Question:
HAS ANYONE HEARD OF A DR. NOT DOING THE SURGERY BECAUSE OF BEING HIGH RISK?

I WENT TO SEE DR. ROBLES YESTERDAY AND HE TOLD THAT HE WOULD NOT DO THE SURGERY UNTIL I LOST 50 LBS...(SUCH AN EASY TASK)..BECAUSE I WAS A HIGH RISK??? I AM A DIABETIC WITH SLEEP APNEA AND A BMI OF 61....WITH A FAMILY HISTORY OF HEART PROBLEM...I HAVE GOOD BLOOD PRESSURE AND NO PROBLEM WITH MY HEART..I TAKE LIPTOR--AND MY CHOLESTROL IS UNDER CONTROL...???? I DON'T UNDERSTAND I THOUGHT THAT WAS WHAT U NEEDED TO HAVE THE SURGERY...ANY ADVISE..OR WHAT TO DO NEXT...PLEASE HELP!!!!    — sheri G. (posted on April 11, 2003)


April 10, 2003
Find a different surgeon, some specilize in higher risk patiewnts. My surgeon does the very high risk over 1000 pounds that other surgeons wouldnt touch.
   — bob-haller

April 10, 2003
I have a wonderful surgeon in Middletown Ct. and deals with all BMI's- Dr. Jonathan Aranow- give him a call. My surgery is coming up April 21st and I cant wait- Great support groups and even better after care and everyone raves over him. I know three girls I work with that had there surgery by him aswell and they look awesome... Good Luck!!
   — [Deactivated Member]

April 10, 2003
I would be thankful that the surgeon you have seen is honest enough not to want to attempt something he is obviously not comfortable with. It sounds like there is someone else in your state who will operate on people with higher BMIs, so I hope that is an option for you.
   — garw

April 10, 2003
I started out with a BMI of 74. I had severe sleep apnea, diabetes, history of heart problems in the family, personal history of lymphoma, and a history of lung/respiratory problems in the family. And my surgeon had no problems operating on me without any pre-op weight loss. I agree with the others who have said to find another surgeon who *will* operate on you...even if you have to travel a bit to see him. JR (open RNY 07/17/02 -167 lbs)
   — John Rushton

April 11, 2003
Personally I think that IF your doctor is going to HELP youu loose the 50 lbs, then he is being extremely responsible. I would then think twice about looking for a new surgeon if I felt that the surgeon I had had my best interests in mind. My surgeon does the same thing for higher risk patients, he puts them on that liquid stuff that Oprah took years ago. He wants them to loose some of the weight for a couple of reasons. First and foremost, so that they can me as healthy as possible for the surgery. He understands your medical history I am sure if he did a complete questionaire on you. He knows why he wants you to loose some weight first. Have him explain to you again why. I am sure that the shock of hearing you have to loose 50 lbs probably surprised you so much that you did not hear all of his explaination.... I know I would be the same way if I was told that. Secondly the reason my surgeon requires it is a personal one for him... he wants to make sure that you are ready. That you have made the concious choice to take control of your life, and your eating habits. This surgery is not a cure for morbid obesity.... it is a TOOL to help you loose weight. You still have to work at it, and my surgeon wants to know that you are willing to take control of your eating habits. That is just my surgeons reasons... yours may be the same or different. Personally again, I would have him re-explain why he wants you to loose weight first, the fact that your "high risk" would not be enough for me. I would have him detail what it is that makes your a higher risk than the norm for this surgery, if you dont get the answers you want, then by all means look for a new surgeon.
   — laura B.

April 11, 2003
Some surgeons cherry pick only the easy cases, which helps keep their death rate low. Now refusing to do surgery on a patient would be bad form. But perhaps setting a almost unreasonable weight loss requirement accomplishes the same thing. I would find another surgeon. Your BMI of 60 isnt that high, many surgeons do LAP even to 80-s bmis. Get a new surgeon.
   — Sam J.

April 11, 2003
Hi, Sheri. My doctor told me the same thing back in November. My BMI was about the same as yours. He told me he wanted me to lose the weight so my healing and my mobility would be better. So, that weekend, I had a few last meals and I'm proud to say that as of last Friday I have lost 53 pounds, am down six inches around my waist, and my BMI's now around 49. My surgery is this Monday, April 14th. If you want this surgery bad enough and this is the doctor you want to do your surgery, you WILL be able to lose the weight. It's just amazing how much better I feel after only losing 50 pounds, I can only imagine what I'll feel like after I lose another 100 pounds. Good luck to you in whatever to decide to do.
   — Julia T.

April 11, 2003
Hi, My mother in law and I are both having the surgery - Well I had the surgery a week ago. We have different surgeons. Her surgeon regularly does high risk patients in Baltimore. She still had to lose 75lbs before he would do her surgery. She lost the weight and is scheduled for later this month. He stated that the 75lbs could make the difference between her living or dying. In her case he felt that at her weight she would not be able to get up and walk after surgery which is so critical to avoid chest complications and blood clots. She could have found another surgeon, and there's more than one out there who will do anyone. You need to weigh in the skill and education of your surgeon. If your surgeon does high risk parients normally or is well documented as knowing their "stuff", and still thinks you need to lose weight before he operates then you may want to heed his advice. If you don't trust his judgement, then you may want to find another surgeon. Good Luck!!
   — M B.

April 11, 2003
My surgeon handles high risk a BIT DIFFERENTLY, HE DOES THE rny IN two STAges. One restrrictive the other after many pounds are lost the intestinal bypass part. This reduces table time and although inconvenient is much safer for the high risk. Easier recovery to.
   — bob-haller

April 11, 2003
Being the non-confrontational person I am.....I always get mad at myself when I get puffed up about something. You have had some terrific responses to this question! However, requiring that a patient lose weight prior to surgery is not "cherry picking" patients - it's responsible patient care. Our surgeons often require patients to go on a high protein weight loss diet prior to surgery. This accomplishes several things. The first, and possibly most important reason, is that it makes your liver smaller. A fatty liver is the main cause that laparoscopic surgeries have to be converted to open. It creates poor visibility in the surgical field. A loss of only 20 pounds or so vastly reduces the size of the liver and improves visibility. Second, protein is a very valuable tool or building block in our recovery. If we're already on our way to good health when we have surgery then it can only get better after the surgery. Weight loss also takes stress off our lungs and makes mobility easier immediately following surgery. Lastly, in defense of the hundreds of wonderful surgeons who perform this surgery......if they all operated on maximum risk patients and didn't require some weight loss and health improvement prior to surgery then there would, in fact, be more deaths. Then, the very same people who complain about having to lose weight prior to surgery would be complaining about the surgeons having a high mortality rate. I commend your surgeon on requiring the pre op weight loss. It means he has your best interest at heart. I know you can do it!! And you'll lose it faster than you think. Hang in there - sounds like you've got a good doc on your side!
   — ronascott

April 11, 2003
Sheri I had the same exact problem when I went to see Dr Robles he told me to quit smoking and lose 50 lbs yeah right. I now am seeing another doctor and having no problems he wants us to lose 20 or close to it that just makes it easier during surgery because it shrinks your liver. But other than that. If you have any more questions or doctors names let me know. Jamie
   — jnmcneil




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