DS after heart attack
Dear new Friends
This is my first post !!! I'm sure there will be more.
I'll attempt to be as brief as possible.
I'm a 6'2" 370lb,42yr old male in Toronto, recently having suffered my third heart attack on june 28th 2011, my previous two were june and aug 09, while in hospital I was further diagnosed with type 2 diabetes and high triglycerides, I also suffer from extreme sleep apnea, after 2 years of dithering, 3 angioplasties with 7 stents in total I have finally come to the conclusion/realization that I need WLS surgery or I'm gonna be a goner soon, after much internet research I've come to the conclusion that I want to have a Biliopancreatic Diversion with Duodenal Switch (BPD-DS). My logic is as follows, I want to maximise weight loss, I want it to stay off, I want to not feel hunger, when I eat I want a feeling of satiety, and when I cheat I want a caloric discount! hahaha.
My questions to you are as follows : (answer what you can )
1. Does anyone do this surgery in Ontario and do they have experience, I've found no one.
2. If I need to travel, I would prefer Montreal, Chicago or Tampa Bay as we have have family in these cities and it would be easier on my family who would travel with me. I've found a Dr Michel Ganger in Montreal ( who is currently in Europe on Vacation ) but have not been able to connect with him yet.
3. if anyone has experience with Dr Gagner in Montreal what are the expected self pay costs and how was the experience
4. What is expected of you pre-op, diet, medications, smoking etc...
5. How soon can I come home? how soon can I go back to work? (I have a driving job, no heavy lifting)
6. My family doctor and cardiologist who I visited with just recently both have not heard of the DS but said they would look into it, my family doctor told me I should wait 6 months post heart attack and my cardiologist said 1 year post heart attack to perform a WLS. of course I want to do it right away.
Does anyone have experience doing WLS post heart attack/angioplasty? what about continuing medications? my daily meds are as follows
Insulin 80 units daily Apo-metoprolol 50mg 2x daily Apo-furosemide 20 mg 1x daily Crestor 40mg 1x daily Insulin 80 units daily Ran-ramipril 10 mg 2x daily Entrophen ( aspirin)325mg 1x daily Plavix 75mg 1x daily
Thanks all for your help!!!
This is my first post !!! I'm sure there will be more.
I'll attempt to be as brief as possible.
I'm a 6'2" 370lb,42yr old male in Toronto, recently having suffered my third heart attack on june 28th 2011, my previous two were june and aug 09, while in hospital I was further diagnosed with type 2 diabetes and high triglycerides, I also suffer from extreme sleep apnea, after 2 years of dithering, 3 angioplasties with 7 stents in total I have finally come to the conclusion/realization that I need WLS surgery or I'm gonna be a goner soon, after much internet research I've come to the conclusion that I want to have a Biliopancreatic Diversion with Duodenal Switch (BPD-DS). My logic is as follows, I want to maximise weight loss, I want it to stay off, I want to not feel hunger, when I eat I want a feeling of satiety, and when I cheat I want a caloric discount! hahaha.
My questions to you are as follows : (answer what you can )
1. Does anyone do this surgery in Ontario and do they have experience, I've found no one.
2. If I need to travel, I would prefer Montreal, Chicago or Tampa Bay as we have have family in these cities and it would be easier on my family who would travel with me. I've found a Dr Michel Ganger in Montreal ( who is currently in Europe on Vacation ) but have not been able to connect with him yet.
3. if anyone has experience with Dr Gagner in Montreal what are the expected self pay costs and how was the experience
4. What is expected of you pre-op, diet, medications, smoking etc...
5. How soon can I come home? how soon can I go back to work? (I have a driving job, no heavy lifting)
6. My family doctor and cardiologist who I visited with just recently both have not heard of the DS but said they would look into it, my family doctor told me I should wait 6 months post heart attack and my cardiologist said 1 year post heart attack to perform a WLS. of course I want to do it right away.
Does anyone have experience doing WLS post heart attack/angioplasty? what about continuing medications? my daily meds are as follows
Insulin 80 units daily Apo-metoprolol 50mg 2x daily Apo-furosemide 20 mg 1x daily Crestor 40mg 1x daily Insulin 80 units daily Ran-ramipril 10 mg 2x daily Entrophen ( aspirin)325mg 1x daily Plavix 75mg 1x daily
Thanks all for your help!!!
Welcome!
I can address some of your questions, though probably not all
There is no one in Ontario doing the Ds. Your best bet would be Dr. Gagner in Montreal, who has an excellent reputation. I have no idea what his costs are. Can't comment on the experience at his hospital, but it's a wonderful city. Can't say how soon you could come home, pre-op requirements, etc, but surely you can get than info when he returns from vacation. There is also no one in Florida doing the DS. There are docs in Chicago, but people have found their program difficult to deal with (I'm going on what others have said, no personal experience)
Regarding your very recent heart attack, it is definitely higher risk for you to have any kind of surgery too soon afterwards. And this is major surgery with general anesthesia. Given that your cardiologist is an expert on the heart, and has surely cared for many other people who have had heart attacks, I would take his advice very seriously, and I suspect Dr. Gagner will also take his recommendations seriously. I totally understand your desire to get going now that you've made this huge decision, but your risk of another heart attack and/or death from having surgery too soon after a heart attack is real.
Smoking - I can't think of anything I could say that you don't already know, or that your doctors haven't already said. I'm just stunned that you would even ask about it.
Medications - not gonna touch that one either.
I think your decision to have the DS is a great decision, but timing will be important as well. Try to take good care of your heart and the rest of yourself in the meantime.
Larra
I can address some of your questions, though probably not all
There is no one in Ontario doing the Ds. Your best bet would be Dr. Gagner in Montreal, who has an excellent reputation. I have no idea what his costs are. Can't comment on the experience at his hospital, but it's a wonderful city. Can't say how soon you could come home, pre-op requirements, etc, but surely you can get than info when he returns from vacation. There is also no one in Florida doing the DS. There are docs in Chicago, but people have found their program difficult to deal with (I'm going on what others have said, no personal experience)
Regarding your very recent heart attack, it is definitely higher risk for you to have any kind of surgery too soon afterwards. And this is major surgery with general anesthesia. Given that your cardiologist is an expert on the heart, and has surely cared for many other people who have had heart attacks, I would take his advice very seriously, and I suspect Dr. Gagner will also take his recommendations seriously. I totally understand your desire to get going now that you've made this huge decision, but your risk of another heart attack and/or death from having surgery too soon after a heart attack is real.
Smoking - I can't think of anything I could say that you don't already know, or that your doctors haven't already said. I'm just stunned that you would even ask about it.
Medications - not gonna touch that one either.
I think your decision to have the DS is a great decision, but timing will be important as well. Try to take good care of your heart and the rest of yourself in the meantime.
Larra
I live in Chicago. After a few years of research, I traveled to San Francisco to have the amazing John Rabkin do my DS. www.paclap.com.
If I could not go to him, I would go to Dr. Gagner if I were you.
Best of luck!
Nicolle
If I could not go to him, I would go to Dr. Gagner if I were you.
Best of luck!
Nicolle
I had the kick-butt duodenal switch (DS)!
HW: 344 lbs CW: 150 lbs
Type 2 diabetes and sleep apnea GONE!
Welcome! I'm glad that your research has brought you here. I will as best as I can address your post.
(1) I don't think that there is anyone in Ontario. You will have to travel to have a DS. Do not just go to anyone, because not everyone knows how to do a DS. Be sure to check out DSfacts.com for a list of vetted surgeons. There are lots of self pay options including Mexico, but with your health history you may want to stay in the U.S. or Canada.
(2) Dr. Gagner. I didn't have him, but hands down he has a great reputation and is vetted here on the boards. Dr. Rabkin is another good choice too. Everyone who has them as surgeons and doctors are very happy with them.
(3). Completly clueless about costs for Gagner or Rabkin, but I think you can expect to pay around $25K.
(4).Changes to your course of medications would be up to your doctor naturally. Damage to your heart and body is already done. Most people, not all though, do have remission of their type II diabetes. As for the rest of your meds you will likely need to stay on them. My husband had a heart attack when he was 36. Followed a couple years later by having and RNY gastric bypass. He currently takes about 7 daily medications. Your blood work will need to be closely followed to be sure you are on the right dosage of meds. Time released meds may need to be re-evaluated due to the short bowel.
Smoking? Well whatever I say here will only parrot what doctors are telling you, which is to quit. You will need to quit prior to surgery as well I'm sure, most doctors do. You want to heal and live right? I know, easier said than done, but it can be done. Nuff said.
Pre-op diet -- depends on the doctor. Mine has his preop patients on a two week liquid protein meal replacement diet. Each doctor is different in this requirement. Losing weight, even just 10 pounds helps to shrink your liver and gives the doctor more room to see and move things around.
Post op diet. Eating fat is mostly ok, but remember you have already done damage to your body and so you still may need to adjust your fat intake. My cholesterol went from 250 to 120, and I eat a LOT of fat but I also have a very short common channel. Fat for me means more trips to the bathroom. Again, I would think that post op, you will need to watch your diet and your blood work to see what is and is not working. You will need to eat low carb. Think Atkins diet. Since you have diabetes you may want to eat things that have a low glycemic effect to your blood sugar. Hang around here long enough and you will learn about Fluff, Dreamfields pasta and lots of other low carb foods and how to eat post operatively.
(5). Depends on if your surgery is open or lap. Open you can expect a 6 to 8 week recovery. Lap is far less, but I think at least 2 to 3 weeks. Stamina and enery levels will be your nemisis and even driving can be energy draining especially if you drive a big truck.
(6) You will need to discuss this with the WLS surgeon. Six months sounds about right though. You need time to heal. Of course you want it right now. I get that, but healing from the injury done to your heart is JUST as important as is having surgery to lose the weight. I addressed the medication issue above, but my guess would be that you would likely need to remain on them though doseage might need adjusting up or down.
Blessings.
Maddie
(1) I don't think that there is anyone in Ontario. You will have to travel to have a DS. Do not just go to anyone, because not everyone knows how to do a DS. Be sure to check out DSfacts.com for a list of vetted surgeons. There are lots of self pay options including Mexico, but with your health history you may want to stay in the U.S. or Canada.
(2) Dr. Gagner. I didn't have him, but hands down he has a great reputation and is vetted here on the boards. Dr. Rabkin is another good choice too. Everyone who has them as surgeons and doctors are very happy with them.
(3). Completly clueless about costs for Gagner or Rabkin, but I think you can expect to pay around $25K.
(4).Changes to your course of medications would be up to your doctor naturally. Damage to your heart and body is already done. Most people, not all though, do have remission of their type II diabetes. As for the rest of your meds you will likely need to stay on them. My husband had a heart attack when he was 36. Followed a couple years later by having and RNY gastric bypass. He currently takes about 7 daily medications. Your blood work will need to be closely followed to be sure you are on the right dosage of meds. Time released meds may need to be re-evaluated due to the short bowel.
Smoking? Well whatever I say here will only parrot what doctors are telling you, which is to quit. You will need to quit prior to surgery as well I'm sure, most doctors do. You want to heal and live right? I know, easier said than done, but it can be done. Nuff said.
Pre-op diet -- depends on the doctor. Mine has his preop patients on a two week liquid protein meal replacement diet. Each doctor is different in this requirement. Losing weight, even just 10 pounds helps to shrink your liver and gives the doctor more room to see and move things around.
Post op diet. Eating fat is mostly ok, but remember you have already done damage to your body and so you still may need to adjust your fat intake. My cholesterol went from 250 to 120, and I eat a LOT of fat but I also have a very short common channel. Fat for me means more trips to the bathroom. Again, I would think that post op, you will need to watch your diet and your blood work to see what is and is not working. You will need to eat low carb. Think Atkins diet. Since you have diabetes you may want to eat things that have a low glycemic effect to your blood sugar. Hang around here long enough and you will learn about Fluff, Dreamfields pasta and lots of other low carb foods and how to eat post operatively.
(5). Depends on if your surgery is open or lap. Open you can expect a 6 to 8 week recovery. Lap is far less, but I think at least 2 to 3 weeks. Stamina and enery levels will be your nemisis and even driving can be energy draining especially if you drive a big truck.
(6) You will need to discuss this with the WLS surgeon. Six months sounds about right though. You need time to heal. Of course you want it right now. I get that, but healing from the injury done to your heart is JUST as important as is having surgery to lose the weight. I addressed the medication issue above, but my guess would be that you would likely need to remain on them though doseage might need adjusting up or down.
Blessings.
Maddie
HW (pre RNY) 430 / HW (pre DS) 302 / SW 288 /
Lowest weight 157 / CW 161 / GW 150
"I'm just one stomach flu away from my goal weight"
-
I have heard anecdotal evidence that the DS can REVERSE coronary artery blockages. Never seen a study on it though.
What about Marceau's group at the Department of Bariatric Surgery, Laval Hospital, Laval University, Chemin Ste-Foy, Quebec, Canada? They have a TON of experience.
picard.marceau@chg.ulaval.ca
What about Marceau's group at the Department of Bariatric Surgery, Laval Hospital, Laval University, Chemin Ste-Foy, Quebec, Canada? They have a TON of experience.
picard.marceau@chg.ulaval.ca
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