Weight loss surgery changes lives

By madisone, Unfiltered 3-07-05

Two and a half years ago, Pam Jean was ashamed of herself.
“I really believed that the only thing anybody saw when they looked at me was a fat person,� she said.
She was morbidly obese, weighing 346 pounds.
In May 2002, she had Roux-en-Y gastric bypass surgery at St. Patrick Hospital in Missoula.
Since then Jean, who is a registered nurse and the bariatric program coordinator at St. Patrick Hospital, has lost 210 pounds, currently weighing 136 pounds.
The procedure changed her life.
“Now I feel 20 years younger,� Jean said. “I can garden, I can play with my grandkids, I can go bowling.�
When she was obese she avoided doing things like that.
“I put up so many road blocks that I blocked myself from doing so much,� Jean said.
Jean was 46 years old when she had the surgery. She was suffering from hypertension, an irregular heartbeat, chronic tendonitis in her feet, and sore hips, knees and ankles.
Jean’s decision to have the surgery came when it hit her that she was actually very sick.
“You get very, very aware that you’re not going to live long,� she said.
Jean wasn’t sure she’d live another five years.
After the surgery all of Jean’s health problems went away. The only medicine she takes today is an antidepressant, which she took before the surgery, and vitamin supplements.
“I now have a future,� Jean said. “I now have hope.�
St. Patrick Hospital has offered gastric bypass surgery for four years, but last spring it began laparoscopic bypass surgery.
The laparoscopic surgery is much less invasive, said Dr. Charles Swannack, one of the two surgeons that perform the surgery.
There are four different gastric surgery options. However, only one version, Roux-en-Y gastric bypass, is offered at St. Patrick Hospital.
The surgery consists of making a small pouch, about the size of a shot glass, in the stomach to restrict food intake. Then, a Y-shaped section of the small intestine is attached to the pouch, forcing food to bypass the lower stomach and the upper part of the small intestine. This bypass lowers calorie intake.
Before the hospital began doing laparoscopic surgery, all the bypass surgeries were done with a large incision through the abdomen.
“With laparoscopic, you have small incisions about the size of your finger,� Swannack said.
In laparoscopic surgery, a small viewing devise is inserted into the incisions and hooked up to a monitor, which allows the surgeon to see what he’s doing.
Laparoscopic surgery usually decreases the hospital stay to two nights, rather than three for open surgery. It also decreases the normal recovery time for the surgery. In addition, there is a reduced risk of hernia.
One advantage to open surgery, however, is that the surgeon can feel what he’s doing, Swannack said.
So far, eight laparoscopic gastric bypass surgeries have been done at St. Pat’s.
An open Roux-en-Y surgery normally takes two to two and a half hours, whereas the laparoscopic version takes about four hours.
Swannack predicts the laparoscopic surgeries will take less time as they do more of them.
“We’re being really, really careful to make sure we’re doing an excellent job,� he said.
Swannack trained for the procedure at the Montefiore Hospital in New York, the affiliated hospital for the Albert Einstein School of Medicine, working with a surgeon who has preformed more than 800 of the laparoscopic surgeries.
Dr. Brad Pickhardt, the other surgeon performing the procedures at St. Patrick Hospital, trained at the Cleveland Clinic Hospital in Florida with a surgeon who has done more than 1,300 of the procedures.
Gastrointestinal surgery is the best option for people who are severely obese and cannot loose weight through traditional means or who suffer from serious obesity-related health problems, according to the National Institutes of Health.
Many gastric bypass surgery patients maintain a long-term weight loss of about 100 pounds, the NIH says.
The surgery also improves most obesity-related conditions such as diabetes, sleep apnea or heart disease.
“It’s just incredible how much this improves those problems,� Swannack said.
This surgery is not considered cosmetic surgery.
“We are doing this, not so people can be real cute, we’re doing this so people can get better,� Jean said.
There are risks involved as well. The NIH says 10 to 20 percent of patients who have weight-loss surgery require follow-up operations to correct complications.
There is also an increased risk of developing gallstones due to the rapid weight loss.
Nutritional deficiencies can also be a problem following the surgery. Nearly 30 percent of patients develop nutritional deficiencies such as anemia, osteoporosis and metabolic bone disease, according to the NIH.
Swannack says nutrition problems can be avoided with vitamin supplements, but these must be taken for the rest of the patient’s life.
St. Patrick Hospital has done more than 370 gastric bypass surgeries. Of those, one person was hospitalized for three months, about four people developed leaks, and one person died from a blood clot after returning home from the hospital, Jean said.
“The surgery works really well, but it is a tool,� Swannack said. “It’s not magic.�
Post-surgical care includes diet and exercise. Patients are supposed to go in for yearly follow up appointments for the rest of their lives. They are also required to attend a support group and take nutritional supplements.
Sheila Hewitt of Missoula had the surgery last May.
She weighed 337 pounds before the surgery and has lost 107 pounds since.
She was suffering from diabetes, high cholesterol and sleep apnea. All of those things have gone away since the surgery, she said.
Getting healthy is a nice feeling, Hewitt said.
“It’s really hard to describe being that big and only 107 pounds later going to get fire wood and doing the things I haven’t done for 20 years,� she said.
The surgery does, however, require you to make dramatic changes in your lifestyle, Hewitt said.
“You have to learn to make a total change and exercise,� she said.

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