Saturday, March 14, 2015

UK teen wants gastric band but seems unaware of what she will face post surgery



A 238 lb UK teen is desperate (she writes) for a gastric band weight loss surgery because she says she's been taunted and bullied about her weight and she wants to "live a normal life" as a teenager which she apparently thinks she will be able to do after the weight loss surgery. Brook is 15 years old and says that she gained the weight eating junk food as a younger child and that her attempts at making healthy food choices have failed.

I have some concerns about this (and apparently the UK NHS has also because they have not yet, approved her for surgery).

First of all, if she gained the weight eating junk food, it's kind of a no brainer that junk food is the first thing she should give up and will have to give up if any sort of surgery or program is going to work.

Secondly, the comment that she thinks having a lap band will enable her to "live a normal life" kind of bothered me because it appears she doesn't have a concept of what weight loss surgery is and what it isn't. 

For example the release form for weight loss surgery used by several surgeons in our area includes the phrase, "you are NEVER NORMAL".

The reason her statement worries me is because the only chance she has of having success with weight loss surgery, is realizing that it is a big life change - a change in how and what she will eat and so forth. She may "look normal size" (if she abides strictly, by her surgeon's rules) but she will have restrictions and more for the rest of her life - for example, I have a hunch eating a piece of pizza with a lap band is next to impossible without the chance of it getting stuck on the way down (which is extremely painful for a couple of hours until it dissolves and/or the person is "scoped")

Pre ops should be shown exactly how life will be after surgery so that they are prepared for the fact that without dieting and exercise, their surgery will not be effective. Also, they should be made aware of the restrictions involved with any change to the digestive tract. 

As a weight loss surgery surgeon friend of mine says "Measure twice, eat once and vomit - never!" 

Friday, February 13, 2015

Big Push for Weight Loss surgery

Tom holds photo of his daughter who died shortly after her gastric bypass - parents of patients who die or become sick, suffer very much for years after

In case you haven't noticed, there has been a big push for Weight Loss surgery in the mass media.  A Fox News article announced that "diet and exercise may not be enough to lose weight" and goes on to state that the "only proven effective treatment for obesity in the long term, is surgery."  Proven?  Hardly.  While it's true that about 5% of dieters can keep off the weight, having surgery only increases that percentage by 2% i.e. 7% of bariatric patients can keep their weight off (Mayo Clinic study, Swedish Obesity study and several others).  Hardly worth reconfiguring the digestive tract in a very unnatural manner which will deny the person much of their digestive ability.

On TV, the old "Big Medicine" shows have been regurgitated under the title "My Weight is Killing Me".  This show, although more honest about how surgical patients have to diet and exercise after surgery (which works, by the way, without surgery), still portrays surgery as "the only way" for people who are clinically obese.

Another show, "My 600 lb life" produced by Dr Younan Nowzaradan, MD (a bariatric - weight loss surgery surgeon), portrays patients who are 600 - 700 lbs - all of them "need" surgery, of course, according to the show... and after they slim down with surgery to a "svelte" 400 or 500 lbs, their lives are supposedly saved.  The show seems to ignore that weights of 400 and 500 lbs are still considered clinically obese, only now after surgery, the patient is not digesting some 100 micro-nutrients (like zinc, etc) which we need on a daily basis to stay healthy.  Not withstanding the patient after a gastric bypass is also not digesting well, macronutrients like proteins and fats.

Interestingly enough, a recent show about a lady named Susan, followed her as she lost 150 lbs before surgery and then, after surgery (gastric bypass), very little more weight and very slowly.  One wonders why they didn't just tell her to go home and continue what she was doing instead of mutilating her stomach and bowel... Well, I guess that's a no brainer - the surgeon takes home $5000 bucks (at least) with every surgery.... so if s/he does five surgeries a week - that's one a day with 2 rest days, his/her weekly pay is $250,000.00!  People have done odd things for far less money than this.

Several studies including some 30 year studies on 30,000 people by the Cooper Institute, have found that it's not weight that endangers health but rather lifestyle and that anyone with a healthy lifestyle (i.e. making healthy food choices most of the time and exercising at least 5 days a week for 20 minutes or more) can live a long life even if their weight is in the obese or clinically obese range.

That being said, Dr Rudy Leibel pointed out that obesity is mostly genetic (60% genetic).  Also being from a family where several relatives were or are overweight, I can attest to the fact that most lived long healthy lives - without having their digestive tract surgically altered.

One of my husband's cousins is celebrating her 80th birthday - she has been clinically overweight all of her adult life and totally healthy (well, in her late 70's, she had a hip replacement surgery).

There are some advantages to calorie restriction - for me, my severe GERD goes into remission as long as I mildly calorie restrict but to say "everyone" needs a digestive tract which no longer works well, is not logical...  We did not get overweight because our GI tract worked and so rendering it somewhat non- functional will only add to the original problem... another no brainer.

If you are considering Weight Loss surgery, please visit this website....  (http://obesitysurgery-info.com)  It gives informed consent information about weight loss surgery - you will find it quite different from what you see on TV but then, remember, TV is for entertainment, not for good education!

Sunday, February 01, 2015

Gastric Sleeve revisited


The sleeve gastrectomy is the popular procedure these days.  Those promoting this surgery suggest it's safer than the gastric bypass because no bowel is bypassed.  But the problem with the procedure is that in order to promote weight loss, surgeons must cut away 90-95% of the stomach, leaving a remnant about twice as long as your thumb and the same size.

True to the "conspiracy of silence" about weight loss surgery, the dark side of this procedure has been mostly not told.

But as the procedure gets more popular, the dark side is emerging.

Some patients are beginning to tell their stories and there is a very dark side to this surgery - one patient mentioned that it's very difficult to get in even the minimum of 6 glasses of water daily and describes the shock of seeing brown urine (extremely dehydrated and hard on the kidneys). 

This makes sense because this procedure retains the lower stomach valve but the tiny thumb sized stomach doesn't really conduct the peristaltic wave very well so perhaps the valve which is dependent on the muscular movement of the stomach, doesn't really work very well (probably why they did not include it in the gastric bypass).  A swallow or two fills the tiny stomach and takes a while to empty - think of the difficulty of swallowing water slowly, a swallow or two at a time and it becomes a real chore just to get even a glass or two of water in, during the day.

Additionally, the tiny stomach likely does not do much digesting of either proteins or fats (we do need some fats) or calcium or B12.

Finally, patients describe a constant and very serious case of GERD or gastric reflux and well as problems with leaks and "fistulas".  The tiny size of the stomach would also tend to cause a detention of the esophagus, a problem seen in the gastric bypass also.

If the patients keep the weight off, it's by starvation and / or dehydration and/or illness - this is anything but healthy!

Patients should realize that doing something unhealthy is not worth getting the weight off - especially as there is no reversal possible of this procedure since the part of the stomach removed is discarded
.
The sleeve gastrectomy is a permanent change to the stomach in other words...

Bottom line, all that glitters is not only not gold but may not even be really glittering when you live with it... Caveat Emptor - or "let the buyer beware".


Thursday, January 15, 2015

Maestro system - a v-bloc by any other name is still a v-bloc? :)

Entermedics has re-introduced in 2015, a device for weight loss which sounded good in 2008 and 2010 but did not produce good weight loss and was not non invasive as was first thought.  I researched this device in 2008 and 2010 and wrote a blog on it which I've updated to reflect the new device (which of course, isn't really new but perhaps they feel the public won't remember the last times around and they are probably right about this!).  You can read the details by clicking here (Vbloc blog)

This V-bloc has a new name ("The Maestro System") but turns out to be hauntingly similar to the device introduced in 2005 and 2010 and by the way, seems by same weight loss surgery surgeon who advocated it the last time(s) around.  I have talked to him on the phone and he is a fine man (and likely a good doctor) but I guess I'm wondering if it didn't work the last two times around, why should things be different now?  I guess we have to wait and see on this! :)

Monday, September 15, 2014

Gastric bypass on TLC TV show

My dearest friend in life, Trish, who died way too early, from complications of a WLS she had had several years previous.  I still miss her and this blog is dedicated to her.
 
The Long Island Medium is a show on TLC about a lady who supposedly talks to dead people. The following article is not arguing whether or not she really is contacting the dead but rather that this week's show was mostly dedicated to a mother of a gastric bypass patient who died after his surgery... Following are the highlights:
Theresa Caputo, who is the "Long Island Medium" was doing a group reading at a restaurant.

She hesitated for a moment and then asked one of her general questions which tend to encourage people to tell her about their deaths in the family etc.

Theresa said "I want to talk about the young man who passed in a tragedy."

A woman in the back of the room, raised her hand quickly.

Theresa, facing her, said, " Your son has been gone for some time..."

The woman whose name is Elaine, answered: "Eleven years."

Continuing, Elaine added: "LJ was my only child - I waited a lifetime for him - now that he's gone, a piece of me is gone."

Therese, pausing for a moment, said: "Your son says it was difficult for you, his mother, because it was a total freaky thing."  (in retrospect - this was something she probably said because the son had passed from complications of WLS - as sort of a disclaimer. Like all reality shows, I'm sure this show is somewhat scripted and it has been written that Theresa Caputo spends some time with each person to be "read" on the show, before taping the show.)
Elaine described her son as a football star in college, admitting she had saved his jerseys from his participation in the sport.

Elaine then continued with: "I never expected LJ to die...LJ was 6'1" and 443 lbs... he had gastric bypass surgery. Obviously there's a risk with any surgery
but LJ's surgery was supposed to be 'textbook' and after the surgery, he seemed to be ok but then a month later, he started having complications..."
The complications put him back in the hospital and soon he required the necessity of life support machines.  Elaine did not specify what the complications were but the attending physicians all stated they were a result of his gastric bypass surgery.

In July, a month after LJ's surgery, his mother had to make the difficult decision to turn off the life support machines and even now, 11 years later, she said, weeping,  that there isn't a day, every day, that she doesn't re-live that moment.

" I go through it every day... he passed away from complications - it was sepsis" Elaine said adding that
"I kissed his eyes, his hands and his feet.", after he had died.
When the doctor broke the bad news that their son was in cardiac arrest to Elaine and her husband, her husband had a heart attack on the spot.  Although he survived that heart attack, he died 18 months later.

Theresa described Elaine as having a shattered soul...and Elaine agreed with her.
Bottom line, no one really talks about the relatives, the family of gastric bypass patients who pass on, but from the few I've met, they seem broken up about it for years after the fact... perhaps because weight loss surgery is an elective surgery and often their adult progeny are healthy before surgery albeit overweight, (in this case, the son was a star athlete).  Watching a kid die has been said to be the worst thing a parent can witness.
This particular show can probably be seen on Netflix or even somewhere on the web - or wait for the re-runs.  (photo is the blog author in 2009 trying to ask a WLS provider at a Women's Expo about complications of WLS and getting nowhere!)

Saturday, July 12, 2014

Permanent Weight loss only Possible with Surgery?

 
 
So say the providers in the latest article circulating the net...  that the ONLY way to keep off weight is to have one's stomach basically deleted!
 
Frankly, this article seems like it's another plug for surgery (picturing the usual midline shots of overweight people, of course) because they say permanent weight loss is just about impossible unless you get surgery preferably the surgery "du jour" now, the gastric sleeve which in most cases, calls for the removal of 95% of the stomach, leaving things wide open for not only nutritional deficiencies like B12 which is digested in the stomach but lack of necessary fats and more. (You can supplement protein if you drink protein drinks but things like calcium from supplements is not used well and can cause kidney stones - I found that out the hard way). Yes people can live without a stomach but how well they live, is questionable.
And the sleeve, unlike the gastric bypass, is in no way, reversible.  If people do some research on weight loss surgery, they might find that if it were so great, why do they have to keep coming up with "new procedures" (when the old procedures not only don't work for most people in the long run but also tend to cause rather gnarly health problems.)....
One individual who did stay slim and seemed the poster child for a drastric weight loss surgery which took out not only most of their stomach but most of their small bowel too, found out when they fell and broke several bones, that they had an extreme case of osteoporosis despite being careful about supplementing.

Watching a gastric sleeve surgery is interesting - the picture is worth 1000 words? As they staple away most of the stomach, leaving something about as big as your thumb (and about twice as long as your thumb), they take what looks like the stomach and toss it into a pan destined for "pathology" (i.e. the step before it becomes garbage).
And that's why if people have the gastric sleeve, even if they get very sick, there is no chance for reversal of this surgery.  As surgeon, Dr Terry Simpson puts it, "fat and healthy greatly beats slim and sick!"

Truth be known, even with basically no stomach, most people end up regaining weight and if you read the fine print on the surgical sites, the surgeons EXPECT people ... most people to regain at least 50% of what they lost... so... if you lose 100 lbs with the surgery, your surgeon will expect you to regain at least 50 lbs which still makes you significantly overweight even though you will be a success in the surgeon's book!
It has always amazed me how open surgeons are about these er...drawbacks to surgery.... how it's not going to work unless you diet and exercise (well that works without surgery too!).... how it causes repercussions....how 1% of patients die in the first month,  how if people eat too much, it comes up again (they joke about that).  And of course, there are lots of things one can eat too much of like milkshakes which go down well.

And yet people still keep opting for surgery - only to find out the sad truth later on - that with or without surgery, keeping weight off requires OUR OWN surgery to the brain - how well I know about that one.
"There is no easy road to a place worth going" (Beverly Sills)

Tuesday, April 01, 2014

Questionable studies on obesity and weight loss surgery abound

Yet another eye catching headline hit recently.  "Obesity primes the colon for cancer!", it triumphantly announced.

And what was this "landmark study" you might ask?  They fed mice lard and then tested, and only the ones which were fat, had the "markers" for cancer.  Huh?  Are people supposed to believe this would apply to humans? 

Although we might have our suspicions about some humans, I can safely say we are NOT mice and a mouse GI tract barely resembles a human GI tract, if at all, and also, the mice which got fat, didn't get cancer -they only "had the markers" for cancer which means they might or might not get cancer by the time their short lives are ended.

If that's not questionable enough, try the the following study - the headline on this was about how Weight Loss surgery "cures" diabetes.  This study was on humans however, among those who had had a gastric bypass (which forces starvation for the first couple of years - starvation will always bring blood sugar levels down), barely more than 1/3 of the patients saw a remission, even in the first three years after surgery.

I wouldn't call those results impressive, especially considering that gastric bypass is so invasive.  Among patients who had the sleeve gastrectomy, the popular "surgery du jour" which only reduces the stomach (to the size of a thumb and about twice as long as a thumb), only 25% experienced a remission of their diabetes in the first three years.  Keeping in mind that without a stomach, digestion of fats and proteins is basically, not happening and patients must for the rest of their lives, consume protein drinks which are expensive, not paid by insurance and not good tasting to avoid protein deficiency diseases which have not been seen since the 1800's... they should also take B12 shots at least once a week since a greatly reduced stomach likely no longer digests vitamin B12 which can cause many and varied problems.... this doesn't seem worth the expense and pain of surgery for the small number of remissions of diabetes early on.

In a buyer, seller's society, consumers must be careful of what they buy -to avoid the myths seen on TV etc - and sadly, for post ops who experience one of the many complications, there is little available to support them.

Definitely, "buyer beware!" or...
  If it's too good to be true, it probably isn't...