I don't want surgery???!? *long*

 ask for a second opinion, for sure. I hope there is a way for you to get surgery safely - I mean, there is always a risk but hopefully that can be managed. I wish you the best! 

don't beat yourself up about gaining 26 pounds back - if it were easy, nobody would need surgery. but most of us did.

Very well said!  

Well, you've already seen how well diets work. They don't. It's not you, it's that diets just don't work.

I'm very sorry that you got postponed. What's the airway problem?

he said that he didn't "like" my airway. It's apparently crowded by fat.

I used to be a Respiratory Therapist and I can tell you from personal experience that it is challenging to intubate an obese patient.  It's not only more difficult to visualize the vocal cords, but also to physically manipulate the ET tube through them.

Your chances of anesthesia complications are higher too.  This particular anesthesiologist felt like the risk outweighed the benefits. 

There might be someone else out there who has more expertise intubating morbidly obese patients, but I wouldn't totally dismiss this doctor's concerns lightly either.

That's a very valid concern. Do you have sleep apnea, and if so, how is it being treated?

You might consider second and third opinions at other locations. Some docs are more comfortable with this particular kind of risk than others are.

If you do find docs who are okay with moving forward, be prepared to need to be intubated while awake. That's no fun, I'm told, but doable. Fortunately they can give you good happy drugs that make it less traumatic and that dim the  memory of the experience.

I had the same kind of airway issue and did fine. I had a total hysterectomy at about 385 pounds, while oxygen dependent with pulmonary hypertension, a couple years before I had my DS. It was a bit nerve wracking for the anesthesia folks and they told me so. (Not in that language of course lol.) But all was well and I got excellent care in both cases. They were able to knock me out (apparently pretty lightly, but that didn't matter to me cuz I was unconscious ha!) before doing the intubation.

I "put off" WLS for YEARS, because I didn't want to do something "so drastic".  But in the end, I came to realize that *I* simply would NEVER permanently lose weight without it. Not even five pounds, PERMANENTLY---every ounce I ever managed to lose, I regained plus some.

Something like 4% of the people who manage to lose more than 50 pounds manage to KEEP it off for as long as five years. That means that the other 96% regain it, and I had no trouble figuring out that I would never be part of the 4%.

You have two choices---you can diet agressively FOR THE REST OF YOUR LIFE and hope you can be one of that 4%. Or you can make a firm decision to have WLS and do whatever it takes to get surgery safely. I recommend you go back to see the anesthesiologist and have a very frank talk with him about ways to get WLS NOW. After all, if you needed any sort of emergency surgery, they'd find a way to do it.

Do you have sleep apnea? Do you use a C-PAP machine? Do you have other co-morbs? Which form of WLS were you planning to have?

My opinion: you need a better bariatrics program, with a surgeon who can manage a very large patient without requiring pre-op weight loss, and who works with an anesthesiologist who knows how to manage a very large patient without being afraid of a restricted airway.

I STRONGLY suggest that if you were not already working with a competent DS surgeon, that you consider doing so.  I further suggest that you look into a DS with one of the experts, Rabkin in San Francisco or Keshishian in Glendale CA.  Rabkin has done lap DS on people weighing up to 800 lbs.

To answer some que's: I have sleep apnea, I'm on a cpap (religiously), I'm pre diabetic, have gerd, have had palpitations, major osteo arthritis in the knees. It's not fun.

Thank you so much for all of the support.

Tracey, if you're looking at having RNY, I would strongly urge you to consider a different type of surgery.   Pain control for your arthritis could be an ongoing issue for you if you can't take NSAIDS.   Some people do have improvement in joint pain after they lose weight, but for others, too much damage has already been done.

Perhaps this delay might not be a bad thing.