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Post by msbatt on Jan 6, 2012 23:07:45 GMT -5
If you're going with an open procedure, I really see no reason to not have the whole thing at once---unless you have other health problems I don't know about.
I had an open DS with a BMI of 74, no problems.
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Post by Deleted on Jan 6, 2012 23:15:59 GMT -5
OK, I have to post this information that I just received. Yes, I am throwing a mini fit. But, ultimately, I will do whatever the Dr. wants me to do because I know he is just wanting me to be safe. Here goes....As some of you may already know I, after much struggle and fight, have accepted that I am a self payer. I chose Dr. Ungson, based on my research of him, costs, and the glowing recommendation from you folks. I submitted my health history to him a few days ago and just heard back from Luz. She told me because of my BMI, 60.4, he will need to see front and side pictures of me to determine my surgery risks. Also, he wants me to consider a TWO-PART SURGERY. Eh? I. Am. A. Frigg'n. Whale. Or, at least that's how I feel right now. Ya know, I understand that with being big all my life that there has always been some degree of denial, on my part, as to my whole weight. I knew I was big, but holy shit! I feel like a fucking freak! (sorry for the dramatics but, I mean, DAMN) Anyways, I didn't know where to go with this new information or the emotions I'm feeling right now...so I posted here. Well, there IS such a thing as medical need for a two parter. But IMO that's a rarity. For the most part, I would say of a surgeon who pushes for a two parter that s/he is looking for two fees. Dr. Ungson has done some VERY complicated people, though, and only extremely rarely has he had to resort to a two parter. Your BMI threw him a flag, I suspect, for him to say he'd better look at you carefully from a distance, because it would really suck to promise you one thing and then have you go all the way down there to discover that he couldn't do what you went there for. Look up Rena on here or on OH, or on Facebook and talk to her about her experience with Dr. U. She had big troubles and wound up going down there twice, but when all was said and done she got her DS in one part. In fact, I'll text her and ask her to hop in here if she hasn't already. |
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Post by lisalou79 on Jan 7, 2012 0:03:08 GMT -5
Oh thank you EN! Any help I can get I always appreciate. Yep, don't know for sure what sent the red flag up on my case. Yeah, the BMI is over 60. Yeah, I've had four previous abdominal surgeries so I'm sure there is plenty of scar tissue to work through. But I didn't ask him why he chose to mention the 2-part option.
I do know that under the med. history it asked if my heart has ever skipped beats or stopped. I had to answer yes because my heart (and I have a slightly high diastolic but only usually at 90 and my PCP didn't recommend I need BP meds for that) has skipped beats here and there. Not sure what that's all about but it makes me feel like I can't breathe and I cough when it happens (no phlem). So, this might be another red flag for him.
I told him I was starting NOW to lose weight. This is panic inducing in a way because I got on the treadmill for the first time in over a year tonight and literally felt like I was going to puke. I had to stop at 7 mins.
Lord help me it hurt! But I am gonna lose weight before surgery and exercise to give myself the best odds.
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Post by Happy DSr on Jan 7, 2012 0:16:30 GMT -5
being as fit and healthy before surgery will help a great del whether a one or two part surgery. I would guess if you are less fit, the surgeon will be more careful and want to reduce the time you are under. So being fit will improve the chances for a one part procedure.
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Post by goodkel on Jan 7, 2012 1:04:47 GMT -5
Dr. Ungson did a one stage DS on a 700 lb. man. He is capable of this. When you get the chance to speak with him, ask him for specifics WHY he would suggest a two-part DS. Be well prepared with counter arguments.
He tried to talk me into a VSG as I was a relative lightweight who hadn't been MO for long. I gave him a lengthy explanation why I needed the DS and why I thought that the VSG would be inadequate long term.
He was satisfied that I knew myself, understood the operation and the post-op requirements. He agreed to my surgery.
I felt like he was testing me and I guess he was.
He wants you "to consider" a two part DS. He's not insisting on it. Explain to him why that won't work for you and insist on the full DS.
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Post by Dudette on Jan 7, 2012 1:17:51 GMT -5
I do know that under the med. history it asked if my heart has ever skipped beats or stopped. I had to answer yes because my heart (and I have a slightly high diastolic but only usually at 90 and my PCP didn't recommend I need BP meds for that) has skipped beats here and there. Not sure what that's all about but it makes me feel like I can't breathe and I cough when it happens (no phlem). So, this might be another red flag for him. I told him I was starting NOW to lose weight. This is panic inducing in a way because I got on the treadmill for the first time in over a year tonight and literally felt like I was going to puke. I had to stop at 7 mins. Lord help me it hurt! But I am gonna lose weight before surgery and exercise to give myself the best odds. My diastolic BP was bad when I got my DS. 195/108. But I was still a relative lightweight at 265 lbs. on the day of my surgery. What you describe with your heart skipping beats does seem a bit concerning though so maybe that's what raised the flag. Regarding the treadmill... good job! I know it was torture. Try to do 7 minutes again tomorrow. The next day go for 8 minutes. Keep it up! |
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Post by lisalou79 on Jan 7, 2012 2:43:15 GMT -5
Thank you Dudette. Yep, tomorrow I plan to get more exercise and lean protein with veggies. Fun fun fun, lol.
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Post by Dudette on Jan 7, 2012 2:51:13 GMT -5
Thank you Dudette. Yep, tomorrow I plan to get more exercise and lean protein with veggies. Fun fun fun, lol. Karma for Lisa for starting to exercise! ;D |
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Post by rena on Jan 7, 2012 4:25:55 GMT -5
So I am late to the party but someone texted me and said I should maybe come and share some of my VAST (ahhaha ok not so vast) knowledge with you. I am an Ungson patient. I went to Mexico twice.... NOT for a 2 part DS tho.... I got there was all ready... all set up IV in and everything and one of the 7 surgeons who assist on the surgery was like... Hey, does it bother anyone that this chick sometimes bleeds for long periods of time and no one really knows why? Everything stopped. There was talking and more talking... Soon i was back up in my room waiting for more word on what the plan was. Dr. U kept checking on me and letting me know that he was doing research and looking for a solution. Without charging me a dime he flew in a Blood specialist that day. The specialist spent time monitoring me and performing tests. The hospital there is awesome. Clean, professional and efficient. It is a private hospital tho. They aren't like ERs here in the states. They don't keep every possible drug in a drawer down the hall. Every surgery is meticulously planned. Every detail thought out. Ungson doesn't loose patients... it just isn't in him. He lost one... a long time ago... Someone with a super high BMI with so many other complications. He came into my room that evening to tell me all about his experiences and even some of his fears. He knew that I would have a better chance in the states figuring out what drugs to use for my bleeding disorder. I was meant to have another surgery there for a cyst removal. He asked if i could go back and have that surgery... heal up for a few months and then come back and see him. I was devastated. But I knew it was a smart decision. I knew he was doing what was best for me. He said that this was never something that had ever happened. He had never not performed surgery on someone. he felt so sorry that he and the rest of his surgical team offered their services for free on my next visit. That I would only pay for the hospital and medication expenses. What did i do? I went home. Got that other procedure scheduled. Took the time to get healthier. Had my cyst removal surgery and had that surgeon send him all of his notes on the surgery and on my bleeding and the medications that they used. Once Dr. U had everything planned out perfectly (how he likes it). I was back in Mexico... This time much less fearful, I had already met the staff and seen everywhere I would be... The surgery was perfect... He was amazing. The surgeons became good friends of mine and Luz is still a close friend of mine. I feel like these people are my family.... I have lost over 225 pounds... and am still loosing slowly. Dr. U and his staff are like a second family. I even intend on returning to visit.  I don't know if any of this helps... but i hope it does. Dr. U is a careful surgeon... but he is a fantastic surgeon... i wouldn't go anywhere else... Please feel free to message me if you have any questions. It is super late as i write this... so... I don't know if any of it makes sense. Hope so... -Rena |
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Post by brybry76 on Jan 7, 2012 8:37:35 GMT -5
My bmi was frickin 80 and my doc said the possibility of a 2 part surgery depended on how much fat there was around the liver and stomach... to prepare I was put on 5 weeks of liquid diet ( right before thanksgiving, damn it!) And that worked for me.. I wish u the best!
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Post by Deleted on Jan 7, 2012 15:16:01 GMT -5
Oh thank you EN! Any help I can get I always appreciate. Yep, don't know for sure what sent the red flag up on my case. Yeah, the BMI is over 60. Yeah, I've had four previous abdominal surgeries so I'm sure there is plenty of scar tissue to work through. But I didn't ask him why he chose to mention the 2-part option. I do know that under the med. history it asked if my heart has ever skipped beats or stopped. I had to answer yes because my heart (and I have a slightly high diastolic but only usually at 90 and my PCP didn't recommend I need BP meds for that) has skipped beats here and there. Not sure what that's all about but it makes me feel like I can't breathe and I cough when it happens (no phlem). So, this might be another red flag for him. I told him I was starting NOW to lose weight. This is panic inducing in a way because I got on the treadmill for the first time in over a year tonight and literally felt like I was going to puke. I had to stop at 7 mins. Lord help me it hurt! But I am gonna lose weight before surgery and exercise to give myself the best odds. HOLD EVERYTHING!!!!!!!!!!!!!!!!!! What do you mean, you felt like you were going to puke on the treadmill? Details please. This is possible ULTRA IMPORTANT and a sign to get your hiney to a cardiologist RIGHT NOW. So please describe in detail what happened. |
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Post by hoosiermama on Jan 7, 2012 15:24:38 GMT -5
Thanks, EN. I had skipped over that part. I, also, have SVT (that's where your heart skips a beat sometimes or I call it my little froggy). SVT is very common but it can be of concern. 2 weeks after my surgery, I spent 3 or 4 days in the cariac unit because my heart kept up the frog beating and fast like 180 and up. They couldn't get it to slow or convert to a normal rhythm. At that point its called atrial fibrallation where the top two chambers are beating to a weird drummer and the bottom two chambers are beating normally. You'll feel weak, nauseus and short of breath.
Now, if you felt nauseus on the treadmill that can have to do with the SVT or something worse. You need to have that checked out here and be cleared before you try for surgery. I wish I had, it would have saved me a lot of problems.
me
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Post by Seeking Healthy on Jan 7, 2012 16:31:25 GMT -5
Hi Lisalou,
You have gotten some REALLY good advice here. I was a lightweight going into surgery so can't help you much with your questions. I know that sometimes this WLS journey we embark on to become healthier can seem to be so slow and that there are so many hoops to jump through. It can be frustrating for sure. Hang in there, you will get there.
You have picked a well respected surgeon with a lot of experience, good for you. I just wanted to wish you well and hope your wait is over soon.
SH
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Post by lisalou79 on Jan 7, 2012 17:45:57 GMT -5
OK, first, thank you Rena for sharing your personal story with me about Dr. Ungson and his team.
Yes, it did help me and reassures me that I have picked a good surgeon.
As for my heart, I haven't had health insurance for very long as I was added to my husband's plan in November and just became active under it on the 1st of this year.
I chalked my heart up to a lot of other things that will need to be checked (mostly maintenance) that will need to be checked out. My heart hasn't skipped a beat in a while and the last time it did I had walked a large flight of stairs(heavy activity for me).
With this is mind, I will be calling my Dr. Monday morning to have some test ordered and see if they can narrow it down or explain it.
I don't have a history of heart disease or heart conditions in my family but I guess you just never know. It may be nothing, it may be my heart trying to pump enough blood to my my body and having a hard time keeping up (I'm just shooting from the hip as I have no medical experience at all)
I really do appreciate all of you for supporting me and giving me excellent advice. I can't tell how welcomed it is for me to have anyone looking out for me.
As for the weekend, I am continuing to eat healthy and get some light exercise (maybe a little slower on treadmill but I'll go longer than yesterday)
I'll keep you guys posted as the journey continues.
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Post by Deleted on Jan 7, 2012 18:18:16 GMT -5
OK, first, thank you Rena for sharing your personal story with me about Dr. Ungson and his team. Yes, it did help me and reassures me that I have picked a good surgeon. As for my heart, I haven't had health insurance for very long as I was added to my husband's plan in November and just became active under it on the 1st of this year. I chalked my heart up to a lot of other things that will need to be checked (mostly maintenance) that will need to be checked out. My heart hasn't skipped a beat in a while and the last time it did I had walked a large flight of stairs(heavy activity for me). With this is mind, I will be calling my Dr. Monday morning to have some test ordered and see if they can narrow it down or explain it. I don't have a history of heart disease or heart conditions in my family but I guess you just never know. It may be nothing, it may be my heart trying to pump enough blood to my my body and having a hard time keeping up (I'm just shooting from the hip as I have no medical experience at all) I really do appreciate all of you for supporting me and giving me excellent advice. I can't tell how welcomed it is for me to have anyone looking out for me. As for the weekend, I am continuing to eat healthy and get some light exercise (maybe a little slower on treadmill but I'll go longer than yesterday) I'll keep you guys posted as the journey continues. [glow=red,2,300] NO.[/glow] Stay OFF the treadmill and refrain from anything strenuous until you have been cleared by cardiology. Feeling bad enough that you feel like you're going to puke is a sign of possible HUGE HUGE trouble. It's also possibly a sign that you're out of shape. However, you are describing really significant symptoms. How do I know this? I tried to kill myself on a treadmill and then a while later by trailing off to elevations a mile or more above sea level with pulmonary hypertension. BAD choices. Learn from my stupidity and take this seriously. Get checked out NOW. And don't do anything that provokes those sensations/symptoms until you're cleared. |
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Post by lisalou79 on Jan 7, 2012 19:08:37 GMT -5
EN, knowing absolutely nothing about cardiac issues, I will hold off until after tests are done on my heart. It's always better to be safe than sorry.
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Post by Seeking Healthy on Jan 7, 2012 19:31:16 GMT -5
EN, knowing absolutely nothing about cardiac issues, I will hold off until after tests are done on my heart. It's always better to be safe than sorry. Prior to my RNY in 2001 after reviewing my families history with heart issues my doctor then, required that I undergo a Cardio stress with contrast before they would go ahead with my surgery. My surgery was already scheduled and I was due to have it within 2 days. Good thing for me their cardiologist was able to fit me in so I didn't have to delay… EN is right, get tested NOW… the results will more then likely be needed for you surgery clearance at any rate. |
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Post by Deleted on Jan 7, 2012 21:06:10 GMT -5
EN, knowing absolutely nothing about cardiac issues, I will hold off until after tests are done on my heart. It's always better to be safe than sorry. Good girl ;D. You would be AMAZED at how good folks can get at ignoring or minimizing really important symptoms. *ahem* I don't know ANYONE like this, nope.... And if you've never had cardio or pulmonary symptoms before, it's all too easy to assume that it comes on you like a freight train. Nope, the vast majority of the time it's so subtle that in retrospect, by the time you get sick enough to seek medical attention, you realize you were in trouble for who knows how long before that. I thought "shortness of breath" meant gasping for air. Uh, no, it means a mild tightness in your chest and a slight sense of straining for enough air. Something we superfatties feel all the time, right? SURE.....Except when it's something more. I didn't think it was all that serious when I walked across the parking lot at one of the stops along Lake Yellowstone (altitude somewhere between 7,000-8,000 feet, I think) and got "lightheaded." Um, well, what I was calling "lightheaded," other people would call the world spinning and tilting. (Denial is a bitch.) Imagine my astonishment when I did a walk test, back at sea level in my pulmonologist's office, and I happily waddled along thinking I was doing fine for a fat person....Until the person doing the test with me stopped me short, nabbed a chair and said SIT DOWN RIGHT NOW. My 02 sats had dropped below 80%--and all I felt was maybe the tiniest bit of pressure on my chest, something I'd felt pretty constantly for a long time and I thought was nothing. I was pretty stunned when the doc sent home health care to my door with oxygen equipment in under 24 hours. You could be doing just fine and only suffering with the miseries of trying to move a body that's more than twice the size it should be. But until you KNOW this, knock off anything that gives you symptoms. |
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Post by lisalou79 on Jan 8, 2012 1:49:14 GMT -5
Wow, that is crazy. Yeah, I've never had anyone I know have any heart problems so I'm pretty ignorant to any of the symptoms.
I told my husband I'll be going for some test Monday. In the meantime, I'm just eating healthy, drinking lots of water and unsweet tea, and taking it easy.
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Post by hoosiermama on Jan 8, 2012 1:59:52 GMT -5
Good Girl When I was in the cardiac unit I found out that a lot of people have atrial fib and don't feel it. They have no idea it's happening. Test as soon as you can and get cleared for surgery then let Dr. Ungson know that you've had a stress test and an echo... me |
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Post by beemerbeeper on Jan 8, 2012 2:54:44 GMT -5
Thank you all for the continued support. I did hear back from Luz and Dr. Ungson reviewed my front/side pics. Ultimately, he told me he is willing to do my surgery-all-at-once if I commit to losing weight to get my BMI down, starting today, until the day of surgery. I respect Dr. Ungson's decision and was given options to either find a Nutritionist here to work with or I could work directly with him. Either way, I have to lose weight before surgery. Even as a light weight I had to lose before surgery. Getting yourself in the best shape possible is only common sense. You don't want to risk a long flight, so don't risk anything else that you can avoid,either. I don't think a 2 step DS is really a DS by the way. The magic that occurs when it is done all at once is not replicated in a 2 step procedure. PLUS there is risk of having a second surgery and a second anesthesia. I'm glad a 2 step procedure was never on the radar for me when I had my DS. Also, I lost weight by eating like a DSer (pre-op). ~Becky |
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Post by Deleted on Jan 20, 2012 21:41:39 GMT -5
I call bulls#!+. Red flag. If the surgeon is wavering about whether they can do DS on a 60 BMI, I might start looking for another surgeon. It may end up costing you more in the long run if you only get a VSG the first time around and have to go back. A 60 BMI is pretty typical for DS.
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Post by lisalou79 on Jan 20, 2012 23:56:42 GMT -5
Slimshady, I've posted on the board Over tHere about my continuing journey to get DS.
I've contacted Dr. Stewart (for if I have to have the sleeve only right now) and just made contact with another DS option today too.
Yes, that did shake my confidence in Ungson a little after finding out from so many people and hearing from Stewart that my condition shouldn't be cause for a two-part DS.
I'm sure Ungson is wonderful, just not sure what's going on with my situation. Still waiting to hear back from him after my last e-mail.
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Post by mark540 on Jan 22, 2012 19:49:12 GMT -5
BMI 75 Lap DS with Dr. O'malley.
I expected an argument from him when I met face to face but he did not question my decision. (He only does about 5% of his WLS surgeries as DS.)
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Post by lisalou79 on Jan 22, 2012 23:30:26 GMT -5
Thanks for the tip Mark. I'm still working to lose weight pre-op. I got on the scale this morning to find my BMI is already down to 60.1 (based at 5'3") So, good thing for me is that I am almost out of the 60s BMI range. ;D I'm thinking one of the studies I read talked about BMI of 60 and over was higher risk? Maybe I'm remembering wrong. Anyways, I at least know that less weight gives me better odds of surgery. Still working to get DS surgery.  |
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Post by Deleted on Jan 23, 2012 12:57:35 GMT -5
Thanks for the tip Mark. I'm still working to lose weight pre-op. I got on the scale this morning to find my BMI is already down to 60.1 (based at 5'3") So, good thing for me is that I am almost out of the 60s BMI range. ;D I'm thinking one of the studies I read talked about BMI of 60 and over was higher risk? Maybe I'm remembering wrong. Anyways, I at least know that less weight gives me better odds of surgery. Still working to get DS surgery. Hang in there with the weight loss attempts. Remember that THIS time you only have to make it work temporarily. With that in mind, you might consider some of the more drastic diet methods....IF you have the mental health to handle them. That's a big consideration. IF you have the psychological wherewithal to do one of those Optifast type things, it just MIGHT do something useful for you, since your need is to drop a good sized chunk of weight fairly quickly and you have no real concerns about the regain that would follow. I could not have done that. I would have been over the edge and off the deep end into God knows where mental health wise. But for someone who has more steel in their psyche than I do, I could see doing something like making a plan with a surgeon and one or more supervising physicians to get down to xyz place BMI wise, get whatever additional medical clearances and then RUSH to the OR before anything changed. |
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Post by Melinda on Jan 23, 2012 15:25:40 GMT -5
Dear Lisa, First I just wanted to say I cringe to this day when I see people refer to themselves as a freak, or a whale  Please stop the negative talk! God knows I beat myself with it for years and years. That's shame talking! We have to get out of that mindset where it's ok to call ourselves names and feel ashamed for who we are at this moment in our lives. Give yourself the positive talk! Look what you are doing! You are taking major, courageous steps to improve your health and lengthen your life! You would call that a HERO not a whale, true? You are valuable! You are worth it. I would have shrugged it off, taken the pics, sent them off, said a prayer and trusted that things will work out the way they are meant to. Believe me I still struggle with allowing the scale to determine how I will feel about myself that day and I realize that type of "self talk" is horrible and destructive. Give yourself a giant pat on the back for being so brave and determined to improve your health! You can do this! I lost weight for my surgery simply by walking. A bit further each day, or using a treadmill. Mostly I was trying to improve my lung function for anesthesia but the weightloss was a nice bonus. I think you should be proud of yourself for doing what you need to do, even when it's uncomfortable. Good luck! You can do it! |
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Post by mommy2006 on Jan 23, 2012 18:24:06 GMT -5
I second Melinda. You're a lovely girl, sweets. No matter what your size. I was 454lbs just prior to surgery with an over 60 BMI (I am 5'11). Sudan wanted to do a 2-part surgery on me and after some advice from the (OH) board I countered and he agreed to do it all lap and move to open to finish if need be. He was able to do it all lap in one fell swoop with no issues. I personally would push for ONE surgery. I hope you get the answers you want. |
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Post by lisalou79 on Jan 23, 2012 18:47:12 GMT -5
Hey, thanks for everyone's support!
EN, I agree with you 100% and the idea of "I just have to diet this ONE last time" I think is what's allowed me to lose the 12 lbs. so far. I even thought about Optifast. I know my insurance won't cover the cost because they won't cover anything weight-loss related. How much does Optifast cost out of pocket?
I was cleared today to walk. I know this will help a lot to lose weight and prepare for surgery.
I don't beat myself up but it's real hard for me to not think of my weight in negative terms. I just feel like a lump of dough. I know this will change but I'm just so uncomfortable in this body right now.
I still have yet to hear anything back from Dr. Ungson's office. I sent them a pretty detailed letter describing an update on my health, weight, etc. I also asked more about DS in one and two parts for clarification. I was kind of anxious to find out the result but they must be busy.
My Dad called me earlier today to tell me he supports me and wants to co-sign for me. The loan still has to be small (at most $6000) so I'm watching the mail like a hawk to get the rest of my tax statement in order to file our income taxes. I need to know what our refund will be so I can get an accurate picture of what I have and what I will need.
The days seem to go by so slow when your stuck in limbo and not knowing what's going to happen for surgery. I've been reading you guy's posts like crazy to keep my mind off of waiting!
Anyways, thanks again. You guys rock!
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Post by lisalou79 on Jan 23, 2012 18:49:27 GMT -5
My bmi was frickin 80 and my doc said the possibility of a 2 part surgery depended on how much fat there was around the liver and stomach... to prepare I was put on 5 weeks of liquid diet ( right before thanksgiving, damn it!) And that worked for me.. I wish u the best! Thank you! Once I have a better idea of a surgery date I'll know my time-frame and can see where I'm at with my weight. If I have to, I'll do the liquid diet. |
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Please stop the negative talk! God knows I beat myself with it for years and years. That's shame talking! We have to get out of that mindset where it's ok to call ourselves names and feel ashamed for who we are at this moment in our lives. Give yourself the positive talk! Look what you are doing! You are taking major, courageous steps to improve your health and lengthen your life! You would call that a HERO not a whale, true? You are valuable! You are worth it. I would have shrugged it off, taken the pics, sent them off, said a prayer and trusted that things will work out the way they are meant to. Believe me I still struggle with allowing the scale to determine how I will feel about myself that day and I realize that type of "self talk" is horrible and destructive. Give yourself a giant pat on the back for being so brave and determined to improve your health! You can do this! I lost weight for my surgery simply by walking. A bit further each day, or using a treadmill. Mostly I was trying to improve my lung function for anesthesia but the weightloss was a nice bonus. I think you should be proud of yourself for doing what you need to do, even when it's uncomfortable.