Bariatric surgery

LakeEmerald · Nov 12, 2014

I have not done any research on the subject, but I can tell you what my perspective is from the Emergency Room. I have seen several patients with complications from gastric bypass surgery that are severe, complex, and not easily solved. The people are always skinny, but most of them regret their decision.

That being said, I see only "the bad side" at my job. Evidently, the benefit of reduction in cardiovascular deaths overall outweighs the risk. Unless, of course, you end up being one of those with complications.

So do your research and if you still think it is right for you, I wish you the best!

Anonymous865 · Nov 12, 2014

I'd like to give you the other side of the story. I know 7 people who have had bariatric surgery and not 1 person regrets doing it.

One friend, a nurse, had the lapband. She was probably the least satisfied with her decision mainly because she had to keep going in and having the restriction on the lap band increased. She lost a lot of weight, but regained probably 50% of what she lost.

4 friends had gastric bypass.

One had type II diabetes and was told by his doctor that he was going to have to start giving himself injections if he didn't do something. At his doctor's recommendation he had the gastric bypass. He was off all medication for his diabetes by the time he left the hospital (3 day hospital stay.)

Another friend was having severe back pain. That quickly resolved following weight loss with gastric bypass. Her surgery was 10 years ago. She has walked 4 miles a day rain or shine for the last 10 years. Her idea of fun now is going hiking.

Another friend had HTN and got out of breath walking only a short distance. Following gastric bypass he was a new man - tennis, biking, etc.

Another friend had gastric sleeve. She had hypertension, GERD, and depression. She was off all medication for HTN by the time she left the hospital. The GERD is gone. Depression is significantly better. Exercise is how she deals with the depression now.

On friend had gastric bypass when they first started doing the surgery. (She had it when Al Roker did.) She does has "stomach issues" now. No Dr can find what is causing her stomach distress. She smokes and has a lot of stress that she doesn't handle well. She also does not eat correctly. I'm more inclined to believe her stomach distress is related to issues other than the bypass.

You need to understand that bariatric surgery is not a miracle cure. It is just a tool to help you make life long changes. You still have to change your eating habits and make exercise an everyday part of your life. One reason bariatric surgery works is that you lose weight immediately and rapidly. That immediate weight loss encourages you to stick to the new lifestyle. Success breeds success.

If you decide to do it, research the different options. Make sure you understand the risks and advantages of each. Talk to your surgeon and find out which option he recommends for you.

Make sure you go to a surgeon who specializes in bariatric surgery and who has a dietician, a psychologist, and an exercise physiologist who works with his patients.

Make sure you go to a hospital that has a specially trained bariatric surgery unit.

Where my friends went the unit handled only bariatric surgery patients. The nurses were hand picked by the surgeon to be especially sensitive to and supportive of bariatric patients. All had bariatric certification. The unit was built out for that surgeon with bariatric suites - larger bathrooms, bariatric beds, a bed for a support person. The OR had special equipment. Table that is wider and handles greater weight. Longer scopes. Larger retractors. Special padding and positioning equipment. Etc. They had bariatric ambassadors - previous bariatric surgery patients who provided encouragement and support to patients.

Check into your insurance requirements. Most insurance companies require you to have participated in 6 months of medically supervised weight loss before they will approve your surgery. If you are thinking of doing the surgery, start the process now. Go to your Dr for a complete physical and make sure s/he will approve you for surgery. Start your 6 months of medically supervised dieting. Start an excercise program even if it is just walking to your mailbox and back each day.

A good surgeon will require you to lose 10% of your excess weight BEFORE surgery. (It improves the health of the liver making surgery safer.)

They will also require you to have started an exercise program.

They will also require you to see a psychologist.

You can start on those requirements now while you decide on whether you want to have bariatric surgery. Even if you decide against the surgery, you will have benefited.

MissCerah · Nov 12, 2014

I'm not currently a nurse, waiting to take the NCLEX, and through school I was wondering the same questions you are now, if my weight will cause a problem with working/school and should I look into getting help surgically? Well, I looked into it and I now have a date of Nov. 25th to get my Sleeve surgery done. I went through a 6 month monitoring program that was required by my insurance. That program doesn't require you to lose any weight, they just need people who are specialized in diet and exercise watch you and make sure you are a candidate for surgery. Usually it's the actual doctor that you see that makes you lose the weight. Depending on the doctor it depends on what they want lost, I haven't done very well with this, but I am still getting the surgery. I exercise three times a week at my local Y and watch my carbs. If you have any questions feel free to ask, I will also be up to any questions AFTER the surgery too! I can say that I have always thought of having the surgery, but I didn't do anything with it until I actually had HTN and borderline sugar issues. Oh, something else I forgot, you also must have Co-morbidities to be approved for the surgery. A certain BMI, diabetes, HTN... issues like that. Best of luck on your decision!

TheCommuter, BSN, RN · Nov 12, 2014

One coworker was more than 100 pounds overweight with PCOS and the resultant insulin resistance when she opted to have a Lap Band several years ago. She slowly lost 20 pounds, then gained it all back plus more.

Another coworker had a gastric bypass about 15 years ago, lost 100+ pounds as a result, and has maintained a healthy weight at a women's size 8.

Another former coworker from the distant past lost 100+ pounds after undergoing gastric bypass, but her golf ball sized stomach eventually stretched, she eventually fell back into her old eating habits, and regained all the weight plus more.

I have several people in my social circle that have had the Lap Band, only to have disappointing results. People seem more pleased with the bypass or the sleeve gastrectomy.

And of course, one of our site administrators (Silverdragon102) has openly discussed her successes after having undergone bariatric surgery. She's mentioned in several posts that she's lost 100+ pounds.

Be aware that bariatric surgery is not a cure-all because any weight lost can be regained. However, as long as you plan to address the underlying issues that drive you to eat more than you need, I suggest you explore your options with a bariatric surgeon or two. Good luck to you!

Christy1019, ASN, RN · Nov 12, 2014

Thank you everyone, I appreciate the feedback. I haven't found a surgeon yet but I've been doing research and am most interested in the sleeve gastrectomy. I also work in the ED and see the complications, however I seem to see them more with the roux-n-y bypass than anything else, and I've also had a friend with the lap band that hated it for the same reasons you all mentioned.

MissCerah, I really hope to keep in contact with you and to hear how you do. I don't think the life long dietary changes will be as big of a problem as the initial 4wks of pureed everything lol. I'm considering doing the baby food diet LOL.

Thanks again everyone, and I would love to hear any other experiences others may have!

817nurse · Nov 12, 2014

The gastric sleeve was the best $11,500 I ever spent. I was self-pay because my crappy health insurance didn't pay for bariatric surgery. I flew to Las Vegas in 2011 to have it done. I was 5'6 and a curvy 230#. I lost 70 pounds in the 1st 12 months. I slowly lost another 25 the next year and have held steady between 135 to 140.

My diabetes went away. My cholesterol went from 296 to 177 from 2011 to 2014. My heart palpitations went away. My only regret is not doing it sooner!

Christy1019, ASN, RN · Nov 12, 2014

Did they allow you to do a payment plan or did you have to have it all up front? How much time were you off work after the surgery? And how'd you handle that 4wks of pureed food lol

817nurse · Nov 12, 2014

Did they allow you to do a payment plan or did you have to have it all up front? How much time were you off work after the surgery? And how'd you handle that 4wks of pureed food lol

I put $1,500 down and financed the rest with CareCredit. I only owe CareCredit another $2k and hope to have that paid in full next year. I was off 2 weeks and came back on light duty for a week. I drank Muscle Milk shakes for the 4 wks postop because they taste pretty good in my opinion. Also, plenty of water!

TheCommuter, BSN, RN · Nov 12, 2014

Also, be mindful of a phenomenon called addiction transfer syndrome, since it is something that many bariatric surgery patients fall into.

Now that a surgical procedure has restricted how much the individual can eat, the compulsive eating patterns disappear, but a new addiction sometimes emerges that was not present prior to the bariatric surgery.

Many former bariatric surgery patients slip into pathological gambling, problem drinking, hardcore shopping and other process addictions. In essence, the addictive behavior has transformed from compulsive eating to something else entirely. is This is why it is so very important to address the emotional component that is often intertwined with compulsive eating.

owens12 · Nov 12, 2014

I am 23 years old and i was able to get the surgery when i was 19. It was the best decision i have made in my life to this point. I was 545 lbs when i weighed in on my day of surgery. At 19 i had hbp, terrible edema, and i couldnt participate in sports with my friends in high school. I had to go through a year of therapy (insurance purposes) to have the surgery paid for. It wasnt fun going through nursing school hearing about how being so overweight was going to kill me one day.

3 years later i have lost about 250 lbs and i feel great. I work in a maximum security prison and i am on my feet almost all day (just like every other nurse!). I dont think i could do my job if i was as heavy as i used to be. I did have severe acute pancreatitis which was a direct result from the surgery. However i still stand this surgery. If you have the support system and continue to do research and decide it is an option, pursue it. Good luck!

Sugar-Phosphate · Nov 13, 2014

Hi,

I had gastric bypass a year ago. I am a nuraing student right now, but can really attest to its effectiveness, managing shifts and complications. Please feel free to message me.

I have lost 160 pounds total so far, 50 prep and 110 post op since halloween 2013.

Reasons for surgery: I was not going to be and hypocrite and give dietary advice if I was severely overweight. It would destroy the rapport I developed with my patients. I am young, and needed tot are control over my life.

Complications: cholecystitis leading to emergency cholecystectomy, acute pancreatitis, vitamin deficiency, iron deficiency, drug intolerances, and a very sensitive stomach.

How it impacts my life: I need to choose my food very wisely. I do not eat pastas, breads, potatoes. I do eat quinoa and cous cous d/t it's high protein content

My biggest worry for you is ketosis. Many doctors in the us focus on extremely low carbohydrates, below 20g per day. When I was that low, I was not able to practice safely and could not administer medications d/t that inability to critically think. So this is something to be very aware of! I usually get about 100 carbs per day, 60-90g protein, and maybe 1000 calories.

This is a great surgery despite its changes. Feel free to message me, as I said, I have lots to say on the subject :)