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I'm scheduled for Nissen Fundoplication surgery @ Mayo next Tuesday...

Posted by @kdubois in Digestive Health, Oct 13, 2016

... and I was wondering if anyone has ever had this surgery before. If so, 360º or 270º? What was your physical recovery like? What was your diet after surgery like and for what duration? I know that I won't be able to eat normal food for a while, and I will lose some weight, but at least I won't have heartburn anymore!

(As background, I'm excited for this surgery! After years of GERD issues and taking medications like Nexium due to a failing sphincter and hiatal hernia, Mayo figured out that I don't properly-metabolize proton pump inhibitors (in addition to a bunch of other medications), and this was why I was so comprehensively sick for years. After stopping these meds, I lost a ton weight, and revisited my GI doctor. He said that since I can't take PPIs and had lost so much weight, I was now an excellent candidate for the surgery.)

barbara likes this

Posted by @kanaazpereira, Oct 14, 2016

Hello @kdubois,
Thank you for sharing your history and concerns about the surgery. I would like you to meet @SherryD and @maxmaximus3; since they've both had Nissen Fundoplication surgery done, a few years ago, they might be able to help you with your questions.

I commend you for being an advocate for your health; here is a great article from Medline Plus which will also give you an in-depth look at the before and after care of the surgery:

I wish you the very best, and would love it if you would let us know about your experience after the procedure.


Posted by @caress, Nov 29, 2016

Hello @kdubois: I read about your Nissen Fundoplation Surgery in October. How are you feeling? and how did the surgery go
Let me know. I too might be having the surgery. Carees


Posted by @kdubois, Dec 1, 2016


I'm so glad I had this surgery! Mayo did an awesome job... they answered my questions before I was even able to ask them every single time. They made sure to take extra special care with anesthesia and pain care because I don't properly-metabolize so many medications.

One of the reasons we did this surgery is because I also don't properly-metabolize proton pump inhibitors and H2 antagonist medications, so this surgery allowed me to stop taking these drugs for the first time in 12.75 years. Eventually, these drugs would have caused me to have liver damage/failure.

I haven't had any GERD or heartburn at all! I can now sleep laying down like a normal person. I can eat dinner later at night now because I had to finish eating before 6 p.m. before. I don't have to worry about drinking a glass of water when I'm working in the garden and then bending over and having it come right back up my esophagus again. Eventually, the GERD issue could have caused esophageal cancer.

The worst part of the surgery is actually the pain you get in your shoulders afterward. During the surgery, they fill up your belly with gas to help them see what they're doing. (I think they use CO2.) The gas ends up rising to your shoulders and slowly dissipates from there. This hurt more than the five abdominal incisions did. Since I can't take pain drugs, they got me a heating pad to put across my shoulders. That helped a lot.

The diet afterward isn't as bad as what other hospitals post on the Internet. As long as you follow the instructions they give you, you'll do fine.


Posted by @caress, Dec 2, 2016

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won't be able to travel to any Mayo Clinics
I'm so weak, I'm losing blood from this hernia and its hard for me to think about any travelling....I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.


Posted by @kdubois, Dec 2, 2016

Ugh... yeah, I have a 4 cm hernia. Horrible to live with. They do nissens all over the place, just be sure to have an doctor who's done a ton of them before, and a thoracic surgeon will be better than a general surgeon. Good luck!


Posted by @caress, Dec 3, 2016

I don't know what size large hiatal hernia is is a 4 cm considered large? My friend told me to go to NYC but I don't know any doctors
there. What a problem, I really don't want surgery, but I can't live like this being so weak....I know this is a difficult
surgery and I don't want to suffer for the rest of my life after surgery


Posted by @kdubois, Dec 3, 2016

Mayo did call it "large" in all of my imaging from the past year.

The only medical center I know about in NYC is Mount Sinai, and it's pretty large and well-known.

If it's any help, I've also had my gallbladder removed (age 40) and had my appendix removed in 1991 with a four-inch incision (age 19), and this fundoplication surgery was *much* easier on me than those two were.

The biggest plus is that the surgery allowed me to stop taking all of those proton pump inhibitor drugs. These drugs were NOT intended to be used long-term -- I think no more than 14 days or so. And here's a very important fact to know... even if you don't have genetic polymorphisms like I do, drugs like Nexium (esomeprazole) inhibit the liver enzyme that your body uses to metabolize all medications that are also metabolized via that enzyme. It basically slows down the your body's ability to get that drug out of your system. Nexium actually inhibits the enzyme that it itself needs to be metabolized. And if you are on any other medications that are also metabolized by that enzyme, it slows down the metabolization of those meds, too.

Unfortunately, the overwhelming majority of doctors out there have such a rudimentary understanding of this system (called cytochrome P450), that they have no clue about the ramifications of long-term use of certain drugs like this. Frankly, I'm *stunned* by how little doctors know about this system of the body and how each drug they add or remove from a patient's regimen can morph how the patient's entire drug metabolization methodology.


Posted by @caress, Dec 3, 2016

I've been using PPI's for years and years, that's probably why my gastroenterologist told me to get a bone density test and it was
discovered I have osteoporosis. May I ask what is polymorphisms? I'm taking an iron pill for this weakness, B12, my Vit. D for the osteoporosis and calcium. I'm not feeling any better though, that's why I'm so scared that he will tell me I'm losing blood. The dr. doesn't even know how I'm feeling right now, all this weakness. I agree I am very surprised doctors don't realize how pills have bad side effects for some people.


Posted by @kdubois, Dec 6, 2016

I just saw your question regarding polymorphisms.

Mayo figured out that I have multiple cytochrome P450 liver enzyme drug metabolization polymorphisms. P450 is a huge system in our bodies that does different things. Part of it is in the liver and consists of a bunch of enzymes that help us metabolize medications, hormones, and toxins. Mayo figured out that a bunch of my enzymes are polymorphic, meaning they are mutated, causing me to improperly-metabolize many medications, which I had been taking for years. One of these medications was Nexium and its generic equivalents. The thing is, even if you don't have polymorphisms like I do, you can still be negatively affected because many drugs inhibit these enzymes from working properly. Nexium even inhibits the very enzyme that it itself needs to be metabolized, so if you take it for a super-long time, which for me was 12+ years, it can make you sick, like it did me.


Posted by @caress, Wed, Feb 15 at 9:11am CDT

Can you suggest a thoracic surgeon from Mayo Clinic that does Nissen Fundoplication. Its time I start doing something about this
hiatal hernia. But I don't know of any doctors that do this surgery near my home. Any help from you would be so greatly


Posted by @kdubois, Wed, Feb 15 at 11:49am CDT

I believe what you want is a thoracic surgeon.

Have you been to Mayo before? They will likely want you to meet with a GI doctor first, and they will then order testing and maybe some labs. You usually don't get to choose which doctor you get, but that's okay because they are all great.

I see Dr. Jeffrey Alexander in GI. He then finds a thoracic surgeon. My thoracic surgeon is Dr. Francis Nichols.

I first met Dr. Alexander in January 2016.

I had a follow-up with him in August, and at that time he said that I was now a candidate for the surgery because I had lost some weight, was healthier, and they had also learned that I cannot take PPIs due to genetic issues. He asked if I could stay a week longer to do the testing and have a subsequent follow-up with him and the surgeon because I lucked out and another patient had just cancelled all of these same appointments I needed.

At the follow-up, I met with him again, and then he pulled a thoracic surgery PA and Dr. Nichols into the room. We talked everything over, and Dr. Nichols then pulled his schedule/calendar up on the computer screen and we picked a surgery date.


Posted by @caress, Wed, Feb 15 at 12:27pm CDT

No, I have never been to the Mayo Clinic
I hope what you say is true, that they are all great
Don't need any mistakes or problems at my age, I'm 75yrs. old
This hiatal hernia never ever bothered me only having the heartburn
Its only been bothering me on and off for the last year. I get very weak
and no energy, I think I'm losing blood, so my gastroenterologist wants
me to have a colonoscopy which I haven't done either.
Not crazy about the prepping for it.

Do the doctors mention to lose weight, before surgery? I've been trying for years without success.
How are you feeling now? Are you happy you went thru with it?

Let me know, thanks so much for the information


On Wed, 2/15/17, Mayo Clinic Connect wrote:

Subject: @kdubois replied to I'm scheduled for Nissen Fundoplication surgery @ Mayo next Tuesday...
Date: Wednesday, February 15, 2017, 12:49 PM

by @kdubois
in Digestive
Health on Wed, Feb 15

I believe what you want is a thoracic surgeon.

Have you been to Mayo before? They will likely want you to
meet with a GI doctor first, and they will then order
testing and maybe some labs. You usually don't get to
choose which doctor you get, but that's okay because
they are all great.

I see Dr. Jeffrey Alexander in GI. He then finds a thoracic
surgeon. My thoracic surgeon is Dr. Francis Nichols.

I first met Dr. Alexander in January 2016.

I had a follow-up with him in August, and at that time he
said that I was now a candidate for the surgery because I
had lost some weight, was healthier, and they had also
learned that I cannot take PPIs due to genetic issues. He
asked if I could stay a week longer to do the testing and
have a subsequent follow-up with him and the surgeon because
I lucked out and another patient had just cancelled all of
these same appointments I needed.

At the follow-up, I met with him again, and then he pulled a
thoracic surgery PA and Dr. Nichols into the room. We talked
everything over, and Dr. Nichols then pulled his
schedule/calendar up on the computer screen and we picked a
surgery date.
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Posted by @kdubois, Wed, Feb 15 at 1:57pm CDT

I've had excellent doctors in all of the specialties I've seen there... GI/Hepatology, Endocrine, Sleep, Nephrology, Pulmonary, Neurology, and NeuroPsychology. (Hmmm... I think that's all of them.) Doctors at Mayo don't strictly stick to 20 minutes and then kick you out the door like they do elsewhere in the country. They spend as long as you need with them. I've even had Mayo doctors chat with me and walk me to the elevator, and I've had Mayo doctors hug me after giving me good news. These are truly nice people.

As part of the pre-surgery testing, they will most likely have you do a manometry and then an esophagram if they want to further-test your esophagus after the manometry. You will need to go off of any PPI and H2 Antagonist medications, and then they will most likely want you to have an endoscopy (I think). They are checking to see what level of esophageal burn you will have from the hernia and not taking the medications. I've had them all performed there, and I've also had a colonoscopy there. Instead of prescription stuff for the prep, there is a prep that I do that uses Dulcolax and Miralax. You can google it and then ask your doctor before the colonoscopy if they feel this is a viable alternative. It's much more tolerable when it comes to having to taste it.

Many surgeons won't perform many types of surgeries if people are heavy because the weight can negatively-affect the outcome. In January 2016, I weighed in at Mayo at 198 pounds. After they figured out that I don't properly-metabolize certain medications later in the year, I was weaned off of them, and I lost ~50 pounds by the time I went back to Mayo in August.

I cannot even tell you how glad I am that I had this surgery. I wish I had done it years sooner!


Posted by @caress, Thu, Feb 16 at 10:51am CDT

Good Morning kdubois: I'm re-reading your post about Nexium, I have a feeling I kinda have that sort of problem with Prevacid. A lot of times when I take Prevacid, hrs. later I may feel a little heartburn, I don't know if that's from what I eat, or the problem you were talking about enzymes being polymorpbhic, I'm just guessing, don't really know. Did you ever think to go to the Florida Mayo Clinic? I was thinking about it because its closer. Let me know, again thanks for all the detailed information which I needed to make a decision about this hiatal hernia. Were you ever a nurse?


Posted by @kdubois, Thu, Feb 16 at 12:55pm CDT

I considered going to the Florida offices, but I ended up going to Minnesota due to logistics. After seeing the success I've had at Mayo, a friend of mine took her daughter to the Florida location and has had much success there.

Regarding the Prevacid, which is an H2 Antagonist, from my experience, I don't feel they are as strong as proton pump inhibitors (like Nexium), so that could be why you feel the acid reflux sooner with Prevacid than with Nexium. It could also be whatever food you had eaten at the time.

They only way to determine if you have cytochrome P450 enzyme drug metabolism polymorphisms is to have genetic testing performed like I did. Currently, it is very expensive and insurers usually don't cover the costs, BUT last week I learned from Mayo's Center for Individualized Medicine that sometime mid-year 2017, they are planning to make a larger set of pharmacogenomics tests more-available and at a very reasonable price. (The tests will use saliva instead of blood.) They will be orderable via your Mayo Clinic primary doctor if you have one, or your home PCP will be able to order the tests via Mayo's pharmacogenomics partner, OneOme. They'll mail the test kit, you create the sample, and you then send it back to them for processing.

I've never worked in the medical field directly. I'm currently not working, but my trade was technical writing, meaning that I wrote specifications for software, user's guides for software and hardware, and technical documents. I have written for several medical devices. My PCP calls me his "professional patient." (My mother was a vascular surgery nurse for 40 years though.)


Posted by @caress, Thu, Feb 16 at 2:18pm CDT

I'm learning more from you than I have ever learned from a doctor. I just went to look at the "Prevacid" I take, its not the Prevacid
you buy over the counter. Its called Lansoprazole manufactured by Breckenridge. I called it Prevacid only because it was easier to remember. But I take this as directed sometimes most times i'll get a little heartburn an hour later. So I don't know what the heck to take anymore. You should consider working with your doctor as his physician assistant.


Posted by @kdubois, Thu, Feb 16 at 3:07pm CDT

I looked it up, and Prevacid and lansoprazole are the same drug. (Drugs have two names. In this case, Prevacid is it's "brand" name.)

And it is a proton pump inhibitor. My doctors had always told me to take my PPI capsule every morning to obtain the best relief from GERD during the day. If you are still getting heartburn, and you are taking it as prescribed, I suggest talking to your doctor.

If you Google lansoprazole, the resulting page will show a turquoise-colored box on the right side of the page, and you can read more about it. This info is derived from valid, reliable sources, including Mayo Clinic.

After my medical experiences for the past decade-plus, I'm considering getting an Advanced Certificate in Analytic Epidemiology, which will help me perform better research. I want to write a book about what happened to me... due to my symptoms of P450 drug metabolisms issues, which doctors around the country are widely-unaware of, I was misdiagnosed with a rare endocrine condition, had brain surgery that I later learned I never needed (which resulted in a brain injury), etc. My home doctors were prescribing me tons of medication of that I don't properly-metabolize, making me sicker and sicker as time went on. Doctors know about the P450 system, but they are pretty much unaware off the issues that can be caused by inhibitive/inductive drugs on Cytochrome P450 system, which can happen even if you don't have polymorphisms. And the more meds you take, the more likely you are to be subject to adverse drug-drug interactions. (I'll also need a pharmacist to co-author it with me.) If I hadn't taken myself to Mayo Clinic in September 2015, had them work on me for following 1.25 years, and had these pharmacogenomics tests done, I'm certain that I would have passed away by the end of 2016 due to these drugs and the "healthcare" I was receiving at home.


Posted by @caress, Thu, Feb 16 at 3:57pm CDT

I always took the Prevacid 1/2 before dinner cause I didn't want any problems at nite and wanting a good nite's
sleep. So like I said before I don't know if this Prevacid isn't strong enough, or its actually my body having bad interactions
with it, or depending what I eat that nite. I have an appt. tomorrow with my primary care and i'll ask him what to take, knowing
him he'll probably give me Nexium haha. Oh no, you had brain surgery that you didn't need and now you have brain surgery
oh my oh my, how awful, I hope you sued them. Thank God you found the Mayo Clinic. God Bless You, you sound like you;'re
doing amazingly well. Thank the Good Lord!


Posted by @kdubois, Fri, Feb 17 at 9:58am CDT

I hope your appointment turns out well today and that you find relief soon.

I cannot sue my doctors. I learned about the misdiagnoses and brain injury six years after they occurred, and in the state I live in, the statute of limitations for medical malpractice is only two-and-a-half years. My primary care doctor and pharmacist have been prompting me to write them a lengthy letter to help them "learn" what they did, which I plan on doing soon.

I'm doing much better, which I entirely attribute to Mayo clinic. With that said, I still don't feel "normal" and I know it will take time. I'm still detoxing from these medications, but I started acupuncture in January, and it is helping with the chronic body pain and inflammation. (I can't take pretty much all heavy-duty pain meds because I don't properly-metabolize them, and basic meds like Tylenol and Advil don't really help, and I don't want to take anything long-term.)

If my symptoms haven't progressed by mid-year, I already talked to my PCP and he supports me in sending me back to Mayo's Center for Individualized Medicine to see if they can help me.


Posted by @caress, Fri, Feb 17 at 11:24am CDT

Oh that is so sad to hear about statue of limitations. I have found acupuncture is great! Thank you for your positive message about seeing my primary care today. All the best to you!


Posted by @caress, Dec 2, 2016

I just googled surgeons at Hackensack Medical Center in NJ that do nissen fundoplications for hiatal hernia and I found one that does robotic
surgeries, did you ever hear of that?


Posted by @kdubois, Dec 2, 2016

I've heard of them, but because my mom was a surgical nurse for 40 years. She's always has positive things to say about stuff like that. I actually don't know what they did on me, but it had be something close. I had five laparoscopic incisions that were each only about an inch long. I know they do it using a camera. Smaller incisions instead of one big incision makes it so you don't have to stay in the hospital as long.


Posted by @caress, Wed, Feb 15 at 12:05am CDT

I've written to you once before on this Nissen Fundoplications and I just read of so many people swearing about the Mayo Clinic. I have
not even returned to my gastroenterologist because I know he will send me to a general surgeon, I think I'm just plain scared of surgery.
How did your surgery go? Were you in a lot of pain? and how long did you stay in the hospital. I don't know how much longer I can go
on like this, feeling so sick all the time, feeling weak, dizzy, nauseous. I do take nausea pills twice a day.


Posted by @kdubois, Wed, Feb 15 at 11:37am CDT

My surgery went very well, and I'm so glad that I had it done! I don't have to sleep sitting up anymore. I don't have to avoid certain foods anymore. I NEVER have heartburn/GERD.

Here's how it went:
• My husband and I flew into Rochester on a Sunday.
• The next day, I had a pre-op appointment with my surgeon and a PA, and I did my pre-surgery labs. (They also had me do one imaging test to check the functionality of my esophagus because some of my tests the August before indicated that it didn't always function properly, but they found that it does.)
• The surgery was on a Tuesday, and I was discharged Wednesday afternoon.

Mayo will allow you to fly home the same day you were discharged if you want to. I chose to stay until Saturday.

They will give you food guidelines because you can't just eat normally right away.

The follow-up imaging is done at your home location, and you then mail Mayo a CD of the imaging. After they review it, they will call you for the follow-up appointment.

Weirdest thing is that most of the pain was in my shoulders afterward despite that I had five abdominal incisions. Apparently, this is normal because while performing the surgery, they fill your tummy up with gas (CO2, I think). They only way for the gas to dissipate from you body is for it to rise up to your shoulders. They will give you pain meds for this. (I can't take pain meds, so they put some kind of warming device on my shoulders, and when I was back at the hotel recovering, I used ThermaCare.)

I would not go to a general surgeon for this. Here's why... they needed to detach my diaphragm, esophagus, and stomach and move them about two inches lower. They then tack everything down, and then they perform the wrap of the stomach around the base of the esophagus. (If the esophagus is performing correctly, which they figure out via an imaging test called an esophagram prior to the surgery, they will do a 360º wrap of part of the stomach around the base of the esophagus. If the esophagus doesn't, then they perform a 270º wrap of the stomach.


Posted by @caress, Wed, Feb 15 at 12:03pm CDT

Thank you for the all valuable information. I've heard horror stories if they wrap too tightly its impossible to vomit. Have you ever heard that?
Is an esophagram where they give you a drink and then they x-ray you as you swallow it? My gastro never mentioned any problems with the esophagus.
I guess its this very large hiatal hernia. Oh it must have been terrible not to be able to take pain meds for the shoulder. Did you have any pain in the stomach
area or diaphgram area? Did you have a problem swallowing after you woke up from surgery? Please excuse all my questions. I'm so petrified
to have this done. May I ask you a personal question? Would you be able to give me the name of the surgeon that performed this surgery
Again thank you for the information.


Posted by @kdubois, Wed, Feb 15 at 1:40pm CDT

I've heard about the wrap being too tight from one person, I think here on Connect, but I'm glad I had the surgery.

For the esophagram...
1. The radiologist stands in a small area nearby looking at a screen. There is also at least one other person with you while you are having the test. They are wearing something to protect them from the radiation.
2. They have you step up onto a platform, put your back up against it, and then drink a small amount of alka-seltzer. They watch it go down your esophagus, and they tell you to try not to burp. They then give you some barium with a straw, have you drink it, and watch it go down.
3. They then lower the table so you are laying down with your back on it. They have you drink more while laying down and watch how your esophagus works. (They hold the cup and straw for you.)
4. While you are laying down, they then have you flip over to lay on your stomach, and they have you drink more while they watch it.
5. Then, they have you turn onto your back and onto your front again. Maybe drinking some more barium.
6. After they are finished, they'll put the table upright again, and you are done.

The barium wasn't that bad and seemed thinner in consistency than I remember from years ago.
Afterward, Mayo gave me a bottle of water to drink to help get the barium out of my system. At home they didn't, but I knew to drink a lot that day from learning so at Mayo.

What size is your hiatal hernia? Mine was three-to-four centimeters. In imaging reports, radiologists act home called it small, but every Mayo radiologist called it large. (I thought that was interesting.)

The incision pains weren't bad at all and never have been. I do get small pains in my abdomen now. My PCP think it's my diaphragm. As soon as they started in early November, I emailed Mayo and they called me within 15 minutes to discuss. (


Posted by @mrsdeecee, Fri, Feb 17 at 10:25am CDT

I have major GI problems also but I'm losing my voice ! It has to be in my esophagus? My brother and sister had hiatal hernia and we're woken up on operating table and walked out ! I have been operated on like you was terrified till day of operation than I had a quiet calm while waiting ? it's a very common operation ! and very successful ,try to chill out ! What relaxes you? Music yoga ECT I think than anticipation is what makes us nervous, I'm sure you will be fine ,I must know 10 people that had this operation all are fine ,Good luck God bless D


Posted by @caress, Fri, Feb 17 at 11:18am CDT

Oh yes anticipation is definitely making me nervous. Thank you for your positive message, God Bless you too
thank you for sending a message to me, I appreciate it.


Posted by @caress, Wed, Feb 15 at 4:10pm CDT

Yes I had that test, it wasn't too bad. I have no idea the size of the hernia, my gastroenterologist never told me
and I never thought to ask. Did they tell y ou why you're getting small pains in your abdomen and what is it from, will they
go away.


Posted by @kdubois, Wed, Feb 15 at 6:13pm CDT

They don't know why I have the pains. With that said, it's definitely getting better with time. It doesn't worry me at all, and it doesn't prevent me from normal activities.

You never know regarding the weight... you and I are different heights and have different circumstance, so they may be willing to perform surgery. Never know until you ask.

Interestingly, I literally just spoke with Medicare today regarding insurance, and I also obtained some Medicare/Mayo payment info from Facebook last week when I saw that someone else asked about Medicare and Mayo answered them.

I have two insurances. I have Medicare Part A as my primary for in-patient hospitalization, and my secondary insurance is via my husband's employment. Mayo is billing my in-patient, hospital stuff from October to Medicare Part A first. Anything not covered will then be billed to my secondary insurance, which Mayo has always accepted despite that I live in Western New York. The Medicare Part A deductible for 2016, when I had the surgery, was $1,288, so I will owe that amount to Mayo. (The Medicare Part A deductible for 2017 is $1,316.)

Based on your age, I assume that you have Medicare Part A, which would be used toward the surgery & hospitalization; Mayo would submit your claims and Medicare will reimburse them directly. With that said, you should be aware that Mayo is a non-participating provider under Medicare Part B, which is used to cover out-patient visits, etc. This means that Mayo sees Medicare Part B patients, but they do not always accept assignment for payment. When this happens, per Medicare, Mayo submits the claims for Part B claims to Medicare, then Medicare pays you, and you would be responsible for reimbursing Mayo.

Some info:


Posted by @caress, Wed, Feb 15 at 5:36pm CDT

Well I have a lot of thinking to do, my weight is a little more than yours was, over 200, what I should do is make an appointment
to visit these doctors and then they can tell me how much weight I have to lose before they can operate. Another thing does your
medical insurance pay for most of the care before and after surgery. Again you've been such a big help to me and I truly appreciate
all the detailed information you gave me.


Posted by @kdubois, Wed, Feb 15 at 6:14pm CDT

See above for some answers to these questions. And you are very welcome!


Posted by @caress, Wed, Feb 15 at 6:35pm CDT

I have a feeling they would tell me to lose some weight, I'm only 5'1 and over 200lbs. So to protect me
I know they would rather me lose the weight. Again thank you so much for all the valuable information.

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