gastric bypass/stomach stapling ??

Ted · May 28, 2002

Amy, my wife, and I just got back from a "dinner date". Of course she didn't finish her dinner. Had to "doggie bag" the rest. She plans on at least having 2 to 3 meals with tonight's leftover.

My wife is turning into a cheap date!! :chuckle

Just had to share!

Ted

NurseDennie, BSN, RN · May 29, 2002

I've been thinking about this, sort of in general. I'd checked with my insurance co. and the only "treatment" they will cover for weight loss is the surgery. I was trying to see if I could get my daughter into a weight-loss program supervised by a doc with menu planning and exercise, etc. I can FIND them, but they're expensive!!

Anyway, as I am *definitely* fighting a weight problem, and my previously-successful regieme is NOT working now, I have been interested in this. I have been afraid that I would sabotage the effects of the surgery by over-eating because of a psychological need. I like big bites, you know?

Anyway, they say that you can only eat a couple of ounces at a time, and should have several meals a day. I've been doing that for a bit now, and sure enough the psychological part of it is the smallest problem for me right now. I'm HUNGRY!

So Maybe that surgery would work for me!! I don't know - if the physical hunger was gone, perhaps then I'd be fantasizing about sweets and larger portions because of the psych component. I don't know.

Love

Dennie

JPRosselle · May 29, 2002

Dennie, I seldom feel hungry, but feel the need to eat, only because it has been a while since I ate last, etc. As I think I may have said before, if you do eat more than will "fit", you just throw up. Ted mentioned that his wife would be uncomfortable. I only feel uncomfortable just prior to losing my meal, snack, etc. Because I take insulin, I have to wait until I have eaten to take my insulin. Otherwise, I may loose my meal and then be in trouble. I can not tolerate oils, grease mostly just fried foods. I also have lots of doggie bags from going out to eat. We are instructed to chew 20 - 30 times per bite, because 1/5 th of the small intestine is removed during surgery. It gives less time to absorb the fat. I have started getting concerned about not eating enough so I am currently writing down everything I eat during a day to take to the surgeon appt. 6/6 will be 3 mo post-op for me and I will then get my blood chemistry checked. I have lost 61 lbs in 11 weeks, so I am concerned that "chemically" I am where I should be.

There are different surgery procedures, so if you don't "qualify" for one, possibly another would work for you. I personally had the RNY - lap. I know this surgery is NOT for everyone, but for those that can have it, it can be a miracle. I was told that with my heart and lungs in the condition they were in, I didn't have long to live.

nursejws · May 29, 2002

Good evening all, I just returned from a support group meeting. All the fears anyone has, that are considering this surgery, are normal. Before the meeting I went with my friend, who's post-op, to dinner...we shared a meal. We went to a chinese restaurant and ordered broccoli chicken...she took a few teaspoons of rice, about five slices of chicken, and a few pieces of broccoli. She also had about half a cup of egg drop soup. This was the first time we had gone to dinner together since her surgery, so I was amazed at her plate, but she was full, and took the leftovers home for tomorrow's lunch.

It is VERY important to have a support group going through this. The program I'm going to go through is building an obesity center, complete with psychologist, dieticians, plastic surgeons, and exercise programs. We even have online support with all Dr's involved online for questions we have out of the blue. Now you know why I say this program is bar none. I went to 2 surgeons before heading to Baylor.

Anyone considering have wls, whether it's the rny gastric bypass, or the gastric band, needs to realize surgery is just a tool. The rest is really up to you. Compared to how I feel now, exercising, eating right, taking vitamins everyday, having my hair fall out for about 3 month, and lifetime support is worth it. For ME, this is worth it. I quit smoking over a year ago because the surgeon said he wouldn't operate on a smoker. I did it in 30days, I also gave up diet coke at that time too. Occasionally I do have a diet dr. pepper, but usually decaf tea. I quit smoking just after my Dad passed away...that was hard, and although I planned on quitting by the end of 2001 ( I promised my Dad), I had another reason to let it go (the surgery)....it's the promise to my Dad I will remember as to why I quit smoking.

As far as exercise goes...this is Texas, so you will NOT find me outside walking around. You WILL find me doing water aerobics as soon as the pool is finished at my apt complex. I never felt better than I did when I was doing water aerobics 2-3 days a week.

To each his/her own, this is what works for me. Even my husband is waiting to have wls. Will it be easy...NO? Will it be worth it...YES! IMO

mattsmom81 · May 29, 2002

I think all of your stories are amazing and I applaud your efforts!

61 # in 11 weeks, JP! WOW! I'm sure your docs are following you closely with this fast a weight loss.

Good luck to everyone...keep us updated on your progress, OK?

Sundowner · Jun 5, 2002

I am so glad I found this thread!

I have been exploring this option for myself for quite some time now, but I just havent had the nerve to go for it. I am ready now.

I am 100lbs overweight, though I dont have any medical issues to speak of....or that I am aware of other than my knees arent doing well....I found this out when I joined a gym and couldnt handle it, my back aches as well, I lean against the wall when I pass meds, my cart is in front of me and I am leaning against the wall.......sad but true.

I am from the Pittsburgh area and from what I understand through speaking to a few that have had the surgery, there is quite a long wait to have it done...aparently everybody is doing it .

I also worry about the insurance nightmare. I have no idea if my insurance will cover this and I am wondering iif anyone can tell me how to go about finding out. I really dont want to get my hopes up and have them dashed.....it may kill me.

JPRosselle · Jun 5, 2002

Sundowner, You could call your insurance company yourself, or you could let the surgeon of your choice do it for you. The surgeons office is skilled on the lingo and such to make sure you are qualified. The response could take from 1 day to 1 year. I was one of the lucky ones. I was approved in less than 1 week. The surgeon's office will also go over the rules as far as the insurance goes, and they will go over everything (hopefully) you yourself will need. One of the best things you can do for yourself, is to research, research, research. A very good website complete with pictures is Obesity.com, they have chat rooms dedicated to this subject. They also have a "journey" so that you can read from start to finish what others have experienced. I had 100 lbs to lose as well. I have lost 61 since 3/6/02. I doubt I am the norm, but it gives you a snapshot of at least one life. Best of luck to you, and please keep this thread posted with our "journey".

JP

katiep · Jun 9, 2004

Hello, I am an RGN working in the independant sector in the UK. We have recently started to pre-operatively assess and admit patients who are to undergo 'lap-banding surgery' for BMI's of 35+. I would be really interested to hear from anybody who has experience either as a nurse or a patient, regarding the type of pre-operative counselling given and also the type of pre-op preparation given, e.g. barium swallow, endoscopy and so on.

Please get in touch,

thanking you in anticipation

Sundowner · Jun 10, 2004

Well....it has been two years since I posted last in this thread....and one year since I had the surgery! I did the rny. I have lost 110 pounds give or take a few and now wear a wonderful size five!!

My knees dont hurt....life is so good.

I still love food.....just not as much of it. I have had no complications or food aversions. It was a breeze thank God.

I made an appointment with a surgeon in August of 2002....he wasnt able to see me until March of 2003. This gave me time to nail things down with the insurance company. I had the help of my PCP which was wonderful. Couldnt have done it with out him.

As far as preoperative care....I know insurance companies have changed the rules a bit here in PA. It seems now that one must undergo six months of a doctor supervised diet before even being considered eligable. I luckily escaped that.

I was required to attend a seminar, which was full of information about what to expect before and after surgery. I also was required to have a psych evaluation. Was handed tons of information on post operative diet.

Pre-op testing consisted of upper GI series, ultrasound of gall bladder, and routine pre op testing...labs cxr ect. Of course there is a bowel prep before surgery :rolleyes: and another gi series after surgery to check for leaks.

I thankfully will not need any further surgery to rid myself of loose skin...I shrank nicely....I have no more flab than any other normal sized mother of three!

SCRN1 · Jun 10, 2004

First off, let me say that I am happy for those who've had this surgery and have had great success with it. I don't get to see those kinds of patients and I wish I could.

We get all the gastric bypass patients on our floor. Like I said, I don't get to see the ones who go off to enjoy life and do well with their surgery. I only see them while they're admitted to the floor when having it done...and worse, when they come back in due to complications. Even though our docs do this surgery the "safest" way and they have the highest rate of success than anywhere else around here, I still say this surgery scares me. I would NOT recommend it unless you're other conditions are at the point of killing you first.

Even though there are lots who have great success stories to tell, there is a percentage that's too high in my opinion who have major complications, including DEATH. I see so many who are back over and over with things like leaks, hernias, or constant nausea/vomiting (not from overeating).

Even though our docs do it laparscopically with about 5 puncture sites & one for the JP drain, it's not without it's risks. YOU STILL ARE HAVING THE SAME SURGERY DONE ON THE INSIDE NO MATTER WHAT IT LOOKS LIKE ON THE OUTSIDE. Of course, the incision site is quicker to heal if it's laparscopically. Just recently, we had a patient who ended up having to be "cut open" after her bypass because her spleen had been nipped during the surgery and she had to have a spleenectomy. This is just ONE of the MANY risks.

All these patients must go through a rigorous screening process.

- Must have a certain BMI.

- Must have been on certain diets & failed.

- Must go through a certain amount of psychological therapy.

- Must have a secondary condition to the obesity such as diabetes, arthritis in the knees, have to use CPAP or BiPAP at bedtime, etc.

I have seen lots of the returning patients depressed. Not only because of the current health problems, but also because they are mourning the loss of their previous lifestyle, which was centered around food. The stomach is reduced to 30 cc. (That is the size of the medicine cup that comes with a bottle of cough syrup for those who can't visualize how much that is.) Most of their families & friends are obese and they are continuing to live that lifestyle while the patient can't, but feel they have to see it.

I could go on & on, but I've already said more than I'd planned. To those who've had it done and are having success, again, I congratulate you!

Katnip, RN · Jun 10, 2004

We get the gastric bypasses on our floor as well. Our surgeons do them laproscopically, so there are 6-7 very small incisions. They all come up with a PCA for a day or two.

We rarely see complications. In the last 8 months I think I've seen 1 that required a stay of more than a few days.

We've had quite a few staff members get this surgery and the follow up is amazing. Of course, each person progresses differently, and some lose faster and more than others, but so far of the 10 who have had it this year, all have gotten rid of their sleep apnea, all are off diabetes and HTN meds. Quite a few are downright fit.

We HAVE had several patients from other hospitals who had bad results. Some of them have had 5 or more correctional surgeries, and finally got referred to our docs.

I firmly believe it depends on the surgeons. Interview more than one. Ask them about their personal records...how many of these surgeries have they done, how many moderate-severe complications occur per 100, how many deaths have they had? If they do a lot, don't expect zero deaths. If the surgeon seems evasive or tries to blow off the questions, find someone else.

adidas99 · Jun 10, 2004

My best friend's mom had gastric bypass done last june. she's tried diets and workign out, etc. And nothing worked, so they were able to get insurance to cover it. She did fairly well with it after surgery. Lisa and I went up there for it, and she was in alot of pain afterwards, and had an NG tube down her. But she does great now....she's lost a total of 90lbs! She has a card she carries in her purse that says she can have a childrens meal, because of this surgery(cuz we know some places are so dang anal about it) She does have her days where sometimes she doesn't feel good, and her stomach bothers her...as in nauseated, or things dont settle right, after she eats.