Wednesday, February 27, 2008

A Whole Floor to treat sick WLS patients?

I was talking with a nurse (RN) who works in neuro ICU in a large hospital in our town. I made some comment about those ICU nurses working super hard (they do - each nurse only has 2 patients and even at that, they basically hardly get to sit down during a 12 hour shift).

She surprised me by saying that was NOT the hardest place to work.

I naturally, asked her what could be harder.

She said that this hospital was a center for treating sick gastric bypass patients, having a whole floor dedicated to those patients. She had worked there once, she told me and felt that was the hardest place she'd EVER worked, even harder than neuro ICU.

I asked her why and she answered, "Because the 'gastric bypass gone bad' patients are so ill - it is so sad!"

Keep in mind that neuro ICU is where those patients with brain bleeds, strokes and brain cancer go.

But this nurse was basically saying that as ill as the neuro ICU patients were, the sick gastric bypass patients were even sicker!

Many people choose to have a gastric bypass after talking to a couple of happy post ops (most of whom are less than 2 years out and all of whom are less than 10 years post op), and attending a seminar in which the presenter shows a nice looking drawing of what is done (which doesn't have much resemblance to the real thing), parades some happy new ops and makes promises like "if you don't like it, it can be reversed" (not true) or "you will never have to diet again" (also not true).

They watch shows like BIG MEDICINE where all the episodes have happy endings and sick patients are never shown. Those who are losing TOO much weight. Those suffering from extreme malnutrition who cannot get out of bed. Those who get neuropathy and end up with mobility problems.

Sometimes pre ops ignore people they know who have had a bad result or even have died after weight loss surgery.

That's because the few post ops they get to meet (the happy ones) assure them that the sick people are a rarity and this is a myth they really want to believe.

A friend who is a medical provider told me about one of his patients who weighed over 500 lbs and rolled into his office in a wheelchair. She told him that her daughter had had a gastric bypass 5 years previous. "She's slim now," said the lady, "but she's been frail and sickly ever since." The mother felt being so large and even having to motivate in a wheelchair was better than what her daughter was suffering.

A whole floor just for sick gastric bypass patients. A whole floor of a large hospital. A place we will never hear about on "Big Medicine" or in the media.


violet_yoshi said...

Are they going to call it the Huxley/Orwell ward? Like after Aldous Huxley & George Orwell, two sci-fi writers who predicted a societial conformity disaster like this one.

AnnieMcPhee said...

Don't forget No. 12 Looks Just Like You from The Twilight Zone.

Intro: "Given the chance, what young girl wouldn't happily exchange a plain face for a lovely one? What girl could refuse the opportunity to be beautiful? For want of a better estimate, let's call it the year 2000. At any rate, imagine a time in the future when science has developed a means of giving everyone the face and body he dreams of. It may not happen tomorrow—but it happens now in the Twilight Zone."

Ending: "Portrait of a young lady in love—with herself. Improbable? Perhaps. But in an age of plastic surgery, body building and an infinity of cosmetics, let us hesitate to say impossible. These and other strange blessings may be waiting in the future—which after all, is the Twilight Zone."

SueW said...

I saw that Twilight Zone show recently during the "New Year's Day" marathon on the SciFi channel. The young girl pushed into "looking like everyone else" i.e. glamorous, felt very depersonalized. I felt the show was very insightful, showing the down side of a trend which is becoming more and more prevalent in our modern society - the destruction of individuality in favor of a stylized idea of "beauty" when in reality, the REAL beauty is IN the individual!

Gwen said...

Just by the by, of all the ICUs I have worked in (trauma, burn, surgical, cardiac, pediatric trauma & burns, medical and neuro) the LEAST sick population was the neuro ICU population. They CAN be very physically ill, but in a different way. It can be a very trying work environment for different reasons. Neurologically ill patients can be puzzling and finding the right way to treat their conditions can be a challenge. But comparing a neuro ICU population to a sick WLS population is not even apples and oranges, it's like apples and pineapples, or something. You have to realize that by the time a RNY patient has gotten to the point of needing to be hospitalized (those who didn't get sick immediately after surgery, which isn't as common any longer) they have used up their body's entire reserve of energy. They are malnourished (by design) and their natural chemical protective mechanisms have been completely tapped. They "crash" very quickly and take much longer to recover. Any further surgery they might require entails longer healing times because their bodies just aren't in any shape to do any healing. Some of the sickest patients I have ever cared for in my career have been RNY patients and most of them were more than 1 year post op when they became ill.

I'm not trying to say neuro ICU RNs don't work hard or have a difficult job. I was one for quite a while. But it's very different, and to me, there is no comparison in how hard the nursing and medical staff have to work to keep the patient alive, and hopefully help them recover.