Gastric Bypass Surgery

grouchy · Oct 18, 2003

Check out the complication rates on this Harvard Med School web site:

http://www.intelihealth.com/IH/ihtIH/WSIHW000/14220/20705/35856.html?d=dmtContent

angelbear · Oct 18, 2003

sjoe, What is the stomach pacemaker? Can you give any further info or websites about this? Thanks

SweetMagnolia · Oct 18, 2003

I have been to some of the WLS support group meetings, and I personally know several people who have had these procedures done. Most people I have met at these meetings and those I know, say they dont regret it. I have met a few who say they do have regrets. I know that those with obesity, especially morbid obesity are at higher risks for complicatioins during surgery. I joined one of the support groups in order to learn more. But this time I wanted to hear more from the nurses in regards to the care that is necessary or might be from these surgeries. I am wondering if anyone knows how this will affect the care of geriatric poplulations if massive amounts of people follow this trend of surgeries. As many have stated here, obesity in the USA is continuing to rise, even among our young people. Healthcare has already had to change its focus towards increased geriatric population in the future, and now will there be an increased need for focus on bariatric patient needs in the future? What will be the special needs of these patients? I agree that without surgery some of the obese patients would never live long enough to reside in a nursing home. I know a set of obese patients who reside in a nursing home at the present and have for several years now, due to the complications of their obesity, and inability to provide self-care. This couple is not elderly at all, yet they reside in the nursing home already. You have to weigh the risk vs the benefits of the surgery. I know some cases in which it has saved lives, and some in which complications have taken the lives. Most of those I know of personally, the deaths resulted from non-compliance (whether voluntary or involuntary). Please keep this thread going. I am not trying to create any debates, but professional input. Also, I will look into the link that you offered from Obesityhelp.com for information. Thank you, and congradulations on your success (LPN to BSN student). Thanks to all of you for your responses. Debra

Nursekatydid · Oct 21, 2003

I work on a surgical floor and we get all of the gastric bypass patients. One thing to stress is to drink lots of water and vitamins, vitamins, vitamins. They MUST take their vitamins. Usually 9 - 10 months after the surgery, they can eat anything, just in smaller amounts and most WLS pts say they stay aways from fats and complex carbs (breads, pastas, etc.) Also, after time their stomaches do stretch. Right after surgery, they may only be 3 - 5ccs but can stretch up to 12 - 15 CCs over time.

passing thru · Oct 21, 2003

What does WLS stand for??

Most hospitals are in the process of opening gastric bypass "wings"...as they are expecting a LOT of patients....as the insurance companies have just approved an average of $25,000

per operation !!

(Approved within the last 6 months)

You can bet your bippy those surgeons will be telling ALL their obese patients that they need it done. !!

"For your own good, my dear." ho ho ha ha

Another sucker surgery for women.

I've read that in 5 years, most are as heavy as they were prior to the operationl.....

anyone heard that?

CardioTrans, BSN, RN · Oct 21, 2003

I worked with a lady that had this surgery done. She is around 14 months post..... to this day she lives on mashed potatoes and green beans..... she isnt able to tolerate any meat whatsoever.....is constantly nauseous......... dont get me wrong, she has lost 160+ lbs in the 14 months, says she feels soooooo much better. This is a very serious and scary surgery from all the research, but like someone else said, that the risks of being overweight a lifetime sometimes can be even worse.

ceecel.dee, MSN, RN · Oct 22, 2003

Are these surgeries becoming too easy to have done?

I have a coworker who is 24. She came to work with us 2 1/2 years ago as a size 10. Now considerably bigger...but I wonder how she qualified for the surgery? She was probably 100# overweight...but not for very long. Don't you have to have really worked at many other forms of uninvasive weight loss first anymore?

Nursekatydid · Oct 22, 2003

A dietician I work with told me that once your 100# overweight it only takes like 500 calories to put on a pound instead of the usual 2500 calories (I think its 2500 calories to put on a pound) But anyways, yeah so once your 100# overweight its like your stuck inbtween a rock and a hard place. You can exercise all you want and eat reasonably,but you will still put on weight

santhony44, MSN, RN, NP · Oct 22, 2003

I had this done almost a year ago. I've had no complications whatsoever. I haven't done as well with weight loss as one poster, but came off three diabetes meds and two BP meds. I do have to take vitamins and iron, do occasionally get sick if I'm not careful enough about what I eat, do have to exercise and drink lots of water. I don't regret it at all, would do it over in a minute. I have a lot more mobility/flexibility, no more reflux, sleep better, have more energy, just overall feel many times better. I knew that I'd never make it to nursing home age, without it. Do I wish that there were easier ways, such as newer better meds, the pacer someone mentioned? Sure! Do I still have to deal with physical and psychological issues? Sure! Would I do it over again? Absolutely! I did read and research it carefully, looked at the morbidity and mortality rates. I "weighed" those against the m&m rates with diabetes, hypertension, etc. and decided the probability of complications and death without the surgery were higher. It needs to be an individual decision, made after very careful consideration (and, for me, prayer).

By the way, the thing about regaining the weight later is not really an issue with bypass surgery; with the old stomach stapling, it was.

DIVINELYBLESSED · Oct 22, 2003

My husband had gastric bypass 7 months ago (he was about 160# overweight). He has struggled with his weight all his life ( or at least since very early teens) and has tried lots of different diets and weight loss pills. He did not make the decision to have surgery lightly, he spent over a year researching it and talking to people online that had had it done. I think his biggest reasons for having the surgery were 1. Once we had children he wanted to be able to get down on the floor and play with them 2. quality of life- ie) being 33 yrs. old and already having NIDDM, boderline hypertension, and sleep apnea. I supported his decison to have the surgery because I knew he had given it much thought and that he fully understood all the risks involved. So far everything has been going well. He has lost 133 lbs., blood sugars have been normal, blood pressure is down, sleep apnea is resolved (he also stopped snoring all together), and he has almost completely stopped getting migraines. He has to watch the kinds of foods he eats and stay away from the ones that make him sick but pretty much eats what ever he wants. He tells everyone that he has absolutely no regrets and he feels better and enjoys life so much more. I love the fact that he feels better about himself and all the energy he now has- before surgery he quit his job because of ?stress? and was subsuquently out of work for 9 months because he had no motivation to look for another one & spent his days laying in bed watching TV, now he has a job he loves and is always on the go or involved in some kind of project or activity. LOL he wears me out sometimes.

I don't think the surgery is right for everybody- you have to weigh the benefits and risks and you have to be willing to make the lifestyles changes after, but for many people the surgery is a lifesaver.

CV CNS CCRN · Oct 23, 2003

I hvae one relative and two close friends who have had the Roux en Y procedure. I recovered each of them in their post discharge recovery at home. None has had significant problems. The worst we saw was a wound infection at the site of a surgical drain. That was quickly identified and antibiotics started. Each of these individuals is not over a year post op. Each has lost 90-150 pounds. Each eats nearly anything they want, only in smaller amounts. But like the posting previously, they eat what a normal "slender" person would eat. Two of the three were brittle diabetics. One was on 40 u insulin BID and three oral meds. She is now totally diet controlled. The other takes only a small dose oral hypoglycemic. All three have BP and labs WNL. Yes, the recovery was not pleasant. None of these three has diarrhea, excessive flatus, or regualr vomiting. Each would do it again in a heartbeat. The risk of death is roughly half that of coronary bypass surgery, which is 2/100. Each of these individuals is happier than I have ever seen them. This is trruly a life altering procedure, and is not for everyone. I believe one of the best chances of success is thorough pre-operative counseling, teaching, and FINDING A SURGEON WHO DOES A LOT OF THESE PROCEDURES. Each of my relatives and friends were able to have it done laparoscopically, but that is not always the case. Find a surgeon who has done AT A MINIMUM 50-60 of these procedures and who will discuss his complication rate with you frankly. According to my case manager pal, more and more insurance companies are beginning to pay for these procedures. I saw one piece in the news a few weeks ago that said that several people were going to be funded by their insurers to have WLS, then followed for the next 10-20 years to see if the lessened cost of treating the results of obesity were more or less than the cost of the procedure. If a patient has DM, hypertension, arthritis, high lipids, etc. I can almost guarantee that the money saved from not having to treat these co morbidities so aggressively will more than pay for the cost of the surgery, over time. Not to mention those who progress to dialysis, amputations, blindness, etc., etc. I cannot speak from personal experience, but from my three friends' perspectives, they could not be happier, and are great advocates for the procedue, the Roux en Y specifically. I do not have the same faith in other procedures. There are a lot of horror stories on the internet, but as one person before me noted, the surgery is ONLY a tool.... the success is largely in the hands of the individual for compliance. Just one person's humble opinion....

santhony44, MSN, RN, NP · Oct 23, 2003

Originally posted by CV CNS CCRN
[ I saw one piece in the news a few weeks ago that said that several people were going to be funded by their insurers to have WLS, then followed for the next 10-20 years to see if the lessened cost of treating the results of obesity were more or less than the cost of the procedure. If a patient has DM, hypertension, arthritis, high lipids, etc. I can almost guarantee that the money saved from not having to treat these co morbidities so aggressively will more than pay for the cost of the surgery, over time. Not to mention those who progress to dialysis, amputations, blindness, etc., etc.
One of the things I did when I was researching this surgery for myself was to calculate the costs of my medications alone. I think you're absolutely right; money saved is going to more than pay for the surgery over time, and I think a year or two is going to be that time frame (consider now that most diabetics are on two or three meds for blood sugar, two or three meds for BP, probably meds for cholesterol, antiinflammatories for arthritis, possibly meds for reflux). The progression to kidney failure, retinopathy, cardivascular disease, etc was also a major factor in my own consideration for surgery. I decided I'd rather risk dying on the operating table than dying bit by bit, as I've seen happen to family members as well as patients.