperine in the hospital. My sister did the same thing, and

I think her BMI was higher than mine.

She has a great web page about her surgery, go to:

http://www.fluffynet.com/wls

Donna

June 13th

Rabkin

-50 at six weeks out (don't have a scale that will weigh me yet)

> I realize that Larry had a very high BMI. My BMI is 67 - 68. How

many

> others out there have had high BMI? Did you have the DS in one

part or two?

> Dr. Booth, MS suggested an assisted lap DS (in one part) for me .

My

> choice whether I wanted to use the " umbrella " to help stop blood

clots from

> getting to my lungs, heart or brain. He only insists on them for

patients

> with a BMI of 70 or above. What complications did you experience?

Though I

> have a high BMI, I do not need any assistance in walking. In fact,

Dr.

> Booth was alittle surprised when he say my BMI was so high. Please,

if you

> started with a BMI of 60 or above, share any information about your

surgery.

> Thanks.

> Jerry, southern gal

>

> >From: cas07@h...

> >Reply-To: duodenalswitch@y...

> >To: duodenalswitch@y...

> >Subject: knowing the risks, and making our own

> >decisions...

> >Date: Sun, 12 Aug 2001 21:24:41 -0000

> >

> >i am so sorry to hear about the passing of any person having wls -

i

> >understand too well the desperation that drives each of us to make

> >our choices regarding surgery, whether it is in deciding which

> >surgery to have or even if we should have surgery. each one of us

> >has been through more than any person should ever have to deal with

> >in several lifetimes, let alone one.

> >

> >when i first decided 2 years ago that i wanted to have wls, i

thought

> >i knew which procedure i wanted, and where i wanted it done. then

i

> >did more research, and found what i really wanted and who i wanted

it

> >done by. i lived on this site for 18 months, reading every single

> >post, learning as much as i could from everyone, and making my

choice

> >for the doctor who would change my life. i went into the operating

> >room the morning of my surgery fully aware i had a good chance of

not

> >coming out alive. i had already given the pastor at my church

> >information about my services, what songs i wanted sung by the

praise

> >band i sing in and the scripture verses i wanted read. i also knew

> >that just making it out of the operating room was just the start -

> >that other things could happen, and i could even die from

> >complications. these were all risks i was willing to take - i

wanted

> >to be free from my obesity, and i knew that if the surgery didn't

> >kill me, my obesity would. today, i am thankful that at 3.5 months

> >out, i am alive and i am on my way to a healthier, hopefully longer

> >life with my children and my husband.

> >

> >larry knew the same odds, and larry decided to take the same risk.

> >since none of us were in the room when the decision was made, nor

> >when the surgery was performed, nor when larry died, i think that

to

> >second guess what happened, or blame it on an inexperienced surgeon

> >is irresponsible to say the least. experience has nothing to do

with

> >wound infections or pulmonary embolisms, and even the incomparable

> >doctors that we all had would tell us the same thing. it is also

> >irresponsible to accuse the members of this list - to say it is our

> >fault he died. larry made a choice to have weight loss surgery -

he

> >made a positive move to better his quality of life. whichever one

he

> >had (including the lap-band) could have resulted in the same

> >outcome. we will never know.

> >

> >i realize no one asked my opinion - but i am a pushy broad, and i

> >couldn't keep it in any longer. i am thankful to the members of

this

> >list, and doctors who are willing to give us a chance at a more

> >normal life.

> >

> >~amy~

> >ds - 4/13/01

> >dr. k

> >-85 pounds and counting

> >

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

---

> >

August 14, 2001

Hi everyone ! Is there a 'standard' rule of thumb as to what a good

'cut-off' point would be for considering

open vs. lap ? My BMI is 46, which seems to be in the safe zone for lap

versus open, but I would love to

hear anyone/everyone's thoughts/findings on this. I had nearly decided to

request an open be done, but

then just yesterday in meeting with a local surgeon (my surgery will take

place in NY, and I live in NC, so I

wanted to be sure there was a local surgeon who would be willing to 'take

me on' as a post-op WLS

patient), he actually is very high on lap vs open for the normal reasons;

less invasive, less chance of

infection, etc.

My consult with Dr. Herron isn't until November 15th (unless they have a

cancellation), so I have plenty

of time to torment myself going back and forth on this :-)

Bye,

Donna

susan4541@...

om To: duodenalswitch

cc:

08/14/2001 Subject: Re: Re:

How many with High BMI?

02:13 PM

Please respond

to

duodenalswitch

In a message dated 8/13/2001 5:49:23 PM Pacific Daylight Time,

chull1@... writes:

<< I know if you were Dr. Anthone's patient he would have you do a panni

first and then do the DS. He also asks patients of that size to

loose 50-100 lbs before surgery.

>>

I don't think Dr. A would recommend panni removal in all patients with high

BMI. I started with a BMI of 69, and was/am able to get around okay. I

think

mobility is a big factor in his recommendation. Luckily, I didn't need it.

I

do agree with you, however, in the risk factor with lap procedures on

higher

BMI's. I had a friend that had MAJOR complications, and with all her weight

in front, as an after thought, her surgeon said she was probably too large

to

do the procedure lap. She will have brain damage for the rest of her life

due

to her serious complications. Needless to say, there is a major law suit

going on because of his negligence. I know more and more surgeons are

willing to perform lap procedures on higher BMI's and alot of them are very

successful. A different set of problems for each surgery I suppose. It's a

tough decision for some, but after what I saw my friend go through, I would

much rather opt for the longer recovery time.

Kim

Dr. Anthone

4/18/01-DGB/DS open

-88 lbs

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

August 14, 2001

> Hi everyone ! Is there a 'standard' rule of thumb as to what a good

> 'cut-off' point would be for considering

> open vs. lap ?

Donna, I think it depends on the doc and on your health history and fat

distribution. I'd be surprised to see any lap surgeon give a definitive

cutoff, but it may happen if for no other reason than to pre-filter

patients. I think for the most part, though, the doc would want to see

you in person and make an assessment based on your individual case.

> My BMI is 46, which seems to be in the safe

> zone for lap versus open, but I would love to

> hear anyone/everyone's thoughts/findings on this.

As far as I know, your BMI, assuming there are no prohibitive factors,

is great for lap. I started out with a BMI of 50ish and my Lap DS went

without a hitch.

> My consult with Dr. Herron isn't until November 15th (unless

> they have a cancellation), so I have plenty of time to torment

> myself going back and forth on this :-)

There are pros and cons to both, and what constitutes a " pro " or " con "

is highly individual!

Some " pros " I have seen mentioned for OPEN:

shorter anesthesia

surgeon can see better

Some " pros " I have seen mentioned for LAP:

Less chance of infection

Less chance of incisional hernia

Surgeon can see better (yep, this has been said for both open and lap,

depending on who you choose to believe. :-))

Lots to think about! I think (IMHO!) first and foremost, you should

choose a surgeon whose skills and experience are unquestionably

excellent. From there, the rest will work itself out.

M.

---

in Valrico, FL, age 39

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

August 14, 2001

Thanks, ! I do have faith in Dr. Herron's reputations, and will

defer to him

as he'll be able to make the proper assessment. If there were distinct

advantages

as to the potentional outcome of the surgery by going open, then I would

want to

specifically ask for that. Haven't worked that out yet :-)

Bye,

Donna

"

Magruder " To:

<melaniemag@ya cc:

hoo.com> Subject: RE: Re:

How many with High BMI?

08/14/2001

02:42 PM

Please respond

to

duodenalswitch

> Hi everyone ! Is there a 'standard' rule of thumb as to what a good

> 'cut-off' point would be for considering

> open vs. lap ?

Donna, I think it depends on the doc and on your health history and fat

distribution. I'd be surprised to see any lap surgeon give a definitive

cutoff, but it may happen if for no other reason than to pre-filter

patients. I think for the most part, though, the doc would want to see

you in person and make an assessment based on your individual case.

> My BMI is 46, which seems to be in the safe

> zone for lap versus open, but I would love to

> hear anyone/everyone's thoughts/findings on this.

As far as I know, your BMI, assuming there are no prohibitive factors,

is great for lap. I started out with a BMI of 50ish and my Lap DS went

without a hitch.

> My consult with Dr. Herron isn't until November 15th (unless

> they have a cancellation), so I have plenty of time to torment

> myself going back and forth on this :-)

There are pros and cons to both, and what constitutes a " pro " or " con "

is highly individual!

Some " pros " I have seen mentioned for OPEN:

shorter anesthesia

surgeon can see better

Some " pros " I have seen mentioned for LAP:

Less chance of infection

Less chance of incisional hernia

Surgeon can see better (yep, this has been said for both open and lap,

depending on who you choose to believe. :-))

Lots to think about! I think (IMHO!) first and foremost, you should

choose a surgeon whose skills and experience are unquestionably

excellent. From there, the rest will work itself out.

M.

---

in Valrico, FL, age 39

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

August 14, 2001

Donna,

My BMI was 52 (down to 44 now) and had lap with Dr. Ren on 7/13. The

operation took 6 hrs. (removal of appendix, gallbladder, and repair of

massive hiatal hernia). Recovery so far has been textbook perfect ( " pooh,

pooh " as Grandma would say). Energy levels back up, incisions healed well,

no nausea or vomiting. I'm not in the SMO range but was higher than you are

if you want to make any comparisons.

Best of Luck,

Marcia

Lap DS