Monday, December 28, 2009

the Survival of the Half Ton teen ... or his demise?

In our Weight Loss surgery (WLS) informed consent online community (and support for ill long term WLS patients) we lost another former member. She died suddenly - probably sudden heart attack which seems to haunt those who keep their weight off with their bypasses, more than the many who re-gain the weight. She was an extremely talented woman and much beloved by her family including husband, children and grandkids. She was in her early 50's. In my opinion, she died way too early..

Which brings to light the fact, that if people survive their first year after a gastric bypass (4-9 percent do not survive the first year post op according to studies which looked at actual patient records), this does not mean they are "out of danger". I've seen plenty of patients die after a few years. It's often a sudden heart attack and never gets connected with the bypass but one wonders...

Yesterday I watched a very disturbing show about two young men, one who is 19 and the other who was 16, both very obese (over 800 lbs) who got weight loss surgery. The title of the show was "SURVIVAL OF THE HALF TON TEEN".

The 16 year old fared better at least a few months after surgery but the disturbing patient was a 19 year old named Billy Robbins, the only son of parents who had lost their first son after 19 months of life. I'm sure he was or is addicted to food and perhaps mother was something of an enabler however, there is also, a huge genetic factor going on with someone who gets that large and until someone has walked a mile in the mother's shoes, I don't think anyone should judge her.

This surgeon they had, did two major surgeries on this kid in 4 months - the first was cutting about 90 lbs of fat off of him which is very risky and generally not done in the medical community because of the risks involved.

And the second was a sleeve gastrectomy (a surgery in which most of the stomach is cut and removed out of the body - it's not reversible). The surgeon who cut him, told the camera that he was planning "the rest of the gastric bypass" when he's lost another 100 lbs or so. But the fact remains, he's not talking about a gastric bypass because that just bypasses the stomach and does not remove it from the body.

After 2 major, risky surgeries in 4 months, this 19 year old was expected to get up and walk for an hour every day (he still weighed over 500 lbs at the end of the show) and when he was reluctant, the psychologist (apparently the one working for the surgeon) tore into the mother on camera, blaming her for all her son's problems.

Everyone ignored that even a normal sized person after two major surgeries is not up dancing the jig!

Talk about abusive? In my opinion, this surgical group was not only abusive of that poor young man for doing so much risky surgery on him but also of the parents who paid him in good faith.

The surgeon talked about getting that young man down to 200 lbs which is too low for him because he looks like he's around 6'2".

Sadly, the way he looked and considering that the fat removing surgery left him with an incision across his entire abdomen and that he no longer has much of a stomach, I frankly do not expect him to survive. (he vomits frequently... the psychologist also blames that on him being "unwilling to get better" and of course, on his mother) His drastic gastrectomy which removed most of his stomach has repercussions in so much that he doesn't digest food well and also doesn't probably digest some vitamins like B12 - contrary to popular belief the stomach is a critical digestive organ and not just a storage place. As Dr Paul Ernsberger (who teaches nutrition in Case Western Medical School) has written:

"All of the operations, old and new, are based on an incorrect assumption: that the stomach is no more than a passive sac for receiving food. In fact, it is a critical digestive organ and cannot be cut away or bypassed without compromising the digestive process."

The "half ton teen" would have, likely, survived longer without surgery. And of course, when he dies, his death will be blamed on "obesity" and not the so called "life giving" surgery that his parents bought in good faith. And they will probably re-run the show again and again with only a short note at the end (maybe) "in memory of Billy Robbins" which many viewers won't notice.

As for Billy's Mom after dealing with her son's early demise, she will have to watch the psychologist condemning her for just loving her son and trying to do the best for him.

A sad note upon which to end this year.

Addenda: a search for an update on him, pulled up one item - this stated that latest news (about 11 months ago) was that he was getting ready to move to a rehab center and that he had had the "second part of the gastric bypass" (probably some kind of intestinal bypass i.e. the third major surgery) and that he now weighed 420 lbs. This article also blamed Billy's situation on his mother, echoing the judgmental psychologist. Doesn't anyone think for themselves these days?


HSofia said...

I saw this mom and her son on the Oprah show some months ago, when Oprah did a show on a mother who died after her WLS. I don't want to judge the mom of this boy, but I have to say, based on what she herself said about the way she raised her son, it seemed that he was victimized. He also seemed angry, spoiled (read: unable to care for himself), and miserable.

This was before the surgery. There wasn't too much coverage of what happened after his surgery, but I think they needed to see a psychologist or therapist completely separate from the weight issue. The mother needed help to grieve for her lost son (the father, too; he seemed to be exasperated and disconnected), and learn how to let her son grow up and be his own person.

I don't think it does any good to "blame" the mom; I don't think she acted out of malice. I think she acted out of pain and fear. She didn't want to lose her second son, and so she did everything for him, didn't really set boundaries, and encouraged him to stay home and avoid the outside world.

Unfortunately, his large size and their dysfunctional family dynamics have been conflated.

Joslyn Sauder said...

The psychologist "Tore into the mother" Wow this boy's life is hanging in the balance and his mother is continuously sabotaging his rehabilitation. How frustrating that must have felt for the staff trying to save his life. At one point when he returns home she suggests that he have a slice of pizza, that one slice wont hurt him. He tells her he doesn't even want one. If he was addicted to drugs and she told him one hit would not hurt would we feel the same way. Now I do agree that its quite obvious the mother is not very competent mentally (almost as childlike as her son) and is not deliberately harming her son. However she needed to be made aware of the seriousness of the situation and I though the psychologist handled everything as best she could under those impossible circumstances. Its not about judging this poor woman its about trying to shake her into reality so she comprehends where she is culpable.

Joslyn Sauder said...

That being said about the mother's causing her son's obesity, I do agree with the rest of your article. I notice many ppl who have had gastric bypass surgery show signs of malnutrition like dry breakable hair etc.

lorifriel said...

Hi there, Im in the UK, and as a nurse, watched billy's story, with great interest and some disbelief. I can't seem to get the 3rd and final episode on demand tv.
So far, I gather billy has dropped to 420 pounds,an amazing feat in itself, but i am wondering now just what the update is on billy, his mum and dad?

Sue Joan said...

lorifriel, I haven't heard anything in the way of an update, but the kid's chances of growing up healthy (regardless of how much weight he lost) are not very good because of the vitamin deficiencies the gastric bypass causes including osteoporosis. Weight loss surgery patients rolling over in bed and breaking bones is quite common - even young ones. There are always trade-offs and there is "nothing for nothing" in this world.

Unknown said...

I thought the mother's psychological problems were the most interesting part of the the episode, she is a feeder, I mean, 8K calories per day. Reminded me The Great Child & The Dire Mother (Thirteen Ghosts).
Just saying :P

Anyhow, seriously, as a nursing student I totally agree with Joslyn Sauder, it must be hard trying to help a patient whose mother is an enabler, being addicted to food is not any different from other addictions, would you think the same if she where saying one hit would not hurt. Right after they get home she starts feeding him continuously for 2 weeks and at least twice again she offers him food that he turns down (at home and at the supermarket). I don't wanna take all responsibility off Billy's arms but I doubt his chances to lead a normal live, I think the psychological damage she has provoked is gonna be very hard to repair.

The mothers words speak for themselves:

“Billy was unable to take a shower because it was too small for him to fit in.
“Even if he could, I would have to bath him because he had such an overhang around his stomach. I had to lift and clean it, and it was extremely heavy.

“I over-compensated after losing Matthew, my first child. It was hard saying no to Billy when he wanted something to eat.
“Maybe it is an addiction, maybe I’m addicted to my child. I’m wondering when I will stop — when I die?
“Or I get crippled or down in my health so I can’t look after him any more?

“It breaks my heart that for Billy to reach his goals, to be anything, to accomplish, to survive, it may mean my death. The guilt I have, sometimes it almost destroys me.”

Sue Joan said...

Some of the commenters are missing the idea of this blog. The son was not "abused" by the mother. What did everyone miss about GENETICS playing a huge part in his size? And that the surgical group should NOT have done surgery on this young man especially surgery which GREATLY undermines his digestive process and can cause serious vitamin deficiencies. How much of a price are people willing to pay to weigh less (and note: he never got down to "normal size" anyway)? Are his chances for living really better when he's not able to sufficiently nourish because his digestive system is greatly compromised? He was a big boy, he CHOSE to eat. Let's not blame the mother - that's simply unfair, to put it mildly. If we want to blame someone, let's blame our fat phobic society which is so cruel to people of size that they get desperate enough to ask for surgery which can shorten their lifespan and undermine their health in exchange for reducing their size. Or let's blame a society which encourages people to eat, advertises food in living color, pushes food on people everywhere they go and puts pressure on folks who say "no" to the constant offers of food. But let's NOT blame the mother who was trying to do the best for her son or even her son who may eat less than his contemporaries but his genetics cause him to put on weight so easily. It's time to get understanding and stop playing the blame game because our narrow mindedness and lack of understanding of the causes of obesity and meanness to people who are obese, are causing illness and heartbreak to a growing segment of the population. Just a thought.

Sue Joan said...

Update on Billy Robbins. According to one website, he weighs about 420 lbs in 2012. That surgery is often ineffective in the long run so the person, has both the weight and the nutrient deficiencies to deal with.