BAPTIST HOSPITAL - DR. SPAW - QUESTIONS PRE SURGERY

was referred to this site by an email from a person who has had surgery by Dr. Spaw. My seminar was yesterday so I am a beginner seeking input from those of you who have had either lapband or laproscopic bypass. Here is a bit about me. I will be 60 next Sunday and I weigh approx. 309. The last time I weighed was the last day of 2005 at the doctor's office. I have had to retire from teaching after having knee replacement in 2001 which turned into a nightmare. Without going into what took place, just let me say that within six months I had five replacement surgeries and two major staph infections. After getting a new surgery who cleaned up the mess with five more surgeries, I now have no quadriceps tendon in my left knee, use a walker in the house and a scooter for longer jaunts. My right leg is used to lift my left one when I am in bed or seated in my lift chair and need to change positions. The right knee is in extreme need of replacement but you can imagine the S word is not in my vocabulary. However, I have no choice for weight loss surgery. Then I will have the right knee done when I have lost a lot of weight to help me recover faster. I have had to make renovations in my home to accommdate my knee being extended with a rod in it for six months as well as to remove the danger zone in my bath. The wall had to be removed for the above purpose. I have a bath bench, handrails and a high potty chair with arms over the commode. I am unable to sit in regualar chairs and couches due to not having a tendon and many other activities that I once could do are no longer part of my life and never will be due to the knee and ankle issue. In 2004 I fell and dislocated my right foot and broke my ankle. Four surgeries were needed to take care of that so I am full of metal in my left leg. I have had major back surgery in 1991 and other surgeries as well. Pre diabetes, hypertension, arthritis in most of my joints are other issues. Now that I have let you know about me which is limited, I have some questions. I now am on medicare and have been told my blue cross preferred will pay nothing on the surgery. Here are several questions I would like your input to help me on my journey. 1. What type of surgery did you have and was it done laproscopacally? 2. What preparation did you make before your surgery to prepare your body for it? 3. What did you do for exercise after your weight loss began and do now? 4. Did you have health problems with your knees or any surgery on your knees or back before you had this surgery? 5. How was your experience in the hospital and the staff in their care for you? 6. Did you attend post op support groups in Nashville or in your hometown and how often? 7. Did you have special needs that Dr. Spaw or your surgeon worked with you on after your surgery (I am concerned about my linited mobility due to my lack of a quad tendon and left knee and ankle. These problems will be addressed by Dr. Christie in his letter to Dr. Spaw.) and how were they handled? 8. What does your typical day's meal plan include? 9. How difficult do you find not eating foods you really liked? 10. Did you get sick at your stomach and throw up much? I fear that and not being able to get to a receptacle in time and I can't clean up after myself due to my knee disability. 11. What other weigth loss methods had you tried? I haven't since fall of 1997 and then my mother got ill and I had to care for her. Before that I had done WW, Nurtri System, Dr. Clark's at Brentwood and other doctor diets of so many calories. I have a thyroid problem and it is hard to loose. I use a walker in the house with a seat on it and a scooter outside and for shopping. My life has drastically changed as I cannot teach, visit friend's homes. Krogers, Wal-Mart, Lowes and the movie theater in my scooter are my outings. If I have left off anything you think would help me, please include in your reply. I thank you for your kind response and the time you take to write to me. Sincerely, NascarLadybug

HEY GIRL, YOU MADE IT!!! I wanted to reply to your post because in my emails to you I had left out some important info. I had the Laproscopic Bypass because I wanted a permanent solution. I felt for myself and my habits, having the band, and knowing it could be removed once I got to my goal weight, I feared that I would gain it back. I wanted something permanent so that's why I chose the surgery I did. Again, the lap band is a wonderful tool for alot of people, but for ME, it wasn't an alternative. As for preparing my body prior to surgery, I tried to increase my water intake and I had to give up smoking. SMALL sacrifice for a lifetime of health! Again I want to emphasize (as I did in my email to you) my taste in food drastically changed after surgery. I don't know if they removed the "sugar fiending gene" out, but I no longer crave sweets like I used to (other than chocolate, gotta have it!) I clearly remember about 2 weeks before my surgery freaking out because I thought I was going to have to end my love affair with so many of my favorite foods that had comforted me for 50 years. NOTHING could be further from the truth! I can still have whatever I want, I just don't want it that much any more, and if and when I do, it takes VERY little to satisfy my cravings. Used to be if I wanted a cookie, that actually translated into the entire package of cookies,,,but now, I eat one, on a bad day, two, and that's all I want...Keep the questions coming sweetie, I'm SOOOOOO PROUD OF YOU...P.S. start your question "list" for Dr. Spaw so when you get there you'll not forget to ask anything. xoxox Carol

I know my ABCs, can count to 100 and add and subtract to ten as a K teacher. Thanks for being proud of me for following your directions! Thanks so much for continuing to give me information. I am passing it on to my nephew in TX who is going to have lap band surgery this summer during his break from school. He coaches so he knows more than I do! I'll be back with more questions soon. Do I need to read all the posts on this board and the main board or limit it to my post's replies? Ladybug

Nancy, I wasn't telling you I was proud of you for following any directions. I was telling you I was proud of you as a matter of principle, for doing something to improve your life. You shouldn't be so quick to jump to conclusions. Your reply "I know my ABCs, can count to 100 and add and subtract to ten as a K teacher" sounded snotty and I must admit, I was very offended. Take care and good luck.

Whew, that's quite a list. I'll try to answer as many as I can. First I will tell you I am 51 and work in human resources at a local university. I had my surgery almost 5 months ago and I have lost 62 lbs since my surgery date. I had already lost 19 lbs prior to surgery while taking Meridia for 6 months. I am 5'3" and my high was 289. 1. I had laproscopic RNY-gastric bypass with Dr. Spaw as my surgeon ( Love him!) 2. Increased my protein, started taking a multivitamin and 5mg Biotin. 3. Initially I did not do anything extra (I know, bad patient) As my weight started coming off I have increased my walking, such as, walking to a co-worker's desk instead of calling, emailing or using campus mail; using the stairs instead of the elevator whenever possible (& reasonable). Just recently I have started working out at the fitness center on campus - treadmill, elliptical, weight machines, etc. 4. I did have issues with both knees but nothing anywhere close to what you have been through. I had injured my knees in a car accident when I was a teenager and they have bothered me ever since. As my weight climbed they hurt worse. I was having severe pain in my feet, ankles, knees, hips and back to the point where I didn't walk unless I had to. 5. The staff at the hospital was great! From everyone in the surgery holding area, all of the surgery team I met to the nurses and techs on 8 Kidd. I only had one nurse who was kinda worthless but the tech I had that day was a WLS grad herself and she was a gem. 6. Yes I do attend support group meetings in Nashville. They are held the first Tuesday of each month in the waiting room of the Metabolic Surgery Center. The Meeting for July is going to be on the 18th since the first Tuesday is the 4th and the Lap Band group meets on the second Tuesday. 7. I did have some special needs but they were concerning medications. Dr. Spaw made sure he wrote the order for one of my meds to be given to me in my IV the entire time I was in the hospital and helped me to find a liquid alternative to another med I need that had the potential of blocking the stoma. 8. Usually a protein shake with fruit for breakfast. Through the rest of the day I may have chicken or turkey (roasted, baked, stewed, fried w/breading removed), cottage cheese, cheddar cheese, FF refried beans w/cheese & enchilada sauce, lettuce, green beans, lima beans, broccoli, fish (baked, broiled, fried w/breading removed), thin sliced deli meat & cheese, string cheese, egg (poached, soft boiled, egg salad, deviled, scrambled, fried in Pam), pimiento cheese spread, chicken salad, yogurt, SF pudding, peanut butter, Wendy's chili, pizza (topping only), SF popsicles. Some of the foods I've not been able to tolerate so far have been - tuna, beef (except for the occasional plain small hamburger pattie from McDonald's or Sonic - 1/2 a pattie and I'm full), pork (except for pork topping on a pizza), Edemame & Soy milk. 9. I haven't had a problem with it so far. If it's something I really want, I will try a small bite. Usually I find that it doesn't taste as good as it used to. I've even gone from being a chocoholic to strawberry being my favorite. LOL 10. The only times I have thrown up was when I ate too fast and therefore I (A) didn't chew well enough, & (B) ate too much; and when I ate something that just didn't agree with my pouch, such as the tuna. (I figure it's my body rebelling because of all of the tuna I have eaten over the years on the various diets I've been on) 11. Name it I've tried it. Weigh****chers, at least 5 times; Dr. supervised exchange diet; Cambridge; 3 day diet; cabbage soup diet; Slim Fast; Weigh Down Workshop; diet pills; Meridia; starvation; grapefruit diet; & others I can't even remember the name of. I know you will be in good hands with Dr. Spaw and the entire staff at MSC and Baptist. The people who did all of my pre-op testing were wonderful too. I never felt like they were judging me or looking down on me through all of the testing. They were all protective of my privacy and dignity and were very pleasant to speak with. Call Dawn at Dr. Spaw's office about the BCBS-medicare issue. It is my understanding that they DO cover WLS when it is medically necessary, and yours is certainly medically necessary. I wish you well on your journey and will pray for a speedy approval from insurance. Susan

A big :-) for you, Misss Susan! You answered the questions without hesitation! Thank you for the time you spent. I really am gaining knowledge and becoming informed with this forum and emails from Dr. Spaw's patients I got on testimonials. Everyone is so kind. I have started on the water and chewing slowly. Three glasses of water today and much toliet paper!!!! LOL I will be pestering ya'll again soon with questions as I think of them and after my visit with the doctor next week. I am calling Blue Cross tomorrow and also asking my doctors to write to them. Sincerely with appreciation, Ladybug

Hi Ladybug, prior to my surgery I had to lose 10% of my weight, that was last Sept. I too have a thyroid problem that causes weight gain, plus I had just found out in July that I have CML (chronic myelogenous leukemia) and would have to take pills for the chemo the rest of my life including while I am in the hospital. What we didn't know at the time was the chemo pills kept bottoming my potassium, I was in the hospital more then I was home. Then it was bringing the equipment out to my home for 2-3 days for me to hook myself up. Now I have to have blood work at the cancer center here in Morristown every week. If my potassium is low then the cancer center would hook me up for 4 hours to potassium. Only to have it bottom out two days later and end up in the hospital. I quit taking the chemo pills six weeks ago (btw, they cause me to gain weight also, and retain fluids) my bloodwork each week since shows my potassium and blood count is in normal range. Most insurance companies require a 3-6 month Dr. supervised diet program just prior to having the surgery. I chose the gastric as I wanted it to be permanent. It was done laproscopic. I don't miss my favorite foods. I drive an hour to knoxville once a month and get ground chicken instead of hamburger. Tastes like hamburger, but doesn't have the fat. Anything you use hamburger for, you can use ground chicken instead. I made chocolate chip cookies the other day using splenda and splenda brown sugar. Half of one calms the craving for chocolate or for a sweet tooth (I have dentures). I was in a power wheelchair for almost 3 years from a broken hip and pelvic. Three hours after I was brought back to my room, they had me up and walking with a walker. I work out 3 times a week at a rehab center. I also have a Tony Little Gazelle that I use at home for the buns and thighes. I watch what I eat, remember the golden rule, protein first. One boneless skinless chicken breast will make me 3 meals. I like to soak it in light Italian dressing then grill it or grill it on my George Foremen grill. It will last you three meals. After 2-3 small bites you will fill satisfied. You will know real quick if you eat something too fast, or eat too much, I keep a trash can near me at all times, I keep a kidney shape tub they give you in the ER when you are sick to your stomach one is by my bed, one in the van, and one in my gym back. I found I could not longer stand water out of the faucet that was in the fridge. I can only tolerate Deer Park spring water. Because I have leukemia, I have a real hard time getting in all my water, so I keep sf jello around at all times. I go out to eat, I will get cottage cheese and strawberries, I can't even fini**** I went to a chinese restaurant recently, all I got was some shrimp. After three and a bite of crab salad, I couldn't eat any more or I knew I would be sick. My taste buds keep changing. One week I could eat something and no problems the next week it will make me really sick. I'll be 6 months out on July 9th, I should be able to eat anything after that, yet I don't miss hamburgery, pork, I buy chicken franks, and eat them without the bun. Carbs make sugar. I can handle a small baked potatoe about once a month, as for bread, it gets moldy before I have eaten two slices. And that's usually when I am sick to my stomach. I can't take my pills with anything except with milk. Water, juices, and up comes the pills. This surgery is a tool, what you do with this tool can make you or break you. If you want to succeed at losing the weigh****ch what you eat, drink, and be sure to work out every day. Walk as much as possible. I still can't walk a mile where others by 6 weeks out are able to walk 2 miles. But my legs are still weak from being in a wheelchair, and having leukemia, I tire out real fast. The best advice I can give you, is to make sure you know just what type of surgery you want. Then pursue it and give it all your best efforts. There are no support groups in my area, so this board is my support line. You can rant, rave, ask for help, ask for prayers, share your joys and disappointments and some one will be on here to help you, encourage you, or just let you rant. You may find that you won't feel hunger, I have only felt it once. But besure when in doubt check with your nutrionist that you will have to see prior to surgery. May God travel with you on this journey. Always here, Kathy

Thank you for your kind reply and the time you spent in writing to me. God bless you, my dear. Your advice will be taken to heart and I shall be in contact with you again. I shall pray for you.

Welcome ladybug!!!! HUGGGGGGGGGGGGGGGG i will be 62 yrs old in July and will be having lap band surgery in late October with Dr david Dyer at Centennial in Nashville Everyone has the highest regard for this fantastic, truly caring,well experienced Dr, I am also on medicare and Dr Dyer accepts only one or 2 patients a month on medicare . so i am very very lucky to be accepted ,iIwas told noone took Medicare at Baptist when i got there.. after I went to baptist hospital for the seminar and listened to dr Spaw (I loved him too) of course when I called them before the seminar I was told they did .. then I had to search for a Dr on the center of excellence and also a center of excellence hosptial . and then go that their seminar also.that is what Medicare requires, Also you must be on at least one doctor suporvised diet for at least 6 months in the past or future before they will operate. I have had my left knee replaced and both hips replaced and a tumor in my spine removed and i know what you went thru and i can relate to many of your problems I have degenerative joint disease and arithitis in my hands and feet I need my right knee replaced and want to wait till i have had my gastric surgery I dread the thought of the rightknee replacement also But i never give up and my glass is always at least half full and an happy in spite of everyting and i can walk without a cane!!! i want to play with my grandkids and garden again and walk trhu the flea markets again I wish you the very best on your journey and I am glad you are here and are taking the first steps ,never never give up. you can do it and we are here to help you any way we can I choose the lap band because it it the least invasive and least dangerous after having so so many surgeries i dont t want to be all cut up anymore than i have toand have my insidei rerouted but eveyone is diffrent and has different needs you have to but you must make up your mind .. make sure you go to the lap band forum and check them out also I know dr spaw was applying for madicare acceptance at the time i went to hs seminar that was in march of this year is he accepting Medicare now? anyway congratulations Arianna:fairy