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Hi Nick,

While I think most of us agree that your comments are valid and very

strong selling points... I still maintain my earlier post that

different procedures are better for different patients. I know that

we all see DS as the best, I do too.. but if there were no DS , I

would have done the RNY.. and I would have done it on hopes that I

didnt have any of the complications you mentioned.. that I would be

one of the lucky ones (like a co-worker of mine who is doing well) and

be able to become healthy that way. There are so many variables which

could validate one type of procedure over the next.. you and I are

just lucky.. :o)..

Love, Sue

post op 9/11/01

Dr. Warden

Ocean sps, MS

> Hi Marcia -

>

> I don't want to start a war, either, but your statements are just a

bit

> unclear.

>

> You said that the DS isn't the right surgery for everyone. Is there

anyone

> who doesn't want to eat normally? Is there anyone who wants more

weight to

> come back post op? Is there anyone who prefers to have marginal

ulcers?

> Is there anyone who never wants to eat meat (or anything with fiber)

that

> hasn't been run through a food processor - maybe they'd actually

prefer

> Gerber's baby foods? Is there someone out there who really wants

to clog

> up their stoma and run on down for a bit of endoscopic maintenance?

>

> Is there anyone without psychological pathology who actually wants

to dump?

>

> Does somebody out there actually want to have band slippage or

erosion?

>

> Please let me know just who these people are because I can't picture

anyone

> who is well informed picking the RNY or Gastric Band . . . or any

other

> weight loss surgery.

>

> I, for one, will not be quite as wishy-washy. Let me go out on a

limb here.

> Anybody who gets the RNY (or other WLS) is a victim of

misinformation or a

> lack of information. Anyone who hopes to lose significant weight

and keep

> it off with the AGB is in fantasyland - unless they haven't bothered

to read

> the results of the FDA trials.

>

> Best,

>

> Nick in Sage

>

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Anyone who would not be a candidate for the DS due to previous

surgeries or other medical issues. I wish I could be more specific,

but Im not a doctor, so I cant quote case studies.. but I can tell you

that I have a friend who had a previous WLS and there are so many

problems with that, DS is not available for her. This has been

confirmed by two DS surgeons.. there must be others like her,

unfortunately.

> > > Hi Marcia -

> > >

> > > I don't want to start a war, either, but your statements are

just a

> > bit

> > > unclear.

> > >

> > > You said that the DS isn't the right surgery for everyone. Is

there

> > anyone

> > > who doesn't want to eat normally? Is there anyone who wants

more

> > weight to

> > > come back post op? Is there anyone who prefers to have

marginal

> > ulcers?

> > > Is there anyone who never wants to eat meat (or anything with

fiber)

> > that

> > > hasn't been run through a food processor - maybe they'd actually

> > prefer

> > > Gerber's baby foods? Is there someone out there who really

wants

> > to clog

> > > up their stoma and run on down for a bit of endoscopic

maintenance?

> > >

> > > Is there anyone without psychological pathology who actually

wants

> > to dump?

> > >

> > > Does somebody out there actually want to have band slippage or

> > erosion?

> > >

> > > Please let me know just who these people are because I can't

picture

> > anyone

> > > who is well informed picking the RNY or Gastric Band . . . or

any

> > other

> > > weight loss surgery.

> > >

> > > I, for one, will not be quite as wishy-washy. Let me go out on

a

> > limb here.

> > > Anybody who gets the RNY (or other WLS) is a victim of

> > misinformation or a

> > > lack of information. Anyone who hopes to lose significant

weight

> > and keep

> > > it off with the AGB is in fantasyland - unless they haven't

bothered

> > to read

> > > the results of the FDA trials.

> > >

> > > Best,

> > >

> > > Nick in Sage

> > >

> >

> >

> >

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

> >

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TOUCHE, Nick!!

;}

> > > > > Hi Marcia -

> > > > >

> > > > > I don't want to start a war, either, but your statements are

> > just a

> > > > bit

> > > > > unclear.

> > > > >

> > > > > You said that the DS isn't the right surgery for everyone.

Is

> > there

> > > > anyone

> > > > > who doesn't want to eat normally? Is there anyone who wants

> > more

> > > > weight to

> > > > > come back post op? Is there anyone who prefers to have

> > marginal

> > > > ulcers?

> > > > > Is there anyone who never wants to eat meat (or anything

with

> > fiber)

> > > > that

> > > > > hasn't been run through a food processor - maybe they'd

actually

> > > > prefer

> > > > > Gerber's baby foods? Is there someone out there who really

> > wants

> > > > to clog

> > > > > up their stoma and run on down for a bit of endoscopic

> > maintenance?

> > > > >

> > > > > Is there anyone without psychological pathology who actually

> > wants

> > > > to dump?

> > > > >

> > > > > Does somebody out there actually want to have band slippage

or

> > > > erosion?

> > > > >

> > > > > Please let me know just who these people are because I can't

> > picture

> > > > anyone

> > > > > who is well informed picking the RNY or Gastric Band . . .

or

> > any

> > > > other

> > > > > weight loss surgery.

> > > > >

> > > > > I, for one, will not be quite as wishy-washy. Let me go

out on

> > a

> > > > limb here.

> > > > > Anybody who gets the RNY (or other WLS) is a victim of

> > > > misinformation or a

> > > > > lack of information. Anyone who hopes to lose significant

> > weight

> > > > and keep

> > > > > it off with the AGB is in fantasyland - unless they haven't

> > bothered

> > > > to read

> > > > > the results of the FDA trials.

> > > > >

> > > > > Best,

> > > > >

> > > > > Nick in Sage

> > > > >

> > > >

> > > >

> > > >

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

----

> > > >

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Because when she had her original surgery done was 18 years ago, dear.

DS wasnt available and so she's stuck with the old 'gastroplasty'.. my

point in a nutshell.

> > > > > Hi Marcia -

> > > > >

> > > > > I don't want to start a war, either, but your statements are

> > just a

> > > > bit

> > > > > unclear.

> > > > >

> > > > > You said that the DS isn't the right surgery for everyone.

Is

> > there

> > > > anyone

> > > > > who doesn't want to eat normally? Is there anyone who wants

> > more

> > > > weight to

> > > > > come back post op? Is there anyone who prefers to have

> > marginal

> > > > ulcers?

> > > > > Is there anyone who never wants to eat meat (or anything

with

> > fiber)

> > > > that

> > > > > hasn't been run through a food processor - maybe they'd

actually

> > > > prefer

> > > > > Gerber's baby foods? Is there someone out there who really

> > wants

> > > > to clog

> > > > > up their stoma and run on down for a bit of endoscopic

> > maintenance?

> > > > >

> > > > > Is there anyone without psychological pathology who actually

> > wants

> > > > to dump?

> > > > >

> > > > > Does somebody out there actually want to have band slippage

or

> > > > erosion?

> > > > >

> > > > > Please let me know just who these people are because I can't

> > picture

> > > > anyone

> > > > > who is well informed picking the RNY or Gastric Band . . .

or

> > any

> > > > other

> > > > > weight loss surgery.

> > > > >

> > > > > I, for one, will not be quite as wishy-washy. Let me go out

on

> > a

> > > > limb here.

> > > > > Anybody who gets the RNY (or other WLS) is a victim of

> > > > misinformation or a

> > > > > lack of information. Anyone who hopes to lose significant

> > weight

> > > > and keep

> > > > > it off with the AGB is in fantasyland - unless they haven't

> > bothered

> > > > to read

> > > > > the results of the FDA trials.

> > > > >

> > > > > Best,

> > > > >

> > > > > Nick in Sage

> > > > >

> > > >

> > > >

> > > >

> >

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

> > > >

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Of course its superior, but not for everyone.. Im trying to say that

there are circumstances that would prevent a DS being done.. and there

are Im sure other scenarios.... :o( .. and that's what my response to

the post was about... its not fair or right to 'assume' that DS is

best for everyone.. cause its not.. even if its the best thing we

have.

> > > > > > > Hi Marcia -

> > > > > > >

> > > > > > > I don't want to start a war, either, but your statements

are

> > > > just a

> > > > > > bit

> > > > > > > unclear.

> > > > > > >

> > > > > > > You said that the DS isn't the right surgery for

everyone.

> > Is

> > > > there

> > > > > > anyone

> > > > > > > who doesn't want to eat normally? Is there anyone who

wants

> > > > more

> > > > > > weight to

> > > > > > > come back post op? Is there anyone who prefers to have

> > > > marginal

> > > > > > ulcers?

> > > > > > > Is there anyone who never wants to eat meat (or anything

> > with

> > > > fiber)

> > > > > > that

> > > > > > > hasn't been run through a food processor - maybe they'd

> > actually

> > > > > > prefer

> > > > > > > Gerber's baby foods? Is there someone out there who

really

> > > > wants

> > > > > > to clog

> > > > > > > up their stoma and run on down for a bit of endoscopic

> > > > maintenance?

> > > > > > >

> > > > > > > Is there anyone without psychological pathology who

actually

> > > > wants

> > > > > > to dump?

> > > > > > >

> > > > > > > Does somebody out there actually want to have band

slippage

> > or

> > > > > > erosion?

> > > > > > >

> > > > > > > Please let me know just who these people are because I

can't

> > > > picture

> > > > > > anyone

> > > > > > > who is well informed picking the RNY or Gastric Band . .

..

> > or

> > > > any

> > > > > > other

> > > > > > > weight loss surgery.

> > > > > > >

> > > > > > > I, for one, will not be quite as wishy-washy. Let me go

out

> > on

> > > > a

> > > > > > limb here.

> > > > > > > Anybody who gets the RNY (or other WLS) is a victim of

> > > > > > misinformation or a

> > > > > > > lack of information. Anyone who hopes to lose

significant

> > > > weight

> > > > > > and keep

> > > > > > > it off with the AGB is in fantasyland - unless they

haven't

> > > > bothered

> > > > > > to read

> > > > > > > the results of the FDA trials.

> > > > > > >

> > > > > > > Best,

> > > > > > >

> > > > > > > Nick in Sage

> > > > > > >

> > > > > >

> > > > > >

> > > > > >

> > > >

> >

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

> > > > > >

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I think I have backed it up, NIck.. I am not a doctor, so I dont know

the medical lingo, terminology etc. What I hear you are saying is

that anyone who is obese can and should have DS done.. but that is

wrong.. if everyone could, then why all the preop testing and medical

history research, etc? Not everyone who wants DS gets DS.. the

problems could be (simply put) anatomical, psychological, or

biological.. I dont know that there are 'stats' kept for turn down

cases.. never heard of that being done.. sorry I couldnt quench your

curiosity more than that. And when have you known me to be sweet or

tolerant? lol

Sue.

> > > > > > > > > Hi Marcia -

> > > > > > > > >

> > > > > > > > > I don't want to start a war, either, but your

statements

> > are

> > > > > > just a

> > > > > > > > bit

> > > > > > > > > unclear.

> > > > > > > > >

> > > > > > > > > You said that the DS isn't the right surgery for

> > everyone.

> > > > Is

> > > > > > there

> > > > > > > > anyone

> > > > > > > > > who doesn't want to eat normally? Is there anyone

who

> > wants

> > > > > > more

> > > > > > > > weight to

> > > > > > > > > come back post op? Is there anyone who prefers to

have

> > > > > > marginal

> > > > > > > > ulcers?

> > > > > > > > > Is there anyone who never wants to eat meat (or

anything

> > > > with

> > > > > > fiber)

> > > > > > > > that

> > > > > > > > > hasn't been run through a food processor - maybe

they'd

> > > > actually

> > > > > > > > prefer

> > > > > > > > > Gerber's baby foods? Is there someone out there

who

> > really

> > > > > > wants

> > > > > > > > to clog

> > > > > > > > > up their stoma and run on down for a bit of

endoscopic

> > > > > > maintenance?

> > > > > > > > >

> > > > > > > > > Is there anyone without psychological pathology who

> > actually

> > > > > > wants

> > > > > > > > to dump?

> > > > > > > > >

> > > > > > > > > Does somebody out there actually want to have band

> > slippage

> > > > or

> > > > > > > > erosion?

> > > > > > > > >

> > > > > > > > > Please let me know just who these people are because

I

> > can't

> > > > > > picture

> > > > > > > > anyone

> > > > > > > > > who is well informed picking the RNY or Gastric Band

.. .

> > .

> > > > or

> > > > > > any

> > > > > > > > other

> > > > > > > > > weight loss surgery.

> > > > > > > > >

> > > > > > > > > I, for one, will not be quite as wishy-washy. Let

me go

> > out

> > > > on

> > > > > > a

> > > > > > > > limb here.

> > > > > > > > > Anybody who gets the RNY (or other WLS) is a victim

of

> > > > > > > > misinformation or a

> > > > > > > > > lack of information. Anyone who hopes to lose

> > significant

> > > > > > weight

> > > > > > > > and keep

> > > > > > > > > it off with the AGB is in fantasyland - unless they

> > haven't

> > > > > > bothered

> > > > > > > > to read

> > > > > > > > > the results of the FDA trials.

> > > > > > > > >

> > > > > > > > > Best,

> > > > > > > > >

> > > > > > > > > Nick in Sage

> > > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > > > >

> > > > > >

> > > >

> >

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

> > > > > > > >

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Soozy,

According to your own statements you're not equipped (or even

partially equipped; e.g. " don't know the medical lingo " ?!) to back up

your statement, so until you are able to understand and cite some

research/information, maybe you shouldn't try. There's

enough " stuff " for people to wade through when trying to make a

informed decision; let's not put any more possibly-well-intentioned

but-unverifiable " information " out there.

Dispensing with the condescending " LOL, "

> > > > > > > > > > Hi Marcia -

> > > > > > > > > >

> > > > > > > > > > I don't want to start a war, either, but your

> statements

> > > are

> > > > > > > just a

> > > > > > > > > bit

> > > > > > > > > > unclear.

> > > > > > > > > >

> > > > > > > > > > You said that the DS isn't the right surgery for

> > > everyone.

> > > > > Is

> > > > > > > there

> > > > > > > > > anyone

> > > > > > > > > > who doesn't want to eat normally? Is there

anyone

> who

> > > wants

> > > > > > > more

> > > > > > > > > weight to

> > > > > > > > > > come back post op? Is there anyone who prefers

to

> have

> > > > > > > marginal

> > > > > > > > > ulcers?

> > > > > > > > > > Is there anyone who never wants to eat meat (or

> anything

> > > > > with

> > > > > > > fiber)

> > > > > > > > > that

> > > > > > > > > > hasn't been run through a food processor - maybe

> they'd

> > > > > actually

> > > > > > > > > prefer

> > > > > > > > > > Gerber's baby foods? Is there someone out there

> who

> > > really

> > > > > > > wants

> > > > > > > > > to clog

> > > > > > > > > > up their stoma and run on down for a bit of

> endoscopic

> > > > > > > maintenance?

> > > > > > > > > >

> > > > > > > > > > Is there anyone without psychological pathology

who

> > > actually

> > > > > > > wants

> > > > > > > > > to dump?

> > > > > > > > > >

> > > > > > > > > > Does somebody out there actually want to have band

> > > slippage

> > > > > or

> > > > > > > > > erosion?

> > > > > > > > > >

> > > > > > > > > > Please let me know just who these people are

because

> I

> > > can't

> > > > > > > picture

> > > > > > > > > anyone

> > > > > > > > > > who is well informed picking the RNY or Gastric

Band

> . .

> > > .

> > > > > or

> > > > > > > any

> > > > > > > > > other

> > > > > > > > > > weight loss surgery.

> > > > > > > > > >

> > > > > > > > > > I, for one, will not be quite as wishy-washy.

Let

> me go

> > > out

> > > > > on

> > > > > > > a

> > > > > > > > > limb here.

> > > > > > > > > > Anybody who gets the RNY (or other WLS) is a

victim

> of

> > > > > > > > > misinformation or a

> > > > > > > > > > lack of information. Anyone who hopes to lose

> > > significant

> > > > > > > weight

> > > > > > > > > and keep

> > > > > > > > > > it off with the AGB is in fantasyland - unless

they

> > > haven't

> > > > > > > bothered

> > > > > > > > > to read

> > > > > > > > > > the results of the FDA trials.

> > > > > > > > > >

> > > > > > > > > > Best,

> > > > > > > > > >

> > > > > > > > > > Nick in Sage

> > > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > > > >

> > > > > > >

> > > > >

> > >

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

--

> > > > > > > > >

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I can't quote scientific studies either, I know of at least one case where

DS was the wrong choice. I remember mentioning it to you a while ago.

Where a young woman was non-compliant with her supplements and protein

intake. She thought she felt fine with out them. Unfortunately you don't

show signs for some time with multiple vitamin deficiencies. She was also

warned a short time before her death from massive systemic infection that

she was probably protein deficient.

I have also heard of other cases like hers, maybe not as drastic.

Someone like this isn't a DS candidate. A RNY (not distal) would have been

better for her.

Also I know several people who have had RNY years ago, who have kept the

weight off. One of them is just recently started regaining some weight.

But, she is now 77 years old and has slowed down drastically because of

arthritis.

I know this isn't a scientific sample, but if there is one case that I know

of, there must be many more.

Rita Black

<<What concerns me is that you have yet to answer the question as to just

who

it is for whom the DS is not the right surgery. You have nothing to back up

your position, or at least you haven't provided it as yet.

It is all very nice and sweet to be tolerant of everyone and accept their

individual choices. However, if there is no scientific study, research or

evidence to back it up, it should not be paraded about as fact.>>

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Rita,

A small percentage of patients (maybee 2%) fail from non-compiance

and either have the procedure reversed or occasionally die. On the

other hand the RNY patients can suffer the same fate. Probably the

lap-band is best for non-compliant patients, though maybe no surgery

is best in that instance.

Hull

> I can't quote scientific studies either, I know of at least one

case where

> DS was the wrong choice. I remember mentioning it to you a while

ago.

> Where a young woman was non-compliant with her supplements and

protein

> intake. She thought she felt fine with out them. Unfortunately

you don't

> show signs for some time with multiple vitamin deficiencies. She

was also

> warned a short time before her death from massive systemic

infection that

> she was probably protein deficient.

> I have also heard of other cases like hers, maybe not as drastic.

> Someone like this isn't a DS candidate. A RNY (not distal) would

have been

> better for her.

>

> Also I know several people who have had RNY years ago, who have

kept the

> weight off. One of them is just recently started regaining some

weight.

> But, she is now 77 years old and has slowed down drastically

because of

> arthritis.

>

> I know this isn't a scientific sample, but if there is one case

that I know

> of, there must be many more.

>

> Rita Black

>

> <<What concerns me is that you have yet to answer the question as

to just

> who

> it is for whom the DS is not the right surgery. You have nothing

to back up

> your position, or at least you haven't provided it as yet.

>

> It is all very nice and sweet to be tolerant of everyone and accept

their

> individual choices. However, if there is no scientific study,

research or

> evidence to back it up, it should not be paraded about as fact.>>

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> I have to think that the lady's noncompliance with the DS would

have been a problem with any procedure. The shrink just plain blew

it with her.>>

I know many of you have not been on the list long enough to know

Aimee, but if that is who you are talking about, you are dead wrong.

She was my friend and her tragic death was not caused by non-

compliance. She struggled for months to be compliant. She tried

desperately to get her protein intake to where it should be. She

tried desperately to be compliant with her vitamins. She consulted

with many doctors and nutritionists about her specific problems. She

drank prescription protein supplements and was admitted to the

hospital to get IV protein. She had several other serious medical

complications prior to surgery, including a history of pancreatitis,

guillane barre syndrome and lymphedema. She was not a psychiatric

case. She was a very sick super MO young woman who saw the DS as a

last desperate attempt to save her life. She died as a result of

massive sepsis many many months after the surgery and several doctors

(not associated with her surgeon) told her family that her death was

not a result of the DS. She had dental work which could have

introduced the infection. She was a very high risk patient to begin

with and she and her surgeon knew it. Of course, her immune system

may have been stronger if she did not have the protein deficiency.

She may have been able to fight off the sepsis if she didn't have the

DS. I don't think anyone will ever know for sure, but I think it is

disrespectful and ignorant to brush her off as a shrink's bad call.

Regards,

Lori H (-120 lbs.)

Lap BPD/DS 8/17/00

Drs. Pomp and Gagner

Mt. Sinai, NYC

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You are entitled to your opinion.. and I respect it.. but that does

not lessen my stance.. regardless if you believe me or not.

Sue.

POST OP 9/11/01

Dr. Warden

Ocean SPS, MS

> Sue -

>

> You are like trying to put your finger into a blob of mercury.

First you

> said that different people were better off with different surgeries.

Next

> you said that you were right because you knew someone who said that

two

> doctors told them that a prior procedure disqualified them from the

DS. Now

> you are saying that some people can't have the DS because of

something that

> might turn up in their pre-op testing.

>

> There was a 60's book on human behavior called " Games People Play. "

One of

> those games is " Yes, but . . . " This is a game at which you excel.

>

> Sue, do you believe that, assuming someone who is morbidly obese and

is a

> candidate for any kind of surgery, might find something other than

the DS to

> be a better surgery for them?

>

> Please support your answer with factual data. It doesn't have to be

> medicalese, but it does have to represent what can be found in

studies and

> not merely in your mind.

>

> In case you haven't been through the pre-op testing, you will find

that most

> of it has to do with how they have to prepare to take care of

predictable

> situations that might occur during surgery. For example, a person

with a

> penchant for DVT will probably find the doctor installing a

Greenfield

> Filter. People with respiratory problems will likely have

precautions taken

> by a pulmonologist - and so on.

>

> Anyone with a problem uncovered at this point and is not able to

have the DS

> could not have other procedures, either, unless they were given an

AGB or,

> perhaps, one of those little balls they inflate in your stomach.

>

> Anyone who fails the psych test will likely not get the surgery,

either.

> That would be equally true, though, for any weight loss surgery.

>

> I could care less if you are sweet or tolerant. What I do care is

that you

> post accurate information and not present your opinion as fact. I

have yet

> to see you back up what you say with anything remotely resembling

facts.

>

> Best -

>

> Nick

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Lori,

I'm not sure if it was your friend that I had heard about, although the

circumstances sound the same. (I have brain freeze when trying to remember

names) The person who posted about her death reported that the last time

they saw her, that the doctor took one look at her and told her to make an

appointment to see him. Also that the young lady said she was feeling just

fine and didn't need to see the doctor.

I don't know if it could have been foreseen from Aimee's previous conditions

that she might have a problem with the malabsortive restrictions of the DS,

but I'm sure they had a hand in her conditions.

It is my understanding that DS is the most malabsortive procedure of WLS,

therefore there are conditions where it would not be indicated for a

patient. Outside of that, I think that the DS should be offered to more

patients.

There are those who shouldn't get any WLS. I met RNY'ers who suck on

lollipops because that is the only thing that makes their stomach feel good.

They would probably eat around their DS also.

Rita Black

<<I know many of you have not been on the list long enough to know

Aimee, but if that is who you are talking about, you are dead wrong.

She was my friend and her tragic death was not caused by non-

compliance. She struggled for months to be compliant. She tried

desperately to get her protein intake to where it should be. She

tried desperately to be compliant with her vitamins. She consulted

with many doctors and nutritionists about her specific problems. She

drank prescription protein supplements and was admitted to the

hospital to get IV protein. She had several other serious medical

complications prior to surgery, including a history of pancreatitis,

guillane barre syndrome and lymphedema. She was not a psychiatric

case. She was a very sick super MO young woman who saw the DS as a

last desperate attempt to save her life. She died as a result of

massive sepsis many many months after the surgery and several doctors

(not associated with her surgeon) told her family that her death was

not a result of the DS. She had dental work which could have

introduced the infection. She was a very high risk patient to begin

with and she and her surgeon knew it. Of course, her immune system

may have been stronger if she did not have the protein deficiency.

She may have been able to fight off the sepsis if she didn't have the

DS. I don't think anyone will ever know for sure, but I think it is

disrespectful and ignorant to brush her off as a shrink's bad call.

Regards,

Lori H (-120 lbs.)>>

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