Expert: John Pilcher, MD - 1/15/2008

Question
Several questions in one:
I am scheduled for prostate removal Feb 20.  Urologist is concerned about putting me under anesthesia for surgery.  

He recommended a medically supervised meal replacement plan.  Wanted me to lose 1 lb/DAY!

Insurance specifically excludes payment for ANY weight loss treatment even if medically necessary.  And money is tight.

So I bought some protein powder on my own and found it impossible to stay on the plan.

I am 5'9, have been 525 lbs, now 482.  Have sleep apnea/CPAP, on warfarin for blood clot prevention for rest of life.

A month ago I was down to 470.  Was successfully following a plan on www.kaysheppard.com and liked it.  Lost abstinence after urologist 1lb/day recommendation and holiday chiding by children.

Have a sister who had lap band surgery with great success.  Have had several friends who had gastric bypass with great success and a niece who nearly died with complications.

I notice one of your sponsored links is a surgeon in Tijuana, Mexico, yet in a prior message you advised against travelling outside of U.S.

Since I was having success with a weight loss plan, I wonder if I am even a candidate for surgery.

Very confused.

Any suggestions?

Answer
John,
I think that either a Band or a gastric bypass could make sense for you, though I don't really have a good answer about the insurance question.  In particular, the fact that you've been able to lose substantial weight on non-operative therapy is very encouraging.

As for the question on the Tijuana link - we may have had that link at some point, but our (newly revised) website does not have that link.  Thanks for pointing out the potential mixed message.

Best of luck,
Dr JP