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	<title>Comments on: Gastric Bypass Risks</title>
	<link>http://erstories.net/archives/295</link>
	<description>ER Stories       Real Life Tales from the Emergency Room</description>
	<pubDate>Tue, 16 Mar 2010 13:13:31 +0000</pubDate>
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		<item>
		<title>By: Bulrush</title>
		<link>http://erstories.net/archives/295#comment-5192</link>
		<dc:creator>Bulrush</dc:creator>
		<pubDate>Wed, 29 Oct 2008 13:51:22 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-5192</guid>
		<description>Is it weight that's determined by genetics? Or addiction to food that's determined by genetics. Or perhaps lack of responsibility is determined by genetics. Food for thought.</description>
		<content:encoded><![CDATA[<p>Is it weight that&#8217;s determined by genetics? Or addiction to food that&#8217;s determined by genetics. Or perhaps lack of responsibility is determined by genetics. Food for thought.</p>
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		<title>By: More Gastric Bypass Problems</title>
		<link>http://erstories.net/archives/295#comment-3688</link>
		<dc:creator>More Gastric Bypass Problems</dc:creator>
		<pubDate>Fri, 01 Aug 2008 05:14:20 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-3688</guid>
		<description>[...] patients come in to the ER with abdominal pain with +/- vomiting.  As I described in a prior post (this one), the complications can be catastrophic (and fatal).  In addition to that case, I have seen [...]</description>
		<content:encoded><![CDATA[<p>[&#8230;] patients come in to the ER with abdominal pain with +/- vomiting.  As I described in a prior post (this one), the complications can be catastrophic (and fatal).  In addition to that case, I have seen [&#8230;]</p>
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		<title>By: R</title>
		<link>http://erstories.net/archives/295#comment-2539</link>
		<dc:creator>R</dc:creator>
		<pubDate>Sun, 29 Jun 2008 15:15:59 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-2539</guid>
		<description>That's what I said. I said that genetics play about a 70% role according tothe latest studies, which is greater than the role genetics plays in height.</description>
		<content:encoded><![CDATA[<p>That&#8217;s what I said. I said that genetics play about a 70% role according tothe latest studies, which is greater than the role genetics plays in height.</p>
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		<title>By: rph3664</title>
		<link>http://erstories.net/archives/295#comment-2502</link>
		<dc:creator>rph3664</dc:creator>
		<pubDate>Sat, 28 Jun 2008 15:45:38 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-2502</guid>
		<description>R, I have known identical twins who remained pretty much the same size all through their adult lives.  Genetic factors play a bigger role than many people realize.</description>
		<content:encoded><![CDATA[<p>R, I have known identical twins who remained pretty much the same size all through their adult lives.  Genetic factors play a bigger role than many people realize.</p>
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		<title>By: R</title>
		<link>http://erstories.net/archives/295#comment-2492</link>
		<dc:creator>R</dc:creator>
		<pubDate>Sat, 28 Jun 2008 05:25:44 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-2492</guid>
		<description>Man these stereotypes are toxic!! Too bad that weight has been determined to be more genetically influenced even then height. 70% to be exact according to the latest double-blind twin studies. Why, even the NIH admits that 95-98% of people who lose more than 75 lbs by dieting gain it back within 3 years. There's even a lot of thought going around that the negative health effects associated with obesity, besides being inadequately documented, are related more to patterns of yo-yo dieting than the weight itself. Maybe if we have to permanently maim part of a persons body to make them lose weight they're just meant to be that size in the first place? Or of course, it could be related to the weight gain that generally takes place after being on a diet, y'know once you permanently alter your metabolism through starving yourself. But don't worry, you likely will never have to worry about it, since there is also virtually no way to make a naturally skinny person permanently fat.</description>
		<content:encoded><![CDATA[<p>Man these stereotypes are toxic!! Too bad that weight has been determined to be more genetically influenced even then height. 70% to be exact according to the latest double-blind twin studies. Why, even the NIH admits that 95-98% of people who lose more than 75 lbs by dieting gain it back within 3 years. There&#8217;s even a lot of thought going around that the negative health effects associated with obesity, besides being inadequately documented, are related more to patterns of yo-yo dieting than the weight itself. Maybe if we have to permanently maim part of a persons body to make them lose weight they&#8217;re just meant to be that size in the first place? Or of course, it could be related to the weight gain that generally takes place after being on a diet, y&#8217;know once you permanently alter your metabolism through starving yourself. But don&#8217;t worry, you likely will never have to worry about it, since there is also virtually no way to make a naturally skinny person permanently fat.</p>
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		<title>By: rph3664</title>
		<link>http://erstories.net/archives/295#comment-2483</link>
		<dc:creator>rph3664</dc:creator>
		<pubDate>Fri, 27 Jun 2008 21:15:22 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-2483</guid>
		<description>If he weighed 443 pounds and looked like that, he must have been well over 6 feet tall.

I once worked at a hospital that did bariatric surgery and had some interaction with the surgeon, and he turned people away all the time even if their insurance approved the procedure because he felt they were not good candidates, for whatever reason.  The general public thinks these people have their surgery, go home, lose weight, and live happily ever after, but it's a lot more complicated than that.</description>
		<content:encoded><![CDATA[<p>If he weighed 443 pounds and looked like that, he must have been well over 6 feet tall.</p>
<p>I once worked at a hospital that did bariatric surgery and had some interaction with the surgeon, and he turned people away all the time even if their insurance approved the procedure because he felt they were not good candidates, for whatever reason.  The general public thinks these people have their surgery, go home, lose weight, and live happily ever after, but it&#8217;s a lot more complicated than that.</p>
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		<title>By: ernurse</title>
		<link>http://erstories.net/archives/295#comment-1871</link>
		<dc:creator>ernurse</dc:creator>
		<pubDate>Wed, 30 Apr 2008 12:53:18 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1871</guid>
		<description>3+speckled, I believe they ARE made aware of the risks, including the limitations of medical equipment with regard to size and weight.  As part of my orientation I went through training and actual patient sessions that covered all the areas my hospital specializes in, one of which is bariatric surgery, and I do know that the patients are made aware of what is and is not medically possible for them related to their size and weight, especially CT scans, because that's a major issue.</description>
		<content:encoded><![CDATA[<p>3+speckled, I believe they ARE made aware of the risks, including the limitations of medical equipment with regard to size and weight.  As part of my orientation I went through training and actual patient sessions that covered all the areas my hospital specializes in, one of which is bariatric surgery, and I do know that the patients are made aware of what is and is not medically possible for them related to their size and weight, especially CT scans, because that&#8217;s a major issue.</p>
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		<title>By: 3+speckled</title>
		<link>http://erstories.net/archives/295#comment-1853</link>
		<dc:creator>3+speckled</dc:creator>
		<pubDate>Tue, 29 Apr 2008 03:10:27 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1853</guid>
		<description>You have to wonder though.  Should a hospital do  "a fair amount" of gastric bypass surgery, if they can't provide essential services for these patients?  If no CT exists for this weight, are patients made aware of the risks?</description>
		<content:encoded><![CDATA[<p>You have to wonder though.  Should a hospital do  &#8220;a fair amount&#8221; of gastric bypass surgery, if they can&#8217;t provide essential services for these patients?  If no CT exists for this weight, are patients made aware of the risks?</p>
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		<title>By: Jeff RN</title>
		<link>http://erstories.net/archives/295#comment-1851</link>
		<dc:creator>Jeff RN</dc:creator>
		<pubDate>Tue, 29 Apr 2008 02:35:03 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1851</guid>
		<description>I've successfully had Gastric Bypass Surgery (I'm 200 lbs below my operative weight from January 2002), so I obviously believe it is a worthwhile surgery (while understanding that there are risks, just as in any surgery). 

However, my friend worked with a Bariatric Doctor, and kept stats on the outcomes of surgery. I wonder how many "bad outcomes" are due to non-compliance? She said there were instances of patients presenting to the ED shortly after surgery with abdominal pain, and when they scoped them, they found partially digested food such as peanuts, pretzels, etc., at a time when the patient should still only be eating yogurt and eggs.</description>
		<content:encoded><![CDATA[<p>I&#8217;ve successfully had Gastric Bypass Surgery (I&#8217;m 200 lbs below my operative weight from January 2002), so I obviously believe it is a worthwhile surgery (while understanding that there are risks, just as in any surgery). </p>
<p>However, my friend worked with a Bariatric Doctor, and kept stats on the outcomes of surgery. I wonder how many &#8220;bad outcomes&#8221; are due to non-compliance? She said there were instances of patients presenting to the ED shortly after surgery with abdominal pain, and when they scoped them, they found partially digested food such as peanuts, pretzels, etc., at a time when the patient should still only be eating yogurt and eggs.</p>
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		<title>By: TK</title>
		<link>http://erstories.net/archives/295#comment-1831</link>
		<dc:creator>TK</dc:creator>
		<pubDate>Mon, 28 Apr 2008 14:11:44 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1831</guid>
		<description>Well, the point is that since he could not get a CT scan, he was explored (ie operated on).  Unfortunately, he could not be saved, the infection was too far spread. A CT scan would have done nothing to save him.</description>
		<content:encoded><![CDATA[<p>Well, the point is that since he could not get a CT scan, he was explored (ie operated on).  Unfortunately, he could not be saved, the infection was too far spread. A CT scan would have done nothing to save him.</p>
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		<title>By: Syna</title>
		<link>http://erstories.net/archives/295#comment-1820</link>
		<dc:creator>Syna</dc:creator>
		<pubDate>Mon, 28 Apr 2008 11:23:34 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1820</guid>
		<description>Wow, the stereotypes, they burn.</description>
		<content:encoded><![CDATA[<p>Wow, the stereotypes, they burn.</p>
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		<title>By: william fisher</title>
		<link>http://erstories.net/archives/295#comment-1807</link>
		<dc:creator>william fisher</dc:creator>
		<pubDate>Mon, 28 Apr 2008 04:20:31 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1807</guid>
		<description>If Vets can have scanners for animals that big, wouldn't you consider getting a scanner for big fat people or shipping them to the vets office for an emergent CT scan.  I am sure they could drink the contrast on the way to the vets office.  Would it be reasonalble to transfer the Pt to a farm or vets office?  Maybe he should have exercised sometime during his life instead of drinking soda and watching TV on the couch.</description>
		<content:encoded><![CDATA[<p>If Vets can have scanners for animals that big, wouldn&#8217;t you consider getting a scanner for big fat people or shipping them to the vets office for an emergent CT scan.  I am sure they could drink the contrast on the way to the vets office.  Would it be reasonalble to transfer the Pt to a farm or vets office?  Maybe he should have exercised sometime during his life instead of drinking soda and watching TV on the couch.</p>
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		<title>By: TK</title>
		<link>http://erstories.net/archives/295#comment-1797</link>
		<dc:creator>TK</dc:creator>
		<pubDate>Mon, 28 Apr 2008 02:06:35 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1797</guid>
		<description>Sorry - they do not make CT scanners to accomidate people of 450 lbs - except at veterinary hospitals.</description>
		<content:encoded><![CDATA[<p>Sorry - they do not make CT scanners to accomidate people of 450 lbs - except at veterinary hospitals.</p>
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		<title>By: Syna</title>
		<link>http://erstories.net/archives/295#comment-1787</link>
		<dc:creator>Syna</dc:creator>
		<pubDate>Sun, 27 Apr 2008 22:01:11 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1787</guid>
		<description>So,

The issue here is that the hospital did not have the facilities to treat this man (appropriate CT scanner) and that because they did not have the facilities, this man had treatment that differed to what a 'thin' person would receive which resulted in his death.

Seems like discrimination here. The hospital should never have taken the patient if they did not have a full complement of machines/facilities to treat him.

Regardless whether or not you think the CT was necessary, if he were thinner he would have gotten one. The question is 'how long was the delay between symptoms and treatment and was that influenced by the negligence of the hospital - ie not having an appropriate CT machine'.</description>
		<content:encoded><![CDATA[<p>So,</p>
<p>The issue here is that the hospital did not have the facilities to treat this man (appropriate CT scanner) and that because they did not have the facilities, this man had treatment that differed to what a &#8216;thin&#8217; person would receive which resulted in his death.</p>
<p>Seems like discrimination here. The hospital should never have taken the patient if they did not have a full complement of machines/facilities to treat him.</p>
<p>Regardless whether or not you think the CT was necessary, if he were thinner he would have gotten one. The question is &#8216;how long was the delay between symptoms and treatment and was that influenced by the negligence of the hospital - ie not having an appropriate CT machine&#8217;.</p>
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		<title>By: Supremacy Claus</title>
		<link>http://erstories.net/archives/295#comment-1708</link>
		<dc:creator>Supremacy Claus</dc:creator>
		<pubDate>Sat, 26 Apr 2008 17:36:08 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1708</guid>
		<description>The jury is the only friend of the doctor in the court. Even in judicial hellholes, their verdicts favor the doctor 70% of the time. If the doctors thought they had done nothing to harm this patient, they had a duty to refuse to settle. It is not their money. They likely preferred to not bother with the effort and risk of a trial. If forced to settle without medical justification, they should sue their insurance company for bad faith.</description>
		<content:encoded><![CDATA[<p>The jury is the only friend of the doctor in the court. Even in judicial hellholes, their verdicts favor the doctor 70% of the time. If the doctors thought they had done nothing to harm this patient, they had a duty to refuse to settle. It is not their money. They likely preferred to not bother with the effort and risk of a trial. If forced to settle without medical justification, they should sue their insurance company for bad faith.</p>
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		<title>By: CHenry</title>
		<link>http://erstories.net/archives/295#comment-1596</link>
		<dc:creator>CHenry</dc:creator>
		<pubDate>Thu, 24 Apr 2008 22:49:08 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1596</guid>
		<description>You aren't supposed to weigh 450 lbs. when you are 19 either, or for that matter at any age. People who allow themselves to become that obese have really taken themselves to a place where normal expectations, like not dying at age 19 don't obtain the way they might otherwise, like someone who abuses narcotics can't really have the normal set of expectations about health and life expectancy.

I'm sure the trial lawyer didn't see it that way. The deceased was painted as someone with hopes and expectations just like everyone else, except for the not-so-small fact that he was an active agent in thwarting those very hopes.

It is a shame for all concerned.</description>
		<content:encoded><![CDATA[<p>You aren&#8217;t supposed to weigh 450 lbs. when you are 19 either, or for that matter at any age. People who allow themselves to become that obese have really taken themselves to a place where normal expectations, like not dying at age 19 don&#8217;t obtain the way they might otherwise, like someone who abuses narcotics can&#8217;t really have the normal set of expectations about health and life expectancy.</p>
<p>I&#8217;m sure the trial lawyer didn&#8217;t see it that way. The deceased was painted as someone with hopes and expectations just like everyone else, except for the not-so-small fact that he was an active agent in thwarting those very hopes.</p>
<p>It is a shame for all concerned.</p>
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		<title>By: Drama Mama</title>
		<link>http://erstories.net/archives/295#comment-1582</link>
		<dc:creator>Drama Mama</dc:creator>
		<pubDate>Thu, 24 Apr 2008 18:21:48 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1582</guid>
		<description>DUH- complications can result from any surgery-
Even a common c-section!
Once again, Jackpot Justice!</description>
		<content:encoded><![CDATA[<p>DUH- complications can result from any surgery-<br />
Even a common c-section!<br />
Once again, Jackpot Justice!</p>
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		<title>By: anonymous</title>
		<link>http://erstories.net/archives/295#comment-1572</link>
		<dc:creator>anonymous</dc:creator>
		<pubDate>Thu, 24 Apr 2008 15:22:28 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1572</guid>
		<description>They do lap bands much more frequently nowdays.  This case was from 2003 when they were not as common.</description>
		<content:encoded><![CDATA[<p>They do lap bands much more frequently nowdays.  This case was from 2003 when they were not as common.</p>
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		<title>By: PM, SN</title>
		<link>http://erstories.net/archives/295#comment-1566</link>
		<dc:creator>PM, SN</dc:creator>
		<pubDate>Thu, 24 Apr 2008 14:24:14 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1566</guid>
		<description>Since gastric bypass surgery is so complex and risky, why don't people get lap-bands instead?  Are they not as effective?  Do they result in a smaller pay-out for the surgeon?</description>
		<content:encoded><![CDATA[<p>Since gastric bypass surgery is so complex and risky, why don&#8217;t people get lap-bands instead?  Are they not as effective?  Do they result in a smaller pay-out for the surgeon?</p>
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		<title>By: Pawan</title>
		<link>http://erstories.net/archives/295#comment-1556</link>
		<dc:creator>Pawan</dc:creator>
		<pubDate>Thu, 24 Apr 2008 11:38:07 +0000</pubDate>
		<guid>http://erstories.net/archives/295#comment-1556</guid>
		<description>I agree!! How come people are so evasive to own up their own responsibility for their own life??!! And I think the american system of having all sorts of unqualified people giving verdicts (Layman's jury) is ridiculous! Take the O.J Simpson case..people decide what is right, not in the light of what happened but because they have a bloody opinion about history and want to see justice done for those who died in the jurassic age to set an example over all!!</description>
		<content:encoded><![CDATA[<p>I agree!! How come people are so evasive to own up their own responsibility for their own life??!! And I think the american system of having all sorts of unqualified people giving verdicts (Layman&#8217;s jury) is ridiculous! Take the O.J Simpson case..people decide what is right, not in the light of what happened but because they have a bloody opinion about history and want to see justice done for those who died in the jurassic age to set an example over all!!</p>
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