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Surgeon: Dr. Kenneth Welker, Portland, OR Most recent update: September 12, 2004
I'm writing this initial piece on October 9th, 2000. I am scheduled for surgery on November 29th. But more about that later. Following is a food and weight loss diary I wrote in preparation for my WLS consultation with Dr. Kenneth Welker. Food and weight loss diary as of 8/25/00 My first wife put me on a strict diet when she saw me go through 245 pounds in about 1965. I was ravenously hungry, so I often stopped on the way home from work and would eat one or two hamburgers so dinner wouldn’t be such a disappointment. I went through 250 during that period, in 1965 or so. I fought the weight and went into counseling off and on over the years for lots of reasons. The principle things I dealt with was failing first and second marriages, and my weight. I went into my third marriage in 1978 or 1979. Prior to that I had been up to 290 or so. I dieted HARD and got below 200, down to around 195 or so at the time of that marriage. In five years I was back up to 285. I went into counseling again with a local counselor. This did a lot of good for my self respect but none for my weight. Finally, in 1985 or so I was up to 325. I began divorce proceedings from my third marriage and began going to a Psychiatrist on the advice of my family doctor. This was for the specific purpose of losing weight. He put me on Prozac, then brand new. In four months with him, the Prozac did no good whatever and I made it to my all time high, 375 pounds. The Psychiatrist put me in an in-house treatment program, then new in San Antonio, The Rader Institute. This began in October of 1989. I spent six weeks in the treatment center. They got me into Overeaters Anonymous. While in the in-house program and over the next three or four years, I lost weight down to 290 pounds or so from the high of 375. I also married then for the fourth (and last) time. I went back to around 340 in 1995. My family doctor put me on Redux. It worked! For a while. I got back down to about 300 pounds when they took it off the market. I gradually gained back to about 320 until about a year ago (1999) when he put me on Meridia. I tried it for about six months and it doesn’t seem to have done any good, certainly nothing like as much good as the Redux did. I am currently at about 340 and have been between 320 and 340 for the last six months or so. I am currently active on two different Overeaters Anonymous groups on the Internet, and while I feel they are keeping me from allowing my eating to go completely crazy, I haven’t been losing any weight. I should also mention that I am on a fairly low dosage of thyroid medication since my early 20’s when a low thyroid condition was diagnosed. It has been checked regularly over the years and now appears normal. I discontinued the Meridia about two months ago, as it didn’t seem to be doing anything for me. I have recently discovered the possibility of weight loss surgery, and feel that could very well be the answer for me. I am willing to do light exercise if it will help. My gross obesity does not allow me to do any heavy exercise at the moment. My cardiologist recommends against heavy exercise because of my heart condition. I am willing to continue to work an OA program. I am willing to get on-going blood tests to monitor my chemical and mineral levels for the rest of my life and take whatever vitamins, minerals or other medications are necessary. Have I been on diets? Yes, of course. As I mentioned, I was simply told in my childhood to not eat so much. I was taught what was "fattening" and what wasn’t. I learned to say no to potatoes and ice cream, and yes to meat and green vegetables, though I didn’t always do it. Later, I learned to count and even memorize charts of calories, carbohydrates, fat grams, etc. Fasting worked briefly on a number of occasions. Then came the Air Force Diet and the Drinking Man’s Diet in the late 50’s or early 60’s. Worked great. For a little while. I lost weight but gained that back and more. Remember "Calories Don’t Count"? I do. Then Atkins, etc. There was one diet where you had nearly zero carbohydrates for six days, then binge on the seventh. Then back for six more days of agony in anticipation of the seventh. It lasted a couple of months with no weight loss. An abject failure. I tried lots of good balanced diets like Weight Watchers and Richard Simmons exchange cards and even an exchange system given to me by a dietitian at Rader Institute. None of them seemed to work even short term for me. So I tended toward the high protein, low carbohydrate ones. They, at least, worked short term. But only short term. Recently my doctor tried to get me on The Zone but I simply couldn’t understand its complications. Of all the food plans long term, it makes the most sense, however. But it would take some study. Recently I have tried the "New" Atkins diet, the Neanderthin Lifestyle, the Carbohydrate Addicts Diet and anything else to help someone make a quick buck by selling me a new promising book. Still, while many worked for a time, none worked for long. My wife Joy and I heard about weight loss surgery in May or so of 2000. We researched it on the web and decided that the RNY, described in a local (San Antonio) doctor's site as the "gold standard of weight loss surgeries" was worth doing. We realized that it would entail a drastic change in life style for both of us, but we had both done everything we could think of to lose and keep weight off, and our health problems told us that we MUST do something. I spoke (on the Internet) with a couple of RNY post-ops and felt that though the change would be difficult, it would be better than dying in the next few years. I was then 59 years old, had high blood pressure, cholesterol, blood sugar and have had congestive heart failure. And numerous less life-threatening co-morbidities. Both my parents had died in their 50's. My days were numbered! I joined the OSSG group on e-Groups. While there, in the first week or so I got messages from two people. One was a lady from Austin who had recently had a VGB reversed to a DS by Dr. Crooks in Los Angeles. The other was from a lady in Germany who had gotten the DS by Dr. Baltasar in Spain. She had also had both her mother and her daughter get the same surgery from the same doctor, and everyone was doing wonderfully. Both these ladies pointed out the major differences between the RNY and the DS, and urged us to check out the DS before committing to the RNY. Thank God they did! I checked out the www.duodenalswitch.com site and it was like awakening to a new world. Joy and I read nearly every story on the site as well as virtually everything else there - a huge amount of material. We quickly decided that the duodenal switch was the surgery for us. We also read a great deal of material on the AMOS site, both doctor's reports and patient stories. A few of them were DS as well, though most were some other surgery. We learned a LOT. At the suggestion of a number of DS'ers, we decided on Dr. Kenneth Welker in Portland, Oregon. We can afford to pay for our surgery in the unlikely event that our insurance does not pay for it. And as this is possibly the most important thing we have ever done, certainly done together, we wanted the absolute best. And Dr. Welker checked out as being the best. We knew we would have to travel as there are no Texas doctors doing the DS currently. So where we went didn't particularly matter. It's a half day to get anywhere, so Portland, Oregon is as close to us as Biloxi, Atlanta or L.A.. We had our initial consultation with Dr. Welker on Thursday, September 28th at 11:00 AM. The evening before, we attended the Welker support group meeting. It was announced there that he had done his first laparoscopic duodenal switch that morning. He was very pumped about that when we met with him. After the meeting Wednesday evening and again after meeting with Dr. Welker Thursday, we stopped by and met Lap-DS patient #1. He did his second on Friday, the day after we met with him. Dr. Welker said that I would be an excellent candidate for laparoscopic DS. He said that because of adhesions and scar tissue from prior surgeries, Joy would most probably be open. We had an outstanding session with him, asking him lots of questions. We knew the answers to many of them already from the DS list but we wanted to be reassured. And we definitely were. We came away from the meeting more sold on Dr. Welker than ever. I got a call on October 4th saying that Dr. Welker had set me for surgery on November 29th, the Wednesday after Thanksgiving. He plans to do Joy's surgery a month to six weeks after mine. And as mine will be laparoscopic, I expect I'll be in fine shape (pun intended) to look after Joy. I know lots will come up and I'll post here as things happen. 10/28/00 Update: A brief update. I received my insurance approval on Wednesday. Dr. Welker had sent in my letter of medical necessity about two weeks before. A rep from United Healthcare called and told me that if I had a change of date I should let them know. I asked if that meant that I was approved. She seemed a little surprised and said that it “was a covered procedure.” I tried not to shout in excitement and relief on the phone and thanked her. I called the insurance lady at Dr. Welker’s office and gave her the good news. I had gotten hotel reservations, rental car, airline tickets, etc. a couple of weeks ago so everything is ready. I have an appointment to get my colonoscopy done on 11/8. Joy will be done a week later. If all that goes without problems we’ll be leaving for Oregon the Saturday after Thanksgiving on November 25th. I have pre-op testing scheduled on Monday the 27th and surgery on the 29th. I have NOT been doing well losing weight before surgery as Dr. Welker wants all his patients to do. I will crank the “last diet” up a notch beginning tomorrow. I’ll probably be adding more post-op. January 30, 2001 Update: I’m writing this on 1/30/01. I have a hard time writing "01" because I missed December. I don’t remember Christmas or New Year’s. For me it never happened. My daughter had to tell me what I bought my grandchildren for Christmas so I would understand when they thanked me. This has turned out to be a lot longer and a lot more detail than many will want to read, so fair warning. I went in the hospital on Wednesday 11/29/00 for the gastric bypass with duodenal switch to be done laparoscopically. Everything went fine. I had an epidural which they removed Friday. That night I had some pain but it wasn’t that serious and I didn’t think much about it. The next afternoon I was released. We went by Fred Meyers to pick up some groceries and assorted items. I waited in the car while Joy went in to shop. I was in some pain which increased as I waited. When we started back to the hotel I was in a lot of pain. I got up to the room I parked myself on the sofa and the pain continued to get worse. I found out what they meant by a 10 level of pain. About 1-1/2 hours later we called the EMS and I was taken to the OHSU emergency room. Dr. Welker had left town and had to be called and he told them what x-rays to take. Dr. Welker returned to town and I was re-admitted. He told me that I had a leak in my stomach wall, away from any suture line. Just in the middle of my stomach. He didn’t believe that it was a place that he had even touched during the operation though he wasn’t sure. He was going to have to open me up and patch the hole and clean out my gut.
I understand that while repairing my first patch they found massive peritonitis. After that surgery the stomach contents ate back through into the stomach from the gut in two places. There was another surgery. At some point I went into septic shock and suffered abdominal compartment syndrome and fluid in the gut which was shutting down my organs, one by one. They drained it before it damaged my heart. At some point my spleen was removed. On Christmas day I was developing a fever and sinking. Dr. Welker was out of town with his family for the holidays. Knowing that he read his e-mail when out of town, Joy wrote him an e-mail telling him that my condition was deteriorating and he cut short his Christmas vacation to come back and try to drain infection around my left lung. It wouldn’t drain. He did a thorocotomy where they spread the ribs and sucked the infection out from the various sites around the lung which was partially collapsed. The other surgery sites are somewhat healed but that one still HURTS. At some point my family, two daughters and son, were called to come to Portland to say their good-byes. I was moments from dying at least twice during the ordeal. Joy told me about the candlelight vigils praying for my recovery by the DS group. I can’t think about all of that without choking up. I’m tearing up right now. I believe that prayer and the love of my wife allowed me to live. Without either I don’t think I would have made it. While I was in the ICU I told them that I intended to use the toilet located about ten feet from my bed. They told me that I really needed to use the bed pan. I insisted. They surrounded me by three men and I stepped out of bed and was heading for the floor when they grabbed me, put me back in bed and brought the bed pan. I couldn’t stand, much less walk. That was perhaps my worst day. I was told that a month flat on my back would do that but I had no idea. I worked with the Physical and Occupational Therapists at OHSU daily to try to learn to walk again. It was decided to transfer me to Providence Portland Hospital Rehab unit for work there. I spent ten days there working very hard. Thanks to some wonderful therapists I can now walk with the aid of a cane. I can go up and down stairs. I can get on and off a toilet with something to grab on to. Stamina is a serious problem. That will simply take time. Knowing what I do now, would I do it over again? Of course not. I’m not stupid! But knowing the odds that what happened to me or even worse was a real possibility, would I do it over again? Yes. I am aware how rare my complications are. But they do happen and they did to me. I’m losing weight rapidly. 65 pounds to date. But I have to say that I know the weight will come off. That is now of very little concern to me. My concern is getting back in the shape I was in before I went in. With some trepidation I will say that my wife is going to have the same surgery on February the 16th. I have to admit that I’m nervous about that. But I feel that the odds are very much with her as they were with me. In the first place I can’t and won’t try to tell her what to do with her life. But I agree with her that this surgery is perhaps her only way out. So, by the grace of God, the talent of a brilliant surgeon and the love of my wife I am alive and recovering. Update as of May 4, 2001: I am doing well. No, very well. There are a couple of new photos at the top of the page which show how well I am doing. My food is drastically different than when it was before the surgery. Other than that, life is getting back pretty much to normal. But that's some gut, isn't it? Plastic surgery and another 70 pounds will take care of that. I find that I am full on two eggs and a couple of slices of bacon with maybe a 1/2 slice of toast in the morning. A lunch is a slice of some kind of meat, possibly BBQ or something left over from earlier dinners. Then often a protein shake in the afternoon. This will have 1-1/2 scoops of pure protein powder, a handful of frozen fruit, 1-1/2 cups of Lactaid milk, some sweetener, usually Splenda, and a handful of ice. Makes a slightly crunchy smoothie. Dinner will usually be a piece of meat and 1/2 package of vegetable, either spinach, Brussels sprouts, or green beans. I split the package (except the Brussels sprouts) with my wife. Before going to bed I'll usually have another meat snack or occasionally a cookie. One cookie. Imagine! I still have a problem when we go out because I want to order FAR more than I can eat. And sometimes do. I have thrown up in some very fine restaurants. But I never throw up unless it's my own damned fault. Health. I have intermittent diarrhea. Not particularly bad now though it got pretty serious for a while. My PCP recommended Fiber Con and it has done the trick. Now it's pretty much dependent on my curtailing fats which set me off. I had my three month blood work done at 4 months. I am a bit low on protein and my Uric acid count is up. So it's back on the Allopurinol (for gout) and the protein shake in the afternoons. Other than that I'm doing very well. I am still somewhat weak from the long stay in the hospital. But that's getting better day by day. This is largely a function of exercise, something I haven't been very good at. I had an appointment with my Cardiologist and he was amazed and tickled to death that my blood pressure, cholesterol and diabetes are back to normal and I'm no longer on ANY of the medications, many of which he originally prescribed. Hopefully later this month we will be able to get on the road in our RV and we will see how I thrive with the increased physical demands on me. And I have an appointment with a plastic surgeon next week. More later. Update as of 6/25: I was disappointed with the plastic surgeon. He indicated that closing my hernia might be a problem. I e-mailed Dr. Welker and he replied that he did not think it would be a problem at all. I have been in contact with him and have a tentative appointment to see him in Eugene in a month or so. We will discuss my hernia and a possible revision for Joy. She has not been losing sufficient weight with her 100 cm common channel and is considering a revision. It looks like going out on the road in the RV will have to be put off for a while. I have had another blood workup. I have had severe swelling of my feet and ankles. I have developed weeping sores on my ankles which have soaked my shoes and bedding in clear serum. It has been giving me quite a bit of pain. I went to my PCP who immediately gave me more blood testing. He also sent me for an abdominal cat-scan. And a deep vein ultra-sound exam. Nothing notable came from those. But the blood test was different. I am quite low on protein. My calcium is also somewhat low. I have gotten away from the protein shake in the afternoon and will definitely get back to it. My PCP told me to double up on my calcium. I’ve been taking six Tums a day. I’ll take twelve from now on. No problem as they are fruit flavored and taste like candy. I have an appointment with an endocrinologist later this week but I expect he will just say to get my protein up. The swelling is a fairly common symptom of low protein. And I’ve got it bad. If it turns out to be anything other than that I’ll come back and explain later. Update as of 6/29/01: Well, it certainly turned out different! The night I wrote this I went to the bathroom about 3:00 AM and went into the kitchen for a drink of water. I woke up on the kitchen floor a while later having emptied my bowels there. I tried to get up and passed out twice more before calling Joy. She gave me some Gatorade, I got stable enough to take a shower and get back to bed by around 6:00 AM. I slept pretty well till 10:30 AM, called my PCP who told me to get to the emergency room. I got there yesterday at about 1:00 PM and they held me overnight. I had no more weakness or dizziness and have had no problem since other than the weeping sores on my swollen feet. While in the ER yesterday I got a call from Dr. Welker in Oregon. He said this is not a common complication but one which is not all that rare and it stems 100% from low protein. I guess that cements the idea that I will have to (1) count my protein grams for at least the next few months, and (b) supplement my diet with protein shakes for the next while. Dr. Welker cautioned me to take the protein shakes IN ADDITION TO high protein meals, not instead of them. So remember folks, do as I say, not as I do. I am now out of the hospital, at home and have an appointment with my cardiologist tomorrow just to be on the safe side but I'm convinced that when I fix the protein the rest will come around. More later. 12/17/01 Update When we returned to San Antonio I got with a local home health care group and they began the TPN at home. That was on about the 17th of September, shortly after the 9/11 situation. On November 20th my protein had improved enough to risk surgery. The surgery was to be extensive. Dr. Welker wanted to explore the old surgery and modify it so I would absorb more. Secondly my hernia which we had named Jumbo had continued to expand and he was going to close that. Finally he was going to do an panniculectomy. He said that was at the limit for any one surgery but he understood my passionate desire to get it all done at once. He did all of the above on 11/20. Dr. Welker found my common channel to be 55 cm and my alimentary limb was 250. He lengthened my common channel to 85 cm and my alimentary limb to 280. That appears to have helped the diarrhea a LOT. We stayed in Eugene until 12/4 when we headed back to San Antonio. The stay was not without drama. My wound began bleeding one night and I went dripping blood into the emergency room. That resulted in a day’s stay for an infusion of 4 units of blood in all. I would love Sacred Heart if their food wasn’t so lousy. Not quite as good as the Valley River Inn, our home away from home. We’ve now been home 13 days and the incision still is leaking a lot. I am covering it with Kotex pads and wearing Depends to protect my clothes. I have an appointment with a surgeon here in San Antonio tomorrow as my PCP thinks things are getting infected. And that could be very bad news indeed. Through all of this my back has been out quite badly and I’ve been spending a lot of time with a chiropractor. Damn it, I just wanna be well! Hopefully things will get straightened out and I can make a brief addendum to that effect in the next week or so. I really look good without the hernia if I do say so myself. I’ll post some pictures soon. 2/9/02 Update They put me in the hospital where I wound up staying for 8 days. They did a good bit there. First, they did a CT scan of my back. Then they did a needle biopsy of the suspicious area around my spine. They gave me a back brace which I found invaluable for comfort when doing everything but lying down. I’m still wearing that. They found a staph infection of my spine. They did some checking and cultured the same infection in my Groshong Catheter which was still in for the protein infusions. So it had to come out. And a PICC line went in. I was started on IV antibiotic infusions based on the cultures they had done on both the needle biopsy and the Groshong Catheter. I was then given a portable IV infusion system and sent home. So I am now home. I’m in a LOT of pain from my back but am under the treatment of a Neurosurgeon, an Infectious Disease Specialist, and a Pain Management Specialist. This is in addition to my PCP. I’m still taking IV antibiotic infusions every 6 hours. And I’m still on a lot of pain medications. My ankles have just begun swelling again so I could have to begin getting my legs compression wrapped again. What a hassle! But the illnesses which were life threatening appear to be behind me. And the pain is under control for the moment. I am taking it one day at a time. Ripping a page from my Overeaters Anonymous book. I can’t control the outcome of my problems. All I can really do is the next right thing. And for today it is to keep my feet elevated, to take my medications, to do the IV infusions, and hope for the best. Again, prayer from those in numerous groups are given and appreciated. And while everyone is different, that, I believe, is the number one factor is my survival and continued improvement. Hopefully I’ll have some really good news to report in the near future. I also want to get a more recent picture posted – one after my hernia has been fixed. An amazing difference. More later. November 11, 2003 Update Joy, my beloved wife, was waiting at the hospital in Eugene, OR where Dr. Welker was to do a revision for her. She was bowel prepped and was actually on the gurney when word came down that Dr. Welker was not going to do the surgery that day. She got dressed and we returned to the hotel, not knowing what else to do. To make a long story short, lots of hospital politics got Dr. Welker’s privileges at the hospital revoked. He is now not only out of doing the DS but out of the doctoring business. We feel like a member of our family has died. In the mean while I was going from bad to worse. I was continuing to lose weight, hitting a low of 131 pounds (down from a high of around 400). In early 2003 we were in Washington, DC at the World Figure Skating Championships. I was in the hotel taking a nap and heard a knock at the door. I jumped up and passed out, twisting my knee badly. Getting home to San Antonio they checked things out. Torn meniscus and ligament damage. I hobbled around in San Antonio for a couple of months on crutches and then canes. Then I had a fall and broke my left hip, the same side as the bum knee. They put in a plate, screw and pins and kept me in the hospital as every time I’d try to get up to walk or exercise with the PT’s my blood pressure would crash and I’d pass out. That was when I hit 131 pounds. They took me off my diuretics and I shot up to 210 pounds within a matter of several days. Not a good idea. I was sent to a rehab hospital here in San Antonio where I learned how to walk again and try to get a bit of my strength back. Shortly before I was to be discharged from there I had a fall in the bathroom and broke my other hip! Exactly the same break, same operation to fix it, and same hardware installed. I really make the airport metal detectors go crazy now with both hips pinned and mesh in my gut. While rehabbing yet again I had blood work done. The day I got home from rehab I contacted Dr. Ara Keshishian in Delano, California who had done a wonderful job on Joy’s revision. He said my protein levels constituted a real emergency and I needed surgery to revise my common channel IMMEDIATELY. So off to the Left Coast we flew. Dr. K. put me on IV TPN to try to build up my protein to make my chances of surviving the surgery better. I had revision surgery on 9/8/03, the day before my 63rd birthday. He more than doubled my common channel, out to some 200cm. Seems awfully long but it appears to have been what was needed. I then spent another two weeks in a rehab institute in Bakersfield, CA., meaning that 4 of the last 5 months had been spent in some sort of hospital setting. Bummer! I am now home. I’m building up strength slowly (according to Joy), or not all (according to me). I’m using crutches, canes or a walker to get around. My weight seems to have settled in the 160 to 170 pound range. The revision seems to make it possible for me to not continue to lose weight while not making me gain weight. That is the best of all possible outcomes but time will have to tell whether this is sustainable. For those of you who pray, please do so for me. For those whose proclivity leans toward positive thoughts, swinging chickens, lighting candles or simply keeping me in your thoughts, I will gladly accept any or all of the above. I will try to post some new pictures soon. I look quite different than the old pictures on the list show. This will be, I hope, my last post to this web site. When I last posted I was hovering between 160 and 170. I found my protein was still falling, however, and had lots of edema in my hands and legs. I upped my diuretic to a fairly ridiculous level (all at the recommendation of various doctors). Then my blood pressure began to drop again. They took me totally off diuretics and I began to swell. My weight had dropped to 150 and I was in the hospital with lots of pain. I gained back to 180, all water weight, and couldn't wear any of my rings. Then I got some blood work which was dramatically worse. My weight then dropped to 117 and I had no strength whatever. I contacted Dr. Keshishian in Delano, California and he told me I was dying of protein malnutrition - rapidly. He suggested I get my butt out to California to have a reversal of my DS. Not a revision this time, a reversal. I had to go on an air ambulance. I was WAY too weak to fly commercial. They gave me a couple of iron infusions and a whole blood transfusion before I left. When I got there I had more of the same and on 11/20/03 I had the reversal surgery. I wasn't happy to get it. I have loved being "thin" for the past 3+ years. But I did want to live and it didn't appear that I would without the reversal. So I am now 185 pounds, have the highest protein levels I've had in 3-1/2 years, am improving my anemia slowly, but am still very weak and can't get around without canes or a walker. I doubt if I'll ever be "normal" but I agreed to the surgery only because of what I felt I owed to my wife Joy who has stood by me through all of this. She doesn't deserve to have me die when I don't have to. I am absorbing normally now. Which means I have to go on that dreaded *diet*. I thought and hoped I'd never have to do that again, but here I am. My resected stomach and heightened satiety response will probably keep me from gaining a lot of weight but where I am now is about as heavy as I ever want to be. My cardiologist actually told me he wanted me to lose 10 to 15 pounds. Maybe I can. In any case I doubt if I'll be called on to have any further surgeries. I've had 20 by actual count in the last 3-1/2 years. That is enough! I won't say never again, but I certainly don't see what good further surgery would do for me. I now plan to give living life without concern toward my weight a try. I don't know if I'll be able to do it but with God's help I can do it today and for the rest of the day. Tomorrow morning I'll decide about that day. For all of you who have prayed for me I give you my most sincere thanks. That was, I believe, a major factor in my recovery. So I am signing off for now and maybe for good. If anything adds to my story I'll be back. Or when I die I expect Joy will let everyone know and add it to this page. Hi all - again. There seems to be just no getting rid of me. I have gotten several messages in the last few weeks saying that having read my story people believe that I wouldn't get the DS again. Let me say in the loudest possible way, THAT IS NOT THE CASE. I did say that if I had absolutely known that I would have the complications I had I would have to be crazy to have done it. I came very close to death on a number of occasions. But I know what the odds are against complications such as mine and the choice was either the risk of imminent death from my co-morbidities and the very low risk of death from surgery. I chose the low risk over the high and even knowing what could happen would do it again without hesitation. I believe that before anyone chooses major surgery over the huge risks of morbid obesity they should have tried all other options first. If there is a diet on the back page of a magazine, a new drug from your PCP, an infomercial that promises anything, some sort of low carb diet with exercise, absolutely try any and all of them before surgery. But when you have tried all the above and they haven't worked, then consider surgery. There are three major types of weight loss surgery as I write this. The least invasive is the Lap Band. It is decidedly safer than the other two. But it affects only the stomach size and doesn't entail any non-absorption. And consequently doesn't work as well as the other two. But it is easily reversed or modified. The RNY has a small non-absorptive component depending on how the surgeon does it, but it is very difficult to revise or reverse. Finally the DS has a major non-absorptive part and also reduces the stomach size. It can be reversed as it continues to use the pyloric valve and the stomach processes food normally though the stomach is much smaller. Unfortunately it is more complicated and expensive than either the RNY or the Lap Band. The patient tends to lose and keep off more weight in addition to which the down the road complications are no worse and in many ways better than the RNY. That is the surgery I chose and would choose it again. I hope this correctly explains how I feel about surgery. In my opinion, if diets have quit working and if you have a BMI of 40 or above, definitely consider surgery. Regards. Joe Frost, old gentleman, not old fart
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So much for the neat laparoscopic puncture holes. From there on I don’t remember much and can tell you very little other than what I have been told. I vaguely recall several different ICUs and recovery rooms. I was welcomed by a number of anesthesiologists. I was told over and over that there was going to have to be "one more surgery." Later I recall being told that I was going to be transferred to 6CVA, the wing where post-op DS patients generally stay. From there on I remember lots of what went on but not everything. I had been in a drug induced coma for something like 3 ½ weeks. And while the effects of the drugs wore off it didn’t happen immediately. I do remember a number of hallucinations that seem as real as anything I’ve ever experienced.