Willie Brooks Jr

Have you checked your MD’s history?

What follows is a piece of an article from a series of articles from the LA Times.  I've been casually following this series, you may recall other posts, some that I deleted, because a lawyer has been up in my email.

I cannot stress ENOUGH the importance of checking up your doctor/facility in your state prior to your procedure, whether it be weight loss surgery or plastic reconstructive surgery.  I was >this close< to having plastic surgery with a doctor who later had his medical license revoked.  It happens.  Be aware.

Willie Brooks Jr

Mr. Brooks, father of six, died a few days after gastric-banding surgery.

Lap-band patients operate in the dark

Information about facilities' disciplinary histories is public, but few consumers know how to find it. 

Willie Brooks Jr. was a 35-year-old substitute custodial worker for the Pomona school district when he decided to do something about his weight last year.

The 6-foot-6 Brooks tipped the scale at nearly 300 pounds. He thought he would be in line for a permanent position if he lost a few pounds. 

So when he noticed the advertising campaign suggesting he find out about weight loss surgery by calling 1-800-GET-SLIM, he followed up.

Brooks had surgery to implant a lap-band — a silicone ring fitted around the upper stomach to suppress appetite — last June 5 at a surgical facility in Beverly Hills operated by Top Surgeons, the sponsor of those 1-800-GET-THIN and 1-800-GET-SLIM billboards that have become as inescapable on Southern California freeways as smog in summer. He was sent home to Perris with a prescription for oxycodone painkiller and instructions to return in a week.

Three days later, Brooks was dead. 

Melting Mama at Highest Weight. (Motivation.)

Pre-op Diets and WLS Better Overall Results!

Melting Mama at Highest Weight. (Motivation.)

MM at highest weight, before the WLS "pre-op" diet.

I guess I have to admit now that going on those grueling pre-operative diets prior to WLS is worth it.  When mentioned, there's usually a lot of "Oh GOOOOD, did your surgeon tell you that you HAD to diet for X amount of time?  Pul-leeze, don't worry about it."  But.

I did it.  And, studies now show, it's worth it.

Half-assedly, but I did!  

I lost 30 pounds prior to roux en y surgery with a bit of Atkins, and a bit of shakes.  But, was I eating french fries at the last. possible. minute?  Maybe.

Medscape –

Preoperative Weight Loss Linked to Better Outcomes From Gastric Bypass Surgery

Laurie Barclay, MD

December 22, 2009 — Preoperative weight loss is associated with fewer complications after gastric bypass surgery, according to the results of a record review reported in the December issue of Archives of Surgery.

“Despite the improved ability to accurately predict an increase in surgical risk, the optimal preoperative preparation of such high-risk bariatric surgery candidates remains controversial,” write Peter N. Benotti, MD, from Saint Francis Medical Center in Trenton, New Jersey, and colleagues.

“Proposed risk-reducing strategies supported by varying degrees of evidence include staged surgical procedures, preoperative gastric balloon placement for weight loss, and preoperative medical weight reduction….Because the major determinant of postoperative length of stay is operative morbidity, we hypothesized that preoperative weight loss will reduce the frequency of surgical complications in patients who undergo bariatric surgery.”

At a comprehensive, multidisciplinary obesity treatment center at a tertiary referral center serving central Pennsylvania, the investigators reviewed records of 881 patients undergoing open or laparoscopic gastric bypass surgery from May 31, 2002, through February 24, 2006. Before surgery, all patients underwent a 6-month multidisciplinary program with the goal of achieving a 10% preoperative weight loss. The primary endpoints of the study were loss of excess body weight and rates of total and major complications.

Loss of 5% or more excess body weight was achieved by 592 (67.2%) of the 881 patients and loss of more than 10% excess body weight by 423 patients (48.0%). Compared with patients undergoing laparoscopic gastric bypass surgery (n = 415), those referred for open gastric bypass (n = 466) were generally older (P < .001), had a higher body mass index (P < .001), and were more often men (P < .001). In addition, they had higher total complication rates (P < .001) and major complication rates (P = .03) vs patients undergoing laparoscopic gastric bypass surgery.

Increased preoperative weight loss was associated with decreased rates of total complications (P = .004) and, most likely, decreased rates of major complications (P = .06), based on univariate analysis. In a multiple logistic regression model controlling for age, sex, baseline body mass index, and type of surgery, increased preoperative weight loss predicted reduced rates of total complications (P = .004) and major complications (P = .03).

“Preoperative weight loss is associated with fewer complications after gastric bypass surgery,” the study authors write. “We hope that these findings will be confirmed by prospective, controlled trials and that bariatric surgeons will consider this modality for preoperative risk reduction in selected patients who are deemed high risk for complications after surgery.”

Limitations of this study include retrospective design, lack of a control group, referral bias, and possible unmeasured confounding variables.

In an accompanying invited critique, Patricia L. Turner, MD, from the University of Maryland Medical Center in Baltimore, recommends emphasizing an aggressive preoperative weight loss regimen.

“Overall, this article presents the largest study thus far, to our knowledge, which may demonstrate a significant advantage to preoperative weight loss,” Dr. Turner writes. “Moreover, the authors did not experience the attrition feared by some surgeons should they require preoperative weight loss of their patients. These findings suggest that consideration be given to incorporating either a suggestion of or the requirement for modest weight loss prior to bariatric surgery as a means of decreasing postoperative complications.”

Jeremy Norman Documentary, “Waiting For My Real Life.”

"Waiting For My Real Life," exposes the politics and
personal stories behind the most significant threat to our future –
obesity. After revealing the scope and tragedy of the obesity crisis,
the film explores rays of hope on the horizon in the field of science
and medicine. The film follows the emotional journeys of several obese
patients, including Jeremy Norman, a young man who has spent the past
two years bedridden yet full of hopes and dreams of living a normal
life. He is truly waiting for his real life to begin.

goodbye bed. I am sick of being confined in you. Yes, the operation
will hurt like nothing before. I will have two huge scars from my butt
down… but it all comes down to FREEDOM… that sweet, sweet word. I guess you could say I truly am waiting for my real life to begin.

—Jeremy Norman

In loving memory of Jeremy Norman.
July 17, 1984 – December 23, 2007