Gastric bypass surgery

  1. A dear friend of mine is considering having the gastric bypass surgery done but is weighing the advantages against the disadvantages. I do not know anyone personally who has had this done, but I do know of people, some who were pleased and others who had very adverse outcomes. Has anyone here had any experience or knowledge of this surgery, and would you recommend it? How about any patients who have had this procedure? Thanks - all comments are very welcome and appreciated.
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  2. 23 Comments

  3. by   OzNurse69
    Worked in a colo-rectal ward for 3 yrs where we did this on a regular basis (ie 2-3 x week). DO NOT LET YOUR FRIEND DO THIS!!!! Have seen people die - far too many, even allowing for the fact that morbidly obese people are bad anaesthetic risks to begin with. Have seen 2 people end up brain damaged through malnutrition - didn't take their supplements post-op. Have seen more revolting wound breakdowns than any other ward I have ever worked in.....am I scaring you yet??

    PLEASE, for your friend's sake, impress on her the adverse outcomes, and allow her to make up her own mind. Obesity is not good for your health, but neither is being dead!!!
  4. by   Vsummer1
    I heard that 1/200 turn bad. Those are not good odds, but if you are going to die if something isn't done, then I guess they are better than no odds at all...
  5. by   PsychoRN
    I had a cousin die from the surgery. I would never have it done!!!
  6. by   LynniNurse
    I know several nurses that have had the gastric bypass. One is a very close friend and I talked to her at length about the procedure and all she went through to lose 150lbs. I've done some research since I'm considering having it done myself. There are MANY different ways to do the bypass. Each doctor seems to have his own method of bypass, his own preference to removing or reconnecting the intestines. It seems no two doctors do it the same way and each doctor seems to be very adamant about the good and bad of how each bypass is done.

    I've talked to at least 10 nurses that had the procedure done by the same doctor in Little Rock, Arkansas. They are all extremely pleased with their results although they admit the surgery and recuperation time was very difficult, requiring a minimum of 6 weeks of time off work. Some of these nurses still have dumping syndrome even 15 years post op. Some still vomit immediately after eating meat such as steak or too much food of any kind. They don't consider this to be a horrible thing. They do what they need to do and immediately resume work, etc. I've talked to other nurses that had the procedure done at Vanderbuilt in Nashville, TN. They too, are very pleased with their outcomes.

    The common thread between the surgeries that were done in the two locations seems to be that none or a very small amount of their intestines or stomachs were actually removed -- just re-routed. They say that if necessary they could have surgery to put their insides back to original status.

    However, I've had two patients that had TROUBLE after the surgery. Both of these patients were extremely overweight needing to lose in excess of 300 lbs each. Both of these patients coded on the operating table but were resuscitated sucessfully. One of these patients ended up with a temporary colostomy for 4 months but that was reversed before they were sent home. Yes, that patient remained hospitalized for over 4 months. These grossly obese patients had a considerable amount of small and large intestine removed. Both of these patients were very much at risk for surgery strictly due to the anesthesia. For both of these patients, the surgery was necessary to sustain life -- it was a do or die situation. Both of these patients had the same surgeon and he isn't in Little Rock or at Vanderbuilt.

    I've done a lot of research online. There are many, many facilites nationwide that offer programs that include gastric bypass. Most facilities/surgeons require that a patient be at least 100 pounds overweight; and most require pre-op and post-op psychological and nutritional counseling. I am not 100lbs overweight so I don't meet the basic requirement; however, I am about 70 lbs above ideal body weight and I have high blood pressure that requires I take 4 antihypertensive meds a day. I also have terrible problems with an arthritic knee secondary to a traumatic injury that gives me FITS. Major weight loss would be of great help to my overall health. Preliminary investigation tells me that I would be considered for the procedure in Little Rock but my old insurance wouldn't pay even a portion of the $20,000 plus fee. I'll have a new insurance carrier after the first of the year, I'll check with them about the procedure.

    All my research tells me that the most important thing is the existing weight of the candidate and how the procedure is done. I'd recommend becoming very familiar with the exact procedure that will be performed and talking to people that have used the particular surgeon in question. If I get the chance to have the surgery, I'll ask for the details on the unsuccessful surgeries the surgeon has done. Of course, the worst case scenario is death but as nurses we know that sometimes death ISN'T the worst outcome. I think I'd rather be fat and take a lot of pills instead of going through some of the things that the patients I cared for endured.

    If my insurance company will pay for the procedure and if I can convince the doctor in Little Rock to "do me", I will have the surgery. The rewards are too great to pass up and the odds are on my side.
  7. by   CraftyLPN
    I have personally had the surgery done, and if time was to reverse itself I would do it again w/out hesitation....I was nearly 600 lbs when i had it... I am down to 250lbs in 3 years.TALK ABOUT A CHANGE FOR THE BETTER.......!!!! I wish your friend good luck and she will be in my prayers!!
  8. by   Ted
    Seems to be working well for her. Of course she has to take her daily suppliments. She feels good with her asthma problems almost gone and back and knee problems totally gone; she looks great (except for the tummy scar . . . But they're doing the procedure laproscopicly now!) Heck, even her cholesterol level went from the high 200's to around 180! (All other blood tests including iron levels and total protein/albumin. . . are WNL!!!)

    Without a doubt, this surgery, like any surgery, has its risks. They knicked her liver early on during surgery which resulted in about 1 liter's blood loss. She was symptomatic with this requiring a transfusion of 2 units of PRBC's . . . two days after the procedure! (The surgeon did tell me about the knicked liver immediately following the operation. I told her that my wife would like a blood transfusion if needed!!! She told me that she would take a "wait and see" approach because Amy - my wife - was relatively young and healthy. ARRRGH!) Amy also had a small incisional post-op infection requiring me to pack her wound for about 2 months.

    Was I totally for this procedure? No. But 9 months after the operation I now see its benefits despite the realized risks Amy suffered. Amy says that she would do it all again. She's happy! That's the bottom line, I guess.

    Here's the main problem that I see! There are many hospitals offering gastro-bypass. But there seems to be no consistant nutritional follow-up!! No real national standard of care!!! This really is very sad. We know of a few other people who had this procedure who had poor nutritional advice in our opinion. One person was told to eat only three meals a day. . .and to eat it all! This person still takes this advice and still purges every so often because her pouch is too full! Another hospital hardly gives any post-precedural nutritional follow-up. I guess the patients just get a pamphlet on what to do. . . and that's it.

    Amy had this procedure at a facility in MA where she did. . . and still does . . . recieve excellent nutritional follow-up. For a year post-op she sees the surgeon then sees the nutritionist. Additionally, there are support-group meetings that meet on a regular basis that focus on anything to do with gastro-bypass (usually they're are discussions about what foods work well and what foods don't. . .). Basically, Amy can eat anything. She does! But it is in real small amounts. . . serving size about 3 to 4 ounces per meal. Amy also eats about 5 to 6 times per day. This is what is recommended by the facility where she had her operation, and it seems to work well with the hundreds of people who had this procedure there. (These support group meetings where literally 200 + people attend have members - pretty much everyone - that are happy campers!!!!!) Additionally, she takes ALL of her nutritional suppliments on a daily basis. . . all of her vitamins and calcium pills. (The downer about this is that she will develop mal-nutrition if she didn't take these pills. Potential for mal-nutrition is a major side-effect of this procedure!!!)

    What also make this program so successful is the Serious psychiatric evaluations Amy had to go through before they would do this procedure. To this facility's credit, if a person doesn't "pass" the psych-eval, they don't get the operation. I wonder how many other facilities offer this precautionary step!!!!

    Lastly. . . Amy met all of the criteria so that our insurance company paid for 100% of the precedure. . . and 100% of the year's follow-up that I mentioned earlier.

    Is gastro-bypass for everyone??? No! Are there risks??? Yes! Is there success??? Without a doubt, Yes!

    I know there are horror stories out there about people undergoing this gastric-bypass. These stories need to be taken seriously. I also know that there isn't a consistant standard of care that is holistic in nature that can be followed and advocated by any and every facility that offers this procedure. There should be!!! And it is unfortunate that there isn't!!!

    But with research, one can find a facility that does offer good nutritional and follow-up services and feel relatively safe in deciding to have this procedure. (There are always risks involved in any surgery!) Gastric by-pass, with the appropriate pre and post op care, and with the appropriate post-op nutritional plan can be and is a life saver.

    If you're interested in finding more information, email me. I'll direct you toward Amy's email who, I'm sure, will be more than happy to answer any and all questions.

    Cheers!

    Ted
    Last edit by Ted on Dec 5, '02
  9. by   ARKYRN
    I have read all the responses to the original thread and was very intrigued by Lynninurse's response. I too am a nurse from Arkansas that had the surgery by a surgeon in Arkansas. I would be interested to see if the surgeon you are speaking of is JWB. He was my surgeon and of course I think he is great. I have not had a moment of trouble that would make me wish I had not done it. Don't get me wrong - I have had a few side-effects but none I could not deal with. If you get the opportunity to come to Arkansas and have it done - by all means do it!

    Good-luck
  10. by   motocross nurse
    Quote from LynniNurse
    I know several nurses that have had the gastric bypass. One is a very close friend and I talked to her at length about the procedure and all she went through to lose 150lbs. I've done some research since I'm considering having it done myself. There are MANY different ways to do the bypass. Each doctor seems to have his own method of bypass, his own preference to removing or reconnecting the intestines. It seems no two doctors do it the same way and each doctor seems to be very adamant about the good and bad of how each bypass is done.

    I've talked to at least 10 nurses that had the procedure done by the same doctor in Little Rock, Arkansas. They are all extremely pleased with their results although they admit the surgery and recuperation time was very difficult, requiring a minimum of 6 weeks of time off work. Some of these nurses still have dumping syndrome even 15 years post op. Some still vomit immediately after eating meat such as steak or too much food of any kind. They don't consider this to be a horrible thing. They do what they need to do and immediately resume work, etc. I've talked to other nurses that had the procedure done at Vanderbuilt in Nashville, TN. They too, are very pleased with their outcomes.

    The common thread between the surgeries that were done in the two locations seems to be that none or a very small amount of their intestines or stomachs were actually removed -- just re-routed. They say that if necessary they could have surgery to put their insides back to original status.

    However, I've had two patients that had TROUBLE after the surgery. Both of these patients were extremely overweight needing to lose in excess of 300 lbs each. Both of these patients coded on the operating table but were resuscitated sucessfully. One of these patients ended up with a temporary colostomy for 4 months but that was reversed before they were sent home. Yes, that patient remained hospitalized for over 4 months. These grossly obese patients had a considerable amount of small and large intestine removed. Both of these patients were very much at risk for surgery strictly due to the anesthesia. For both of these patients, the surgery was necessary to sustain life -- it was a do or die situation. Both of these patients had the same surgeon and he isn't in Little Rock or at Vanderbuilt.

    I've done a lot of research online. There are many, many facilites nationwide that offer programs that include gastric bypass. Most facilities/surgeons require that a patient be at least 100 pounds overweight; and most require pre-op and post-op psychological and nutritional counseling. I am not 100lbs overweight so I don't meet the basic requirement; however, I am about 70 lbs above ideal body weight and I have high blood pressure that requires I take 4 antihypertensive meds a day. I also have terrible problems with an arthritic knee secondary to a traumatic injury that gives me FITS. Major weight loss would be of great help to my overall health. Preliminary investigation tells me that I would be considered for the procedure in Little Rock but my old insurance wouldn't pay even a portion of the $20,000 plus fee. I'll have a new insurance carrier after the first of the year, I'll check with them about the procedure.

    All my research tells me that the most important thing is the existing weight of the candidate and how the procedure is done. I'd recommend becoming very familiar with the exact procedure that will be performed and talking to people that have used the particular surgeon in question. If I get the chance to have the surgery, I'll ask for the details on the unsuccessful surgeries the surgeon has done. Of course, the worst case scenario is death but as nurses we know that sometimes death ISN'T the worst outcome. I think I'd rather be fat and take a lot of pills instead of going through some of the things that the patients I cared for endured.

    If my insurance company will pay for the procedure and if I can convince the doctor in Little Rock to "do me", I will have the surgery. The rewards are too great to pass up and the odds are on my side.
    Hello, I was wondering what dr. in Little Rock, these nurses used , b/c i have a sister interested in it after christmas, any recommendations? And at what hospital? She will be using a Little Rock Dr. Thank You!!
  11. by   Alibaba
    interesting this should come up... yesterday, my friend told me she's going to MEXICO!!! to get the bypass done. She is a nurse and someone I thought had a good head on her shoulders until now. Says she and her best friend are going there next month. After all those reports on 20/20, I don't care how much less it costs, I still wouldn't get on that boat.
  12. by   Bipley
    Quote from Alibaba
    interesting this should come up... yesterday, my friend told me she's going to MEXICO!!! to get the bypass done. She is a nurse and someone I thought had a good head on her shoulders until now. Says she and her best friend are going there next month. After all those reports on 20/20, I don't care how much less it costs, I still wouldn't get on that boat.
    There are a couple of select dentists I would go to (I live in AZ, Mexico isn't far) in Mexico but certainly NOT for any major surgery. That's just stupid.
  13. by   LilRedRN1973
    I work in the ICU and I've yet to see a patient live after having a gastric bypass. They just don't seem to go well. One gentleman has been in and out of the ICU since his surgery 2 years ago. Last I saw, he was on a propofol gtt, xigris for sepsis, etc. I just don't have any good experiences relating to gastric bypass to think it's a good thing. And I certainly wouldn't have it done in Mexico!!

    Melanie = )
  14. by   grannynurse FNP student
    Quote from RNnTraining1973
    I work in the ICU and I've yet to see a patient live after having a gastric bypass. They just don't seem to go well. One gentleman has been in and out of the ICU since his surgery 2 years ago. Last I saw, he was on a propofol gtt, xigris for sepsis, etc. I just don't have any good experiences relating to gastric bypass to think it's a good thing. And I certainly wouldn't have it done in Mexico!!

    Melanie = )
    GBS is something that I have never considered nor would I likely chose if I were to need it. The statistics have changed since Medicare has approved this type of surgery. The number of deaths and rates of complications has increased. Part of the problem appears to be related to the age of the person and the selection of that person. Also there appears to be an impact by the skill of the surgeon. It is not a surgery that most of us would undergo and certainly not in Mexico.

    Grannynurse

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