Thursday, October 04, 2018

Another gastric bypass disaster

On TV, this AM, on a unrelated to WLS show, I encountered the case of a weight loss surgery patient, who, like many people fighting weight issues, had yo yo dieted from the age of 7 when he suffered severe emotional trauma.  As a young man, when he was a sales rep,  he heard of the lap band before it got FDA approval.  He went down to Mexico to have a lap band procedure, and had good weight loss results but four years later, he found himself in excruciating pain. His band had eroded into his stomach. He was ex-banded and gained some weight back.  So after he and his wife, had a child, he had a gastric bypass, but shortly after the procedure, he got scar tissue growing into his digestive organs and was found, on the floor, bleeding.  He also suffered ulcers and septicemia, in addition to losing some of his small bowel (probably after a gastric bypass reversal).  He spent 400 days in the hospital, and ICU.  He coded twice going into full congestive heart failure, and was in a coma and on a respirator.  He feels the gastric bypass (and all the complications) was a reason why his marriage failed. (50% of marriages break up after weight loss surgery.)  He sought weight loss surgery, he said, because he thought surgery was easy. Now, he is engaged again to someone connected with a very skilled plastic surgeon. He likely, was seeking plastic surgery to fix the issues with his scar as the multiple abdominal surgeries had left a hole in his abdomin.  Bottom line, although many surgeons are no longer doing the gastric bypass, there are still several doing it when, in truth, even under the best circumstances, it can be life shortening and more.  Education is our best weapon.  "There is no short cut to a place worth going!"

Thursday, September 21, 2017

Another study on gastric bypass

Every so often, a new study comes out, presumably "proving" how effective the gastric bypass is.  That's because this surgery is a huge cash cow for the medical field and less and less folks are having it - because of the post op, high complication and death rate (never mentioned in the studies of course). And because at the end of the day, it's not even very effective for weight loss.

This study which appeared in NEJM, was similar to the others.  Sounds very impressive - it was a 12 year observational study they tell us - as the surgery was shown as slightly effective for weight loss and very effective for diabetics.  Let's remember that patients are told if they don't diet and exercise, they won't lose any weight even after an invasive surgery like the gastric bypass but of course, diet and exercise work well without risking one's life to have a gastric bypass, thus the first thing they slip by us, is not distinguishing those who dieted and exercised (which would have caused a weight loss without surgery) from those who didn't.  

If we break down the study, you will see, it's not what it seems to be.  Here's a money quote:

In the study by Adams et al., despite a wide variation in change in body weight across the sample, 360 of 387 patients (93%) in the surgery group maintained at least a 10% weight loss from baseline to year 12, 271 (70%) maintained at least a 20% weight loss, and 155 (40%) maintained at least a 30% weight loss. Only 4 of 387 patients (1%) in the surgery group had regained all their postsurgical weight loss. 

First of all, a 10% weight loss on a 300 lb person is only 30 lbs. But secondly, of course, the high death rate for this surgery (5% in the first month after surgery) is not counted and also even a 30% weight loss is not very impressive. Also, the gastric bypass, more often than not, causes malnutrition which can cause weight loss. (The important parts of the digestive tract are severely undermined or bypassed)  To be fair, they should eliminate all members of the cohort who are suffering from hypoglycemia or malnutrition but of course, they never do that.  

For diabetes, it looks even more impressive:

In the surgery group followed by Adams et al., remission of type 2 diabetes was observed in 66 of 88 patients (75%) at 2 years, in 54 of 87 patients (62%) at 6 years, and in 43 of 84 patients (51%) at 12 years. Of the 62 patients in the surgery group who had initial remission at 2 years and had 12-year follow-up data, 69% remained free of type 2 diabetes at 12 years. Successful remission of type 2 diabetes was strongly predicted by baseline medication status.

But let's look at how they pick the cohort (study participants). Usually, they pick folks who are - what is called - pre diabetic. Which means they don't have diabetes yet, and if and when they come down with diabetes, it's several years before it gets really bad.  Additionally, malnutrition after the gastric bypass helps with this aspect too.  It's well known that starvation or semi starvation will cause diabetes, especially early diabetes, to go into remission.  Bottom line, starvation or semi starvation with a non mutilated digestive tract is safer than that caused by a mutilated digestive tract and causes a better weight loss than invasive outdated surgery.

The study was funded by the diabetes assn and it's a known fact that the funding does influence the results of the study. 

In other words, it's the same old trick - the hope that the public will believe this, rather than do research or question, and rush out to buy the surgery. Because the bottom line is, although they should not even DO this outdated, risky and not real effective surgery anymore, it's a big cash cow.  Buyer beware, especially in a "for profit" medical provider setup.

Tuesday, August 22, 2017

Gastric balloon update and lawsuit

Did you have a gastric balloon weight loss procedure???

The Food and Drug Administration (FDA) issued a safety alert concerning gastric balloon systems after there were five "unanticipated deaths" from 2016 to the present that occurred in patients who had liquid-filled intragastric balloon systems inserted.

Gastric balloon procedures are considered "minimally invasive" FDA approved procedures that are used for treating obesity because the device is inserted through the mouth and requires no surgical incision.  But of course, it's still invasive. All the reported deaths occurred within a month of the procedure but apparently, many other people suffered serious complications from these devices.

Overview: Gastric Balloon Deaths Lead to FDA Warning

Gastric balloons, also called intragastric balloons or weight loss balloons, were approved by the FDA in 2015. There are currently two gastric balloons on the market: the Orbera Intragastric Balloon System by Apollo Endo Surgery, approved in August 2015 and the ReShape Integrated Dual Balloon System made by ReShape Medical, approved in July 2015.

Four of the reported deaths were of patients who had the Orbera weight loss balloon implanted and the fifth death was a patient who had the ReShape gastric balloon. All of the deaths took place within a month of when the gastric balloons were implanted. Three of the deaths took place within one to three days of implantation.

The FDA says that it does not yet know if the deaths were caused by the devices themselves or were caused by the insertion procedure when the intragastric balloons were implanted.

There were two additional deaths reported during the same time period that the federal agency says may also be linked to gastric balloon complications. One death was caused by a gastric perforation in a patient that had the Orbera Intragastric Balloon System, and the other death was caused by esophageal perforation in a patient who had the ReShape Integrated Dual Balloon System implanted.

How Gastric Balloons Work

Intragastric balloons are one of the many gastric procedures that exist to treat obesity. In some cases, patients with type-2 diabetes were able to reverse their disease after a gastric procedure, but only immediately after the procedures. Studies of patients several years after surgery found most diabetics were no longer, diabetes free. Many gastric procedures, such as a gastric bypass, are considered invasive surgical procedures and are not done as often as before because of the high complication and death rate in follow up studies.

Intragastric balloons are implanted without the need for a surgical incision therefore were sold as a "non surgical procedure". They were implanted via a scope down the esophagus through the mouth.  Once in the stomach, they are filled with fluid and are left in the stomach for 6 months.

The Orbera gastric balloon system uses one balloon. The ReShape system uses two.

Through this procedure, patients typically lose a third of their weight in 6 months.

Gastric Balloon Side Effects & Complications

Gastric balloon systems were advertised as having fewer risks than traditional bariatric surgery but this may be misleading as the balloons can cause several nasty complications and in fact, the FDA recently issued a warning because five deaths were connected to the gastric balloon.

The FDA first issued a safety report in February 2017 concerning gastric balloons after receiving "multiple reports" of two different serious complications linked to the weight loss procedure:

1. Spontaneous over-inflation: The federal agency said that several dozen patients have suffered from over-inflation problems, leading them to need to have the device to be removed prematurely. Symptoms of over-inflation include: abdominal pain, swelling/distention of the abdomen, breathing difficulty, and vomiting. In some cases, over-inflation has occurred nine days after the procedure. This complication occurred mostly in patients with the Orbera weight loss balloon system, but it has also occurred in patients with the ReShape system. At the time this alert was posted, the FDA said that over-inflation was not listed on the current warning label for the devices and that ER personnel and other healthcare professionals may not be aware of the problem.

2. Acute Pancreatitis: Both the Orbera and ReShape weight loss balloons have been linked to acute pancreatitis. The FDA says that this side effect has been caused by "the compression of gastrointestinal structures created by the implanted balloon(s)." In all of the patients who suffered from acute pancreatitis, the devices had to be removed prematurely, and in a handful of cases, the patients had to be hospitalized. This gastric balloon side effect occurred in some patients within days of having the device implanted. Symptoms include: severe abdominal and back pain. Acute pancreatitis is also not listed as a possible complication of gastric balloon devices, which means medical professionals may not be aware of it, leading to inappropriate or delayed treatment.

Gastric Balloon Class Action Lawsuit

If you or a loved one has suffered from complications following a gastric balloon procedure, you may be entitled to compensation. Learn more by filling out the form on this page or calling 1-(855)-JONES-LAW (1-855-566-3752) for a free case evaluation. 


Friday, August 11, 2017

Five people die after having gastric balloon (for weight loss) inserted

The idea of inserting a balloon in the stomach, and somehow inflating it to supposedly kill the appetite, is not new. It was first introduced as the state of the art, non invasive obesity treatment years ago but, I know patients who found the gastric bypass to be a lot kinder to live with than the gastric balloon and the bypass is not at all, easy to live with. But the earlier bad experiences with it which some describe as a nightmare, did not stop the providers from re-introducing the gastric balloon, a year or two ago.

Different this time, however, is the FDA put out a safety alert about it because five people have died after the insertion of the gastric balloon.  I know I've written about this before, telling folks to run the other way.  Hopefully, the word will finally get out that this procedure causes all kinds of problems in the stomach.

Reported on CNN

Three died one to three days after the balloon placement. The remaining two deaths could be related to "potential complications associated with balloon treatment," -- one was a stomach perforation and the other was a perforation in the esophagus, according to the FDA.
History repeats!

All the weight loss surgery procedures, assume that by mutilating or somehow disabling the stomach, the person will not have an appetite and people keep jumping on the operating table with all hopes of being "normal".

As Dr Livingston and others warned --- after weight loss surgery you are NOT normal, EVER, and people should keep in mind that the appetite centers are in the brain which is why, if the patient doesn't do the work - diet and exercise - which of course works fine without surgery, any weight loss surgery does not "work".

Friday, June 02, 2017

My 600 lb Life - Laura

This week's, "My 600 lb Life - Where are they Now" featured a lady who lost most of her weight and ended up in the 180's after skin removal surgeries.

Interesting to note was the massive loss and new style of eating, took its toll on her relationship.  Sadly it was a "common law" marriage i.e. they were living together as husband and wife but not legally married (common law marriages are no longer acknowledged as legally binding in most states).

And one might ask "why".  There are hints in the show. First of all, the husband has Multiple Sclerosis, a serious neurological illness which only a few years before TV checked in on the couple, paralyzed him at one point.  The show said Laura had "nursed him" back to health but he obviously was disabled to the point of not being able to work - always a strain on the marriage to begin with.

Second, Laura was very addicted to food and had used food all of her life to "feel better" in the presence of adversity and certainly, having the burden of supporting the couple and other stresses she alluded to (probably connected with her partner), were difficult for her to deal with, without the help of the food which had helped her in the past.  Her weight loss had come to an standstill, so the good doc revised her gastric sleeve to a gastric bypass, which, of course, zapped her strength because of the non digestion of nutrients (we need some 100 micro-nutrients a day and that's in addition to macro-nutrients, most of which cannot be digested by gastric bypass patients since the very important digestive organ, the duodenum, the first several feet of small bowel, is bypassed in this surgery.)

Less than 25% of surgeons still do the bypass because of not only, the short term repercussions, but long term ones as well.  The inventor of the gastric bypass, stopped doing them in the early 90's, pointing out the numerous issues with this surgery.  But of course, the 72 year old doctor "Now" on "My 600 lb Life" is likely not up with the current science and doesn't realize that people who get pretty sick (as Laura DID after her bypass  - she suffered a lot of nausea and most things she ate didn't stay down), may need a takedown immediately.  I'm sure that she felt badly did not help her patience with her husband.

The show put out a note that 85% of bariatric patients end up divorcing their spouses.

Let's hope Laura gets herself to a doctor who is more up with the science of digestion and realizes she badly needs a takedown NOW.

Sunday, April 09, 2017

The Dark Side of the Gastric Sleeve

There are apparently several famous people who got gastric sleeve or sleeve gastrectomy. It looks good. It's not a gastric bypass, so other than undermining protein and fat digestion in the stomach (some surgeons remove 90% of the stomach and put delicately, "send it to pathology"... in other words, discard it), the duodenum which is one of the main digestive organs is left in tact and after all, sleeve gastrectomy is or seems a less risky surgery than gastric bypass et al.

But the gastric sleeve appears to have a darker side. The stomach which is now, about as big as your thumb and twice as long as your thumb, doesn't hold much of anything...for example, patients describe difficulty in drinking liquids and some have observed brown urine from dehydration etc.

Mama June Shannon, mother of the cute little girl who starred on "Here Comes Honey Boo Boo" TV Show, was quite overweight although likely not, the 450 lbs she claimed, had the gastric sleeve.

She said it was an, a lot more painful process than she expected as she also had a couple of skin removal surgeries but on tonight's show, "Mama June, From Not to Hot", she was able to strut her stuff at her ex hubby's "Sugar Bear's" wedding. June was never married to Sugar Bear as she was likely still married to the father of one of her other kids but they made a commitment ceremony last season on Honey Boo Boo's show.

On tonight's show, Mama June, apparently healed from her multiple surgeries, thin and blond, went to her ex's wedding and after, had a fun burning of her old large clothing.  Since June and her daughters have moved into a new rather nice home (TV pays well!), she and friends went out to the middle of the woods for the burning ceremony. However, when she went back home afterward, she suddenly, got very sick. They rushed her to the ER, complaining of severe abdominal pain.  She lived and they promise that next week's show, will feature the entire story of what happened to her. She was in enough pain that she couldn't stand up.

One thing I've seen happen with the sleeve, is a staple line leakage. A patient I know, had to go through multiple surgeries to fix that and included in the dark side of the sleeve, is the fact that unlike the gastric bypass, there is no way to reverse it.

Bottom line, none of these surgeries are really effective because we now know the appetite centers are in the brain...thus surgery or no surgery, we can only lose weight and keep it off by reconfiguring our thinking processes and living in a jungle of high fat, high calorie food, this is never an easy process.  Even Dr Now of the TV show, "My 600 lb Life", admits that surgery is only effective IF the patient diets and exercises...which is, of course, effective without surgery.

So why do they still do weight loss surgery? Because it's a cash cow. The average weight loss surgery surgeon makes $1.5 million bucks a year. People have done strange things for much less than that!

I felt bad for Mama June...she was a happy, reasonably healthy, overweight person and now, she has all sorts of issues with her mutilated digestive tract. 

It's a vicious circle. Providers generally don't follow post ops and complications from all surgeries, are handled by emergency medicine. Overweight people, desperate to lose weight, tend to not do the research they should do, relying on their providers to inform them but without following up on post ops, the providers may not know much more of the long term repercussions than do the patients.

Buyer, very careful in surgically removing or mutilating the stomach.  That our digestive systems work, wasn't the reason we gained weight and disabling it, is likely to cause more problems than we bargained for.

Thursday, March 23, 2017

Higher rate heart attack and suicide after gastric bypass

In the gastric bypass, the stomach is very compromised and the duodenum, a vital part of digestion, is bypassed.  This is why it causes nutritional deficiencies in most patients.

Yesterday's broadcast "My 600 lb life", was unsettling, especially in my watching it for the second time.  I'm assuming because the patient died from heart disease, soon after they had stopped following him, they haven't shown this episode much because of the possible negative effects on the audience of prospective surgical patients.

What was interesting to me is that he apparently, had heart disease before surgery because during his excess skin removal surgery, he suffered a total cardiac arrest.  "I actually died on the table," the patient tells the camera, but they were able to resuscitate him.

He called his resuscitation, a miracle but a year or two after these procedures, he had a heart attack while driving a school bus and crashed the school bus.  He was D.O.A. when he got to the hospital. We weren't told how many kids were injured but since he'd had a heart attack a year or two earlier, while driving a shuttle bus, one questions why he was again driving and then, a school bus.  One of many questions with this case.

One question that arises was - was this person who obviously already had heart disease, really a good candidate for a procedure like the gastric bypass which tends to raise the risk of heart disease? 

A study published in the "Archives of Surgery" in 2007, found that gastric bypass actually increased the risk of both heart attack and suicide in post ops.  The study examined the records of 16,683 weight loss surgeries among Pennsylvania residents.  They found a substantial number of excess deaths attributed to both heart disease and suicide.  As post surgery time increased, the researchers continued, so did the death rates with heart disease topping the list.  The bariatric industry basically ignored the study, pointing out that these ailments are higher among the obese anyway.

The Dr on TV requires prospective patients to lose 50 to 100 lbs before surgery which they all diligently do, pointing out that diet and exercise are needed to continue weight loss after surgery, but of course, diet and exercise also work well to effect a weight loss without surgery and often, the patient, anxious for the surgery, loses weight at a faster rate before surgery, than after.

When the gastric bypass was promulgated in the 1960's, it was thought that the stomach controls appetite and thus, mutilating this vital digestive organ, would help the person to control their overeating.

They didn't realize then, that the stomach, although a key player in the digestion of proteins, fats and vitamin B12, does NOT control the appetite centers which we now know, are located in the brain.  Moderns who have the gastric bypass are disappointed that their cravings (which originate in the brain) have not been affected by the surgery.

Interestingly, if we look at the repercussions of the gastric bypass more closely, we see that although the weight loss effects are temporary (according to TV bariatric surgeon, Dr Nowzaradan), the complications not only last much longer but increase in the years after surgery.

Happily, less and less surgeons are doing gastric bypass - hopefully, we will see the end of this invasive but not that effective procedure in the near future.

One doctor told his patients to diet and exercise before surgery and then, when they'd had a substantial weight loss, he told them "Now, go home and continue what you are doing!  You don't need surgery!"