Gastric bypass - psycho

[brax881]

Do any other nurses deal with post gastric bypass patients and the difficulties they have as a result of their procedure? I find a lot of gastric bypass patients to be extremely rude and demanding. The other day another nurse and I were splitting a room, I had B bed and the other nurse had A bed. The gastric bypass patient in A bed began complaining to her nurse that she wanted regular sugar and jello and not all this diet stuff. The nurse explained to her that the doctor ordered a clear liquid gastric bypass diet and explained the advantages of being placed on that type of diet. The patient did not care she began to yell at the nurse stating that all the other nurses brought her in a regular tray and that she was just being difficult. For the second time the nurse told the patient that she would place a call to the doctor to try to have the diet changed. The patient was utterly obnoxious to the nurse. The nurse walked out and the patient called the nursing coordinator. She explained her exaggerated story to the coordinator. The coordinator must have told the patient that the nurse was handling it appropriately, because I heard the patient say, "you don't see a problem with this?" And began yelling and screaming all sorts of rude things. In report nurses just cringed ever time they have a patient with a history of gastric by bypass, and ask are they psycho? Anyone else find gastric bypass patients to be difficult?

[Daytonite, BSN, RN]

here's a big reveal i've never made public on allnurses before. i had gastric bypass surgery; i also have metabolic syndrome. i don't think i'm a psycho and or a problem patient, but i did and still do have behavioral problems when it comes to food. i would have never acted out with strangers because my mother believed in corporal punishment, had the ethics of judge judy and dr. laura and would have brought out the belt and spanked my sorry butt when i got out of line. that kind of conditioning is ingrained forever in one's mind. i'm getting ready to be admitted to have abdominal surgery that is being done by a surgeon who was carefully chosen because of my past history of a roux-en-y gastric bypass and other abdominal surgeries. i'm sitting here wondering if i'm going to have to go through the 6 to 8 months of recovery that i went through with the bypass. it was tough, but when it was over, i lost so much weight and felt so good about it that i was literally prancing around where ever i went because i was so happy. now, i'm looking at the prospect of facing it all again. sigh. i had a lot of hair that fell out because i just couldn't get enough protein in my system post-op. i was puking up any fish or meat i ate as fast as i swallowed it. it's probably going to happen again, i fear. i'm going to a different hospital and my surgery is being done by a different surgeon who just happens to also do gastric bypasses although he didn't do mine. i am fully aware that i am probably going to get served the post-op gastric bypass surgery diet when i am able to start eating. love those sugar free popsicles that are nearly melted by the time they get to your room--not!!! do you know they melt faster than the ones with sugar in them? i did a study.

people who get to morbid obesity states delude themselves about their eating habits and cannot admit what they are really doing to maintain their weights. our minds are powerful. polishing off a half gallon of ice cream or a whole package of cookies, donuts or potato chips at one sitting isn't normal. why would anyone 'fess up to that? but people who get to 300 and 400 pounds and more often do things like that although they won't admit it openly. i had gastric bypass, am a diabetic and i also use some regular sugar and eat regular popsicles. (i feel like i might be at an aa meeting here!) i'll occasionally eat a candy bar. if i can't get a diet pepsi out of a pop machine i will drink a regular pepsi, gasp, with sugar in it. i'm sorry people of atlanta, but i don't like coke. i won't eat nutrasweet if i can help it (although there's plenty of it in diet pepsi), but i will use splenda. i understand the pathophysiology of my insulin resistance and how the anatomical changes of the bypass affect the digestion of my food. i can tell you all about dumping syndrome, a wanted side effect of this surgery. the first time i wasn't paying attention, having my little rebellion, and let a whole bunch of ice cream blissfully roll down my throat, spoonful after spoonful (bad habits are hard to break and come back real quick) and got my first experience of dumping syndrome, i thought i was gonna die! did i learn? you bet! you never forget what the belt or dumping syndrome feels like.

i'm going into the hospital later this week. i sincerely hope the nurses don't think i'm a psycho. i'm taking a stash of my own bigelow tea bags and a baggie full of splenda with me since i know the hospital doesn't have either of them. splenda is incredibly sweet. i will be talking up allnurses in between my demerol haze and periods of alertness. ha! ha! hopefully, we'll get some new members. i'm debating whether or not to reveal my screen name to the nurses or not. maybe, if they are already a registered member, i'll ask if there's any member they really despise before i say anything. if they say, "that damn daytonite" i'm keeping my trap shut! ha! ha! i keep telling people i'm really a nice person and not to judge me by what i post on the website.

if any of you are contemplating gastric bypass and want to discuss it, you can pm me, but do it before the end of the week. i talked to lots of people who had it before i went ahead and had the surgery myself. my biggest fear was that i would miss my food, particularly taco bell. my biggest wish was that i could stop eating all those half gallons of ice cream and 1-pound bags of m&ms and circus peanuts. my fear never materialized and i just had a (as in one) taco from taco bell for lunch today, and i got my wish and there's no more of that gluttonous eating. you all just have to put up with all my verbose writing! you may not be able to live with it, but i can! it's non-caloric.

[allele, LPN]

Yep, I've taken care of a few. I've never had any "psycho" patients, although I know other nurses have had some patients with some issues. We were all required to go through some sensitivity training before we began taking these patients, and we did learn that many of these patients DO have some psychiatric issues. Depression is certainly one, they're living with obesity in a thin-oriented society that generally looks down on the obese. They're seen as having no self control, people have probably said some pretty mean things to them all their lives. So, on top of depression, I'm sure many of them develop coping mechanisms that many of us may see as "psycho". Not to mention they're probable physical discomforts and health dangers. I'm not sure I'm explaining myself well here, I'm a bit tired. The more difficult patients were in the minority for us, at any rate. I orignally had a difficult time understanding why anyone would want to take such a drastic step to lose weight (I'm about 70 lbs overweight myself, and can't imagine doing this), but after working with the patients I did start to see their own point of views, and I saw very few regrets. Right now we hardly see any Roux en Y procedures anymore, it seems. Everyone is going for the lap band procedure and doing quite well! Home the same day!! )

[WickedRedRN, BSN, RN]

Daytonite,

Thank you for sharing such a wonderful post. I hear you, loud and clear. I admit it, I have a food addiction. I will always have it, but now, I am not able to participate in my addition. The psychology of my addiction issue is always there, and like I said, therapy has been involved.

Best wishes and many prayers to you on your upcoming surgery. I know full well the dread of being sent back to the starting line, but I pray you cruise through recovery and will send healing thoughts your way.

[sirI, MSN, APRN, NP]

Thank you so much for you post, Day. Hope all goes well for you and your up and coming hospitalization. Bless you...........

[deeDawntee, RN]

Hi Daytonite,

Hey thanks for the post. Your description of dumping syndrome is very powerful. Good luck to you with your surgery. What kind of surgery are you having? Doesn't sound like fun.... deeDawntee

[Jo Dirt]

WOW!!! I am approx 100# overweight and was considering this as an option. Type 2 diabetes, joint pain, etc. Does anyone have anything positive to say about this procedure? It is depressing to be so overweight. I have truly "done it all" to lose weight. I also walk and exercise regularly, and am well educated as to how I should eat-just don't practice what I preach. Maybe I will search through the threads and of course talk with my PCP, I certainly know this is not the "easy way out" but is it a good option for anyone?

I'm also about 100 pds. overweight, though at this time I really have no health issues, other than severe depression. I think maybe some people are just built a certain way with a certain number of fat cells. I've thought of lap band surgery but now I don't think I would go for it, one reason is that when a person has their digestive tract altered like that they suffer from malabsorption. I know of a woman who won't even subject her co-workers to the aftermath of a trip to the bathroom and instead goes down the street to use the gas station. Another woman I know personally who had the procedure done has so much loose skin and sagging it looks absolutely horrible and that couldn't be healthy, either.

I'll stay a big chubbo with my missing front tooth, thank you.

[ArizonaMark]

It's such a tragedy that our way of life in the US leads to such a state that a growing percentage of people are becoming more and more obese. Perhaps we should begin at square one and try to figure out a better path, a better way that doesn't lead to such a tragic middle, end, and back-end for scores of people.

I guess I just want to say that perhaps a greater emphasis on preventative measures would be a first step....

IMHO

Mark

[Daytonite, BSN, RN]

It's such a tragedy that our way of life in the US leads to such a state that a growing percentage of people are becoming more and more obese. Perhaps we should begin at square one and try to figure out a better path, a better way that doesn't lead to such a tragic middle, end, and back-end for scores of people.

I guess I just want to say that perhaps a greater emphasis on preventative measures would be a first step....

IMHO

Mark

Well, Mark, have you got any ideas? When we go into the surgeons for these surgeries, one of the questions we are asked, usually a number of times, is what have you done to try to lose the weight and how long have you had a problem with being overweight. We were sending my little brother to the corner store to buy the bigger bags of candy (not candy bars) when I was in high school. My mother had cake or cookies on the table every night for desert, ice cream every Saturday night and could she bake! I weighed 190 when I graduated from high school and only went up from there. Believe me, these surgeons know what has gone in to making us overweight even though they still ask us the questions. The only ones who don't understand, it seems, are the many others who have no clue about this condition. It's not a matter of instituting preventative measures. If it were, I'd have been wearing a size 8 a long time ago. This is a multi-faceted and complex problem that also involves some very deeply ingrained behavioral issues.

[brax881]

Does the clear liquid GB diet include a clear liquid meal replacement or protein drink? Sometimes we have people with diabetes on a clear liquid diet and they are sent chicken broth and diet jello. When the diet is clear liquid, even the person with diabetes needs apple juice or regular jello to provide some caloric intake.

Clear Liquids -- gastric bypass diet, clear liquids (meaning beverages that you can almost see through). The clear liquid diet starts with sips of water, and then allows foods like sugar-free juice, diet gelatin, boullion or clear broth, and flat (no fizz) diet soda in small amounts, usually 2-3 ounces at a time.

[grace90, LPN, LVN]

I personally haven't found gastric bypass patients to be difficult. I think their post-op care is rather interesting:idea:, since their care the first night or two can be pretty involved, at least in my experiences with them- monitoring urine output, JP output, watching for fluid overload, etc... But it seems like a lot, but not all, that had their surgery at my facility have come back with complications- such as bleeds, infections, fistulas, obstructions, etc... :uhoh21:

[Megsd, BSN, RN]

I feel that gastric bypass surgery can be a good tool for people who have honestly tried to lose weight naturally and need a kickstart. People who have the surgery and return to old eating habits are bound to not do well, from what I have seen and read. It's a major surgery, and major lifestyle modifications need to be made to be successful over all.

What irritates me about the surgery is people who view it as the easy way out. My mother had a friend who was overweight (I don't know how much.. I never met the woman) and went to her doctor for a consult on bypass surgery. He told her he will only do the surgery on people weighing X pounds or more, and she weighed about 30 lbs less than that, so he refused to operate.

She purposefully gained 40 pounds so she would qualify for the surgery. I think that was a very foolish thing to do. Since the surgery she has had complications because she never changed her eating habits, and she consumes a LOT of alcohol, which combined with the altered absorption of her digestive system has gotten her into a few DUI car crashes. I don't know if the alcohol use intensified after her surgery as a secondary addiction or if the drinking is more noticeable because she cannot tolerate alcohol as she used to, but it's really turned into a miserable situation.

[MB37]

I have 2 friends who have had the surgery - and are both in great shape, following their diets, and healthy, happy people right now - but one replaced his food addiction with one to alcohol and wound up going to rehab, and the other also gained about 100 pounds in the year before her surgery so insurance would pay for it, and while I don't know the exact circumstances of it she too has made the decision to swear off all alcohol. Obesity is a disease that has psych symptoms, and I think those are ignored sometimes with all the physical things it can cause.