over 400 lb spouse, new have q's

my husband is over the limit the doctor says the hospital will let him do  bypass surgery at.   (set at 400 lbs because of  hospital regs. and equip. )   is this common?  he needs to lose over 40lbs and with every loss attempt he gains more weight.  i am at a loss at how to support him.  has any one had the surgery done weighing that or more?  can it be safely done?  who does it? when we got a second opinion that dr said have the lap band to lose the weight then go back and have bypass.  that is 2x the surgery. any help?  ideas?  he is so frustrated i am afraid he is going to give up.  that will be a disaster as he is already having severe health complications (diabetes, leg problems, walking, high blood pressure...) as well as emotional ones.   i love him so much i dont want to lose him at 40. m

There are others on this board that have had surgery at over 400 lbs, I believe, and they should chime in on that. There may be limits on the equipment at a particular facility, but another place may have bigger items,

Regardless of equipment limits, pre-surgery weight loss is recommended by most docs for the following reasons:

1. A pre-surgery weight loss will shrink the liver. This allows more room inside the abdomen for the surgeon and increases the possibility of doing the surgery laproscopically.

2. Surgery at a much higher BMI is riskier. The more you can lose prior to surgery, the easier the recovery will be.

3. The ability to achieve a pre-surgery weight loss indicates commitment. The surgery is just a tool. The patient needs to commit to better health. 

Lots of folks on this board were worried about being able to lose beforehand. Talk to your doctor about options such as liquid diets or Medifast.

Don't give up. It's a journey, and can be frustrating at times. I'm over 400 lbs too.

I admire your love and devotion for your husband.  Will your husband join us?  Maybe we can be of more help if he will come to us or the guys at the men's forum.  We care for you both and I wish you much success.  Loris

he is actually lurking but hasnt quite made the step to join.... i love him and  would still love him healthier!  he has been heavy since i met him 8 yrs ago. he has had several attempts at weight loss and the diabetes keeps making them fail as well as his stress levels and "slips."  he has had several dr appts, has all the "paperwork"  and tests done for surgery but now the dr has left the hospital, so we are looking for a new one. 

Diet and exercise (anything he can do) are extremely important for improving his strength and recovery time after surgery, so whether he finds a doctor willing to do it at his current weight or not it is important and highly beneficial for him to do the best he can each day to make healthy food choices and increase his activity level.  Most docs require some weight loss from patients (someone above gave the biggest reasons).  I was 440 when I visited the surgeon, and 405  when I had surgery.  He would have liked me lower than that but was pleased that I'd managed to drop 35lbs.  I did it using 2-3 atkins advantage protein shakes and a small dinner of 4-6oz lean protein and unlimited (unsauced/buttered) cooked and raw veggies.  It was tough to get started but it got easier.  Medifast and optifast are also very good options to get weight off fast, but they are expensive.  Did the surgeon give him any suggestions for getting the weight off?  Honestly, and I am not trying to be harsh here, if your husband really wants this surgery he will do what it takes to lose some weight beforehand.  Its a pain, but its so important for his health and recovery, and every lb lost lowers the risk of complications.  He can do this, choose a program and stick to it.  If he messes up one day, put it behind him and do better the next day.  Honestly after the first 3 months or so post-op, losing weight will still take a lot of effort and commitment anyway, so he may as well get started now.  I wish you both the best and he is very lucky to have such a supportive and loving spouse!  Please keep us posted and encourage your husband to seek support locally or on OH - this board is wonderful and we would love to have more male perspectives here.  There is also a men's board that is very helpful and supportive.  Jenn

i appreciate your honesty and candor.   he has been walking and in warmer weather he swims, but is now suffering from a torn knee (an old injury re-done). he does need to take more responsible actions on dieting but his diabetes is out of control, and that dr gives him info that contradicts what the surgeon says... it is so confusing and crazy.  and now we have to start over with new surgeon.  i feel lost and can only imagine how he feels....

When I went to my preop appt. I weighed 468 that was on 9/12/07 My surgery was scheduled for 10/1/07 I was put on a 2 week medifast diet. and lost approx. 30 lbs. I was worried the morning of surgery that he would not do it because I did not loose enough weight. But he didn't even weigh me. He pushed around my tummy that morning and did the surgery. No problems.  I suggest looking for a different dr.  But it is not the easy way out. I will tell you that. This is work and he has to commit to the process. This is the hardest thing I have had to do in my life. I am an emotional eater and not being able to eat my "problems" has caused me a lot of emotional stress. I try to exercise when things get to much.  Sorry I digress. Good luck to your hubby.

I will say that most doctors will put the patient on a mandatory liquid diet prior to the surgery anyway and it's imperative for the success of that liquid diet to shrink the liver.  The liver hangs out over the stomach and makes the surgery much more difficult for a lap rny. At some point, he's going to have to come to terms with why he got to this weight and realize that his eating habits will have to change if he has the surgery or not in order for him to become healthy.  As dunny said earlier, exercise and the change in eating habits are crucial to the success of this surgery. I wish you both luck!

Your post hit close to home for me.  I have an acquaintance who has very similar health issues to your husband, and a somewhat similar background.  He's been diabetic for years, has high blood pressure, high cholestrol, etc.  He had looked into WLS several times, but was unable and/or unwilling to do the pre-op diet that his surgeons required so his surgery would be less risky and he'd have a good chance of survival.   Fast forward a year or so.  He gets a small blister on his foot.  Which turns into a huge blister.  Which does not heal because of his diabetes.  He winds up need surgery on the foot, then going into rehab.  His health was in a very serious decline and the doctors were very, very concerned about how much longer his body could hold out.... He was very, very lucky that his insurance approved a Vertical Sleeve (one type of weight loss surgery) on an emergency basis about a month ago.  He went directly from the facility where he was doing rehab for his foot back to the hospital for surgery, and from what I understand is now doing well.  Depending on how much he loses w/ the Vertical Sleeve, he may "convert" to an RNY to finish losing what he needs, so he may face two surgeries as well.  But the second surgery should be much less risky as he will have already lost a significant amount of weight by then... I tell you this not to frighten you, but to encourage you and your husband to act now.  Before he develops other serious health problems.  WLS can help turn your husband's health around.  Will it require changes?  Absolutely.  Will it require taking a hard look at the reasons he gained so much weight?  Absolutely.  But regaining his health, lengthening his life, improving his quality of life are all, in my humble opinion, worth the sacrifices.   Good luck on your continuing journey -  Kellie

we actually lost a friend in the fall due to complications of diabetes, he got an infection in his foot that spread rapidly and killed him.  he was overweight also.  i have discussed this all with hubby but only he can make the changes required.  i do not enable his emotional eating, i cannot control him as he is an adult and 2 teen girls are enough.  he understands why he eats the way he does but still does it.  i changed the way we ate as a family and i lost weight but  he sabatoges himself by eating once i go to sleep. i have decided to add walking myself and see if he will just join me.  i have 3 lazy pitbulls snoring away that could stand some extra walking! (i do rescue). thank u for all your support and views, it is helpful to read and vent.  maybe i will be able to help him.