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Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery
21911 76th Ave. W, #106, Edmonds, Washington
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21 Questions Answered
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QUESTIONS ANSWERED

I have no restriction after 6 years of being banded. Experiencing a little discomfort on left side erosion, dilation, leak, or?

Asked By:AnonymousANSWERS (1)
Your story is concerning and it sounds like you are receiving care.  I recommend an upper GI to look for slip, erosion and esophageal dilation.  Upper endoscopy is also very important.  Removing fluid from band now is key to decreasing risks.  

Pouch dilation and esophageal dilation both cause feeling if no restriction but what's really occurring is a reservoir phenomenon above the band.  Erosion can occur when band is overfilled or inflammation occurs at band site chronically.  Leakage from band fluid out of band typically isn't painful but a slip or erosion definitely can be.  I'd make sure all these diagnoses are ruled out and often insurance will only cover band revision to a different Bariatric operation with a technical failure, so ask your surgeon to carefully document any such findings!  Good luck.
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

Is it possible after Roux-en-Y Gastric Bypass I'll weight around 130-140 lbs from 295 lbs?

Asked By:AnonymousANSWERS (1)
Possible and probable are difficult things to discuss.  I would never say it's impossible for a young, very motivated person willing to lift weights 4-6d week or some for of strength training and add cardio exercising and careful structured eating to lose all of their excess weight. However, most patients lose about 1/3 of their total body weight or 50-70% of excess weight.  Any way you calculate the estimate, the variables that improve your odds of losing more are mobility and willingness to exercise, age, diabetes and some other medical conditions that might hamper weight loss should be evaluated by a trained physician.  Gastric bypass tends to offer more weight loss in current literature than the sleeve gastrectomy, however, follow up and long-term care in a dedicated program can equalize those results some.  If you plan on having children, some surgeons feel the sleeve gastrectomy is a safer choice due to lower risk of twisted bowel or internal hernia.

Excess skin depends on genetics, where you carry your weight and age.  If you are willing to lift weights and do strength training this may greatly help.  The younger you are the better chance you have of a good cosmetic outcome.  Seek out guidance about this and avoid surgery for cosmetics or excess skin for at minimum 18 months after Bariatric surgery to allow you to reach your lowest weight and continue to change your body muscle composition. Good luck!
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

My lap band has slipped and the doctors will only offer removing it. Is there a non surgical option instead?

Asked By:AnonymousANSWERS (1)
Unfortunately no.  A slipped band and a normal or low BMI won't qualify you for a revision operation.  The great news is that you are now at a BMI where with proper nutrition and a very good exercise program you probably can keep the weight off.  Also, a new medication exists call Belviq or locarserin that is designed for long-term use that helps decrease hunger.  It can be expensive.  It really works best with exercise and with a nutrition plan.  Topiramate can also greatly decrease hunger but does have side effects such as feeling a little forgetful sometimes, temporary numb fingers, and dry mouth.   With a slip the band really does need to be removed to avoid a severe emergency such as a larger slip that decreases blood flow to the stomach.  Good luck!
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

I am 5'3, 265 lbs...according to the BMI calculator it is 47. Will I qualify for sleeve surgery?

Asked By:AnonymousANSWERS (1)
Short answer is yes.  In general patients with a BMI over 40 with or without comorbid conditions related to obesity qualify and those with a BMI between 35-40 with medical conditions or comorbid conditions like sleep apnea or hypertension also qualify.  Whether or not your medical insurance allows bariatric surgery or has an EXCLUSION for bariatric surgery is the key.  Medically you qualify.  I would talk with a high volume bariatric center the does a lot of sleeve gastrectomies and they can help you figure out the insurance and whether you need further testing like cardiac studies or a sleep study to look for sleep apnea.  Good luck on your journey!
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

I had the gastric sleeve performed on 08/22, what is a normal weight loss? I only lost 1 pound in my second week.

Asked By:AnonymousANSWERS (1)
Good question.

Usually people lose weight in the first few weeks due to fluid shifts from around the time of the operation and based on the diet and foods they are eating.  Most of the actual weight loss that occurs in the first week is due to getting rid of the several liters of fluid (2.2 pounds per liter, usually patients get 3-6 liters or 6-12 pounds of fluid) they receive during and immediately after the OR.  I suspect much of your weight loss in that first week was actually just your body getting rid of the fluid.  The real weight loss will now start more so once you are able to increase your protein intake and now that you are really stopping the simple sugars, carbohydrates and once you are allowed to start to exercise.  

Good luck.  I would also talk to your doctor and make sure you are doing well.  It's important to feel comfortable asking the doctor who did your operation if labs or anything else needs to be checked. 
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

I weigh roughly 190 lbs and I am 5'2". Can I get a Gastric Bypass surgery?

Asked By:AnonymousANSWERS (1)
Great questions.

The symptoms you describe include what sounds like sleep apnea.  I would definitely get tested because if you have insurance that covers bariatric surgery that and other medical problems like high blood pressure and cholesterol levels can make you eligible around your weight.  If you are exactly 190# and 5'2" then your BMI is 34.7.  Most insurance companies, if they do cover bariatric surgery, require a patient to have a BMI over 40 or between 35 and 40 with medical conditions related to obesity like sleep apnea, high blood pressure, early arthritis, high cholesterol and others.  I suggest you see first your primary care doctor and get tested and then a large bariatric center.  Another good option for you is the sleeve gastrectomy.  It's a bit more simple in how it's done, doesn't require bowel re-routing and is faster in the operating room.  Usually it's better tolerated and in good programs with long follow up with a dietician and if you are willing to exercise and be very compliant with the food program you can lose around the same amount of weight.  Weight loss surgery is only a tool that you can use and won't do the weight loss for you.  It certainly does make it easier.  Some people "self-pay" for weight loss surgery and this option does work however it must be approached with knowledge that future complications of the operation are often also "self-pay".  I would definitely talk to a bariatric surgery program as they often have insurance specialists who can help you figure out if you have coverage and the costs associated with the operation if you are a candidate.  Good luck.  
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

Will a stomach sleeve help me loose weight and maintain a healthy weight if I have had a total Thyroidectomy?

Asked By:AnonymousANSWERS (1)
A sleeve gastrectomy will, in general, act as a great tool to help you manage your good intake and help control hunger.  Any Bariatric operation can be outdone by eating sugary foods, drinking sugary drinks or eating ice cream, over eating or expecting the operation to lose the weight for you.  You are still in charge and must first work with a program and nutritionist that helps you figure out ways to make permanent changes in food choices before surgery.  If you add a sleeve gastrectomy to dietary structured eating and exercise with strength training you should absolutely see results.  I'd highly recommend you seek guidance from your primary care doctor or an experienced surgeon.  Good luck!
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

Is RNY Gastric bypass surgery reversible under severe weight loss?

Asked By:AnonymousANSWERS (1)
First, you should have a CT scan with oral and IV contrast of your abdomen and pelvis to look for twisted intestine or internal hernia.  Intussusception or adhesive (scar tissue band) bowel obstruction can also cause your symptoms.  CT scan may also diagnose other problems.  Some people get problems with other body systems such as kidneys or liver that cause weight loss.  At minimum I'd consider, with the counsel of an experienced Bariatric surgeon, a diagnostic laparoscopy.   Why you are having abdominal pain after bypass should be looked into.  If that fails to show a reason for your weight loss, and work up shows no other cause then reversal of a bypass can be done.  It is a large and risky undertaking.  The reconstructed stomach often never works well and patients report problems with bloating, decreased gastric function and other problems.  Open surgery is often needed.  Again counsel for full work up for why you are losing weight is a must then with an experienced Bariatric center if you consider surgery.   Good luck.  
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

Am I good candidate for tummy tuck and lipo or gastric bypass? (Photo)

Asked By:AnonymousANSWERS (1)
No right answer here. What I see in my practice are patients in your BMI range(38+) who have a tummy tuck and liposuction then a few years later are the same weight or higher and need Bariatric surgery.  It's far better to go about it the opposite way.  Losing the weight first will allow your plastic surgeon to offer you far better cosmetic results and much lower chances of regaining the weight and undoing the cosmetic gains. Once patients lose 75-100+ pounds with Bariatric surgery, the results from tummy tucks, liposuction, breast lifts, legs and arm lifts, and any number of other choices can greatly decrease extra skin.  The weight loss will greatly decrease medical problems and future risk of heart disease, sleep apnea, arthritis, some cancers, back pain and diabetes.
provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

Do I qualify for bariatric surgery? I'm 180 lbs and pre-diabetic.

Asked By:AnonymousANSWERS (1)
Medically qualifying fur Bariatric Surgery means having a BMI or body mass index in a range consider morbidly obese or obese in some cases. This is a calculation based on height and weight.  Qualifying for insurance coverage is another issue completely and is based on your specific policy.  

In general only,(medically) patients qualify for Bariatric surgery in 2 major categories: Morbidly obese or low-BMI.
People are considered morbidly obese if they're BMI is 40 or higher OR between 35 and 39.9 and certain weight-related conditions are present. Low-BMI patients are between 30-34.9.  It's now allowed medically to have surgery in this BMI range.  

Weight loss following Bariatric surgery depends on many variables including how much excess weight you have now, your age, your mobility, if you exercise, and genetics as well as the type of operation you have.  Many different predictions exist and seeking guidance from an experiences Bariatric surgeon and program will help you with these estimates, questions and if Bariatric surgery is right for you.

provider-Jedediah Kaufman, MD-photo

Jedediah Kaufman, MD

Bariatric Surgeon, Board Certified in General Surgery

Jedediah Kaufman, MD reviews

Jedediah Kaufman, MD

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$4381 month post-opGastric Sleeve Surgery

binabean01

Gastric Sleeve. New Year New ME!! - Seattle, WA

Hi. After years of being overweight and generally unhealthy I decided to make the journey to have gastric sleeve. My insurance covers it pretty well except I have some out of pocket expenses I will not be able to pay. I set up a go fund me account I will post later in the story About me: I am a 32 years old living in Seattle Washington, I work in the food service industry so right now I am a barista, but I have been a prep cook, bartender, waitress, server, you name it!! I stand on my feet all day , lift heavy objects all day.I want my quality of life back. I have plantar ficiatis in both feet, a bad knee, bad back, pre diabetic and a bmi over 40. I used to be active in dance and now I am too tired to walk up the stairs. my height is 5'2 shirt size xxx1 pant size 16-20 depending on the brand!! my highest weight was 246 my current weight is 230 my pre op diet stars July 11TH and my surgery date is July 25th my goal weight is to be 150 or a size 8I have a go fund me account set up but I don't know if people will actually do that. It would be awesome!! if I had enough patrons I would start a youtube channel and give weekly updates along with bariatric barista recipes I am sure I will be able to come up with being a barista!!

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