Sunday Morning Weigh In, FAQ is up edition

sleevicidal_maniac
on 9/27/12 9:07 am
 Hi Jim,

I'm a VSG patient, and less than 6 weeks at that. I had a ****load of complications which have now been sorted. Like you, I had to have two surgeries and the second caused me fits. However, I also had a monster chest pain that wrapped from under my chin around to my back by way of my left armpit. I went for about a dozen tests and xrays, ultrasounds, a 3D ultrasound... you get the picture.

I started walking with my hands above my head and don't you know the chest pain was a gas pocket caused by the nitrous from one of the two surgeries. It took 4 weeks to manifest and another week to work out. I know you're months out, but maybe? At the end of the day, they can't test for gas, they can't see the gas and they can't treat for it. 

It was my PCP who told me to do in a pool and dive to the bottom of the deep end and then go for long walks and make full arm circles above my head. Because it wasn't intestinal gas, it wasn't like I farted it out, but after about 3 days of folowing his recommendation, it just stopped mid-walk.

Maybe it seems to simple an explanation, but if it hadn't happened to me, I wouldn't say that it's worth a try.

If it's a suture through a nerve (I had that too...) then you'll need help from a higher power. Good luck, brother. 
OldmanJim
on 9/27/12 12:21 pm - AZ
Thanks for the info Mr Maniac (don't know your name).  After 2 months and all the crap, I'm willing to try anything.  I see my surgeon on Tues and I'll see what he says about your info.  Wanna bet he doesn't agreee with it?  I'll let you know.  I have been walking every other day and I will give this a try tomorrow.  I really do appreciate you posting this to me.

Hope all your problems have been worked out.

Jim
sleevicidal_maniac
on 9/27/12 12:30 pm
On September 27, 2012 at 7:21 PM Pacific Time, OldmanJim wrote:
Thanks for the info Mr Maniac (don't know your name).  After 2 months and all the crap, I'm willing to try anything.  I see my surgeon on Tues and I'll see what he says about your info.  Wanna bet he doesn't agreee with it?  I'll let you know.  I have been walking every other day and I will give this a try tomorrow.  I really do appreciate you posting this to me.

Hope all your problems have been worked out.

Jim
I'm getting there. I documented everything in my blog if you are looking for a chuckle. Jason's the name, by the way. Well, whatever is wrong, I hope they find it for you. Best of luck.
sleevicidal_maniac
on 9/28/12 7:24 am
 I've just been stewing on this for a few days... y'know, f*** the surgeon. All the doctors that you've spoken of and to, you'd think one of them would be able to tell you what's wrong and causing all your pain. The problem is that they're all about being sure it was nothing they've done and not about making the pain subside.

My wife and I took the responsibility of just figuring out what was wrong with me ourselves and then finding medical pros who would listen to us. My surgeons botched my first opeation, drug me through a second in two days time and then when they closed me up, put sutures through a nerve which caused an indescribable amount of pain when the morphine wore off and now I can't feel my toes.

I would spend the most time with your PCP who will probably be willing to spend the most time with you. He's also got no reason to "defend his actions" and rule out anything he did as a cause of your pain. he can look at it objectively with the broadest medical viewpoint instead of the surgeons and the bariatric docs who are mechanics and single disciplinarians.

I fix Porsches. When someone calls me up with a problem, I can usually narrow it down to 3-4 possible issues and then fix their car. Sometimes, though, it's a combination of several things, or even something that I haven't seen before. After I have tested what I think it is, if I can't fix the car, I don't just stop and say "Well, it can't be fixed" or, even worse, "I didn't maintain this car, so I couldn't have broken it, and therefore I can't help you fix it." 

Be careful getting wheeled in and out of the OR by a bunch of guys who aren't sure what's wrong. I would be leery, if it were me, at least. I hope you don't mind, i just hate seeing people suffer when they don't need to. there's enough that we have to deal with without nicompoops making it worse. Anyway, didn't mean to rant, just my 2c.


OldmanJim
on 10/6/12 12:34 pm - AZ
Jason, I'm sorry I haven't responded before tonight.  I've been away from my computer for a few days and I didn't see that you made a followup post on Sep 28th.  I will say after reading the above post I hope you got yourself a good lawyer!  I can see why you seem to be negative towards some doctors.  My trip has been a cake walk compared to yours.  I know where your coming from as far as the dr's covering their a**.  I have what I feel is botched knee replacement and there was no way I could get the surgeon to admit it or find another orth dr who would testify to what went wrong.  I hope you can get some type of relief for your pain and suffering.  Also that the feeling comes back to your toes.

I saw my surgeon on Tues and I asked him about the possiblity that gas could be trapped in my chest cavity.  He said "it isn't possible as they suck all the gas out after the surgery and if there was any left it would desipate(sic) in about 12 hrs,  I also asked about the suture thru a nerve and he said I did not have that happen to me.  I really do like the doctor.  He answers all my questions and when I see him he gives me his complete attention.  I really can't complain as far as the RNY surgery with the hernia repair and the gallbladder removal.  Like I said I diidn't have any problem with chest pain until the end of July.  I did say to him that I guess both procedures he did in Sep were a waste of time.  He said no because he was able to check out my esophagus inside and out and that he did not see any signs of any type of cancer.  Also that I did not have any ulcers or hernias. He did mention my pain could be muscular.

So I guess it's back to my PCP (appt this Fri).  I had the surgeon sentd the results of the procedures to my PCP so he can look at them along with the cardio dr's report and the pulmnary dr's report (from his ofc).  Hopefully I can get an ultra sound or a CAT of my chest and hope like hell they would show something.  I know I'm not nuts and I am not in love with the percocet I take.  I agree with you about being wheeled in and out of the O.R. and having things done under gas and still not finding the cause of my pain. 

I did try your suggestion about walking and having my arms over my head.  Sort of a mix result.  I only got a little relief.  I do appreceiate you taking the time to address my compliants when your problems are more severe than mine.

Thanks again.

Jim

      
(deactivated member)
on 10/4/12 11:09 am - Canada
 Hi Jim...I haven't been here for a few weeks due to business problems and more, but when I searched for your handle found this post saying you're down 100 lbs.  congratulations.

Youre not so old...I'm 71.  Passed all my tests and went to see the surgeon 2 weeks ago and he scared me into rethinking it.  At my age, 405 lbs, a blood disorder of low platelets, and two clotting situations in the past, he said I would have a 10% chance of dying on the table...or risking slow healing or leaks after surgery.  Told me to take Optifast for 4 weeks and think this over very carefully before agreeing to voluntary surgery.  I see him in 2 weeks and already down 20 lbs to 385...not cheating at all.  Almost makes me feel I could lose it all on Optifast for several months but assume that's not practical.  But, more than a pound a day loss makes you wonder.  Is this standard procedure with surgeons...to try and talk you out of it?  I do think he's a very responsible surgeon just for making me rethink it all.  Tough decision got tougher.  Perhaps the VSG would be better for me, but the doc said that would increase the risk of leaking.   

Sure hope it's all going well or you in every aspect of recovery, Jim.
OldmanJim
on 10/6/12 2:29 pm - AZ
I can't remember your first name AdMan.  I forget a lot of peoples names lately.  I'm sorry I didn't respond before tonight to your most distressing comments as I didn't have time last night when I first read it.  I did check this good book I have on WLS called "The Experts Guide to Weight-Loss Surgery" by Garth Davis, MD (Amazon) from Houston, TX, on what he says about age.  I'll talk more about what he says later in this post.

First let me say that I understand somewhat about what you are going thru.  When I first thought about WLS I thought I would be too old.  As to what your surgeon said to you, you do have a tough call to make.  I can understand 10% chance and the slow healing but the part about leaks I don't get.  I just had my entire insides checked with this last surgery and I have no leaks and I'm 4 1/2 post RNY.  The fact that you lost 20 lbs in 2 weeks is great.  When I was on my pre-op liqiud protein meal replacement diet (Bariatric Advantage) I lost 22 plus lbs over 14 days with a flush the last day.  I was amazed I did that and I thought maybe I could lose my 140 excess lbs just dieting and not have the surgery.  I only cheated once during those 14 days but I knew I could never stay on that diet long enough to reach my goal.  I will tell you I had my doubts right up till the time they slipped me the gas.  I personally didn't get to 341 by following diet plans like I should.  My surgeon also said he would only do the RNY on me because of my age.

Compared to you my life is a breese.  No one including the surgeon can pinpoint my chest pain.  I'll start over with my PCP this Fri and see if he will have me take an ultrasound or CAT of my chest.  I'll let you know what happens.

Now for what Dr Davis has to say.  (I shortened the answers in some cases)  In chapter 6 (page 79 in paperback) He asks "Does your doctor consider you to be a good candidate ?"  He than lists reasons that many surgical practices use to measure if you are eligible:
     1  Be ambulatory.  Confined to a bed or wheelchair you would have a much higher risk for blood clots.
     2  Be below a BMI of 50.  Dr Davis requires all patients with a greater BMI than 50 to lose 10 % of their weight prior to surgery.
     3  Be under a certain age.  Studies have shown that the risk-benefit ratio for these surgeries changes pretty dramatically in older patients, which is to say that they get more dangerous - and less efficacious - after age 65.  For that reason, many surgeons don't operate on older people.  This is a hotly debated topic.  Some people say the band is better than the bypass for older people because it is less risky - but it is also less effective.  Personally, I think that if you are fairly fit, the bypass is an option up to about 70 years old.  (#3 is word for word)

Other reasons why your doctor may conclude that you are not an ideal candidate:
     1  There are medical conditions that increase risks, such as clotting disorders, lupus, and connective tissue disorder.
     2  Patients coming for WLS so they can qualify for kidney transplant.
     3  Patients with Crohn's disease or ulcerative colitis cannot have WLS.
     4  Arthritis patients must know that most arthritis pain meds can cause an ulcer in the pouch and should not be taken after surgery.
     5  Dr Davis requires cardiac clearance for all patients over 50, or in any patient who is diabetic, has had chest pains, or has both high blood pressure and high cholestrol.  It is easy to get into a catch-22 with cardiac issues.
     6  Prior surgeries can interfere with patient selection.  If you've had many hernia surgeries it may become difficult to get into your abdomen.  A band may work better.
Following comment #6 Dr Davis says:  "AS DISAPPOINTED AS YOU MAY BE WHEN A SURGEON TELLS YOU YOU'RE NOT A GOOD CANDIDATE, YOU SHOULDN'T ARGUE; YOU DON'T WANT A DOCTOR TO DO SOMETHING OUTSIDE HIS OR HER COMFORT LEVEL.  IF YOU GET A NO FROM A SURGEON, ASK IF THERE'S A PROCEDURE THAT WOULD BE SAFE FOR YOU.  IF NOT, ASK IF THE SURGEON KNOWS A DOCTOR WHO MIGHT BE WILLING TO OPERATE ON YOU; SOME PRACTICES SPECIALIZE IN DIFFICULT CASES.

I don't know if this is what you wanted from me or not.  I read this part of chapter 6 more than a couple of times for myself.  You have a hell of a desision to make and I don't really know what to tell you.  Maybe you should post tomorrow on the Mens Forum and you could get answers from vets with a lot more experience than I have.  I can only tell you that other than my chest pain, that appears to be unrelated to my RNY, I have had no trouble with my RNY.  I have never thrown up since I left the hoispital.  I've got'en quessy (sic) a couple of times probably because I didn't chew my food enough or I ate too fast or too much.  I'm down 106 lbs (78 since RNY) in a little over 4 1/2 months.  Even with oxygen I can walk a mile and a half in increments and ride a stationary bike for 20 - 30 minutes.  My knees get a little sore but I couldn't walk 100 yards before surgery.

Which ever decision you make you will have a lot of brothers on the Mens Forum who will be in your corner.  I wish you luck and I will be praying for you.

Jim 
(deactivated member)
on 10/6/12 3:28 pm - Canada
 Hi Jim...very much appreciate your thoughts.  It is a tough decision for everyone.  But I know if I turn this down my window will close.  I'm surprisingly not having trouble with the Optifast...it seems to keep me full. Have a big family dinner tomorrow so this will be a good test of my will power to stick with it.  I was supposed to see the surgeon on Tues but his office called and postponed it 10 days due to operations he had scheduled...so that gives me more time to reach a decision.  I'll do as you suggest and post on the Men's section.  Thanks again.
dan434
on 9/23/12 11:18 pm - NJ
RNY on 05/22/12
good morning guys
hw 456
1st dr visit434 2 27 12
surgery 5 22 12 390
9 23 314
got a nice suprise when i hoped on scale this mornig i so can,t wait til that scale gets in the 200 hundreds hope all is well with you all and will keep those ineed in prayer have a great day! good job Brian keep up the good work!!!!!!!!!!!!
    
Sam LifeNerd
on 9/25/12 12:02 am
 355  8/1/11  Start of the program
321  9/21/11 RNY Surgery Day

200.00 as of this morning!  (Down a couple pounds, been bouncing as low as 197, high as much as 207 over the last 3 weeks or so)

Ran my second 5k last Friday night, finished in 37.11, which was about 1.30 longer than my first one.  But this course was tough, it was 1.5 miles downhill, but that means 1.5 miles UPHILL when you are already tired!?

Two ladies from the local WLSupport group also ran, and so I went back and ran the last 2/10 mile with each of them as they finished up!!

Painted my brother in laws basement for 3+ hours then on Saturday, painted another hour or two on Sunday.  (They just closed on Thursday)  Kinda amazing that I am the skinny guy now up on the ladder doing the high trim work!!   :)

I spoke last week at the local seminar for the hospital where they introduce the various surgeries.  My surgeon was there speaking and did NOT recognize me when I came in to speak, just thought to himself, well that guy does not need surgery....

As I was speaking, the doctor mentioned to the group that I was now wearing a smaller sized pants than HIM...and grumble, he might need to hit the gym a little harder himself!!   :)

I turn 42 on Thursday...life sure is different 1 year later!!

Sam (Life is Good) Nerd!
         
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