Too chubby for surgery

[breakingwaves]

Well I have been thinking all day about my visit with the cardio doc today. I had anticpated some interesting words but not quite what he had to say. He had thought that my last echo while in the hospital was probably more pronounced because of hospital stress, he thought that the monitor results would be not much to talk about but the echo and the leaking was a little worse and the monitor said that my heart rate had slowed to 40 beats which he kept shaking his head and saying not good, not good. Blood presssure still very high.

So I asked the natural question, when do you forsee surgery. His reply was I was really overweight, no surprise there, I have been the same chubbo for the last twenty years, short and stout. Told me that he would not recommend a surgeon until I lost 50 pounds, I am currently at 245. told me if I didn't lose 2 pounds a week I would most likely die. Changed meds from calicum beta blocker to Altace, the ace inhibitor.

Not quite sure what to make of it, don't know if I should pursue a surgeon without him or what. Plan to of course start the diet right away but any adiditional advice would be appreciated.

[tobagotwo]

I think you said it yourself: "any additional advice would be appreciated." That means a second opinion, cardiologist or surgeon.

What he did was to try to make you feel that you would die, and it would be your own fault for being heavy. That was supposed to frighten and shame you into going on the diet he feels you need.

While he probably believes that the end justifies the means, it was a crude attempt at a carrot on a sitck. And you're no donkey.

I would take his advice, and work to get the weight down, as it will hamper your recovery, regardless of a willing surgeon. And in spite of the fact that he acted like an horse's behind. You want all the odds you can get on your side for OHS.

You may still want to get that second opinion, though, just in case.

Best wishes,

[Nancy]

It may be that you have to lose some weight, however, it might also be an idea to get a second and even a third opinion.

Unfortunately, many people with impaired heart function retain lots of fluid weight because their hearts aren't working correctly. This may or may not be the case with you. My husband has had twenty pounds of fluid from time to time when his heart was not working well, and he is normally a slender man.

Getting a second and even a third opinion will help to get a solid assessment of your situation regarding the risk of waiting versus the risk of going ahead in your present condition.

You also need to get an assessment of that slow heart rate.

At those numbers, my husband was passing out regularly, and had to have a pacemaker implanted. While passed out, I couldn't get a heartbeat. EMTs revived him. But it was scary.

I wish you all the best.

[breakingwaves]

Thanks Bob! I got the message of the weight issue loud and clear but I do think he could have put it into terms that would have sustained a better partnership and working relationship. It wasn't like I adding obese to my Christmas list or anything. My husband asked him, so is there any suggestions you might have to her losing this much weight and he said very loudly, not with that valve!

[breakingwaves]

Thank you Nancy, I was really disappointed, I went into today hoping for a future plan of action, instead I felt scolded like a child with their fingers caught in the cookie jar. I have been telling him and my general doc, about lots of swelling that has been happening, of course doesn't take away the fact that I need to lose weight.

You know he could have even done what you have just done, explained some of the risks, and told me of what some possible symptoms could be, heavens knows I mentioned to him that I am 3 hours on the road every day taking my kids to school and back, instead when I ask him what to do if I felt any symptoms, his advice was to stop and rest. Not always an easy thing to do when I find myself caring for the 8,9 and 11 year old by myself most times while my husband travels.

He kind of left me stunned that I had left my life and the well being of my family's future in his hands and he left me with just one option which he felt was of my own doing.

[Nancy]

Well, if you do have fluid retention because of your impaired heart function, if you get proper medication to help you get rid of it, it certainly will help get you started on the weight loss plan and will make you feel a whole lot better.

But those low heartbeats have to be addresed, especially when you are caring for children.

Hope you find some better answers soon.

[breakingwaves]

I forgot to mention, the man is not a slim trim guy himself in fact I would venture to say that some treats have passed his way too, so I guess he can be glad that his ticker is working as it should.

[breakingwaves]

I agree, I am looking for some solutions so we can get on with our life, and truthfully, I didn't have a clue about what was low or high, just that he kept saying this is bad, this is bad. I am looking forward to seeing my regular family physician because he tends to interpret what the tests and the Cardio guys have to say.

[Karlynn]

It would have been nice if he'd made your weight-loss issue into a partnership for the two of you. "We're going to get your weight down, so we can fix your heart." I don't know of anyone who has gone on to lose weight after being made to feel shame about it.

Not to mention the fact that it's stressful to have heart issues and if you are like me, you head to the cupboard to de-stress. It's hard to break that habit.

My suggestion would be to not try and start any big weight loss plan until after the holidays. Then begin by setting attainable goals for yourself.

[JimL]

On the echo results: Was it a standard echo, or a TEE?

Even though I am and have always been tall and slim, I gained and lost twenty pounds within days around the time of surgery, all just fluid. Lasix is really wonderful stuff for shedding that extra water weight.

[Nan]

That was really not a helpful way to deal with a patient (you in this case).
(I was also overweight at surgery - size 16-18- not as brave as you to give my actual weight)

I think you should most definitely find another surgeon/cardio and get another opinion.

You want to be as healthy as you can be going into OHS....you have to be careful about what kind of diet you choose. Perhaps your PCP could refer you to a nutritionist? Or you might check out weight watchers, they have a pretty healthy plan.

Good for you for facing this heart problem and trying to find a solution.

And don't despair, take it one day a time, both with your heart and with your weight.

Good luck, I'll be looking for more posts from you!

[Marguerite53]

Hi. I'm sorry you had such an insensitive conversation with your doctor. My cardio is also very interested in me losing weight. I'm 5'8" and about 195. (long legged, sturdy boned, large breasted). She said a pound a week, and when, after 3 months, nothing much had changed on the scale, she asked me if she could help me in any way. I wasn't actually sure what she meant, so I just shrugged her off. Her best suggestion was the South Beach Diet since it was designed by a cardiologist and didn't have you doing weird things.

My general practitioner thinks she is being harsh. I have changed my diet choices and am walking about 10 miles a week. I know that I am improving my general health, at a slow pace, perhaps, much slower than the cardio would like, but at a pace where the change can become permanent. I loved the South Beach Diet book. Am I actually on the diet? No. But I have taken the non-sugar approach and am very good about avoiding bad carbs and sugars. What's amazing is how the body adapts. You really go from craving the carbs, to not realizing you want any. There are some great receipes and health rules and info in that book. Please get a copy.

Another diet book I read several years ago stated one thing quite well. When the author stopped different sized people on the street and asked them the same question, the thinnest, healthiest looking people always answered the same way. The question was, when do you eat? The heavier people describe many different scenarios often related to holidays, events, moods, seasonal likes, times of day, etc. The thinnest people consistently answered....I only eat when I'm hungry. The South Beach book has a very helpful section on hunger and eating habits.

It is hard to get invigorated about exercise when you feel tired all the time. It is frustrating to hear from everyone that if you'd just exercise you would feel so much better. I don't think, in our condition, it is actually true.

I do know that my legs are stronger (not that they were weak) and my stamina is improving with the walking. All I've done is find a very chatty friend who will walk 3-4 times a week with me around a nearby middle school track. The track is flat (there is no way I could be walking around my hilly neighborhood on a daily basis) and cushioned and easy. Perhaps you might think about dropping off your last child at school, parking, and going to the school track. Your children will support you. They will make sure you are wearing your walking shoes! They can be your biggest allies in this. Whatever you normally do after you take them (or get them off to school), put it off an hour and start walking.

I have 3 children also, 22, 20 and 17. If I were feeling like I'm feeling now, when they were 8,10 and 12, I would be crumpled into the fetal position sobbing most of my days. I honestly don't know how you women with young children are doing this. You have my complete and utmost respect.

I hope these ideas can be useful to you. It is tough with the holidays. Treats and gratification abound. At least, I was thinking, if you were to start a walking routine, (oh, gee, where are you, is it temperate enough??) then, well, at least it's a start.

I agree with others that a second cardio opinion, or a confirmation from a surgeon about the weight issue, is a totally reasonable idea.

Let us know!

:) Marguerite

[Englander]

That was not fair at all. Very very cruel. Nish was a little chubby and his cardiologist did mention ways to loose the weight. which we tried and succeeded. A little bit of support from him would go a long way. I stress with one child and you have 3. I wish you all the best.
Love,
Bess

[Johnny Stephens]

Wow - I'm a pretty laid back guy, but several of your cardio's comments would caused my "redhead's temper" to surface. At the time of my surgery, I was substantially heavier than you. My cardio pointed out that I needed to lose weight (duh), and that anything I could do before surgery rolled around would help. My eventual surgeon alluded to my "body habitus" not being a problem with the surgery itself, but that it might cause some extra rehab effort and possible breathing workload post-surgery. (actual: rehab yes, breathing no)

I have switched doctors in the past for their insensitive, and frankly, ignorant references to my weight. My current GP is borderline in this area, but my cardio and surgeon are very compassionate.

I hope you get some more realistic answers and some medicos you can work with.

[breakingwaves]

I started keeping track today of food iintake, I am switching to the new meds the ace inhibitor and diuretic so I will ease into major calorie counting. I did have a healthy choice tv dinner for dinner which was actually pretty good, I was surprised, it said it was 280 calories. I also plan to do as he suggested not eat anything more this evening. Went to the grocery store to start stocking the fridge with healthy things, threw out all the leftover Thanksgiving stuff.
Most of my problem is not having much time to do meal preparation for me, with my husband away most of the time, I cook for the kids and grab something easy to eat, but now I will be more careful.

[breakingwaves]

He did put me on Hyrocholorothiazide, a thiazide diuetic. It was a regular echo, and I haven't gotten my copy yet, I am going to examine it carefully when I get it from my GP next week. He had expected the test to be not as pronounced as the recent one, I have had three echos in the last three months. He said, my heart aortic valve does not close completely, and instead of being able to compensate, it doesn't know what to do so it has to work harder. Didn't share the actual numbers with me.

[Nancy]

You have every right (by law) to ask for and receive copies of your medical records. They cannot refuse you (but they still might), however you have the HIPAA law on your side.

Get copies of your tests.

[breakingwaves]

I am a pretty easy going, really don't speak up much for myself kind of person. Takes me a while for the words to sink in, sometimes I wish anger would come faster than it does when things are not quite right, but today I got mad. You are right, he was, not much of a help anyway and ended up making me feel small and not too bright. My spouse has been in major denial and I drug him along to finally get the scoop, didn't help much that he made it sound like I had chosen this way of life and if I could lose 50 pounds in 6 months it would all go away. 2 pounds per week are the doctor's orders. what it did was make me very hestitant to call him if anything not feeling came around and I don't think that is a healthy way to feel. I am usually a very optmistic person, so I was feeling pretty down today.

I kind of feel about the weight admission like I do about doning on a gown at this point , if something ends up showing, its a little too late for me to be too modest, hehe! In a way its all hanging out!

[breakingwaves]

Lots of good advice! tomorrow is the day to start the new ace inhibitor and when it gets into my system and I have dealth with any side effects, I am going to start the walking in our local mall. I need to do some more Christmas shopping so I might be able to browse in the windows as I buzz by!
I have no idea what this is going to yield but I will be able to look any doc in the eye and say, this is what I have done, let us move on to a resolution. I am not the fittest person in the world but I have the soul of a hard working farm gal so I will give it my best shot.

I will choose to look on this in a positve way and say he wouldn't be the one I would choose for his bed side manner and don't think he will be the one I would choose to make the decision about the surgery but he did strike a chord!

[breakingwaves]

If he had taken the time to get to know me, he would have realized talking with me would have been more effective than talking at me. It seemed to me we are in the mist of choosing some life partners, not a way to make a happy marriage of doctor and patient! GGRR!

[breakingwaves]

Thanks, in deeper reflection of it today, I think he was way out of line, the appointment could have been used in a much better way. I would have appreciated him saying, here's where we are, without a weight loss and with the weight loss. He gave me lots of mixed messages.

I tend to move forward and it feels like pretty much without his help.

[breakingwaves]

I moved up my PCP appointment so we can do just that, go over the tests the cardio guy didn't, he has been pretty good with working with me.

[breakingwaves]

Some very good points, I appreciate so much hearing and learning this type of information because I have to make myself speak up sometimes, the used to doing for others in the family first condition. If it would be one of my kids, or my husband I wouldn't hestitate at all, so I have to think what this means to my family.

[Harpoon]

Lots of good stuff here...


For what it's worth:

I'd pay some close attention to the salt/sodium in your diet. nancy said before that water weight is often a problem for people who have heart conditions. I don't know what your situation is, but I wouldn't be surprised if at least some of the weight you carry is nothing more than excess fluids.

Finding another, BETTER cardiologist is definitely worth looking into. I'm suprized that your current one didn't offer to set you up with a program to lose that weight he said you needed to lose. I'm only about 20 pounds over my "BMI" and my cardiologist has twice offered to help me find a nutritionist or a dietitian who would be covered by my insurance...

On a side note, we discussed it and I'm doing OK on my own for the moment, though I'm still leaving the option open.

Some simple suggestions beyond the obvious stuff:

WeightWatchers and other freezer meals for dieting/low carb are nice, but you have to be selective about the sodium content if you have heart issues. Some of those things can have over half the US RDA for sodium. That, two slices of white toast, an egg, and two sausage links and maybe a ham salad sandwich (again on white) for lunch puts you over the limit before you've hit dinner.

A lot of people tout a "water" diet where you gulp down bottled water all day long instead of reaching for snacks. Well that might work for heart healthy folks, but probably not for us at all. Certainly not for me! I like my carbonated drinks, I'm kind of addicted. I also started drinking flavored seltzer water. The brand I've found is unsweetened, just carbonated water and some lemon (or raspberry, lime, plain, whatever) extract for flavor. I like it a lot and it's no carb, no sodium. Basically no nutrition really ( :D ) but it's probably a lot helathier for me than drinking Dr. Pepper all day...

Fruits and veggies are great for snacks and even meals. There's nothing that says you can't pick out on a veggie tray as long as you have a sensible dip if you like such things. Peter Pan now has a low sodium peanutbutter that's great on celery. It's the only time I can get my 4 y/o son to eat celery....


The other suggestion I'd make if you're really serious about losing weight have pretty much exhausted all other forms of diets and such would be jumping into the stomach reduction fad...

Mind you, I REALLY don't know what they'd say about working on someone with known heart issues, however I DO know that having an essentially life threatening condition that would be alleviated (at least in part) by a drastic reduction in weight is one of the qualifying marks such surgeons look for.

My sister-in-law had it done at the end of June this year when school let out for the summer (she's a teacher) and she's lost (over, I think) 100 pounds by now. She was teetering on the edge of diabetes and she and my brother have wanted to start having children, something that would be very difficult for her at the weight she had before surgery. She has to be picky for a while about what she eats and she does a fair amount of exercise, but as she recovers, her diet can include anything. The trick the the surgery is that by reducing the physical size of the stomach, one gets fuller much faster. Where she may have used to have two helpings of spaghetti at a meal, now she usually leaves a little of one helping behind, and she's FULL and satisfied. She's doing great.

It may be worth asking aobut if all other options have failed.


Ask around about cardiologists and talk to a surgeon or two. You should be getting help to get better, not being told you're going to die because you're too fat.

[breakingwaves]

Thanks for the information, a very good point about the ready made meals, I will be taking that into consideration as well. Not sure I want to add another possible operation on to the list, I am glad it has worked out though for your sister in law.
I do have to get more veggies in the house, the raw ones are tasty, I did go fruit shopping today, although I know some can be pretty sweet too. I did look at drink options today, I am a long time Pepsi addict. Only vice that has been consistent in my life, that I can account for.
So far tonight I have not broken the eating after 7 rule and soon I will be pulling up the sheets so I will be happy with this one day at a time!

[Karlynn]

It's not for everyone, but I have been following a low carb eating plan for about 4 years now. I'm not as strict as I used to be and it is more a modified low-carb plan.

Here are just a few thoughts based on what I follow. If you find you eat a lot of pasta, rice, potatoes and/or bread, try cutting those things out and see what happens. Replace those things with vegetables to fill you up. If you get hungry in between meals, have some almonds or walnuts on hand to snack on, or eat a few cubes of cheese. If you like juice, try eating the fruit instead of drinking the juice. You get about the same amount of nutrition without all the concentrated carbohydrates.

If you aren't retaining water because of your heart issues or have pulmonary hypertension, make sure you drink 8 glasses of water a day. Most people are in a constant state of dehydration because we just don't take in enough fluids. A lot of back and joint pain is the result of dehydration. Once I started drinking adaquate amounts of water, my horrible morning back ache disappeared.

And as I said before - don't try to be too successful until after the holidays. ;)

And just because I'm giving some suggestions doesn't mean I've changed my mind on what the doctor said to you. He remains a class A donkey's rear end. :)

[Marguerite53]

Karlynn, that comment about water is interesting. I did not realize that back and joint pain could be so exascerbated by dehydration. I never drink enough -- going to be more attentive to that.

Um. Breakingwaves, I'm not that experienced here, but I do know that each time my cardio listens deeply to my heartbeat, she is listening to make sure that the aortic valve is closing. There is a definite click, she says. She needs to hear that. If yours is NOT closing, then I think it is possibly time to consult a surgeon. If it were me, and I am somewhat in a similar condition here, I would definitely jump past the cardio and consult with a surgeon. Remember, the surgeons are knife happy and like to get on with things sooner. Even my cardio says that. When I asked her when she would send me to one, she said when I was ready. When the surgeon gets the nod from the cardiologist, the surgeon figures the cardio has deemed it time to operate. I think the pecking order is confusing and exasperating. But surgeons are very busy getting more practiced (which we want!!) so their time is very valuable. The fact that the cardio does not DO the surgery, it would seem to me that a surgeon should have a look at you personally and tell you whether he wants you slimmed down or not. Since you are making the appointment with the surgeon, he will not surmise that it is the cardiologists notion that you are ready, but rather that YOU are advocating for your own health and safety and need some answers and information about your condition.

Check with your insurance as to whether or not you can get an opinion from a surgeon. Get copies of all your recent tests, and perhaps fax them over to the surgeon prior to the visit as a courtesy.

Again, I'm just suggesting. I have a difficult time sticking up for myself also, and my cardio is so glib and personable, we chat and the time is gone!! But this is your life and health and you have a right and obligation to your family to push ahead. Many of us understand the denial of family members and the belittling of the condition by outsiders. It's rough. You have to decide for yourself that you want to get through this the best way possible. It's not easy to "put yourself on the front burner" so to speak. I'm a back burner mom and wife. Honest. I really know where you're coming from. But this is one time where you really don't have a choice. You need to do these things for yourself and everybody else will just have to get used to it!!

Well, I've sure said a piece! Guess you opened up a Pandora's box! I'll step down from the box now......... just wishing you a smooth road.

:) Marguerite

[Nancy]

For all of you who are shy about advocating for yourselves, please know that everyone here has been that way at the beginning. After having stuff happen that seriously impairs your health, you DO become much more assertive.

Don't let the stuff happen first. Advocate for yourself at the next opportunity. The first time is the hardest, after that it becomes much easier. You won't regret it and you will find the best doctors that way.

Any doctor who is intimidated by an intelligent patient is not someone you want to stay with. You also don't want to be subjected to a patronizing attitude.

Go forth and advocate.

[tobagotwo]

BW,

Know your enemies: There are several things that make weight loss more difficult for you at this time. You are under stress from personal concerns with the surgery. You are going through the holiday seasons. You may be carrying extra fluids (hopefully, your new diuretic can help some with that). And you are dealing with the extra fatigue that comes from your heart issues. When your body is tired, it can either eat or sleep to gain energy. We all know how much time we get to sleep with three kids, especially around the holidays. These are the things you must try not to let rule you.

Don't let it get you down. You're going to do fine. Once you know what you're fighting, you can focus better.

As far as your valve not closing all the way, I would have to think that the cardiologist is simply referring to aortic regurgitation. It's not surprising with severe stenosis to also have regurgitation persent, as there's usually some pretty good calcification by that time. It is a double burden for your heart, as it has to pump harder to get enough blood out of the ventricle through the stenotic (too small) valve opening, and then some of it leaks back into the heart at the end of the beat, because the valve can't close all the way (regurgitation). That wastes some of the heart's extra effort.

Usually, some of the calcification that is making the valve opening too small eventually starts also blocking the motion of the valve leaflets, keeping them from closing all the way. Mine was so badly calcified before surgery, that two of my leaflets were completely glued together, and the other barely moved. My interventional cardiologist (the one who does the catheterization, a.k.a. angiogram) was 99% convinced that I had a bicuspid valve because of it.

After cleaning my excised valve, the surgeon verified it was a "normal" three-leafer, but was astonished my heart was actually getting any blood through it. So, it can go quite a ways into horrible and still function enough to get by somehow.

My actual valve opening size was measured large enough that some cardiologists wouldn't even have sent me to a surgeon. This is why I caution against that as a solo criterion for surgery.

Best wishes,

[catwoman]

Breakingwaves:

Good luck with the weight loss!

I am down 41 pounds since the day before my MVR. I lost 23 pounds post-op, regained 8 afterward. Joined Weight Watchers this past June and have lost 25+, for a total of 41 pounds lost since June 23, 2003.
My niece and her husband are lifetime WW members; she's lost 20-25 pounds, he's lost 65 (!!!).
I watch portion sizes like a hawk, fat/fiber/calorie content as well as sodium. I eat a lot of fresh fruit and veggies, no sodas of any kind even diet ones, grilled meat, homemade soups with extra veggies.
I do eat some pasta -- wholewheat pasta is kosher on WW's Core Plan, the plan I follow.
What I've done is change my eating habits, the way I think about food and my activity level.

When I snack, it's fresh fruit, natural applesauce, 94% fatfree popcorn, a skinny latte. I do eat 3 servings of skimmed milk daily (24 oz. of milk, or 4 containers of fat-free yogurt flavored w/ Splenda). Weight loss can cause some bone loss, particularly with women, so make sure you are getting 3 servings of milk (skim best) or milk products (low-fat cheese, yogurt, etc.).

For Thanksgiving, I made a pumpkin pie with evaporated SKIM milk, Egg Beaters, Splenda and the usual spices & canned pumpkin. I used a pie crust, but when I ate my piece, I ate only the pie filling. Tasted great to me. I added an extra egg white to give the filling some lift in the final product.

I bought a Trek 7200 24-speed bike this fall and am using it, along with doing a lot of walking.

My heart rate is great now, as is my BP. Can't wait for my next blood panel to see how my weight loss and increased exercise have improved my cholesterol levels.

Last night I bagged up 8 loads of clothes to give to a shelter for battered women -- some still have price tags on them. It's great to be able to fit into 10s and 12s now, instead of 16W-18W. I decided if I let my "fat" clothes hang around in the closet, it was giving me permission to put weight back on.

Good luck losing weight -- and finding a more sensitive cardio!

[Karlynn]

Marsha, interesting that you should mention the milk products. Recents studies have shown that weight loss is significantly increased and then maintained when dairy products are included in the plan - regardless of which plan you follow. I'm not certain, but I want to say that 4 servings a day was the standard, maybe 3. Taking a calcium suppliment doesn't seem to have the same effect.

I love cottage cheese and have that for breakfast just about every morning when strawberries are in season.

[Peggy in Alaska]

Catwoman:

I had that same pumpkin pie this Thanksgiving and with fat free cool whip on top, it was delightful. I didn't miss the crust at all.

Weight Watchers is a great plan

[breakingwaves]

I have to force myself to drink liquids so I need to re discover the only liquid that my Mom used to have in the house. When we would ask what's to drink she would point to the faucet.

[breakingwaves]

Wise words, Nancy.

[breakingwaves]

That is so cool, it sounds like you have developed a new lifestyle. You have really achieved something special!

[breakingwaves]

Thanks for the advice, I really needed to hear what I was thinking, one of these days the words will meet my reaction. Its hard to imagine that a few short years ago, I was a spokesperson for a charity of people that couldn't speak for themselves when I am resistent to speak up for myself.

I think about what you have said in the past and it has already helped me a great deal.

[breakingwaves]

You need to do these things for yourself and everybody else will just have to get used to it!!

So True!

[Sherry]

Hi, BW. I'll join in the chorus by saying Dr. Insensitive was just plain wrong to chide you about your weight the way he did. If you need the surgery -- you need the surgery, plain and simple. I too have had good luck with a modified low-carb diet. I've banished the white bread and rice. I've traded baked potatoes for baked sweet potatoes, a nutritional powerhouse itself, and am really limiting the pasta (once per week or so). The water intake is also very important too, as everyone here has already mentioned.

Best of luck and please let us know what you find out with the new doctor.

[perkicar]

When I had my TEE done a month ago, my cardiologist very nicely (I thought, or maybe it was the VERSED affecting my mood!) talked about my weight and that losing 10% of my body weight before I saw him next (in Feb) would be wonderful. I'm fortunate in that for the moment they're not rushing me into surgery, but I'm also looking at my results and timing and wondering if I should just get it over with. But I do know that my weight increases other risks associated with the surgery, such as pulmonary embolism, plus just the added stress to my heart from carrying the extra weight.
What is your diagnosis, BW? I have a good friend who lives in Red Lion, maybe we can get together some time if I go out there to see her. I have aortic stenosis, classified as severe, caused by radiation therapy I received for Hodgkin's disease in 1978-79.
Carolyn