Saturday, January 03, 2009

dying from a surgery which might not work anyway

The doctor gently told the family to dis-robe and remove their jewelry. They were standing outside a modern facility and were told that they would be released but first were to be allowed to take a shower so they would be presentable to their loved ones. The people wondered if this doctor could be trusted because he worked with their jailers but surely since he was a doctor, he had their best interest in mind. Most of all, they WANTED to trust him. So they suppressed their fears and doubts. Showering would be nice, they thought since, they had not had this luxury during their time there. After taking off their clothing, they filed into the what looked like a community shower. They might have had hopes of "getting their lives back" because this is what they were told by those who led them into the building. Somehow one thinks they might have been in denial about things because their jailers were not really into saving their lives. But people will believe what they WANT to believe and they wanted to believe the nightmare would end with their shower. Standing in front of the shower head, they looked forward to living normally again. But no water came out of the shower head. Instead a deadly gas filled the air tight building. Their "release" was only by death. This was Nazi Germany.

And the kindly doctor who led them into the "shower" to their death, was on hand to sign the death certificates and report that he had further "taken care of the Jewish problem".

In 2006, Ray, a very large person, blogged for a year how he felt a radical type of weight loss surgery was going to "magically" save his life. To their credit, several bariatric surgeons refused to operate on him. He weighed close to 500 lbs and was still mobile (he drove a truck) but was in kidney failure from diabetes and required dialysis three times a week. One of the surgeons who refused him was Dr Baltazar of Spain who tried to explain to Ray that he didn't have a prayer of surviving weight loss surgery. But Ray bought the hype he had heard on some of the discussion groups and TV. He truly believed that Weight loss surgery would somehow make him slim and "normal". He did not speak well of those doctors who refused to operate on him and finally, he found someone who WOULD operate. Because insurance did not pay, Ray's grandma went to her savings to come up with the $50,000 for Ray's surgery. Ray's last letter before surgery, expressed hope that he would "get his life back" after surgery and he went into the hospital, confident and optimistic.

But after surgery, several other organs joined his failing kidneys and went into failure. He was awake, awake enough to realize that what those doctors who refused him surgery had warned about, was happening. His surgery was not going to save his life. On the contrary. People who went to see him, described him as very depressed before he died about 3 weeks after his weight loss surgery.

Ray may not have had the life he wanted before surgery (dialysis isn't everyone's first choice of a fun thing to do) but he _had_ a life. He drove his truck, he held his nieces and nephews, he saw his Grandma, he still could get around. Instead of giving Ray his life back, the bariatric surgery had denied him of the life he had.

TV just showed another similar case. Renee Williams was a pretty lady who at 29 years old, looked young. She had been bedfast for 4 years, partially due to a crushed leg from a car accident. And she had gained weight to 900 lbs. She video blogged and said she wanted to "get her life back" and do more things with her two kids. Like Ray, she had contacted many surgeons who refused to operate on her because she was too big a risk. But finally she found a surgeon who agreed to do a gastric bypass on her. After her bypass, he came out smiling at her family. "The surgery went well," he told them. Visiting Renee after she woke up, this surgeon said to her "and you will soon be skinny". And in the next 3 weeks, she lost 60 lbs. But then one night she had a sudden heart attack. The surgery HAD been too much for her. Her older daughter said tearfully that her mother had been her best friend.

"I know I have 100 percent chance of dying in the next year," Renee told her video blog.

But seems with the gastric bypass, Renee didn't even have a year to live but only weeks.

And Manual Uribe who refused the offer of a gastric bypass, and only a hundred lbs or so less than Renee, is still living albeit still bedfast. (It's a no brainer that walking is a lot more than being slimmer - many muscles must be developed before that even should be attempted.)

Somehow, I feel Renee's life was wasted and that she was given false promises because this drastic invasive surgery is not even that effective on larger people. One of the few studies we have which looked at many patients 10 years post op, found that 34 percent of them with a BMI over 50 regained all or most of the weight they lost.

We to date, have no data on weight loss 20 years after gastric bypass despite the fact that gastric bypasses have been done for 40 years. Why is that, some wonder. Dr Paul Ernsberger, associate professor of nutrition at Case Western Medical school, opined:

"A number of trials have been started, and the final results have never been reported. We have to ask, you know, why haven't we seen the final results? I think it's because it's bad news." (Dr Ernsberger on "The Donahue Show")

When these very large people showed hesitation about the surgery, this surgeon (now under lawsuit for the death of another patient) paraded a woman who had had a gastric bypass and lost 400 lbs. "It's the best decision I ever made in my life," this patient who works for the surgeon as a "liaison" said, enthusiastically. But that woman is only two years post op. We should remember that 6 months after Big Pete Herida appeared on Oprah and said how losing 600 lbs with his gastricbypass had "saved his life", Herida died of congestive heart failure.

And then there is another lady I know who weighs in excess of 500 lbs who is in her 50's and not real mobile. She says she's _outlived_ 48 of her friends who had Weight Loss surgery. One never hears about that on TV.

There is some evidence that losing a lot of weight even slowly, may be more of a strain on the heart than NOT losing it.

What really upset me was the misrepresentations going on.

"If Renee survives this surgery, she will lose 700 lbs" stated Renee's surgeon to the TV cameras.

None of the very large folks I know, have lost more than 400 or 500 lbs with gastric bypass (many have lost less) and most of them regain a significant amount of weight (if they live) within 4 or 5 years.

"Renee only had a year to live" was another thing we heard a lot on the TV show and no one can predict that at all. Surely it's not real healthy to be in bed weighing 900 lbs but who really can predict the lifespan of anyone. Telling her that seemed more like a misrepresentation in order to scare her into surgery.

And the worst thing was the spin they put on the show "If Renee had been accepted for surgery earlier, things would have been different. She called many doctors and begged them to help her."

This seems to suggest that those surgeons who were ethical enough to NOT operate on her were somehow guilty of her death.

"The show has inspired many to call for help - to not wait until it is 'too late' like Renee did. " the show told us detailing two other patients, both of whom got bypasses but are still in bed.

It's way past time to realize that what we hear on TV may not, and probably IS NOT the truth. TV makes only a commitment to entertain, not to tell the truth.

During the trials after the game show scans in the 1950's, one of the producers shrugged his shoulders when confronted with their lies, giving contestants the answers etc (there is a movie called "QUIZ SHOW" which details this famous case). "Well," said the producer, "no one was hurt. The contestants won money and the people were entertained."

Now with today's spin, giving people false hopes about surgery which may not even help them (and may cause their death), can we really say anymore that "no one is being hurt"?


Heidi Getz said...

Hi Sue-
I'm a new reader (I found you through the Fatosphere), and I've never commented here before, but I wanted to speak up about something in this post. I think you make a great deal of entirely valid points. In particular, I agree with your thoughts that although Ray and Renee (and so many others) may not have had ideal lives before WLS, they had lives at all, and that's something that's so often overlooked by people and doctors trying to sell the benefits of WLS. In fact, I share your opinion on almost everything you just posted about. And I think it's important that it's being written about at all, so thank you.

But I do think it's going way, way too far to equate WLS (on everyone or just on very large people?) with the Holocaust's gas chambers, as you seem to do by introducing your post with that quote. These two situations are nowhere near equivalent. The Nazis were responsible for genocide: they wanted to rid the world of entire races of people. And no matter what your opinion of WLS, I think it's pretty obvious that the large majority of doctors pushing it are not doing so in hopes that their patients die. They might be misguided, misinformed, or in denial, but most doctors I know want their patients to live better, healthier lives. They could certainly benefit from learning how WLS doesn't always lead to this (by reading posts like yours), but that does not by ANY means indicate that they are guilty of the same crimes against humanity that the Nazis were.


Sue Joan said...

Hello Heidi and thanks for reading (and commenting) on my blog.

I was comparing the misleading with that part of the holocaust. And think of the doctor who told his charges that story about the shower - didn't he feel he was doing the best for them? I think many surgeons KNOW about the ineffectiveness of these procedures and the early deaths (1 in 50 die within 30 days and another 4-7 percent - depending on age etc - die within the first year) which are well documented thanks to Dr David Flum. But some feel that it might be better to be dead than fat, some do buy the hype that a fat person is going to die shortly (just like Nazi doctors bought the hype that terminating those individuals was for the good of society). And if you do the math, 7800 people die from WLS yearly and that's twice the number of Americans who died in Irag, the first 3 years of the war. But no one gets upset about them. And in the show, they took the attitude that she took the "chance" for life and that was better than living a bit longer which I don't think her daughters will agree with. When a cancer patient walks in for treatment, they are NOT blamed for their illness despite the fact that the American Cancer Society states that cancer is 85 percent lifestyle caused (which is more than obesity... which is only 40 to 60 percent lifestyle caused). They are treated with respect. Fat people are not treated with respect but I suspect from the recklessness with which some take chances with their lives, fat people may be considered a "throw away" group of people. This MUST change, I feel. Many doctors refused these super obese folks so that is to their credit but I disliked how the show suggested that the doctors who were ethical enough to NOT operate on these people were somehow responsible for their deaths... Hope this clarifies... in this blog I am SPECIFICALLY talking about this population who is over 600 or 700 lbs...

GrayPyre said...

I cried as I read this. I have an appointment on the 15th to discuss a LAP-Band procedure with a surgeon. My therapist and GP both think this will be good for me, but I'm not sure. I want more childern and somehow ( I really can't pinpoint the source) I've been convenced that it will be extremly difficult to impossible at my current weight. I'm so confused and scared that I just don't know what to do.

Sue Joan said...

Thanks for your comment, GrayPyre, I guess I didn't express this very well but my blog is talking specifically about a certain population (those in the very high category like BMI 90) as was portrayed in the TV shows and also specifically about the gastric bypass. The Lap Band is a different beastie because it does NOT induce vitamin deficiencies, it does NOT include 300-400 staples in your stomach and bowel and it does NOT include re-sectioning the bowel (basically cutting into pieces and reconnecting it in a very different manner from the "way it came from the factory". My advice to you is research, research, research. If you feel uncomfortable with any decision, hold off. The world is not going to end. For all the studies which suggest that being fat is dangerous, there are an EQUAL number of studies which suggest that being fat is NOT dangerous but the risk factors lie more in things like lifestyle, what you eat, how much you exercise etc. Also you might want to explore a type of lifestyle called "HAES" or Health at Every Size - a clinical study at USC found that folks on HAES were actually healthier or ended up healthier than those who dieted. Any WLS is a lifestyle and people who have WLS know they are starting a new lifestyle. Dr Simpson states that success in WLS is 10 percent the surgery and 90 percent the person. Which greatly suggests that you can put in that 90 percent without the surgery and still make it in a healthy lifestyle. There are lots of options. Just take your time and make the choice you are the most comfortable with. Here is the link to the HAES study:

HAES study at USC

Here is the link to Dr Bacon's website - she has a great book out on HAES:

Dr Bacon's website

Good luck! Sue

GrayPyre said...

It wasn't the thought that it would kill me, but what I thought was the premise of your blog, that we trust doctors to do what is right by us...never questioning them and we can sometimes can be convinced to do things that go against our best judgement and think they are good for us. Maybe I just read into it what I needed to hear at the moment.
I realized that I really don't think I need to loose a lot of weight but want to just be more fit. And truthfully I really think that is all I need to have another baby anyway. Weighing 150 lbs won't make me a better wife or mother or a happier person, mainly because I'm pretty good at those things already and well that makes me pretty damn happy.

Sue Joan said...

Blindly trusting doctors WAS one of the premises of my blog... have you investigated HAES? You said you just want to be "more fit"... you can do that without a focus on Weight loss through HAES, just making more healthy food choices and starting to exercise 3-5 times a week. You are right - you don't have to be slim to be happy and everyone can be fit regardless of size... good luck! hugs, Sue

herbmom said...

comment to GrayPrye- I felt compelled to share that I struggled with trying to get pg. When I hit 175 I was told I needed to loose 25lbs to get pg. I ended up gaining 25-30 and finally got pg. I craved raw fruits and veggies. I walked during my lunch break and snacked on good foods throughout the day. I actually lost about 20lbs my first tri mester. Dr started to worry. That was the smallest I have ever been during pregnancies.

I grew up a skinny kid, my family ate pretty healthy but through dieting I gained weight. Being anorexic killed my metobolism.

Over the years I started gaining. I also have thyroid issues and kept gaining. I now have 5 children and the last one I was 280 when I got pg. No health problems. Infact I lost 15 lbs before I realized I was pg and I gained that the last month of pg and ended up weighing less than I started after the baby was born. I have low to normal blood pressure. I walk. I eat healthier than a lot of people but struggle with loosing weight.

My point was that I'm over 100lbs heavier than you and I feel pretty good. I am working on fixing my thyroid and adrenal and drinking more water but I feel pretty healthy. I love what was said about "HAES" I'm going to look into it.

If you feel healthy than do your best to eat healthier, get some physical exercise, emotional exercise and spiritual exercise. I would try that before opting for surgery.

May you find peace in your decisions.

By the way Sue- I loved your post. I see way to many of us blindly trusting our Dr's even when we feel uncomfortable with their recommendations.

Thank you for your blog.