I REALLY NEED YOUR HELP!!!!
I'd recommend contacting Chris Powell (Reshape the Nation) or David Smith (Google 650 lb virgin to get his story from TLC). They both take on M obese clients that others won't consider. They do not have anything to do with WLS but are inspiring and very "on task" with their program and sensitivity.
Does your fiance have insurance coverage for WLS? If so, then call the insurance to get their list of Bariatric surgeons and start calling all of them with your fiance's details. .... With that amount of weight, your guy really needs a DS. So, grab the list of DS surgeon's from the dsfacts.com website and start calling them.
That's great that your fiance doesn't have the typical co-morbidities BUT I would guess that the "pain" could be documented and listed as a viable co-morbidity. Surely he has a fatty liver as well and the lymphedema alone should get him into some specialists.
There is a forum for those who have had BMI's over 50. I'd run your question on that support site to see where others have found their help.
Good luck! .... It sounds like your guy has at least one great support person! .... If you are the Chef at your home then you can start right now with help by "cleaning up the meals" a bit. ... I LOVE the easy exchange system of "eat this instead of that".....There's a book that I don't know the exact title but it's written by a Chef/nutritionist who simply provide healthy options with similar flavors for the same list of foods that people normally buy & eat.
Email David. He's amazing, very inspiring and has "been there done that"! (this is the revision forum and not your best place for zillions of ideas......try the DS forum, the over 50 BMI forum, the main board forum, etc.) .... Don't give up! Life is soooo worth it!
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Rny 2/11/03-> ERny 12/26/07-> Duodenal Switch 5/12/2010
www.dsfacts.com , www.dssurgery.com , & www.duodenalswitch.com