Gastric Bypass.... yes or no???

steelcityrn, RN · Nov 6, 2005

One of the latest cases I have had was woman around 45 who had a gastric bypass followed by a lower lift. Not only did she have all the digestion problems, she also developed infection in her incisions which opened and required packing daily. Her peak weight before the bypass was 225 and she is 5'7". She ended up needing more surgery for debreadment and closed with retention sutures, staples and penrose drains. These were located across her abdomen and lower back. Keflex was reordered for 10 days 3 times. Please try losing weight the old fashioned way if you can. Daily walks, increase your h20, don't buy comfort food. Try everything before the bypass first.

Gompers, BSN, RN · Nov 6, 2005

Her peak weight before the bypass was 225 and she is 5'7"

:uhoh3:

I can't believe a doctor actually did surgery on someone who was not even 100 pounds overweight. I thought that was a guideline or something?

RENAISSANCE RN · Nov 6, 2005

DutchgirlRN, ASN, RN · Nov 7, 2005

I've been told by the docs that the percentage of patient who gain their weight back after a gastric bypass is 50% and many patient have complications. The patient who loses to the correct weight and doesn't have any complications are rare. Unless you're at risk of dying unless you lose weight I wouldn't do it. I am 100 pounds overweight myself so can say "been there, done that"

MiaNJ · Nov 7, 2005

I have a good friend who is over 100 lbs overweight and wants to get it done also. But she has been talking to past patients and while some are happy, there are many who have complications and wished they never did it.

Another issue that some people forget to think about it Skin elasticity. If someone is over 100 lbs overweight esp. for many years, that skin has been damaged and will never return to a normal shape. So more than likely 'multiple' surgeries will be necessary to get the skin lifted and put into a decent shape. Maybe this isn't an issue for some people but for women, esp. in their 20s or 30s they can be highly disappointed if they loose all the weight and could end up hating their body even more when they see how saggy and wrinkly it looks.

My friend talked to a 32 yr. old gp patient who had it done 2 yrs ago and her skin was so saggy that she would pull several inches off her stomach and arms, like if she were wearing another shirt.

She's very depressed since the multiple surgeries to fix this will cost over $50K and not covered by insurance since it's elective.

Even if she had the money and got it done by a good plastic surgeon, skin will never look completely normal. She will always have scars and stretch marks. Plus, it will never be as firm as someone the same age who never had this problem.

This probably doesn't bother some people and they just want to 'feel' better after gastric bypass. But it's something to think about.

The 32 pt. who is depressed about her skin now said that no one told her about the skin issues, and if she had known how severe it would be she would never have had the gp surgery.

I know diets don't work for many people or some people have medical conditions that prevent them from losing weight.

But for people w/o medical conditions, if they just don't think of it as 'dieting' and don't follow and fads or even well known 'diets' but just cut back on calories and increase activities they can lose weight. ..eventually even if it's slowly. Plus it's better to lose it slowly than too fast to give the skin more chance to snap back. There could still be some stretch marks but maybe not as bad as losing it as fast as with gastric bypass.

I know it's easier said than done, but just cutting back on desserts or maybe simply eating a bit less off plates daily and choosing lower fat meats and less simple carbs (whole grains instead) or not drinking soda or juice but just water...will help eventually...since with gastric bypass weight loss will essentially come from exactly that...less caloric intake since people will be forced to eat less.

So if eating less leads to weight loss with gp..then it will also work if done w/o the surgery.Of course, it's hard to do for many people.

But I've known people who were very overweight and lost it with a healthy diet and exercise. No need for deprivation, or starvation just different choices in eating..and to be done for life...not just for a time period where it's thought of as a 'diet'. This is why most diets fail even in people who are not obese and just want to lose a few lbs.

adidas99 · Nov 10, 2005

Alichael,

I have known someone close to me go thru gastric bypass. It is my "second mom"(what my best friend and i call each other's moms). She had tried dieting, exercising, and just couldn't get the weight off. Also, was causing achig in her knees. Worked out well when she had it done, because her daughter was getting married that next yr. She had it done about 2 yrs ago, and is doing fairly well. However, right after surgery she was miserable with the NG tube down her, and in severe pain(but i think nina just has poor pain tolerance anyway) Her only set back has been scar tissue causing intestinal blockage a few months later, so she had that fixed. She's lost a total of 100 some pounds. She'd been about 200 some pounds.

I wish you luck with your decision!

**RosesrReder, BSN, MSN, RN** · Nov 10, 2005

I vote for no surgery. I know to well how difficult it is to be obese. I too tried everything out there to lose weight and no success. Well this what made me comfortable in saying. I decided to lose try the weightloss battle one more time and I by eating right and excercise and over 140 lbs lighter, here I am today.

My point is that it is too risky, and I truly believe anyone can lose the weight without the surgery. I too suffer from PCOS, and it made no difference in my weightloss.

Hope you find a solution soon.

Jess

mistoff · Nov 10, 2005

I had RNY gastric bypass in November 2001. I was one of the smaller people the surgeon did at 5'8 & 350lbs. I lost 155lbs. I did end up in the OR again on day 2 for wound dehisence but it was the best thing I ever did in my life and I would do it again.

5 other staff at our facility had it done also. The only unsuccessful person was someone who chose to go to a non-bariatric certified physician because she could get in sooner. Right from the beginning, she was overeating

Go to

http://www.obesityhelp.com

From there, you can chat with others contimplating surgery, check out different procedures, surgeons, and facilities and find out if your insurance company covers the procedures.

HOpe that helps.

jen

adidas99 · Nov 10, 2005

.....

Wicket16 · Aug 12, 2006

What about this new procedure..lap-band surgery. They say it's less invasive and has less recovery time. Any input on this? Thanks!!

MiaNJ · Aug 12, 2006

What about this new procedure..lap-band surgery. They say it's less invasive and has less recovery time. Any input on this? Thanks!!

There are downsides to that too, since the band can stretch with too much food. My friend's mom had that done, and she lost some weight initially but now she's gaining some back. Plus,the skin on her arms/legs sagged alot and now needs body work. So it's not a perfect cure either. The bottom line is that with any kind of gastric surgery, people still need to change their way of eating, and still be able to resist temptation, because it's possible to eat thru the bands or even staples. My friend's mom ate whenever the food went down and felt less full, then she would eat again. Even though she didn't stretch out the band, she gained weight because she cheated the system..kept eating as soon as the stomach didn't feel full again.

So counseling or support groups, plus working out is still recommended.

Also the band is not for everyone, i think people have to be less than 50 and not be allergic to certain things.

Here's some info:

http://health.learninginfo.org/bariatric-surgery-procedures.htm

Mermaid4 · Nov 16, 2006

This whole thing is scary and difficult.....I mean, the thought of what to do when contemplating one way or the other. It is such a personal thing.....I don't see it as a quick fix but I can see how some people would...Good points all around...