Almanza...unethical?

[Lee6Lee]

My daughter and myself got sleeved by Ortiz. Mine was over a year ago and my daughter three weeks ago. I have another daughter, 25 pounds overweight or less, who wanted to get WLS. But Almanza accepted her at the low BMI of 27. Recalculating her height and weight, her BMI is really 24.8 at 140 lbs. and 5'3". I didn't want her to go to Almanza, so contacted Dr. Ortiz . He wouldn't do the surgery, saying her BMI was too low and surgery wasn't necessary. Just knowing Ortiz wouldn't do the surgery turned the tide for me. He wouldn't take our other daughter's gall bladder out (gall stone prevention) because he doesn't take out healthy organs. I'm not going to support her getting the surgery at all. She'll have to do it the old fashioned way. That's how highly esteemed he is by us. Before you start throwing rocks, the daughter in question is 42 years old. Not a kid. She saw us losing weight and didn't want to be left behind. I heard of a thin guy mentioned on here getting his THIRD sleeve, by Almanza, to lose 11 pounds. I thought that was broad minded of Almanza, at the time, but now I call it unscrupulous. Probably because now it involved someone I love.

Haven't been on here in a while. Getting on with my life. Keeping the weight off and still getting lots of compliments!

[Luann]

It may not be necessary, but I don't know that I would necessarily call it unethical. Did your daughter spend most of her life at a much lower weight than she is right now? Any physical condition that makes it impossible for her to exercise? For people who are very small boned / have a small frame, a BMI that may only be a little chunky on another person could be verging on obesity for them. My BMI was below 30 at my heaviest, but I was having comorbidities even then. I'm part Japanese, after my surgery I learned that in Japan they classify obesity as being at a BMI of 25 or above.


There are other measures of overweight that may have more validity than BMI. Measures of central obesity like waist to hip ratio is one. European Union classifies a waist measurement over 37" in a man = central obesity, and over 31.5" in a non-pregnant woman. Wikipedia article I read suggested lower cut offs appropriate for Japanese or Chinese population. At my heaviest, I had a 42" waist on a small frame. I still didn't meet USA standards of obesity, but I was. For people who gain most of their weight around their midsection & have a lot of visceral fat, that brings a high risk of cardiovascular disease & diabetes. So it depends? I'm not saying Almanza is appropriate for being willing to sleeve your daughter, but I think each case should be evaluated individually & not only based on BMI. Some doctors in Mexico wouldn't have taken me as a patient either, but I know I needed & benefited from being sleeved. Lopez told me I qualified because of my spine degeneration & inability to exercise. All I know is anyone who saw the gut on me would have to realize I was obese.

[Lee6Lee]

That's so interesting! She doesn't have any health problems at all.

[Joe Poppa]

I guess the other surgeon saw a large mass in your 24.8 BMI daughter's wallet that needed to be removed -stat!

[mem222]

Joe ��

[mem222]

Joe ��
:-)

[Lee6Lee]

I guess the other surgeon saw a large mass in your 24.8 BMI daughter's wallet that needed to be removed -stat!

Funny....again!

[Sleeveroo]

Amazing

[tinman]

Lee....

I've always enjoyed your posts and you have always struck me as someone willing to take a look at issues from both sides before making any decision. So, I want to throw out something for you to think about in order to help balance the scale...so to speak.

There is an entire forum on this board dedicated to cosmetic surgery. One would say that in some cases, cosmetic surgery is a medical necessity. Some would also argue that your daughter's desire for VSG is medically necessary.

Some would say that any cosmetic surgery is purely a play for vanity. Some would say the same for your daughter. Either way, no one faults a cosmetic surgeon for work they do even though, for the most part, the surgeries they do are more invasive, more complicated, carry far more risk than the average VSG and, again for the most part, are medically unnecessary.

I think, at the end of the day, each of us needs to be accountable only to ourselves. We all have been a victim of some one elses bias when it came to this surgery. We all had our reasons for wanting it and some of those reasons make more sense than others. Regardless, the decision to have this surgery doesn't lie with the surgeon. It lies with the person having the procedure.

[Lee6Lee]

Lee....

I've always enjoyed your posts and you have always struck me as someone willing to take a look at issues from both sides before making any decision. So, I want to throw out something for you to think about in order to help balance the scale...so to speak.

There is an entire forum on this board dedicated to cosmetic surgery. One would say that in some cases, cosmetic surgery is a medical necessity. Some would also argue that your daughter's desire for VSG is medically necessary.

Some would say that any cosmetic surgery is purely a play for vanity. Some would say the same for your daughter. Either way, no one faults a cosmetic surgeon for work they do even though, for the most part, the surgeries they do are more invasive, more complicated, carry far more risk than the average VSG and, again for the most part, are medically unnecessary.

I think, at the end of the day, each of us needs to be accountable only to ourselves. We all have been a victim of some one elses bias when it came to this surgery. We all had our reasons for wanting it and some of those reasons make more sense than others. Regardless, the decision to have this surgery doesn't lie with the surgeon. It lies with the person having the procedure.

Thanks, Tinman.
When I emailed our daughter with Dr. Ortiz' response, she was sad, but understood. Her being 42, I told her I'd support her all the way if she decided to do it. Although it's a lot of money to spend for that little weight. But what if she carries it around for the rest of her life, unhappy? That I understand. She's a beautiful girl and a few pounds can make it or break it.
Thanks for the vote of confidence.

[Joe Poppa]

Lee,

It is wonderful that your other daughter would like to lose weight and improve her health too.
Has your daughter ever been significantly more overweight than 25lbs? If not, then maybe she can try the traditional methods one last time before she has the surgery, since the VSG is permanent.

[Ann2]

I've lost nearly 90 pounds in 8-1/2 months. Doing so was relatively easy, thanks to the early restriction of the sleeve -- eating first 500 calories, then 800 calories, then 1,000, then 1,200. I've tried to stop losing weight by eating 1,400 calories and am now moving to 1,600 calories. (Anyone who's read my posts know that during the weight loss phases I ate lots of protein, ate protein first, ate good, healthy carbs, and changed a lot of eating and moving behaviors, etc.)

But I could no more have eaten 1,600 calories when I was 2, 3, 4, 5, 6 months out from surgery than a man in the moon.

Therefore, how much weight will a 42-year-old woman who weighs 140 pounds likely lose after VSG surgery? I bet she'd lose a helluva lot more weight than she needs to lose--and in too short a period of time to build very permanent new eating / moving behaviors.

This is only one common-sense reason why WLS isn't used for people who want to lose 25 pounds. And it's obvious (to me, at least) why qualified doctors should decide whether the risks of surgery outweigh the benefits of surgery.

Apparently, doctors make different decisions based on the same information--which, in this case, is a telling difference. I think Dr. Ortiz made the right decision.

[Lee6Lee]

Lee,

It is wonderful that your other daughter would like to lose weight and improve her health too.
Has your daughter ever been significantly more overweight than 25lbs? If not, then maybe she can try the traditional methods one last time before she has the surgery, since the VSG is permanent.

She has been a little heavier in the past, after being pregnant. I think she's leaning towards trying to lose it herself. She said, "I can do it". If she doesn't, she knows she has options.
I'm nervous to have her get the surgery. It was bad enough wondering if our other daughter was going to make it through alright. No matter what surgeon she was using.

[Lee6Lee]

I've lost nearly 90 pounds in 8-1/2 months. Doing so was relatively easy, thanks to the early restriction of the sleeve -- eating first 500 calories, then 800 calories, then 1,000, then 1,200. I've tried to stop losing weight by eating 1,400 calories and am now moving to 1,600 calories. (Anyone who's read my posts know that during the weight loss phases I ate lots of protein, ate protein first, ate good, healthy carbs, and changed a lot of eating and moving behaviors, etc.)

But I could no more have eaten 1,600 calories when I was 2, 3, 4, 5, 6 months out from surgery than a man in the moon.

Therefore, how much weight will a 42-year-old woman who weighs 140 pounds likely lose after VSG surgery? I bet she'd lose a helluva lot more weight than she needs to lose--and in too short a period of time to build very permanent new eating / moving behaviors.

This is only one common-sense reason why WLS isn't used for people who want to lose 20 pounds. And it's obvious (to me, at least) why qualified doctors should decide whether the risks of surgery outweigh the benefits of surgery.

Apparently, doctors make different decisions based on the same information--which, in this case, is a telling difference. I think Dr. Ortiz made the right decision.

Thanks, Ann.
I think Almanza would use a different size bougie for that weight.
At this point, she's not going to do it. I understand every angle and every emotion.

[Lee6Lee]

Ann, just reread your post. The part about the risks of surgery outweighing the benefits of surgery...had me shaking in my boots. A deal breaker for me. And for 25 pounds and no health problems! Not worth it. Thank you to everyone for your input. That's what this forum is for.