Re: HUGE DISAPPOINTMENT

[Guest guest]

Im so sorry, Alice. I'll pray that whatever happens, its the

healthiest option for you. Good luck. Sue.

> Hi All. I can hardly write this news...still teary-eyed..I got a

call at

> 11AM Friday from Ivonne at Dr. Gagner's office stating that my

surgery

> scheduled for Monday the 24 has been canceled " indefinitely " because

Dr.

> Gagner wants to consult with his colleagues as to whether he can do

the

> surgery on someone with serum albumn levels which hover between low

normal

> and slightly below normal. This is NOT A NEW issue. Since my first

consult in

> early May, I have had everytest Dr. G. suggested and then some. I

have no

> symptoms of heart, liver, kidney, malabsorption, etc. Neither my PCP

or the

> GI I consulted for my endoscopy can find any abnormalites, and

neither has

> any concerns that I shouldn't have this surgery. Obviously, It's Dr.

Gagner's

> call, but so far I haven't heard from him directly. When I asked for

Ivonne

> to have him call me, she said: " That's not possible " Your surgery

is

> cancelled and that's final! " I immediately e-mailed Dr Gagner, but

have not

> yet heard from him as to when and how he will make his decision. I

must admit

> that I am fearful, too, because I still do not know the basis of his

> concerns....Alll he has said is to consult with your PCP. All of

this is so

> upsetting. All the plans ......hotel accommodations, travel,

arrangements at

> work.....I can't believe that it has turned out this wayl

> Alice

[Guest guest]

Dear Alice - I cried for you while reading your note. If there is one

thing we all understand here it is the anticipation of this surgery

and what it will do for our quality of life afterward. Knowing that

they waited until such a late time to inform you of the cancellation

must have been devistating.

I do not understand the issues, however, if I were you, I would find a

way to speak directly with the doctor. I too went to Mt. Sinai, and

have found that e-mailing the doctor directly is the fastest and

easiest way to reach them.

I will add you to my prayer list, and please keep us updated about

your progress.

Lots of luv,

Mickey

> Hi All. I can hardly write this news...still teary-eyed..I got a

call at

> 11AM Friday from Ivonne at Dr. Gagner's office stating that my

surgery

> scheduled for Monday the 24 has been canceled " indefinitely " because

Dr.

> Gagner wants to consult with his colleagues as to whether he can do

the

> surgery on someone with serum albumn levels which hover between low

normal

> and slightly below normal. This is NOT A NEW issue. Since my first

consult in

> early May, I have had everytest Dr. G. suggested and then some. I

have no

> symptoms of heart, liver, kidney, malabsorption, etc. Neither my PCP

or the

> GI I consulted for my endoscopy can find any abnormalites, and

neither has

> any concerns that I shouldn't have this surgery. Obviously, It's Dr.

Gagner's

> call, but so far I haven't heard from him directly. When I asked for

Ivonne

> to have him call me, she said: " That's not possible " Your surgery

is

> cancelled and that's final! " I immediately e-mailed Dr Gagner, but

have not

> yet heard from him as to when and how he will make his decision. I

must admit

> that I am fearful, too, because I still do not know the basis of his

> concerns....Alll he has said is to consult with your PCP. All of

this is so

> upsetting. All the plans ......hotel accommodations, travel,

arrangements at

> work.....I can't believe that it has turned out this wayl

> Alice

[Guest guest]

Oh Alice, I am so sorry to hear that your plans have been changed. I

do understand the issue, though. The post op morbidity of folks who

have low albumin is significant. Low albumin can complicate your

immediate recovery and may put you at great risk for protein

depletion post op. This can mean major malnutrition just like you

have seen in pictures of starving children of the work with skinny

limbs and swollen bellies.

There are some ways to address getting this up to normal if your

liver is functioning well. The low albumin can be one of a

constellation of signs of liver disease. Abnormal And there are no

clinical signs of this early on. Just some test abnormalities.

I know that you are very upset. However, your body may not be ready

for surgery. If you have tried to get your level up (I assume it is

under a 3? The normal range is 3.4 to 5.4 gm/dl) Is your prealbumin

also abnormal?

As hard as this is for you. I certainly would not be willing to have

surgery with a low albumin level. This needs to be corrected pre op.

And if your liver and kidneys are healthy, you can do that.

in Seattle

> Hi All. I can hardly write this news...still teary-eyed..I got a

call at

> 11AM Friday from Ivonne at Dr. Gagner's office stating that my

surgery

> scheduled for Monday the 24 has been canceled " indefinitely "

because Dr.

> Gagner wants to consult with his colleagues as to whether he can do

the

> surgery on someone with serum albumn levels which hover between low

normal

> and slightly below normal.

[Guest guest]

Would have been happy to work with any suggestions that Dr. Gagner or his

nutritionist had to offerl Just sent me to my pcp who cleared me along with

my GI doc, neither of who can find ANY abnormalities whatsoever. Dr. Gagner

has made no suggestions about what might be the cause or remedy . This is

what is so frustrating. I am a very intellligent person who would never put

myself in jeopardy and who is totally compliant with all recommendations. I

just don't know what to do about a surgeon who " shrugs " when you ask a

questions, sends me back to my internist, refuses to speak personally with

her and then, evidently, rejects her medical input, which is based upon

thorough examination. Sorry to sound touchy, but I thought that your reply

implied that I was looking to find someone do do my surgery " no matter what " .

Nothing could be farther from the truth. I am looking for a physician whose

concern for his patients extends to common courtesy.

[Guest guest]

In a message dated 9/22/01 2:35:12 PM, duodenalswitch writes:

<< Obviously, It's Dr. Gagner's

call, but so far I haven't heard from him directly. When I asked for Ivonne

to have him call me, she said: " That's not possible " Your surgery is

cancelled and that's final! " I immediately e-mailed Dr Gagner, but have not

yet heard from him as to when and how he will make his decision. I must admit

that I am fearful, too, because I still do not know the basis of his

concerns....Alll he has said is to consult with your PCP. All of this is so

upsetting. All the plans ......hotel accommodations, travel, arrangements at

work.....I can't believe that it has turned out this wayl >>

Alice: How discouraging! I'm so sorry to hear about this... Is your PCP

familiar with this issue and what this could mean (i.e. the low albumin)? I

certainly hope so since Ivonne is advising you go to your PCP for further

instruction and explanation... I know it sounds really depressing but I would

definately trust Dr. Gagner's expertise. I would also be irritated, though,

that no one has really explained to you what this condition means and how it

could affect you post-op. It sounds like the problem isn't your current

health but how the surgery might make your levels plunge and you would be

more susceptible to low protein. This can become a very serious deficiency

so I don't think Dr. Gagner would take it lightly.

It sounds to me like you have some options: Definately you deserve a clear

explanation of why this condition would potentially put your body in danger

with the surgery. You can also try to consult with other surgeons if you

honestly feel that Dr. Gagner is 'too conservative' or that another surgeon

may have a different opinion on the matter. This could be costly, though so

perhaps you could e-mail some surgeons and get your feelers out about whether

this would be a possible condition to work with post-operatively. ALSO, has

ANYONE mentioned how you can help to raise these levels? Have you tried

various means, if possible, to raise the albumin level? I mean, if there's

some way to change this then you should be given the opportunity to, IMHO.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. gAgner/Mt. Sinai/NYC

eight months post-op and still feelin' fabu!

preop: 307 lbs/bmi 45

now: 217

[Guest guest]

Dear Alice, I don't know who you are but I do know what it feels like to want

something so bad only to have the door close. Since you were approved with one

Dr. I wonder if there would be another Dr. who'd be willing without the worry

that the other Dr. has? I hope so!!!

Hoping things turn in your favor,

a, Pre-op

Re: Re: HUGE DISAPPOINTMENT

Hi All. I can hardly write this news...still teary-eyed..

[Guest guest]

,

Damn girl, look at that weight loss!!! I am totally stunned. You

were so beautiful before, I can't wait to see new pics. Even better,

you sound like your life is normalizing and you are feeling good.

Huge hugs from the other,

Theresa

>

> In a message dated 9/22/01 2:35:12 PM, duodenalswitch@y... writes:

>

> << Obviously, It's Dr. Gagner's

> call, but so far I haven't heard from him directly. When I asked

for Ivonne

> to have him call me, she said: " That's not possible " Your surgery

is

> cancelled and that's final! " I immediately e-mailed Dr Gagner, but

have not

> yet heard from him as to when and how he will make his decision. I

must admit

> that I am fearful, too, because I still do not know the basis of

his

> concerns....Alll he has said is to consult with your PCP. All of

this is so

> upsetting. All the plans ......hotel accommodations, travel,

arrangements at

> work.....I can't believe that it has turned out this wayl >>

>

>

>

> Alice: How discouraging! I'm so sorry to hear about this... Is

your PCP

> familiar with this issue and what this could mean (i.e. the low

albumin)? I

> certainly hope so since Ivonne is advising you go to your PCP for

further

> instruction and explanation... I know it sounds really depressing

but I would

> definately trust Dr. Gagner's expertise. I would also be

irritated, though,

> that no one has really explained to you what this condition means

and how it

> could affect you post-op. It sounds like the problem isn't your

current

> health but how the surgery might make your levels plunge and you

would be

> more susceptible to low protein. This can become a very serious

deficiency

> so I don't think Dr. Gagner would take it lightly.

>

> It sounds to me like you have some options: Definately you deserve

a clear

> explanation of why this condition would potentially put your body

in danger

> with the surgery. You can also try to consult with other surgeons

if you

> honestly feel that Dr. Gagner is 'too conservative' or that another

surgeon

> may have a different opinion on the matter. This could be costly,

though so

> perhaps you could e-mail some surgeons and get your feelers out

about whether

> this would be a possible condition to work with post-operatively.

ALSO, has

> ANYONE mentioned how you can help to raise these levels? Have you

tried

> various means, if possible, to raise the albumin level? I mean, if

there's

> some way to change this then you should be given the opportunity

to, IMHO.

>

> all the best,

>

> lap ds with gallbladder removal

> January 25, 2001

> Dr. gAgner/Mt. Sinai/NYC

>

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

>

> preop: 307 lbs/bmi 45

> now: 217

[Guest guest]

And you deserve to be treated with utmost respect. It is not

necessary to be disrespectful or rude when saying " no " .

Unfortunately, in addition to the many stories about Dr Gagner's

incredible surgical skills, the sad tales of his office staff have

also been remarkable. I just can't imagine how those folks keep their

jobs and treat patients so badly. My experience behind the scenes

with surgeons is that many of them are what my mom would call " high

strung " and should never be exposed to an unanesthesized patient.

For the welfare of the patient, of course.

the decision makes sense to me.. your treatment at the hands of the

Gagner gang does not.

However, having said that, it is true that understanding the

intricate process by which the body makes or does not make albumin is

not what surgeons study. You probably do need a specialist for this

since your problem seems to be something of a mystery.

Good look and wishing normal protein levels for you.

in Seattle

> Would have been happy to work with any suggestions that Dr. Gagner

or his

> nutritionist had to offerl Just sent me to my pcp who cleared me

along with

> my GI doc, neither of who can find ANY abnormalities whatsoever.

Dr. Gagner

> has made no suggestions about what might be the cause or remedy .

This is

> what is so frustrating. I am a very intellligent person who would

never put

> myself in jeopardy and who is totally compliant with all

recommendations. I

> just don't know what to do about a surgeon who " shrugs " when you

ask a

> questions, sends me back to my internist, refuses to speak

personally with

> her and then, evidently, rejects her medical input, which is based

upon

> thorough examination. Sorry to sound touchy, but I thought that

your reply

> implied that I was looking to find someone do do my surgery " no

matter what " .

> Nothing could be farther from the truth. I am looking for a

physician whose

> concern for his patients extends to common courtesy.

[Guest guest]

In a message dated 9/23/01 6:31:52 PM, duodenalswitch writes:

<< WOW.. its just falling off of you!

I hope I do so well after this plateau.. I'm having my first real " oh

no its stopping I'll need a revision " panic attacks here- Watching

your numbers drop is such a comfort (yep, I'm strange). You go,

girl.. You're practically in the 100's... when do we see new

pictures???

>>

I am totally amazed: I tell you I've gotten into a pattern of eating

sandwiches: Salami, balogna & cheese, corned beef, chicken on Wonder Bread

(childhood comfort foods LOL). I don't know if that has anything to do with

it, but man it IS just falling off (for NOW LOL). I usually eat in

'cycles': I'll love cheese omlettes for breakfast for awhile, then

sandwiches, etc. I usually have one sandwich for breakfast than lunch

(snacking in between on some stuff) and then have a regular 'dinner'

(pork/beef/chicken, some carbs and veggies). I'll usually have a yogurt (I

love the Dannon Light n' Fit -- it has 16 gms/sugar and 8 gm of protein but I

can STOMACH it -- I had the other non-fat yogurts), cottage cheese, fresh

fruit (apples/bananas, etc.) or peanuts/pistachios for snacks. I've even

broken down and had some COKE and SNICKERS mini-bars!!! I figure at least

I'm getting protein from the peanuts, right? LOL I may eat anywhere from

2-4 at a time but not necessarily every day.

I can't WAIT to get out of the 200s alltogether and kiss them GOODBYE!!!!!!!

Good RIDDANCE, man!

I have to get a recent photo up --- People are really starting to notice now.

I feel so much better and have so much more energy. I always get hungrier

when I'm losing and then pretty much lose my appetite when I'm on a plateau.

I just try to get the food in (mainly protein) when I'm on that plateau and

try to kick up the exercise (walking more frequently)... Now, talk to me in a

few weeks and I'll most likely be lamenting that I'm never going to lose

another pound and the plateau will last forever! LOL

all the best,

lap ds with gallbladder removal

january 25, 2001

Dr. Gagner/Mt. Sinai/nYC

eight months post-op and still feelin' fabu!

preop: 3 07 lbs/bmi 45

now: 215