Gastric Bypass Surgery

SmilingBluEyes · Oct 17, 2003

coworker had this.

lost a lot of weight.

has not been healthy since. with a stomach the size of her thumb, small wonder why not.

seems she can digest hardly anything.....it all causes grief. Diarrhea all the time...not to mention, foul-smelling flatus, making hard to be around her. She looks sick. Seems so uncomfortable. I feel sorry for her. She looks just miserable even if she has lost a lot of weight. Was it worth it? I don't know,and she is beginning to wonder that herself. NOW eating is misery, not even a matter of sustainence. Seems SO not worth it, seeing all this. I think we are taking this too cavalierly myself. WE really need to examine if such a radical and life-altering surgery is the answer. For this gal, it seems not.

Long Term Care Columnist / Guide · Oct 17, 2003

I wouldn't get this done, even if I were told I'd be dead in ten years because of my weight. I've seen too many people with bad outcomes, one especially memorable lady I've taken care of several times who had WLS in January and ended up with about six feet of necrotic gut, which had to be removed. Then she got sepsis and almost died three different times. Now she is emaciated, has a PEG tube because she can't eat, has a colostomy d/t short-bowel syndrome, has been on TPN for most of this year, had infected central line & PICC sites a couple of times and most recently a bowel obstruction........all because she had this surgery.

I was researching WLS a couple of years ago because at 200+ pounds with co-morbidities, I certainly qualify for it. But I already have irritable bowel and other stomach problems, and it would just be my luck to wind up like that poor lady. She'll be dead in another six months, if not sooner, if she continues on this way, and there hasn't been a day in all this time that she hasn't thrown up, been in pain, and felt lousy. What kind of life is that?

I may be shortening my life by being so heavy, but I feel good, am almost never ill, and can do what I want and need to do, so I'll take my chances, thank you.

nowplayingEDRN · Oct 17, 2003

I have cared for many patients after the RGB procedure. Most of my patients have done well, lost massive amounts of weight, exercised, when allowed and watched what they ate. The biggest problem that I have heard them complain of is dumping syndrome when they try to eat something to rich or that they are not supposed to eat. I have never had to have one get a PEG tube placed. They are usually dc'd from the hospital on chewable MVI and a B vit. I had 1 pt that has not really done well since her surgery, 4 days post op developed PSVT, which turned out to be a-fib and has just been sickly and keeps getting thinner and thinner........the long term effects of this surgery (ie years down the road) are still unknown and I am not a proponent of having it done but it is not for me to judge anyone that chooses to go through it. I truely think that exercise and calorie counting is still the very best way as opposed to all the fad diets that are running around out there (Atkins included). But that is just MHO and experience with caring for these patients.

Marie_LPN, RN, LPN, RN · Oct 17, 2003

My aunt had it done, but i don't know how her health is since or if she has any regrets.

Tweety, BSN, RN · Oct 17, 2003

It is interesting to wonder about the nursing home, elderly thing. Never thought of that. But you're right. That is going to be an issue.

I work with a lady who had it done, lost over 150 lbs. Walks a lot and eats well and never had any problems. She's amazing. Her big complaint is she has so much sagging skin and can't afford the plastic surgery to remove it.

A good friend of mine had it done and so far has lost 80 lbs. He is now off his diabeties meds and BP meds. He has a pleural effusion post-op and had to have a chest tube. But still has no regrets. He still tries to cheat and regrets it when he does. Slips in extra calories in the form of wine. But basically he has no regrets either.

I have mixed emotions. I think the weight loss dramatically improves their quality of life and health and it should be considered a last ditch effort. But some patients need a lot of pyschological support afterwards, to deal with the emotional issues involved in their overeating. The best programs have a lot of aftercare with group therapy sessions with other patients in various stages of post-op.

grouchy · Oct 17, 2003

Please research this carefully! I have seen some bad outcomes. A friend's sister, age 33, about 100-150 lbs overweight, had the roux-and-y procedure last year and has had complications (leaking, necrosis, sepsis) requiring 3 additional surgeries, a period of being tube fed at home, placement of a PICC line, etc. She's finally doing better and just returned to work after approx 1 year off.

I had a 38 year old SICU pt, probably 100 lbs overweight, who developed respiratory complications after the surgery, and ended up being trached and on a vent for several weeks, despite no signifigant medical history.

Another friend, a man, age 37, had the laparascopic banding procedure done. He did well, lost alot of weight, but did end up briefly hospitalized with a GI Bleed approx. 1 year after the surgery.

When I saw what happened to my friend's sister, I did a little web searching. I remembered reading an article in U.S. News and World Report stating that the procedure is so prone to complications that nurses have a new acronym for it; "G.B.G.B." - gastric bypass gone bad. I was unable to access the article for free, but I found alot of frightening stuff by typing that phrase into Google's search engine.

I'm overweight myself, and I have decided that if I ever give up on the diet and exercise route, I will have my teeth wired shut, rather than getting a gastric bypass. Seriously. I mean, think about it. Don't they really accomplish the same thing? I mean, sure, it would be alot more embarassing. But, hey, nobody dies from getting their teeth wired shut, right? I'd rather be alive, healthy, and embarassed!

SweetMagnolia · Oct 18, 2003

I want to thank each of you for your response to this. The peg tubes I was referring to was in later years while in nursing homes. I have a boss who is trying to have this procedure done before the first of the year. She is a nurse also. I would like to let her know your responses here if that is okay. Please feel free to continue to comment on this subject. Debra

LPNtoBSNstudent, BSN, RN · Oct 18, 2003

My thoughts on this are:

Some people will not make it to the ripe old typical nursing home age if they don't do something about their weight, period.

My father had a massive CVA at age 48 and died at age 51 from complications related to obesity. He wasn't even THAT obese. Some would be surprised at what classifies at obese.

I had this surgery, so I have done tons of research on it. I had a friend die a few days post op from PE. I have known others to have serious complications. But I have known MORE to have serious complications of obesity.

I now weigh 135 pounds at 5'3". I am a 'runner' now (I run distances of 3-5 miles daily--eventually hope to work up to a 1/2 marathon). I no longer have ANY arthritic pain in my knees, hips, back and ankles. My plantar faschitis has lessened. My blood pressure has dropped from 150/90 to 110/50. My resting heart rate is lower and I consider myself pretty fit physically. My blood sugar is under control. For the first time in my life at age 34 I feel healthy and have a healthy relationship with food. Not to mention I used to wear size 24 and now size 8, sometimes size 6.

oh and yes I have some skin, but I could care less. I feel GOOD!

This surgery is a tool, it is NOT a miracle. You have to be dedicated and have to work at it. And yes, there are major complications and risks involved, just as there are for any surgery...but the obese are at a higher risk for complications for any surgery anyway.

I am not able to eat as much as I used to (thankfully!) and if I eat something too sweet, I feel sick, which makes me steer clear of it later.

BUT, I can eat what I need, and some of what I want. At first you are not able to eat much at all. (maybe the size of a med cup -30cc's for each meal and a snack) and now I think I eat what the normal skinny person eats. When I go out for lunch or dinner with people, they don't even notice the amount of food I eat, because it is just a little less than they eat! Well, actually I've known some skinny people who eat a lot! My blood work has always came out ok.

There are thousands just like me in a community located at

Obesityhelp.com

At that address there are about 200,000 members with a huge database of questions and answers regarding surgery. There is a message board and there are thousands of before and after pictures along with daily journals you can read. There are resouces to help you see if your insurance company covers the procedure and to see what doctors in your area do it (and to read reviews by others with that same doctor!).

That address has the stories, good and bad.

It is a major life changing surgery, nobody should take it lightly. But it may also be a life saving sugery for some. Think carefully and do your research. Almost every city has a support group. I would suggest going to some meetings and seeing what other have to say. Also most surgeons require their patients to go to meetings prior to even setting up an appointment with them about it. And yes, it should be tried after all else fails.

But, in my case, I can lose weight. In fact I have lost hundreds of pounds, only to put them back on again. I have tried and had success at many diets, only to feel like a failure in the end...until my self esteem had whittled its way down to nothing and I had no more energy to try another diet. Just eating healthy does not do it if you have a stomach the size of a 2 liter bottle (my surgeon said mine was!). No wonder I never felt satisfied.

It is a fact that over indulgence in food is making America obese and it is killing 200,000+ Americans per year. Having this surgery was the scariest thing I ever did, but I don't regret anything about it.

anyway, I've probably said to much. good luck in whatever you decide. Feel free to message me, anyone, regarding this.

mother/babyRN, RN · Oct 18, 2003

Have had three co workers who have had this done and the one who is unhealthy is the one who is and always was non compliant..I briefly entertained the idea and researched it, but my husband is dead set against it, and as I have not ever yet been emotionally committed to changing my body so drastically with surgery, I have not officially looked into it. Good thread though..And tempting surgery....

sjoe · Oct 18, 2003

That new stomach pacemaker looks like a better idea--if and when it is approved in the US. Apparently it is already being used in Europe.

Katnip, RN · Oct 18, 2003

Our hospital does a lot of gastric bypasses. We've had several of our nurses as patients. I haven't seen one bad outcome at our facility yet, but did see one as a student.

If patients follow their diets faithfully in the beginning they will evetually eat regular-sized meals. The people I've talked to said they truly don't feel hungry. There is some behavioral modification that needs to be done, and some folks do overeat for psychological issues as well. But in time, people can eat anything, even cake. Most said they had problems with dumping at least once, and they learned from it.

As far as the future, it will be interesting. I don't know if they'll need to hav special feeding or not.