gastric bypass/stomach stapling ??

Nurses General Nursing

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I have a good friend who is seriously considering having this surgery done. I have never taken care of pts who've had this procedure and don't know anyone who has.

This really scares me because of the things I've read about it, as far as SE. blood loss, etc.

My friend is a copd pt, on home 02/2l, still smokes some, iddm, overweight and on prednisone,-- the whole works. She said the surg told her they would be rerouting the bowel to the stomach,--what is this??

Also her pulmonoligist wants to be in the OR while she is having the procedure.

Could y'all please give me some info from actual cases you've seen and cared for, as well as how these pt's do 6mo to a yr down the road.

I knew someone that had it done, years later, she gained it all back.........then again it is all about lifestyle, and obviously she didn't change a thing!

Hello! I am the friend that rjlRN was talking about. I found out that the surgeon wants to it laproscopically. (sp). I think this would be the best for me, my lungs, my heart, and the bleeding issues. Less time "out of it", less wounds to heal. My intent is to get rid of the Insulin, HTN meds, O2 24/day by there being less pressure on my lungs. One thing I had to learn as a lunger, is that too much food, pushes on the diaghram and make it more difficult to breath. I am an unhealthy mess currently. I am ready to have the surgery. I still have to do my homework and find out how many of these procedures she has done to date. May be scary being #1 or #2, but I believe I would do it. Is it me, or are there alot of TV commercials now for the Bariatric surgery? I would appreciate any and all input I can get. My doctor gave me a list of support groups and times. Thanks again, and Take Care

I don't mean to be a downer, but you sound like a very poor surgical risk to me. Just because you may have the procedure done laparscopically, does not mean it is less risky. In fact a laparscopic procedure can take longer than an open procedure because the surgeon is working in a tighter area. You probably will be under anesthesia just as long or longer. Sometimes, for one reason or another, it is impossible to do the procedure laparscopically(adhesions from previous surgery, etc) and they end up doing an open procedure. There is also just as great, it not greater risk of bleeding due the surgeon working in a more confined space. And you will have pain even though you don't have the big incision down the middle of your belly. It is my understanding that this surgery is best done before one becomes an unhealthy mess, as you describe yourself. The healthier one is going in to surgery, the less risk there is of complications. I am surprised that a surgeon would even consider operating on someone in your state of health. Have you tried alternative measures to lose weight? Your surgeon needs to thorougly explain all of risks and complications and I would certainly make sure that the surgeon is well experienced in bariatric surgery. I hope your surgeon isn't encouraging this just because she wants to do one. Another thing, the surgery is not a magic bullet. Yes, you do lose weight, but if you don't make some life style changes with it, you probably will eventually gain it back. I used to work for a surgeon who did these procedures and I have seen it happen all too often. I know I don't sound to optimistic about your situation, but I've seen a lot of patients go through this procedure and most of them get along very well in the immediate postop period, but then again they don't have the medical problems that you have. In fact, the surgeons I know would not even consider you as a surgical candidate. Anyway, I'm just telling you what I know from my experience. Whatever you decide, I wish you well.

I thank you for your honesty. I am still doing the homework thing. I want to do what is safe for myself. The vent scares me more than anything. I think the docs consider me a "train wreck". Your point about whether the Surgeon just wants to do another procedure, was a very good one. She is listed under Obesity/Help.com. I really need your input on this. I have only been investigating this a couple of months, as well as calls to the docs.

I have since found out that I will be the surgeon's first candidate for laproscopic surgery. She said I am a perfect candidate because I am obese, but do not have alot of belly fat. She said that alot of belly fat makes it harder to go in. There will be 6 incisions, and I will feel the same as if I had been opened up. I will also give permission to be "cut open" as usual if for some reason the lap does not go as planned. There will be less chance of wound infection. She did not say what percentage was less. Recovery will be easier, with most patients returning to light excerise within 2 weeks post-op. Any comments would be appreciated.

Specializes in Vents, Telemetry, Home Care, Home infusion.

JP:

Seek a different physician. With your breathing problems, you do not want to be her first patient. You need someone experienced who can handle complications that may occur. How long has this surgeon been practicing and where did they get trained?? Does the hospital staff have any experience in caring for patients after this surgery would be my other concern. Unless in a teaching/academic hospital I'd be very leary of a new doc. Trust your gut in making this decision.

Hi Karen, She is not a new Doc, nor new to Gastric Stapling. She is new to the lap procedure. She just returned from Dallas, where she learned the technique. My Pulmo Doc will be with me when the procedure is done. My Cardiologist has also given the go ahead. She has hoped to start offering the procedures the first week of March. I was wondering if I should postpone for a month or so as NOT to be the first. Should I be as nervous as I am?

UPDATE - My surgery was March 6. It turned out that I was the docs 2nd lap patient. All went well. I had a small infection in the "main" portal where the bowel is brought out, 1/5 th removed and then reinserted. Kinda the "butthole" during the surgery. I am now 11 weeks post op, and I have lost 61 lbs. No oxygen. Went from over 100 u of insulin a day to 22. Had a few problems week 2 - 3 postop with dehydration. No longer a problem. I believe in the counseling for "emotional" eaters. Food is no longer my friend. I suddenly realized that food is to give your body the energy it needs to do what it has to do. Too bad I had to be nearly 50 before that sunk in. :-) Just wanted to give you an update and the results I have experienced. But if we bariatric folks over eat, even a tiny bit, we throw up. PERIOD. Hard to get used to that. I would do it all over again. Take care! JP

I have been researching this since March 2001, so I know a lot about the gastric bypass. The only reason I have not had surgery yet is due to my insurance. First surgeon was out of network, 2nd surgeon decided to "resign", and now the 3rd surgeon has just dropped my insurance. I'm sticking with the 3rd surgeons as they are the best in Dallas. They prefer the lap procedure and patients are discharged within 24-36 hours after surgery as long as there are no complications...which they rarely have. (This is why I want my medical records)

I will try again after open enrollment and hope for a speedy approval. I have watched several people, that I met through support group meetings, lose a lot of weight and they look fantastic. Even the few that have had complications say they would do it again. When it comes to anything as serious as the gastric bypass KNOWLEDGE IS POWER!!!!

Specializes in RETIRED Cath Lab/Cardiology/Radiology.
:p Good for you, doing research, asking questions, persevering, -- hanging on and hanging in! Let us know how things go when you have it (after open enrollment). My brother-in-law had it two years ago and did very well, I honestly haven't done much research on it, only have his experience to go by. He had a tummy tuck this year, to reduce the remaining flab (called himself "Squishy Man" after he'd lost all the weight - about 100lb - and was left with all the loose skin.) in front -- something to consider in the future, depending on how your experience compares w/his. Best to you, and COURAGE! --- Diana

Thanks dianah. Trust me, when I get approved, everyone and their God will know. My older sister and her daughter had it done a few years ago...they live in Pgh, Pa...of course, I didn't know what she did until she'd been post-op for over a year. The list is a mile long of the things I can't wait to do.

Actually, wls was part of my inspiration in becoming a nurse...I wanted to help future bariatric patients. Bariatrics or L & D is where I hope to be. I hope by the time I graduate I am post-op. I find that I am looked over for jobs because of my weight, and I really do not want that to happen after I graduate. Some people may disagree with my observation, but this is what I have observed in my area.

The hospital I chose is opening an Obesity Center at the end of summer. The program they have is really awesome.

my mother had bariatric surgery last year, but she had a procedure called a "duodenal switch" there is a website http://www.duodenalswitch.com that is very informative. For my mom, this was the greatest thing. She lost over 100 lbs. in a year, & is no longer diabetic or hypertensive.

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