weight loss surgery

[Guest guest]

Robbi,

I don't know about weight loss surgery, but this much I do know: after

being on MTX for 5 1/2 years, new rheumatologist prescribed Arava and Vioxx.

I could do things I hadn't done in years, had more energy and flexibility,

and best of all I started losing weight right away. One year later I had

lost 53 of 56 pounds gained on MTX. After taking Arava 1 year, 3 mos.

(October 2001) I began experiencing bad swelling in several different

joints, especially feet and ankles. Rheumy reintroduced MTX in January

2002, but side effects were so severe I was unable to continue taking this

time.

I felt so well and enjoyed myself so much that first year on Arava I

would say it is definitely worth a try--hope it works well for you, too,

only for much, much longer. Good luck!-- in Virginia

[ ] Weight Loss Surgery

> Have any of you PA'ers out there had Weight Loss Surgery, or the

> gastric bypass? If so, how did your P & PA react to it.

>

> On another note, my rheumy is changing me from MTX to Arava. Slowly

> decreasing the MTX, and am having noticeable discomfort and soreness

> in the affected fingers. Which frightens me somewhat. I havent had

> this discomfort in a long time! Any opinions on Arava vs. MTX?

>

> Thanks

> Robbi

>

>

>

>

>

[Guest guest]

Robbi,

I had gastric bypass on 7/2/01 and so far lost 91 lbs. Before the

surgery I couldn't even wash dishes as the PA in my spine would start

hurting right away. Now I can do that plus much much more. My PA

still bothers me, but I can handle it better. As far as the P, mine

has kinda gone crazy since the surgery, but I think thats because I

haven't been able to go back on my meds like I did before. When I

went back on the same amount of MTX I was taking without problems

before surgery, my liver enzymes went back up. I didn't wean off MTX

either and I think that thru me into a flare. Also, I had my surgery

done " open " and I now have P on most of my scar. Its a small price

to pay in my opinion to gets this weight off and live a healthier

life.

Tempe, AZ.

> Have any of you PA'ers out there had Weight Loss Surgery, or the

> gastric bypass? If so, how did your P & PA react to it.

>

> On another note, my rheumy is changing me from MTX to Arava.

Slowly

> decreasing the MTX, and am having noticeable discomfort and

soreness

> in the affected fingers. Which frightens me somewhat. I havent

had

> this discomfort in a long time! Any opinions on Arava vs. MTX?

>

> Thanks

> Robbi

[Guest guest]

I too went off MT slowly as I began taking Arava. I have been taking Arava

alone now for 9 months. I don't see a big difference, one way or the other.

PA is getting worse, but then I was told to expect it to get worse. I am

going to Dr. in a week or so to see about progression, other meds, etc.

[Guest guest]

Dear Tess,

I am so sorry that you are having such a tough time with this. It sounds

like you are doing things right though in asking all of your drs to support

you in this. I would explain the advantages of having this done in terms

that they could understand......money. It would be more cost effective to

solve the problem than to keep treating it. Some of your other conditions

may be relieved or even solved by the weight loss. Meaning that they would

eventually pay less for your medical treatment and medications. Sometimes

the bottom line is all they look at. Best of luck.

Love and Hugs

Stacey in PA

[Guest guest]

oh tess good luck. the letters i have written for my appeals have been

straight from the heart. i hope you get the help you need, and any decisions

are in you and your health's best interest. kathy in il

[Guest guest]

Thanks, Kathy...straight from the heart for sure. Thank you for your

encouagement & friendship.

Love You, Kiddo...

Tess

[Guest guest]

Hi Stacey...I am adding up all my meds costs and projecting them 20

years, etc....I know the bottom line is $$$ for them, for me it is life.

Thank you for your wisdom & support.

Love & Hugs...

Tess

[Guest guest]

OK, my friend,

I used to work in the Notification Department for United Healthcare and it

was our job to approve/deny these types of requests. They are looking for

your weight, height, BMI, previous weight loss attempts, medical conditions

and medications that you take. They are also looking for your commitment to

sticking with this new lifestyle that this surgery will require. The first

part is strictly clinical in nature. The second part where they want to know

your commitment and understanding of the ramifications of this surgery, such

as being permanent and not reversible, are very well understood. At this

point, please speak from your heart as this shows your conviction. If they

are willing to give you the chance, then you are going to be more than

willing to do everything that this procedure requires. Don't forget to tell

them that you are aware of the restricted dietary changes but also the need

for exercise to make this a success. Tell them that you are aware that you

know that this more than just a diet, but a true lifestyle change, which you

are looking forward to and anxiously awaiting the results, both medical and

social. You know that the surgery does come with risks, but are willing to

take them in order to improve you overall health and quality of life. This

surgery is not being done for the cosmetic changes, but for the chance to

life a healthy life for yourself and your family.

You are a strong, Christian woman who will say and write the correct words

for them to give you a chance and that is all that you are asking for at this

time. EVERYONE is entitled to at least a chance! I put my money on you,

sweetie. It is not going to change our Tess, just make her able to be with

us for many years to come and to share her love and knowledge with so many

people. If I had a vote on the committee, you would get my big ol' YES!

All the best, my dear friend and will keep good thoughts for a positive

experience.

You know, I am always here to support and offer prayers!

Debs

[Guest guest]

Hi Tess,

I don't have any ideas about what to say to the committee, but I think what

Deb said about reiterating your commitment to making a lifestyle change

including exercise as well as diet would be good. Of course, we know your

exercise regimen is limited by the RA, but don't emphasize that with them.

As always, you're in my prayers. Keep us informed of how it goes, my

friend.

Love and hugs,

Carol

[ ] weight loss surgery

Hi Friends...some of you know I have been investigating gastric bypass

surgery because of my morbid obesity. I have twice requested permission

from my insurer just for a consult with a surgeon, to even see if it is

an option for me. Twice they denied me. The first time they said they

don't cover " obesity " (yet they payed for Fen-Phen in 96). Second

denial said my comorbidities are currently managed by the medications I

take.

I have disputed this, and found out Friday that they have invited me to

present my case before their grievance committee on August 9 @ 2:30pm

PDT.

They gave me 2 weeks notice, so I hurriedly sent out letters to all 9 of

my physicians asking them to write supportive letters. I am preparing a

list of all the weight loss attempts I have made, a list of all my

medications and their monthly costs, and some of the expected

deteriorations I'm being warned of if the weight doesn't come off.

I am not at all sure weight loss surgery is for me, but at over 300 lbs

and 5 ft 3in, with many comorbidities, I believe I have a right to at

least a consult.

If you have any ideas as to what to put in my letter I'm writing to go

along with the doctor's reports, or just any advice, please share.

This is a very tough battle. I need to present my case well, and I do

believe my request is valid.

Love...

Tess

[Guest guest]

Dear Jan...thank you for writing. You sure have gone through a lot,

bless your heart.

I take 50 mg. of elavil to sleep, but haven't put weight on during that

time. I know we are each different in our response to meds. Last

summer (2001) I went about 2 months with an extreme sleep deprivation

and landed in the hospital for 3 days. Of course I got some sleep

during those 2 months, but it was maybe 2 hours of broken sleep, coupled

with apnea.

I'm afraid to get my hopes up about weight loss surgery...I haven't even

spoken to a surgeon to see if I'm a good candidate. I'll just do the

best job I can do with the presentation, then I have to put it n God's

hands.

I'm sorry you went through such painful experiences, Jan. Thank you for

the sweet encouragement.

With Hugs of Hope...

Tess

[Guest guest]

Hi Kim,

Out of curiousity, how tall are you? 200 does not sound that big to me. It

does not sound like an unreasonable amout to be able to lose. (250 would be a

lot different) Do you want to risk the danger of the surgery, and even more

so... I don't know your age or anything... but do you want to risk the way skin

tends to look after that surgery. When you lose weight naturally your skin has

the chance to recover some, but this surgery does not give the skin that chance

due to how fast you lose. I think losing is something you must do, but is this

the way to go? That's the only question I would have to ponder? Have you

worked with a personal trainer/nutritionist, etc? What other problems are you

having due to your weight?

In a message dated 1/8/2003 3:12:41 PM Eastern Standard Time, BarnabyQ writes:

> My rheumy knows I am considering surgery, and he

> didn't mention anything except that it wouldn't improve the disease, just

> relieve some joint problems. Anyway, has anyone gone

> through this?

>

> Kim in FL

[Guest guest]

I can certainly appreciate the weight problem. I am at my all-time heavy as

we speak. I just don't believe any system that " fixes " the problem w/o

making a lifestyle change will have long-term benefit.

I lost weight on Weight Watchers. It is a very healthy way to lose weight.

It works. It is a lifestyle change.

My medications, sausage digits that kept me from walking, depression have

let me slowly gain back the weight. I simply don't care enough to go back

on the program when I am in " survival " mode.

I have very little faith in pills, surgery or any other " fix. " It takes

good nutrition and exercise to lose weight.

I am very sympathetic. Our disease is one vicious circle. After three

months of healing from my toenail removal, I am finally able to walk again.

It has been almost two years since I have been able to do that. When I can

walk, I do better with eating and depression is much better. I hope I'm

starting to gain on that " cycle. "

Check out other support groups as well. Here, there is TOPS (take off

pounds sensibly) and our GP has another group where they weigh in weekly and

discuss failures and successes. Good luck to you.

Ks Di

[ ] weight loss surgery

> It's probably a shot in the dark, but I was wondering if anyone on the

list

> has had any kind of weight loss surgery (gastric bypass, not cosmetic)

since

> their dx with PA. I'm considering this surgery as I'm almost 200 pounds

> overweight and am beginning to have some serious health problems besides

PA.

> It took me until last to realize that my Remicade and mtx usage might

cause a

> problem with recovery. My rheumy knows I am considering surgery, and he

> didn't mention anything except that it wouldn't improve the disease, just

> relieve some joint problems. Anyway, has anyone gone through this?

>

> Kim in FL

[Guest guest]

I'm in the same boat as you. I just wanted to let you know that what

I'm about to say is not coming from a skinny person with the opinion

that you can fix the problem easily. I don't recommend the surgery.

Losing the weight requires patience and understanding from yourself.

You must reach a point where you are willing to lose weight for

yourself and not for someone else. It requires a life-style change

that you can commit to. Weight Watchers is an excellent program. It

is also an expense that can be saved for other things such as

arthritis meds. I do recommend getting program that

is based on a sound nutritional program and it allows you to eat real

food in moderation. It is also recommended for those who are

diabetic. It would be a one time expense for about $40 where weight

watchers is a meeting once a week plus about $20 weekly. I found

that I like the Plan best. I also need to lose 100-

125 lbs as I weigh 250 now and don't want another pound added. You

need to lose slowly for best results. Doctors recommend no more than

1 to 2 lbs weekly. You will however lose more in the first week or

two. Please go to www.richardsimmons.com to see for yourself. I

have the plan and would be willing to work on it with you as a buddy

system. It would benefit both of us. I personally need the added

motivation of someone else with the same problem. E-mail me if you

are interested in trying this. dbeamon@... Cassie

[Guest guest]

Hi Kim, I understand what you are going through. I am in the same

situation. I have considered the surgery, but decided against it. I

am currently on Enbrel, MTX and Arthrotec. I had cataract surgery

last March and had to be off the Enbrel and MTX the week before, the

week of and the week after the surgery. It was not a pleasant

experience. I started breaking out the psoriasis before the end of the

first week off meds and by the end of the third week I was a mess.

Once I went back on the meds, my skin cleared up quickly, but I have

had several bad arthritic " flares " since. So the meds have never

worked quite as good as before. I have a friend who had gastric bypass

in October. She had been taking Vioxx for arthritis (not PA). She

can no longer take it or any pain meds other than tylenol. Anyway, as

it was she ended up with a severe staph infection one week post op and

she doesn't have a compromised immune system. Nasty! I personally

don't think the risk is worth it. But I also realize the risk of

being overweight. But talk to your doctors and make sure you have all

the information about treating your PA during and after the surgery

before making a decision. I just started weight watchers and it seems

(so far) to be easy to follow and a doable program. Although I know

it is difficult to follow any type of program when you feel crappy

most of the time. But we can't give up!!! Good luck in whatever you

choose! ...Anita

[Guest guest]

my brother had weightloss surgery at brigham hospital in boston . he does not

have psoriatic arthritis but does have 3 herniated disks in his backwhich he

will now have much needed back surgery . he also had a hernia operation and a

gallbladder removed on the same day and was in the hospital for 3 days . he

has lost 80 pounds since last august 5th . he looks good and feels good .

however hwe said to me he would not recommend the surgey to anyone . it was a

difficult thing to go through . he said it was the right thing for him but he

felt he had no choice as he weighed 360 pounds . please reconsider the

surgery . it should only be done if there are no more choices .left . a lady

my husband works with had her gastric bypass at mass . general in boston and

suffered many complications and almost died . [hers was not a medical

necessity .] she elected to have the surgery on her own and her insurance

did not pay for it . [the operation alone - not counting hospital stay and

weeks that she spent in intensive care cost 20 thousand dollars. her gastric

bypass leaked and she had to have the operation again to save her life and

nearly died from a massive infection . take my advice find another way to

lose weight cathy from mass

[Guest guest]

> It's probably a shot in the dark, but I was wondering if anyone on

the list

> has had any kind of weight loss surgery (gastric bypass, not

cosmetic) since

> their dx with PA.

Kim,

I did not have the gastric by-pass, but I did have the Adjustable

Gastric Lapband surgery on Nov. 28, 2002. I have lost 35 pounds in 6

weeks. My Rheumy doctor did know about the surgery. I okay'd it

with him before having it done.

If you would like to check the lapband out. Just go to

and put lapband in the Search.

Good luck with whatever you decide.

Debra J

[Guest guest]

Hi,

I need to lose over 100 lbs and I am interested to see if anyone on the list has had gastric bypass surgery. I am going to look into this and also the lapband surgery. I have RA and take Enbrel and mtx and I was wondering how the surgery itself affected you. I know the weight lose would help but I'm anxious aboput going into surgery.

Any comments?

Thanks,

Vicki__________________________________________________