Reviewing MGB packets!

[Guest guest]

Hi,

I am spending the day reviewing MGB packets ;-)

I was just reading this great set of letters from a patient and her husband

that saw me for the first time three years ago and will be going ahead with

surgery soon.

I thought you might be interested in their comments.

10/19/00

Dear Dr. Rutledge,

Prior to meeting you three and a half years ago, my husband and I found a

Bariatric Physician. He gave me speed, and some " stuff " which only increased

my GERD and I just gained weight. One week later I went to see my Gasto Dr

had an attack and begged me not to return.

Three and a half years ago I made an appointment to see you, and drove up

from Flagler Beach, FL for the consultation at your office at UNC. I learned

from you that there wasn't any medication coming that would give any hope of

loosing my weight and medical problems. I learned that short, of the MGB

surgery, I would remain obese and that it would get worse over time. The

reason I did not have surgery then is because my medical insurance would not

pay. Now I can afford it and am ready to set an appointment.

FOR THREE AND A HALF DOG YEARS, I have waited for " " The Appointment " '.

I understand that the MGB surgery is a total living modification. Not only

in eating and exercising, but also changing all of my daily habits. I know

that after the surgery, it is important to follow all of the guidelines and

the added benefit is that I may have relief from my GERD and my Asthma.

Understanding How the Operation is Performed

I understand that I will be taken to the OR, draped and then put to sleep.

Five 12mm openings will be made in my abdomen. Then the MGB really begins. A

Laparoscopic holder and a self-retaining retractor are placed in the

openings. The Endo GIA stapler is inserted in the opening locating the

stomach and firing the staple gun makes a new long gastric pouch from one

side of the stomach. Once that is completed the small intestine is

identified. Six feet from the beginning of the small intestine a loop of

intestine is grasped and pulled up to the new gastric pouch. The stomach and

the small bowel are opened and the Endo GIA stapler is used to attach the

new stomach to the small bowel. The stapler opening is sutured and the

operation is complete. Operation time 20 - 40 Minutes!!

After joining an obesity surgery support group in FL I really found out what

the other two types of surgeries are all about. Dr performs the Roux en Y

procedure and from the tales of the patients it sounds almost barbaric. Dr

went on to say how much more expensive Laparoscopic surgery is and in some

cases they have to terminate the laparoscopic surgery and do the normal

operation. Operating time here is 2.5 to 3.5 hours. My husband and myself

just looked at each other in total disbelief at his statements.

There were people there, who after 9-- 12 weeks post op, are still on

feeding tubes and have not had anything by mouth. Exercising was totally out

of the question for months after his surgery. Evidently very traumatic.

Talk about depression Holy Cow!!

I don't know if I will continue with this support group after my MGB, as I

don't feel I will have very much in common with them, other that loosing

weight. I can always return if the need arises.

Understanding the Expected Benefits of the Surgery

The first benefit that I am praying for is after loosing 30 - 40 lbs I will

be able to stand longer than 10 minutes.

Secondly, that my GERD and Asthma will be greatly diminished.

I will be able, thru exercising daily, to regain my cardio-vascular health.

Just being out in public again will be great. Not having to go to the

" 'Fat " ' section of a clothing store will be another great benefit.

I also know that none of the is going to happen over night and that's ok.

I look forward to walking on our beautiful beach again with my cloggies; and

they too will be happy campers.

My husband has, just two weeks ago, been diagnosed with Diabetes. I have

been worrying not only about him but also myself having the same problem.

His doctor told him that if he lost 20 - 25% of his body weight, he might

get rid of his Diabetes.

The greatest hope for me is that I May NEVER HAVE A WEIGHT PROBLEM AGAIN.

Understanding the Risks of the Surgery

I understand the greatest risk of this surgery is death.

I understand the risk of major infections, but I also understand with having

the MGB as opposed to other types of the surgery this risk is less.

I understand that the other major risks are Allergic Reactions, bleeding,

embolisms, infections, leaks, ulcers, narrowing, dumping syndrome, bowel

obstruction, laparoscopic puncture and surgery risks, side effects of drugs,

loss of bodily function, risk of transfusion, hernias, hair loss, vitamin

and mineral deficiencies, and depression.

I feel confident I have chosen the best Doctor, the best procedure and the

best facility in the country. I feel confident that should anything

unexpected arise, I will be well looked after.

Understanding Alternatives to Surgery

Been there, done that, read the book, seen the movie and have the " T " shirt.

I been on every diet known to man and some I tried to devise myself. They

ALL failed in the end even when under the care of a physician.

Dieting is probably the hardest work, mentally and physically, that a person

will ever do. Especially when failure is just around the corner. Gotta loose

5 lbs, 10 lbs it is still a lot of work. When you have to loose 130lbs it is

almost impossible.

The worst diet was the Pritikin Diet and only being on the diet for two

weeks I thought I was going to die.

I know the MGB surgery is the only choice for me!

Understanding Post Operative Diet Changes

I know, after MGB surgery, dietary changes are made immediately. For the 1st

two months my diet will consist of primarily of fruit juices, liquids and

protein enriched drinks. As a native born Floridian it has been extremely

difficult to give up all citrus. I'm sure, in the beginning my fruit juices

will have to be diluted with water because of my reflux problem. My father's

grapefruit tree in Tampa, FL, is 56 years old, produces 500 pieces of fruit

per year, and produces the best pink grapefruit I've ever had. I'm looking

forward later in the season to be able to enjoy them once again.

The following two months, I can add soft foods as tolerated. As my husband

and I are such excellent cooks, this will become an interesting part of my

daily routine. I plan to keep a lot of notes about the soft foods and share

them with the people on the web site.

For me, satisfying my taste buds is everything. I already incorporate plain

non­fat yogurt into my diet. So, having to eat yogurt will be a pleasure not

a problem.

Not having alcohol is not going to be a problem, because of my husbands

Diabetes, drinking has been totally ended.

Since I will be 51 in November, I am not concerned about becoming pregnant.

I realize that being on liquids for the first two months after the MGB will

be very difficult, but manageable. I know that I can do anything for two

months.

Dr Rutledge, something peculiar happened this past summer. For the Ist time

ever I did not enjoy my pool this year. Getting into the pool and being

almost weightless was bliss, however, getting out of the water and having

all of this crushing weight on my joints was agony. I really look forward to

the upcoming spring to be able to continue with my aquatic aerobics, and my

swimming.

I have found in the past that varying ones exercise program keeps one from

getting bored. That is why I plan to do all of the above, described program.

As a matter of fact, several years ago when I was rowing so much, I had my

machine set at the hardest level (20 minutes a day 6 days a week) and I had

gained so much upper body strength that when I got in the pool for the first

time that summer and started swimming laps I almost swam out of the pool.

Another thing I am looking forward to again is, 2 years ago the 201b dog

food bag weighed nothing and now it weighs a ton.

Conclusion

During this past summer, I think in June, I was watching Good Morning

America. The young Pop singer Carnie of the group - ,

was going to have her Gastric Bypass Surgery done on the Internet. Dr

Schniederman, she is the GMA Doctor, was interviewing Ms. and her San

Diego physician. The disdain in her voice, and her totally condescending

attitude toward Gastric Bypass Surgery, left me at a total loss for words. I

have read on your web site about this attitude amongst doctors and seeing it

and reading it is two entirely different things. I realize that everyone has

to do what is right or best for him or her. Once again, having done all of

the research for the past three and a half years, speaking with my doctors,

and with my husband behind 150% of the way I know in my heart that this

decision is right for me.

On my online application is my occupation Homemaker/Inventor. I have

developed a whole new process of binding books to make it easier for people

world wide to read. Especially, like myself, who have arthritis or other

hand infirmities, and the elderly. Because of my weight, proceeding with the

marketing of my invention has come to a dead halt. I no longer have the

confidence I feel I need to speak with people in the publishing industry. I

know all they will see is the " fat " .

I definitely understand that MGB is not the easy way out. I know that it is

a life changing procedure and I am ready to change my life. I have been

obese and I have been thin and thin is definitely better. I look forward to

the postoperative medical follow up. I fell that the change in life style

and eating habits is not going to be neither a problem nor a major stress in

my life. I have made the commitment to this and am ready for it to begin.

The added vitamins and mineral supplements is not a problem because I take

most all that is required already. I hope you can see that I have done my

homework and that I have a good attitude concerning the MGB surgery. I think

I am an excellent candidate for the procedure and can hardly wait to have my

appointment scheduled.

Sincerely,

Gloria H.-W.

October 19, 2000

Dr. Rutledge, MD, F.A.C.S.

Center for Laparoscopic Obesity Surgery

4301 Ben lin Blvd.

Durham, NC 27704

Dear Dr. Rutledge,

Three years ago, my wife, G. W. (G.), and I came to your clinic at UNC for a

consultation and to find out if G. was a candidate for the MGB procedure.

She was a candidate then, but the insurance my company provided flat refused

to pay for the operation, then $20,000. We now have the money and G. can

hardly wait until she is approved for the surgery and finally have a date

set. This has been a long three-year goal that she has never wavered from at

all.

The only thing that has happened in the past three years is that G. has

become heavier, her health has deteriorated, and she has become almost a

shut- in. She travels with me occasionally on by business trips but will not

go to any dinners or activities when it includes other people and especially

strangers. All meals have to be either picked up and brought to the hotel

room or delivered. We have done so much research into obesity surgery that

we know, and knew, when we came to see you three years ago, you were the one

to perform the MGB surgery.

Last night, G. and I went to a Gastric Bypass (Roux-en-Y) support meeting in

FL for the second time. It was like middle ages surgery. All of the

complications, the amount of time on the operating table (2.5-4 hours),

people saying they have a feeding tube in place after 6 months, and even

more scary things. If G. had wanted this surgery, I would not have even

considered supporting it for one minute, after being at the two support

meetings. Even though, there were people there with great success stories,

and lives that had been retrieved from certain death. So, for some, it was a

good thing. It just seemed so barbaric.

G. and I have read the manual at least 4-6 times each, and will continue to

read it again and again, and I learn more with each reading. BUT, the bottom

line still remains in a statement you made at the consultation we had with

you three years ago. " " There is no medicine coming down the pike that is

going to treat obesity. " This MGB is the best alternative to the

inevitability of the obesity becoming more severe, all of the diseases

related to obesity showing them self, becoming more and more unable to

perform daily normal tasks, severe depression, and then, like clock work,

one of the complications killing you.

Death may be inevitable, but, quality of life is much more important to us

in the mean time. We are still relatively young and still have a lot more to

accomplish in our lives than fight obesity with ineffective weapons.

Basically, Dr Rutledge, I want you to give us our life back to us. We have

been married for over thirty (30) years and this is the worst time of the

entire marriage. We have so much we want to do and so many places we still

want to go. To go without the prejudice I see in everyone eyes when they see

my wife. We have been together 32 years through thick and thin and we are in

this MGB surgery together. I support this 1000% and will do everything in my

power to see that G. is successful in the months and years after the

surgery.

WE are looking forward to seeing you again in the NEAR future.

Claude W....

RR

Rutledge, M.D., F.A.C.S.

The Center for Laparoscopic Obesity Surgery

4301 Ben lin Blvd.

Durham, N.C. 27704

Telephone #:

Fax #:

Email: DrR@...

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Re: 2 week post op

> you go girl.

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