Gastric Bypass: trading one set of problems for another?

Tweety, BSN, RN · Dec 30, 2007

I think in the hospital we're seeing those with complications, but there are many out there we don't see doing fine. So our view might be skewed.

But it does seem the risk of complications is very high that first year and the odds really don't seem to be in their favor.

I had a friend develop a post-op penumo, and other develop dehydration. However both are doing great now and experienced a massive weight loss.

FireStarterRN, BSN, RN · Dec 30, 2007

Thanks Tweety, yes we do see sick people in the hospital, so true.

I think I'm longing to be a part of something other than standard medicine, I'm realizing more and more. I wonder if I'm basically philosophically opposed to the standard approach to healthcare that we see in the West?

Hospital nursing is basically the end of the line, where we try to patch people together quickly and send them on their way. Maybe I'm just tired of that?

Silverdragon102, BSN · Dec 30, 2007

I think in hospital we definitely only see the ones with problems. I have had bypass and the best thing I have ever done. Maybe really lucky as the only problem I have had is B12 deficiency and now on injections, have lost 100lb that otherwise despite numerous diets could not loose. I also know of many others who have had no problems but also some that have had problems. What I do believe with some is they think it is the quick way to loose weight and not follow guidance properly. It is a tool and if followed properly it can and will work. I suppose it doesn't help when all the media tends to show is the bad ones either the unlucky ones who have complications or the ones who have the op and still continue to eat the stuff as if nothing has happened. My average portion size is children's and I concentrate on protein first but if I still want something sweet then I will have it but in moderation.

Some people feel it is the easy way out, I don't and was not a decision I made lightly. It is a tool and should be remembered as such

zaggar · Dec 30, 2007

Someone I know had gastric bypass - Roux-en-Y, where they actually set the biggest part of the stomach off to the side, out of the main route of the digestive tract. Here's how it all went.

She lost weight very rapidly over the first six months, and lost some hair. She looked skeletal. She vomited if she ate too quickly or ate foods that were too fatty. Her entire outlook on eating changed. Then about 3 years into it she started to put some weight back on and is now a normal body weight. She has anemia due to poor vitamin B12 and iron absorption, and needs monthly B12 shots.

I would say it was worth it for her, just for the psychological boost if nothing else.

Virgo_RN, BSN, RN · Dec 30, 2007

We need to remember that in the hospital, we're seeing only a small percentage of the total population.

rph3664 · Dec 30, 2007

I worked briefly at a hospital that did bariatric surgery, and it was quite an interesting experience. The surgeon turned away lots of patients, even those for whom the procedure had been approved by their insurance company, because he didn't feel comfortable operating on them, for a multitude of reasons.

My mom's best friend had a stomach stapling in the early 1980s, and she had to have it reversed because she vomited every time she ate or drank ANYTHING. I understand this is not unusual at first, but it never went away. Oh, and yes, she did gain all the weight back and more.

I have heard lots of stories about people who lost the weight, and some other behavior took over - compulsive spending, gambling, hypersexuality, drinking, etc. Conversely, I have a friend who once worked in substance abuse treatment and she said eating disorders are very common in people who have stopped drinking or using drugs; it is more common in, but not limited to, women. This is a more complex problem than most people realize. NPR recently did a show about a teenager who had bariatric surgery, and without being too graphic, he's now bulimic, and admits it.

Silverdragon, you are right: It is NOT "the easy way out."

nici1978 · Dec 30, 2007

i do think it is somewhat an easy way out, what about exercise and eating right

not dieting, that helped for a friend of mine, she lost over 100p in a little bit over a year

and all with a conservative approach.

nici

plumrn, BSN, RN · Dec 30, 2007

Scary to me. A friend of mine had the surgery and he has been in ICU several times with complications from GI bleeding to renal failure. Wonder if the Lap Band procedure has many complications? Anyone know?

TiredMD · Dec 31, 2007

Wonder if the Lap Band procedure has many complications? Anyone know?

It has fewer initial surgical complications, though with more and more surgeons doing the roux-en-y procedure laparoscopically, the complication rates of that procedure are improving. But yes, unlike bypass (which is extremely extremely difficult to reverse), the lap band can be "turned off" any time if symptoms are too severe.

The main disadvantages of the lap band are that (1) you have to go back frequently to have it readjusted with percutaneous inflation/deflation, (2) it can slip off, and (3) the weight loss with lap band is signficantly less than with bypass. It's not my field (I hate the abdomen) but off the top of my head I want to say that the band has a 2y EBW (excess body weight) loss of 50-60%, while the bypass is more on the order of 80%.

SuesquatchRN, BSN, RN · Dec 31, 2007

Realistically, a gastric bypass works so well not only by limiting intake, but by limiting absorption and, unless the patient is careful about supplementing the diet with vitamins, they will become malnourished. It is an operation specifically designed to induce malabsorption in the recipient. The literature refers to this.

That said, I'd like a little tuck taken in my tummy. I'm getting as big as a whale. Well, okay, a baby dolphin.

SuesquatchRN, BSN, RN · Dec 31, 2007

i do think it is somewhat an easy way out, what about exercise and eating right
not dieting, that helped for a friend of mine, she lost over 100p in a little bit over a year
and all with a conservative approach.
nici

Wow! I wonder if they've ever thought of that!