Friday, February 01, 2008
Big Medicine - some interesting things
Big Medicine, the TV show about Weight Loss surgery (WLS) always ends on a happy note, with grinning post ops saying how much they love their gastric bypasses and this last episode was no exception. We saw a 478 lb bus driver visit the fire station because although he loves his bus driving job (in case his boss watches the show!) his dream is to be a fire fighter. We are told that he lost 101 lbs in a few months after his gastric bypass, the producers hoping that we will forget that he lost from 579 to 536 on the liquid diet -before- his gastric bypass. Actual weight loss was 57 lbs after his gastric bypass which is good but not -quite- as impressive as it is if they add the weight that he lost on the liquid diet. What's a little exaggeration between friends, right?
We also saw a 2 year post op gastric bypass patient who got plastic surgery for oversized legs who said he was happy to go into the "normal man's store" and buy clothing "off the shelf". Trouble was he was in a "BIG MAN'S WAREHOUSE" so probably could have gotten clothing off the shelves at his original weight of 535 lbs. "I lost 230 lbs" he said - it was 220 before plastic surgery on his legs and he said his weight loss had been at a standstill for several months. Dr Garth said that maybe this plastic surgery would get his weight loss restarted. But the "window of opportunity" has closed for this man so weight loss from this point will be the old fashioned way involving a diet. Trouble is, he was likely not told that before surgery. In the several weeks after his plastic surgery, he had NOT lost any more weight.
Thing is they show his before photo where he weighed 545 and his after photo where he weighed (it said) 215 lbs (and I stopped the DVR to check that too!) and weight loss of 230 lbs. I guess they are hoping no one watching will do the math... his current weight would be 315 lbs!
All the wizardry and small oops's aside, there were some interesting things which one who is listening carefully, might notice.
The man who got plastic surgery had -lymphodema- (the plastic surgeon did mumble that a couple of times) and so we all know that cutting that off doesn't necessarily cure it especially in someone who is still clinically obese (which of course, they are not supposed to be after this magical surgery).
Couple that with the gal who had her bypass 3 years ago and was regaining her weight. "I don't get full anymore after a meal" she told us. She went to the surgeon to see if anything was wrong - pouch stretched etc.
This of course, poses a dilemma to the producers - if they find something wrong with the pouch, they preserve the myth that if everything is in tact, patients will never have a weight problem again -but- it also could reflect not so well on the doctors. However, if nothing is wrong with the pouch then the audience might get the message that the surgery stops working after a few years which is of course, the case with many patients.
The producers decided to take the latter route and showed a scene in which slim Mary Jo, the staff psychologist, was telling the lady how it was all her fault that she regained because she's off track etc etc etc. Mary Jo's solution: keep a food journal and diet. Hmmm but isn't a gastric bypass supposed to make it so folks "never have to diet again"? After all, if they had been successful on diets, they would not have gone for the bypass in the first place. (which is a comment I hear repeatedly on the gastric bypass regain support lists!)
Finally after Dr Garth was called in to look at the 2 year 315 lb patient's lymphodema, he walks out and tells Dr DelMonico (the plastic surgeon) "Well, gotta go and make more patients for you!"
Somehow that remark seemed more than a bit inappropriate but gives an inkling just how some in the medical profession view the process - as a money making deal.
Greatly contrasting with the positive attitude on the "Big Medicine" show was a letter I received today - her spouse had a gastric bypass 6 months ago and has had nothing but medical problems since, and she is at the end of her rope. I get 1-2 of these every week. And I don't think you will ever see -those- patients on "Big Medicine" because the surgery making someone very ill is still a -big secret!.