Help? Does anyone know?

My fiance has been looking to get the surgery for quite some time now.  He keeps getting turned down because he is "too big" for surgery.  He is a little over 700 lbs and he really needs help.  He has a lump now expanding under his leg and its getting difficult for him to walk because of it.  The other reason no one will touch him is because 10 years ago, he was a banding patient when they were still working out the kinks.  It didn't work, so he's bigger than ever.  They need to undo his original surgery before doing the main surgery.  He has thought about going to a bariatric weight loss clinic.  They are also turning him down because he is "too big" yet the same clinic he was turned down from was on Oprah the other day claiming they take any sized persons.  What do I do?  He is getting more and more down, and the side effects of being obese are starting to take over his life.  I dont want to lose him.

What surgery is he looking to have? He would benefit greatly from the DS although because of his weight the surgery would probably have to be done in 2 parts (VSG and then the switch part about a year or so later). His risks are much higher with any surgery because of his weight, but if you are aware of those risks there are surgeons who will do this surgery on a patient weighing that much.

He is looking to do gastric bypass.  There is a doctor that we talked to that suggested having the original surgery undone and the bypass later, but they are still wary about doing it because of his size.  The multiple surgeons and doctors he and I have contacted won't work with anyone over 500-600 lbs (depending on the doc) and that is where the problem lies.  He was looking into a few weight loss clinics, such as BrookHaven, but they turned him down saying he was too big and people that big aren't successful to them.  There was one that we looked at in Ohio for the same reason, and was again denied due to his size.  I just don't understand how you can be "too big" for weight loss programs.  THe lump under his knee is getting bigger again, and I just don't know what I can do to help him anymore. 

i have to agree with Tammy, that the DS would be worth investigating for him, particularly given his BMI. 

Dr. Rabkin in California is an experienced revision surgeon, and he's also known for taking on many higher-risk patients.  He's a very friendly guy, and could explain really well why the DS would be a good option for your H to consider.

best of luck.  here's a link, if you'd care to read a little about Dr. Rabkin.

www.paclap.com/aboutus/jrabkin/

There are two surgeons that I know of that perform on high-risk patients. They both are well-known for the DS, but if he's stuck on RNY they both do that as well. They are Dr. Rabkin and Dr Husted. Honestly, though, at his weight, I think he may have a better success rate with the DS. You should explore his options before deciding. You can get some good information at www.dsfacts.com or www.duodenalswitch.com. You will also find the information for both of the mentioned surgeons at either of those sites.

I would hate to see him have an RNY at his size. The DS is really the surgery you need to be focusing on, for his size.

In addition to the two surgeons the others noted, you might also contact Dr David Greenbaum in Willingboro, NJ. He's known for taking on patients that no one else will take. He's an experienced revision surgeon, and contracts with many insurance companies that some of the others do not.

He's doing my VGB to DS revision. It sounds like your guy might have a VBG. It was called a "stomach stapling," way back when.

The best of luck to y ou both.

Your fiancee is fortunate to have your looking out for him!
    I have to agree with the previous posters about both the DS as the best choice for his cir****tances and also on the names of surgeons suggested. As you have already learned, many bariatric surgeons will not take on the highest risk patients. Drs. Rabkin, Husted, and Greenbaum are all very experienced DS surgeons who accept both high risk and revision patients, and our fiancee is both (because that old band has probably created scar tissue around the stomach, which makes any wls more difficult, and of course the band needs to be removed).
    On of the great things about the DS is that, if necessary, it can be done in 2 stages: the band could be removed and the sleeve gastrectomy (the stomach part of the operation) done the first time), and the "switch" part done at a second operation after your fiancee has lost some weight and is lower risk. Of maybe it could all be done at once, depending on how things go, but there may be no way of knowing until the surgeon gets in there.
    The Ds is also the best choice for heavier patients because it has the highest percentage excess weight loss of all the available wls and the best maintainence of that weight loss. It works well for "light weights", too, but for someone witha lot of weight to lose, chances of success are best with the DS.
    And don't feel bad about being turned down by Brookhaven. Have you seen that place on TV?  They are very negative about wls, yet somehow their patients never seem to improve with whatever treatment they are doing there.
    Please come over to the DS forum and learn more about this operation. Your fiancee needs to know about all his potential options.

Larra

Please, please do not think that the gastric bypass is the only way to go for your fiance. Please check out the DS (duodena switch) weight loss surgery. your fiance couldn't be in better hands than with the surgeons already mentioned. You owe it to your fiance and yourself to at least read up on the DS at both of those sites mentioned.  I don't know where you live, but it would  be certainly worth it even if you have to travel. I do not know his criteria for the more heavier patients, but Dr. Ara Keshishian in Delano, California, is quite an expert when it comes to revisions. DO NOT just trust in the gastric bypass, it is not top of the line when it comes to the heavier patient.

Hi,
You may want to contact Dr. John Maguire in Dayton, Ohio at 937-208-5300. I believe I've heard that he has done surgery on someone that heavy before. Good luck and best wishes!
Ginger

I totally agree with the other posters - Dr. John Husted does very difficult revisions and operates on very large patients.  He is in Kentucky.  Where are you located?