Considering Weight Loss Surgery

DutchgirlRN, ASN, RN · Oct 5, 2004

Hi, Your story sounds soooo familiar. I am menopausal, 250 pounds, on antidepressants (which I'm not giving up either!) and finding it very difficult to lose. It's so discouraging when you know you're doing everything right and not cheating at all. I have just started taking Cortislim. I don't know if it will help but I don't think it could hurt. The only difference between us is that I don't have any health problems. So far all is well. I'm 49 years old and feel as though if I don't lose a serious amount of weight that I will develop health problems. Our insurance stopped covering bariatric surgery effective Jan 2004. A fellow nurse had bypass surgery in December of 2003 and she is down from a size 22 to a size 10. She looks really great. She said she would do it again in a minute. On the flip side we had a patient on the floor this week that is wasting away to nothing due to the surgery. Her Hgb was 4.6 Several of the nurses have had the lap banding done and don't recommend it at all. I think it boils down to the state of your health. If you are becoming seriously ill because of the weight then I would think the benefits would outweigh the risk. I am having a breast reduction next month. I have suffered with EEE boobs since a was a thin teenager and finally have had enough of the neck and back pain and decided it was time for them to go. I had a scare with a lump (benign) and had to have several mamograms, each breast done in sections because they are so large and still the tissue they said was very dense. I ended up having a golf ball size section removed from under my left nipple. The doctor said "if you have a breast reduction, and you are definately a candidate, then your future mamograms will be much more accurate". I have a family history of Breast CA. That was all I needed to hear to make up my mind. I'm rambling now. Sorry. I wish you luck on whatever you decide. Let us know!

Long Term Care Columnist / Guide · Oct 5, 2004

Triple-E's??? :eek: Holy God, and I thought my girls were big.....they fill up a DDD cup (although I probably should be in a single-E cup for better control) and I have permanent indentations in my shoulders from my bra straps. WOW.

Speaking of which......I once saw a size H bra in a thrift shop. I didn't know they even made 'em that big.........my whole @$$ would have fit in one of those cups!! Whoever the poor woman was that wore those bras, I hope she got herself a nice breast-reduction surgery. :)

I'd love to have one of those done myself if I ever get a significant amount of this weight off, although I'll want to deal with the hanging stomach first. I've actually been able to improve it somewhat with crunches and sit-ups, but I need to lose a lot more abdominal fat before it makes a real difference.

Maggie in NC · Oct 5, 2004

You sound like you have hit a plateau in your efforts. Have you thought about changing up your routine and modifying your diet? I can totally understand why WLS is appealling but, before you go there...try a new routine.

I gained almost 100 lbs after a cancer surgery and severe depression. One day I woke up and said, "I can't stand myself!" I was watch Montel Williams that day. He had this guy named Bill Phillips on the show. He was promoting his book, "Body For Life". I thought it was a gimmic but then LIVE people started coming out on stage showing their BEFORE pics and the results were AMAZING! I bought the book and started the program. I lost 60 lbs within 6 months and have kept it off and then some. (the "some" was swelling from all the meds.)

I don't follow the diet to the "T". I hate those protein shakes so I don't drink them unless I am hard up. I also didn't do ALL the exercises but, I did swim EVERY day for at least 30 minutes continously. I do eat ALOT of chicken and fish and try to plan my food intake a day ahead of time. Can't give up Diet Coke-I drink it and feel like I am cheating but I don't care.

The good things about Body For Life:

-One day a week you get to eat ANYTHING YOU WANT and don't have to exercise.

-It's easy to follow

-There are support groups on line www.bodyforlife.com

-There's a cookbook that helps: Eating for Life

-You can get both books at Walmart

-You're probably already doing most of what the book tells you

If you still want to do WLS, I have lots of friends that have had it done. None of them have regretted it. The most inspiring friend went to Brazil for her surgery. She's lost 200 lbs and had plastic surgery. She looks like a different person! Do your research! There are lots of different types of WLS. I think Obesity.com has list of the types of surgery and a reference list of physicians all over the country.

Good luck!

PS-my sister wears combat boots too!!!:rotfl:

beckymcrn · Oct 5, 2004

I completely understand how you feel. I too am 200 something, menpausal, and have been struggling with the yoyo diet syndrom for more than 20 years. I made a pact with my self to loose this weight before I was 45. I am now 43 and still here I am. But, now I suffer from HTN, DM, hyperlipidemia and terrible arthrittis in my neck, knees, and ankles. ( Infact I went to have my knees checked a few months ago before I knew I had arthr there and the doc told me they were bad enogh for replacement surgery, but since they new knees would only last 20 yrs he wanted to hold off as long as he could. So I just live with the pain)

I too am active considering my ailments. My doc has been talking about by pass surgery for a while now. I am scared. Are the complications of surgery really worth it, then again are the compilcations of my ailments worth it?

I just signed on with a weight loss research study for diabetics at our hospital. I will be on a monitered diet for 6 months. This is my last straw. I pray this works. If not I will probally look deeper into the surgery.

NeuroICURN · Oct 5, 2004

Ok Marla...

Because I have really come to respect you and like you because of your postings on here, I'm going to give it to you straight......from the perspective of an ICU nurse who has cared for several of these patients (overflow into our unit).

First and foremost....Do you realize that this surgery has a mortality rate of almost 50%??? And this is not just at one facility, it's at all facilities. I have seen more people die after this surgery than is even funny. Heck, just had one die in our unit a couple days ago. Even saw one that was in another ICU, when I floated over there, that was only 38 and died.

Now....assuming you do live, many have a HELL of a time getting off the vent. They end up trached.

Ok...so, let's say you live and are off the vent...have you considered the multiple health problems that can be associated with having this done? Such as malnutrition, malabsorption, dumping syndrome...the list goes on and on. It can be more of a problem to have it done compared to not.

So my advice to you, and anyone else thinking of having it done...DON'T!!!!! I cannot say this enough! Or, if you still think you might want to, track down one of these pt's in the ICU and spend a few hours with them....trust me, you'll change your mind!

I WOULD NEVER HAVE IT DONE AND WOULD NEVER RECOMMEND IT!!!!!

Long Term Care Columnist / Guide · Oct 5, 2004

Thank you, Maggie! Yes, I've tried changing my diet, shaking up my workout routine, trying supplements etc...........nothing. I'm not exaggerating when I say that I've done just about everything to try to lose weight, except the medical fasts and the Jenny Craig-type programs because they're too expensive and don't really teach you how to eat in the real world. I was bulimic in my late teens and screwed up my GI tract, so I'm really wary of anything that stresses the digestive system.......that's why I've hesitated this long even to consider WLS.

The procedure they do at the center closest to my home is the Roux-en-Y, which I hear usually produces good results with less risk than some other types of WLS. I'm also thinking that my odds for a swift recovery are pretty good; as 'bariatric' patients go, I'm on the small side, and I'm relatively healthy. Most of the patients I know who live in this area are in the 400-500# range and they're diabetic, or they have severe heart disease, or they have sleep apnea & other respiratory issues requiring some sort of mechanical ventilation. I have none of those conditions---yet ---, and heck, at well below 300 I don't even need special equipment.

I'm just afraid that if I don't do something soon to lose a significant amount of weight, I WILL develop one or more of these problems, and it will kill me within a few years. I've been hypertensive off and on since I was 23, and even now am already so far down that road that I have to take the maximum doses of three different meds, plus Lasix, to achieve even modest control........how much longer can that go on? My risk for developing diabetes is astronomical; three of my babies were well over 9 pounds, and I've had trouble with hypoglycemia for two decades......I'm sure the day is coming when I'll finally tip over into full-blown DM if I don't get a good amount of this weight off.

At this point, I know I will probably NEVER be thin; I want only to be functional and healthy, and if that happens at 160 or even 180, so be it. I want to avoid becoming diabetic if at all possible; I also want to be able to control my HTN without so many drugs, and to regain the physical freedom I had when I wasn't so heavy. Lord knows I'm a whole lot better now than I was when I weighed 340 a couple years ago; but I can evidently get no further on my own. I need help now.

Thanks for responding. :)

Long Term Care Columnist / Guide · Oct 5, 2004

Ok Marla...
Because I have really come to respect you and like you because of your postings on here, I'm going to give it to you straight......from the perspective of an ICU nurse who has cared for several of these patients (overflow into our unit).
First and foremost....Do you realize that this surgery has a mortality rate of almost 50%??? And this is not just at one facility, it's at all facilities. I have seen more people die after this surgery than is even funny. Heck, just had one die in our unit a couple days ago. Even saw one that was in another ICU, when I floated over there, that was only 38 and died.
Now....assuming you do live, many have a HELL of a time getting off the vent. They end up trached.
Ok...so, let's say you live and are off the vent...have you considered the multiple health problems that can be associated with having this done? Such as malnutrition, malabsorption, dumping syndrome...the list goes on and on. It can be more of a problem to have it done compared to not.
So my advice to you, and anyone else thinking of having it done...DON'T!!!!! I cannot say this enough! Or, if you still think you might want to, track down one of these pt's in the ICU and spend a few hours with them....trust me, you'll change your mind!
I WOULD NEVER HAVE IT DONE AND WOULD NEVER RECOMMEND IT!!!!!

And I appreciate your perspective too, my friend.......this is why I'm asking for advice in the first place. I know people die from this surgery, and I'm acquainted with a couple of former WLS patients who are nothing but skin and bones, chronically on TPN/lipids for malnutrition and have even had to have PEG tubes put in because they can't eat. In fact, they are two of the living, breathing reasons I've resisted my doctor's advice to have this done......I would just hate to live that way.

But I also sense that my time here on Earth is going to be severely limited, and in the not-too-distant future, if I can't make enough weight go away (and stay away) to make a difference in my health. Losing forty pounds was a start.......actually, it was more like 70 altogether, as I was approaching 340 two years ago......but I've gained back a dozen of them for no particularly good reason, and even with the net loss of almost 60 lbs. it's nowhere near enough to lower my BP or reduce my risk of developing diabetes, heart disease and/or stroke. My knees are as bad as the average 80-year-old's. My lower back, which hurt even when I was a 120-lb. teenager, bothers me every day of my life. I have GERD, and I know carrying this much weight around doesn't help my asthma much either. I'm at the end of my rope, friends........something's gotta happen, and soon.

WickedRedRN, BSN, RN · Oct 5, 2004

Hey there! I SO have been in the same spot. A year ago I decided I could "accept" having the WLS if it was the lap band. I could not and still cannot come to terms with the RNY process. Hubby and I went to the information session and began the insurance approval process. I was denied for Lap Band, but insurance advised if I opted for RNY, they would approve right away. After discussion with the clinic, I went into the medically managed WL program, which consisted of 5 supplements a day for 18 weeks, then transition back to food. It has not been easy, but I have lost 70+ lbs since Dec 9th of last year, and am ready to go another 18 weeks soon.

Now, I have 9 co-workers in my office who have all had RNY. 2 had serious complications, once had a liver laceration and has had several surgeries since to correct problems. Another had a similar situation, with additional surgery. One woman had it done with her sister, she was fine, no probs, her sister was in ICU for over a month with a complications. She told me the other day her sister is better but still is not the same person she was before. They had this WLS almost 2 years ago. Every one of these follks has told me had they known before hand they would have these problems, they still would have elected to proceed with the surgery though. I share these things, not to scare you, but to give you some info to think about before you make your decision. I totally respect anyone who chooses to have WLS, I think it is a life saving proceedure for anyone who needs it. But, my point is, you have to weigh all the options and do a lot of soul searching to decide.

Good luck to you and God Bless in your journey. Please let us know what you decide??

Gompers, BSN, RN · Oct 5, 2004

I have a very good friend that is considering this surgery, and I fear that complications will take his life. My grandfather had a similar operation done, but not for weight loss - they removed 2/3 of his stomach and part of his small intestine due to severe ulcers back in the early 70's. He went from being a huge, strong 250 pound man to a 100 pound weakling in less than 2 years time. For the rest of his life he had severe malnutrition and dumping syndrome - which was both embarassing and painful for him. He was always anemic and even needed several blood transfusions, before they finally started him on monthly B12 shots. He was NEVER the same. The poor man could never be more than 100 feet from a toilet.

Maybe an endocrinologist could be of some help? You may have have a metabolic problem that is slowing down your weight loss. Take it from someone with severe PCOS - a good endocrinologist is worth his weight in gold.

Gompers, BSN, RN · Oct 5, 2004

I am having a breast reduction next month. I have suffered with EEE boobs since a was a thin teenager and finally have had enough of the neck and back pain and decided it was time for them to go. I had a scare with a lump (benign) and had to have several mamograms, each breast done in sections because they are so large and still the tissue they said was very dense. I ended up having a golf ball size section removed from under my left nipple. The doctor said "if you have a breast reduction, and you are definately a candidate, then your future mamograms will be much more accurate". I have a family history of Breast CA. That was all I needed to hear to make up my mind.

You will not regret the breast reduction, but will wonder why in the world you waited so long. Yeah, the scars kind of suck - but every single woman I know who has had a reduction - myself included - would do it over again in a second. Best surgery in the world. Good luck!!!

talaxandra · Oct 5, 2004

Without in any way discounting your health problems, keep in mind that skinny people can have all those problems too - they're not necessarily weight related, but that's certainly the easiest target for health providers to blame.

Can I recommend a book? I've just finished "The Obesity Myth: Why our obsession with weight is hazardous to our health" by Paul Campos. He looks at all the data and (mis)inforation about the 'obesity' epidemic and looks at the dangers of focussing on weight loss. What he recommends is a orienting on a healthy (but not restricted) diet and fitness, regardless of weight.

My BMI is somewhere in the high 30's (I don't weigh myself but I had orthodontic surgery about sixteen months ago and I'm estimating on that - my dimensions haven't changed in fifteen years, since I said goodbye to dieting and eating disorder); I have a balanced non-meat diet (for ethical not health reasons), walk to work most days (an hour and a half at a brisk pace), take the stairs, take yoga and stretch classes a couple of times a week, and have a fortnightly remedial massage. Before starting this I had four significant back injuries that forced me to take time off work - have only had the odd twinge since. I'm in better physical shape than either of my (thinner than average) younger sisters. I'm a generous E cup, but had bra fittings and have no strap indentations, ever.

I belong to a Yahoo group - Don'tTellMeWhatSize IMust B - and have read some horrific stories about WLS survivors. Even those who do well often have long-term complications, including weight gain. If we can accept that some people are naturally thinner than others it seems illogical to believe that the only people fatter than 'average' are out of control gluttons.

Good luck with whatever you choose to do :)