Larry Young, Dr. Husted & Choosing Your Surgeon

August 11, 2001

In a message dated 8/11/01 11:44:40 AM Pacific Daylight Time,

tlarussa@... writes:

> Do we care about our fellow MO folks? Do we care enough to caution

> them against doing something we know in our hearts is foolish or

> dangerous?

>

I think you made some very very good points. I am as guilty as the next

although I'd never heard of Larry until his passing. I also didn't realize

this was his surgeon's first DS. I would have to agree that as a surgeon,

maybe that was a bit ambitious to take on. While Larry didn't have anything

major wrong (ie nothing most of us have either), his high weight was enough

to move even an experienced surgeon to take more precautions and some even to

refuse to do the surgery before trying to get some weight off. You brought

up many good things, and while you're right, its not going to help Larry...we

have to as a group and as individuals, speak up if we think something is

being overlooked or leaving someone at a higher risk than necessary.

Thank you for bringing this up. I wish I'd given the whole situation more

thought and I am now, so thank you for bringing it to my attention.

~~* AJ *~~

Post op 7/24/01

self pay - Dr Baltasar -Alcoy Spain

07/24/01 BMI 64 - 415.1

08/06/01 BMI 59 - 390.2 -24.9 lbs!!!!!!!!!!~~~~

Check out the

Bellingham Support for WLS

WWW.WLSBellingham.homestead.com

August 11, 2001

In a message dated 8/11/2001 11:45:06 AM Pacific Daylight Time,

tlarussa@... writes:

<<

I am quite disappointed by the reaction of the membership of this

list to the death of Larry Young.

The death of someone who has had the same surgery we have all either had or

hope to have is something that everyone is going to process differently.

What you read on the list is only a small portion of the reactions people may

be having. Not everything we think or feel makes it to the list....although

sometimes it sure seems that it does!

Go ahead and label me the a$$hole of the century if you want

I would never do that! I like you.

my reaction to Larry's death is not so much sadness as ANGER and a

desire to know WHY.

Understandable.

WHO FAILED LARRY?

1. Dr. Husted failed him

What the HELL was this man thinking, taking on a 686 pound patient

with a BMI of 88.1 for his very FIRST BPD/DS procedure?

I agree with you that this was not the best choice for a first procedure.

BUT, Dr. Husted was up front with Larry and Diane, and they were told that it

was his first DS procedure. I would hold him accountable if he had been less

than forthcoming about the fact that he had not done this procedure before.

It is unclear whether they had time and/or access to information regarding

the learning curve, etc. Without the numerous DS lists, the amount of

information available to prospective DS patients is nowhere near adequate,

but this is true of all surgeries I think. If we simply listen to what one

surgeon tells us, we get the party line and may miss a lot of pertinent

information. But how are people to know this?

2. WE FAILED HIM!

Who we? Yes WE!

How? By being so EFFING scared of hurting someone's feelings that we

almost never discuss the hard truths about this surgery, (or if we

do, the conversation is quickly shouted down).

Here are some of those hard truths we don't talk about:

1. This surgery is technically difficult and, in inexperienced

hands, extremely dangerous;

We must talk about this, because I am aware of it, and was pre-surgery.

2. The DS has a steep learning curve, i.e., if you choose a surgeon

who has not performed many of the procedures, you GREATLY increase

your chances of serious complications and/or death;

Ditto, we must talk about it, because I am aware of this and was pre-surgery,

also.

3. All DS surgeons are not equal. Some have performed the surgery

so many times they could probably do it in their sleep, while others

are so wet behind the ears they probably need an instruction manual

in the operating room;

Ditto, although your description, above, is a great way to illustrate the

point.

4. Being a good surgeon requires much, much more than memorizing the

human anatomy and learning how to cut and stitch tissues and organs.

It takes, more than anything else, GOOD JUDGMENT -- which I define as

the ability to make decisions PRIOR to surgery such as to minimize

the risk of that surgery, as well as the ability to make the right

decision quickly when faced with a crisis in the operating room.

ABSOLUTELY. And I think we have talked about what makes a good surgeon

versus a not-so-good one. We may not all agree, but even in our

disagreement, a lot of information is passed along. A lot of ideas to

consider are thrown into the mix.

5. There is no correlation between how much a surgeon's patients

like that surgeon and how capable that surgeon is. Nor is there any

correlation between how nice a surgeon is at the consult, or how much

time s/he spends with you, and how capable a surgeon s/he is.

Very true, and we've discussed this on list in the past. Again, in our

divergent views, a lot of good, helpful information has been passed along.

Unfortunately, human nature being what it is, some proportion of prospective

DS patients will chose surgeons based on what " feels good " to them, sort of

the " heart " method versus the " mind " method of choosing a surgeon. All we

can do is inform people, but in the end the choice is theirs.

Do we care about our fellow MO folks? Do we care enough to caution

them against doing something we know in our hearts is foolish or

dangerous?

I think we do this, given the opportunity. I think we need to be tactful and

caring and give information freely. But that is all we can do. It is up to

the individual to do with it what they will.

No flames for the " tactful " please. It is my personal opinion that in being

tactful we are more likely to have people listen to our point of view. If we

are respectful of others opinions and feelings, they are more likely to want

to listen to what we have to say. We can express strong feelings,

controversial opinions and/or stern cautionary warnings in a way that people

are likely to listen to, versus doing so in a way that makes them think we

are militant nutcases, which is likely to have them reject our opinions out

of hand - without considering the merit of our words. What we have to say is

important, and I want people to listen and understand. Being tactful in no

way lessens the importance or impact of the information we are trying to get

across. YMMV

Will we care enough about the next Larry to tell him DON'T GO TO AN

INEXPERIENCED SURGEON -- DON'T BE FIRST -- DON'T BE A GUINEA PIG!

Absolutely. Again, I think the statistics speak for themselves. However,

without these lists, or internet searches, where do people get this

information? That is what frightens me, the thought of people considering

any weight loss surgery without the information that is available to us right

here.

I knew, going into surgery, that there was a chance I would die in the

process. I knew it on a very deep, gut wrenching level, not as just words to

say. I knew that surgery on a SMO person was high risk. I knew that each

co-morbidity added to that risk. When I was doing my preop research and then

testing, Joe and then Sharon were having MAJOR complications. It brought

home to me in a way that sheer statistics could not, that this was no game.

That serious complications really DID happen in a certain percentage of

cases. And I read everything I could find. And, yes, people did DIE as a

result of their obesity and having WLS. This is real stuff, people. I truly

hope that everyone who undertakes this really truly understands this. We

aren't playing games here. No one wants to be " the one " , and everyone hopes

to come out just fine. That is obvious.

For myself, the choice was a matter of dying at some unknown point, probably

within the next 5 years, without surgery - as well as living a life full of

indignities, large and small, until that point, versus having the HOPE of a

future. I am a single parent and love my children desperately. Believe me,

I did not undertake this surgery, with the very real risk of death, lightly.

I wish that no one died from this surgery. I wish that no one died from

complications of their obesity, either. I wish everyone knew where to find

the information to make truly informed choices. I wish more people chose

with their " head " and less with their " heart " . I wish people would study the

statistics, the history of WLS, as well as the long term and short term

issues involved with the DS as well as with morbid obesity.

In the end though, we can make the information available, but it is up to

each individual to decide whether or not to make use of it.

My only thought as to how this might be enhanced, is to see if the DS

surgeons would refer their patients to the DS sites in order to gain access

to information.

Dawna

August 11, 2001

Do we care about our fellow MO folks? Do we care enough to caution

them against doing something we know in our hearts is foolish or

dangerous?

Will we care enough about the next Larry to tell him DON'T GO TO AN

INEXPERIENCED SURGEON -- DON'T BE FIRST -- DON'T BE A GUINEA PIG!

Or will we just sit on our hands until s/he's dead or maimed, and

then wring them in sadness? >>>>>

'

Tom: I agree that we should be more proactive about helping others in their

surgery decisions, guiding them and providing them with as much information

and experience as possible. However, I disagree that anyone in the DS

community

is responsible for Larry's death -- In fact, he was going to get a fobi pouch

and Dr. Hares decided to switch procedures soon before the surgery (how soon

I am not sure but the post dated July 30, the day of his surgery, says that

Dr. Hares stopped by THAT DAY to discussing switching surgeries: 07/30 02:32

PM

Angel update ~*~ I visited with Larry and Dianne last night at the hospital

in Nashville. We enjoyed a wonderful time together. Larry's doctor, Dr.

Husted, came by to talk with Larry and Dianne about his decision to change

the procedure he wanted to preform on Larry. He felt that Larry would better

benefit from the DS as opposed to the Fobi pouch. Dr. Husted felt Larry would

lose more of his excess weight with the DS. Larry was in agreement with his

doctor and felt confident in his opinion.

~*~*~*~*~*~*~*~*~*~*~*~*~**~*~*~*~~**~*~~**~~*~*~* Angel update ~*~ Larry

went into surgery this morning at 8 a.m. and came out at 3:15 p.m. Dr. Husted

found a large stone in Larry's gall bladder and it was causing Larry much

pain, Larry no longer has a gall bladder!! Larry's intestines were VERY

confind and this made the surgery rather difficult. Dr. Husted also took

Larry's appendix. Larry came thru the surgery very well but will be in ICU

for the remainder of the day and into tomorrow morning. He is on a

respirator. They are hopeful that he will come off of it in the morning.

Larry will be in the hospital for 7 days and will not have anything to eat

for 5 days. Welcome to the thinner side of life Larry!!! You made it thru!!!

Congrats Larry!!!!! ).

I do not think he has ever posted here nor do I think he was a member of the

group, most likely because he didn't consider himself a pre-op DS until right

before his surgery (this was mentioned in my post as well).

All information I obtained on Larry was from the AMOS site. Perhaps people

need to be more proactive on THAT list and check to see if those who are

obtaining a DS are getting the proper knowledge and support they need. I do

this as much as possible and I know , Jill Sokol and Heidi (as well as

many others) often post responses to people and provide information

('s profile is full of DS links and is extremely informative).

If a surgeon decides to switch surgeries the day of the surgery and the

patient consents, I really don' t think there is much anyone can do to

prevent a catastrophe from happening. I don't even know if Larry had the

opportunity to really research DS as an option because it wasn't even

originally considered. In other words, his choice of surgeons was NOT EVEN

based on level of experience with the DS procedure because this was not even

the procedure he was going to undergo.

Perhaps if Larry had more time to weigh his decision and ask advice from

post-op DSers, etc. he may have switched surgeons once highly advised against

being a first post-op for a particular surgeon. Perhaps he would have still

made the choice if he felt comfortable with the surgeon (which he appeared to

be). He may have made his initial choice based on location and proximity and

perhaps felt that since he had gotten insurance approval, etc. already lined

up he didn't want to wait any longer to travel long distance to another

surgeon, etc. I don't know what his reasoning was.

Since Larry had such a high bmi, I agree that it would have been advisable to

choose a more experienced surgeon. It may have been wisest to have had the

procedure done in two parts since evidence shows that those with a bmi of 60

or higher is at far greater risk for complications. Even with the most experi

enced surgeon Larry may have encountered similar complications and lost his

life. It has happened to the most seasoned of surgeons -- from deaths on the

operating table to various deaths as a result of post-op complications.

I'm not saying Dr. Hares did not act irresponsibly in attempting his first DS

on a patient at such a high risk. Why he decided to switch surgeries without

allowing Larry and his family enough time to really make a more informed and

careful decision is beyond me.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

August 11, 2001