Monday, January 21, 2008

It's all her fault that she got a repercussion of WLS

In my favorite WLSer blog, "Melting Mama" , Beth details how some "rocket scientists" are accusing her of -causing- her reactive hypoglycemia. "You ate too many carbs" they tell her.

She answers:

"I'm currently diagnosed as a reactive hypoglycemic, and The Cause IS my Roux En Y Gastric Bypass. I do not know if I have nesidioblastosis, because that is tested by doing an arterial calcium stimulation test to the pancreas, which is probably in my future if my episodes of hypoglycemia do not improve with medication and diet, or get worse.

Seriously, though, do you really, truly, think that eating carbohydrates CAUSED this?

It's a fair question, I guess, but, really? If that were the case - everyone around me should be dead."

I hate it when patients get a repercussion of the bypass and both the WLS community AND medical providers blame -them-.

For example the other day, I phoned a 9 year post op gastric bypass patient who had been repeatedly told she was a failure. She had originally lost 150 lbs (from 320 to 170) but had had a rebound gain of 85 lbs. In addition, she has anemia requiring iron infusions a few times a year. She is a very compliant patient, following carefully the rules for post gastric bypass including taking her supplements, getting regular medical follow-up and watching what she eats.

The bottom line though is that she is -keeping off-, 70 lbs - something she likely, would not be able to do without WLS.

She was extremely surprised when I told her she was a textbook success. Repercussions like anemia are expected in some patients (after all, the part which digests iron has been bypassed in a gastric bypass) and surgeons write in the medical papers that they expect most patients to have a 50-60 percent rebound gain within a few years of surgery.

The problem is that this is -seldom- what the patient has been told. Most patients have been to seminars where the small percentage of patients who can remain slim after their surgery have been paraded, thus strongly suggesting that this is or can be, a cosmetic procedure to make them _look_ better and fit in better. They are told things like "if you don't like this you can have it reversed" (- not - true - the gastric bypass is considered a -permanent- change to the body) or "You will never have a weight problem again" (very not true - post WLS patients of any procedure are -expected- to diet and exercise to maintain their weight loss and only a small percentage will maintain the -entire- weight loss, that is, most will regain a significant amount of weight).

One patient who had regained it all and complains that anything she eats will cause more gain, was told by a medical provider:

"You are regaining weight because your body is in starvation mode from the malnutrition caused by the WLS"
Kind of a no brainer so why aren't -more- patients told this? Simple - because in my observations when patients are told the full informed consent information about Weight Loss Surgery, only 50 percent or less of those who were originally investigating, go ahead with the procedure. Even many who are keeping off as much as 100 lbs feel that the repercussions they got like neuropathy were -not- worth suffering the comorbities caused by the surgery.

And if you do the math, if half of those seeking WLS, decide against it, that means they will -only- be doing 100,000 WLS surgeries a year instead of 200,000. While 100,000 WLS procedures sounds like a lot, it's not what will keep the providers in the style to which they have become accustomed.

Whatever, the case, patients have a right to know the informed consent information, before surgery - if nothing else than to be able to answer the naysayers who will blame them if they get normal and usual repercussions after their WLS procedures.

"An informed patient is a healthy patient"

(Note the pictured person is not a gastric bypass patient but rather a fashion model)

1 comment:

Anonymous said...

I think the thing, is that even after someone has had WLS. The doctors still view them as that uncontrollable fatty, who can't control what they eat.

So obviously they must've eaten the wrong thing, cause even though they're thin via WLS now. They still must not be able to control what they eat, cause they needed a surgery to help control them. It's all a cycle of misinformation based on fat prejudices.