My husband, who has had diabetes for many years, weighs about 600 pounds, has trouble breathing, and the doctor says this is because he has blood clots in his legs which are breaking loose and may have moved to his lungs. They came to this conclusion because of his low oxygen and high heart rate, and pressure in his chest. He also has high blood pressure and has had toes amputated. They cannot do a scan because of his size, and I am very worried. What can be done?

This is a very difficult problem, as you already know. In talking about risk versus benefit for any treatment, you need to know that if nothing is done, he will still have a high risk for a negative medical outcome. Surgery to treat obesity may be very risky. It sounds like he needs to get his heart condition and oxygenation improved in the acute phase. That means acute weight loss with marked calorie restriction and some means of eliminating the obstructive component to his breathing and improving his oxygenation.

I would suggest you consult a bariatric surgery team. This team would have a number of individuals with expertise in cardiology, pulmonary medicine, diabetes, and surgery.

JTL