Blog: Dying to Lose Weight - What Have You Got To Lose?

[costello22]

What have you got to lose? Twenty, thirty, one hundred pounds?

How much pain and suffering are you willing to go through to lose it?

How about losing the ability to ever enjoy food again?

What about the loss of your life?
July 28th, 2008

"Well, we're heading for Texas tomorrow where I will have Gastric Bypass on Tuesday the 29th. I'm a little scared; I don't know why. Say a prayer for me.... love to all."

The woman who sent that email to me is in an Intensive Care Unit on a ventilator in a Texas hospital as I write this. About a month ago she underwent surgery to help her lose weight.

I understood her thought process. She had battled with her weight for most of her adult life, and while I never thought of her as obese, I knew she had been on every diet that exists and tried most diet pills/prescriptions. She would need knee replacement surgery if the weight didn't come off this time.


She had also watched her mother die a slow, painful death from complications due to diabetes.

Beth lives in New Mexico, but had her surgery at a hospital in Texas that specializes in this, and other, weight loss procedures.

Beth's gastric bypass surgery went as anticipated, and she was expected to be able to return to work as early as the following Monday due in part to the laparoscopic surgery that was used to decrease incisions and scarring.

Instead, something went terribly wrong.

August 01, 2008

"Well, I had my surgery. I feel like crap! I should have stayed like God made me, fat and happy. They say I'll feel better in a couple of weeks. I hope so, love you."

Beth sent me that email the day she should have gone back to work - the day her husband came home early from work because when he had tried to talk to her by phone over his lunch break she said she couldn't hear him.

It was fortunate that he left work and didn't dismiss her groggy, incoherent state as post surgery blahs, or drowsiness from her pain medication. Instead he called 911, which saved her life - we hope.

Beth was taken by paramedics that evening to an area hospital in Albuquerque, New Mexico - a city close to where she lives.

She was placed in ICU for a couple of days while they tried to determine what was wrong with her as they administered heavy doses of antibiotics.

After a couple of days with no change in her condition, and no additional knowledge of what had gone wrong, they life-flighted her back to the original hospital in Texas where she had the procedure.

Beth has now undergone additional surgery to remove intestinal abscesses to her surgical site. Apparently the surgery punctured a small opening in her intestine which allowed digested and undigested food, as well as waste material, to ooze into the surrounding area causing massive infections.

It isn't clear to me why she is unable to breath on her own; perhaps because her body is so incredibly stressed with infection.

Will Beth make it? I sure hope so. Will she ever enjoy eating and drinking again? Probably not.

I recently read statistics that state up to 20% of people who have this type of surgery get an infection before they leave the hospital. An additional 20% get an infection so severe that it requires further surgery (similar to Beth's) in the first six months of their release.

Then there are the people who have IBS (irritable bowel syndrome), or what is termed "dumping" - the need to empty their bowel immediately following ingestion of food or liquid.


There is also a percentage of patients who are unable to swallow foods without great difficulty, and a percentage who gain a considerable amount of weight back within a year of the surgery. Death rate is said to be between one death to every 200 to 300 procedures (one would think they would have a more precise statistic than that).

Additional side effects listed by the Mayo clinic on line informational site:

Leaking at one of the staple lines in the stomach. This severe postoperative problem is treated with antibiotics. Many cases heal with time. Often, however, the leak can be serious enough to require emergency surgery.

Incision hernia. An incision hernia is a weakness in the incision. This is more likely to occur if you have an open procedure and a large abdominal incision. This usually requires surgical repair, depending on the symptoms and the extent of the hernia.

Narrowing of the opening between the stomach and small intestine. This rare complication may require either an outpatient procedure — in which a tube is passed through your mouth to widen (dilate) the narrowed opening — or a corrective surgery.

Dumping syndrome. This is a condition where stomach contents move too quickly through the small intestine, causing nausea, vomiting, diarrhea, dizziness and sweating. It's frequently experienced after eating sweets or high-fat foods.

Other potential complications of gastric bypass surgery include:

Vitamin and mineral deficiency (iron deficiency anemia, vitamin B-12 deficiency and vitamin D deficiency) Dehydration Gallstones Bleeding stomach ulcer Intolerance to certain foods Kidney stones Low blood sugar (hypoglycemia) related to excessive insulin production

What attempts have you made to lose weight?

Do you know of anyone who has had this surgery?

What has their experience been?

http://www2.ljworld.com/weblogs/at-random/2008/aug/25/dying-to-lose-weight---what-have-you-got-to-lose/

[Wifezilla]

WOw. That poor woman. I know people turn to this surgery out of desperation...but damn!!

[capmikee]

After watching the Olympics wifey is even more horrified by these procedures. There were people competing in the Olympics at 399lbs and plenty of people over 250 lbs. If they can be fit enough to compete at that level, anybody can become more fit at any weight and improve their health.

[Glendora]

The writer of this blog says that she never thought of Beth as obese. If Beth were not morbidly obese, she would not have been able to have the surgery, AFAIK.

I understand how horrible it is to lose someone you love, and how angry you get, and how you think "If only s/he hadn't done (X Y Z), s/he would still be alive/fine". And there's always an if only. If this woman was in fact morbidly obese, she may have been risking her life through obesity itself. This may not be true of everyone (that severe overweight is a life risk)...but I personally have seen written on this very site a fair amount of people who were morbidly obese and were having such severe health issues that they thought they might die, were told they were going to die, etc. Or who couldn't make it up a flight of stairs. Or who, like Beth, were facing surgery to replace knees or other stressed parts. Or who had heart issues...blood pressure issues...Type II D, obviously...etc.

I do understand how the blogger feels with the possibility of losing a friend. But first of all, Beth isn't dead yet...give the poor girl a chance! And second of all, this writer takes a tone almost that her friend were having cosmetic surgery. "Why risk your life for something like a few pounds?" is the gist. But again, if this woman were not a hundred pounds overweight or more, she wouldn't qualify for the surgery. I just can't believe she was ten or twenty pounds overweight and found a doctor who would perform gastric bypass surgery on her. I don't believe this blog author understands what it feels like to be so overweight and sick that you think you might die.

I don't qualify for gastric bypass surgery but even I understand that. After my last baby, I weighed 210 pounds. I think I may have just barely qualified for gastric bypass at that weight based on my height (five foot one), or might not have quite been at that cutoff line. Regardless, that was only 200 pounds...and honestly, with every step I thought I was going to die. I got a lot of visual "floaters". I had a lot of odd head throbbing that I was afraid of. Uncomfortable standing up, uncomfortable sitting down. Exhausted (and not just from having a new baby). Hot all the time. I can't imagine feeling like that, and even more so at a heavier weight, for many years. I can't. I'd think I was dying too.

Trying to see both sides here. Hang in there, Beth!

[Nancy LC]

I don't think your symptoms were necessarily caused by your weight. Sounds like it could have been lots of things.

The thing that is frustrating to those of us that have found low carb to be the answer is that it was such a good answer for our weight issues. We feel that many people are over looking something that is going to improve their health even before they start losing weight and going for what sounds easy.

Surgery is always easier sounding than it is in reality. A few hours under the knife, with a team of people doing all the work. Someone tells you there's a 4% chance of death... doesn't really sound all that bad. It is when you hear real stories like this one that it brings a little more reality back into it. What they don't tell you is that your risk of death is higher for many years after this sort of surgery.

And then I still haven't heard what percentage of people gain the weight back. So to undergo all that, roll the dice and get lucky, maybe suffer permanent malnutrition and still gain the weight back... wow. I just can't see how anyone would choose it.

[Mrs. Skip]

I know four people who have done it, and all have come through with flying colors and lost a lot of weight quite quickly. Three are women, and they have kept the weight off, although one of them still has very large upper arms. (not sure why?) The man, however, has regained a lot of his weight back.

I think because there are so many success stories out there, that makes many people feel that the odds are in their favor. (which, actually, is true) But it makes me wish you could tell people before they do it, that they should try low carb--especially since after the surgery they are obligated to pretty much eat low carb anyway!

[LessLiz]

Many reputable surgeons make patients go on a VLC diet before surgery, and test for compliance. There are people here on our forum that didn't get the surgery because they did so well on the diet and some that did go on to get the surgery.

If I hadn't lost weight on VLC and very low cal I would have had surgery. Despite what some people believe, there does come a point at which gastric bypass surgery is the best chance a person has to live. Blanket condemnation of the procedure or the people who have it, in my opinion, comes from the enviable ignorance of having never been in that position. I was in that position and it could easily have gone the other way. When I decided not to have the surgery, because I was finally losing weight, the people who had taken so much time to tell me about their surgical experience cheered me on through each and every pound I lost. I will not forget that, either.

[ValerieL]

Despite what some people believe, there does come a point at which gastric bypass surgery is the best chance a person has to live. Blanket condemnation of the procedure or the people who have it, in my opinion, comes from the enviable ignorance of having never been in that position.

Oh, I couldn't have said it better, myself. Very well said, Liz. Thank you.

[Nancy LC]

Then again if the world's fattest man at over 1300 pounds turned down gastric surgery and has lost 570 or so pounds.
http://en.wikipedia.org/wiki/Manuel_Uribe_Garza

Anyway, for selfish reasons I'm glad you all didn't resort to the surgery, otherwise I probably wouldn't have gotten to know you here!

From my understanding not all doctors are exactly being scrupulous about WLS. Some are taking patients that are just obese, not morbidly so. I doubt the screening is all that good for many doctors. Probably as good as it is at babybariatrics.com... check it out: http://www.babybariatrics.com/qualify.html

[MandalayVA]

A lot of people die from WLS and many, many more have complications. I hate how so many doctors sell this as a quick safe fix. A friend of mine had the surgery about five years ago and while she is "thin" she looks like death on toast.

[LessLiz]

And there we get to where these stories always head.

People die.
A lot of people get complications.

So if they didn't die or didn't get complications they are going to look like hell. :)

Just an FYI, but if you lose a lot of weight there are a large number of people who are going to think you look like death on toast. I've been asked if I had cancer by people who knew me when I was so fat and saw me a couple of years later (and after they found out it was me because they didn't recognize me.) There are people to this day who will tell you how much healthier and better I looked at 340, when I was close to dying. It wasn't a gastric bypass that made me look like death on toast though -- it was the Atkins diet. And yes, I am completely convinced that the reason I look like hell to those people is because they *know* I did Atkins and my kidneys are gonna asplode any day now. It's the Atkins kidney disease that makes me look so bad, not the loose skin or the wrinkles I developed when 5 pounds of fat disappeared from my face.

[jschwab]

Many reputable surgeons make patients go on a VLC diet before surgery, and test for compliance. There are people here on our forum that didn't get the surgery because they did so well on the diet and some that did go on to get the surgery.

If I hadn't lost weight on VLC and very low cal I would have had surgery. Despite what some people believe, there does come a point at which gastric bypass surgery is the best chance a person has to live. Blanket condemnation of the procedure or the people who have it, in my opinion, comes from the enviable ignorance of having never been in that position. I was in that position and it could easily have gone the other way. When I decided not to have the surgery, because I was finally losing weight, the people who had taken so much time to tell me about their surgical experience cheered me on through each and every pound I lost. I will not forget that, either.

I think what I would like to make the point of, however, is that it is not the weight that is the problem, it's health. I could do cartwheels at 280 pounds. A woman on this list was doing lots of triathlons at 250+ pounds. If the surgery is what makes you stop eating whatever it is that is killing you or reverse the severe metabolic disorder that you have, then it might be good for some people. But lots of people are extremely healthy at very high weights. I would rather see someone given the opportunity to exercise in a safe space and eat well before trying surgery. I also know people who've had it done who were maybe just over the line into obese. I have a colleague who did it along with his wife (insurance paid) and he was trying to get me to do it - he didn't realize I was just 8 months pregnant. He never really lost much and anything he did lose he's gained back by drinking beer all the time. She lost 30 pounds in total - I would guess she wears about a size 8 and weighs 150 pounds now so she defnitely wasn't very heavy when the surgery was performed.

Janine

[jschwab]

And there we get to where these stories always head.

People die.
A lot of people get complications.

So if they didn't die or didn't get complications they are going to look like hell. :)

Just an FYI, but if you lose a lot of weight there are a large number of people who are going to think you look like death on toast. I've been asked if I had cancer by people who knew me when I was so fat and saw me a couple of years later (and after they found out it was me because they didn't recognize me.) There are people to this day who will tell you how much healthier and better I looked at 340, when I was close to dying. It wasn't a gastric bypass that made me look like death on toast though -- it was the Atkins diet. And yes, I am completely convinced that the reason I look like hell to those people is because they *know* I did Atkins and my kidneys are gonna asplode any day now. It's the Atkins kidney disease that makes me look so bad, not the loose skin or the wrinkles I developed when 5 pounds of fat disappeared from my face.

You've been through so much, that just seems so UNFAIR! I feel a bit like death on toast right now (was 235 in May, now 193) and not really at optimal health because I've lost weight so quickly that my body is having a hard time adjusting. I look fine (thanks mom, for the elastic facial skin!) but my bones are all out of sorts. I can feel my ribs shrinking and it hurts. My back and shoulders are "clicky" and hurt all the time from adjusting to holding less weight. And my butt, well, let's just say, it looks anorexic. I feel like after I gave birth and my upper torso had to snap back to normal.

If anyone ever asked me if I was sick, I would be so mad! I think it just shows how you defied the odds. Most people have probably never met anyone who was as successful with their weight loss as you have been.

Janine

[LessLiz]

I don't think it's unfair, I just think its that people see what they expect to see. I suppose in some metaphysical way that is unfair, but really, to me, its just life among my fellow humans. I do the same thing in different ways.

What I object to is the judgmentalism. No one knows what is going on inside another person, that person's history or health. It is very easy to look at someone or work with someone and think you know about them. It is even easier to see someone make a decision about something very serious without giving it much thought, then transferring that observation to everyone else who made the same decision but got there after agonizing soul-searching.

[lowcarbUgh]

The lap band procedure is reversing Type 2 diabetes in some patients. Doctors will probably become very enthusiastic about it as the trials on that are published.

[jschwab]

I think it's like a lot of things - I don't have any issues with the people who take this route. But I don't think there is anything wrong with being critical of the kind of thinking that says that overweight is the sole cause of health problems and by fixing that, you fix everything. It seems that many doctors have ethical guidelines as to who is eligible for this kind of surgery and it is clear that other doctors do not follow the same kinds of rules, including performing the surgery on people who are not very overweight. I think as the procedures become more popular and are used to treat things like Type II there will be alot more blurring of the line between what is ethical and sound medicine and what is not and who is eligible and who is not. Someone who weighs 300 pounds and is healthy should clearly have more options, including LC. And they should be able to see themselves as a healthy individual instead of having it shoved down their throat constantly that they are going to drop dead.

Janine

[jessica70]

My mother had gastric bypass surgery many years ago before it was performed laproscopically (sp?). She had a giant incision from her mid chest down to her pelvis, and as a result, her healing time was much longer than it is today. She was successful in losing about 70 lbs, I believe, but I know that each and every day was hard for her. She used to get sick after many meals of eating more than her body could handle. Ya know what though? I believe she was happier being thinner and puking regularly than she was being fat. She struggled forever with dieting and had tried just about every diet around with limited success. Let's face it. We're all here because we are, or have been, fat. We all know that its no walk in the park taking the weight off. Its different for everyone. Unfortunately, my mom passed away at 58, 8 1/2 yrs ago from (a non smokers) lung cancer, so we didn't have a chance to know what her long term success would have been from the surgery. She passed just a couple years after her surgery.

On another note, I had a good friend that had precancerous cells in her uterus, and underwent a hysterectomy as a result. Rather "routine" surgery, but the hospital neglected to properly monitor her blood levels. She had 5 mini strokes within hours of being released from the hospital. This was a result of dangerously low potassium. She never was to work again, because parts of her brain were so damaged that some of her motor skills would not come back.

Just saying, there's no guarantees in life, people make choices that they want or need to do, and it doesn't always turn out as it should.

[Nancy LC]

Surgery is never a picnic. That's why I probably won't undergo the knife for anything that isn't 100% necessary.

Bring back the leeches! They can cure everything! :lol:

[lowcarbUgh]

Surgery is never a picnic. That's why I probably won't undergo the knife for anything that isn't 100% necessary.

Bring back the leeches! They can cure everything! :lol:

My gr-gr-grandfather was a doctor during the civil war period. He practiced "water cures." I think that would be more fun that leeches. :D

[Adorablema]

The lap band procedure is reversing Type 2 diabetes in some patients. Doctors will probably become very enthusiastic about it as the trials on that are published.

What do they mean reversing? Can the people eat cherry cheesecake and snickers and not raise their bg? If so, I might consider it. ;)

[xantioppe]

You've been through so much, that just seems so UNFAIR! I feel a bit like death on toast right now (was 235 in May, now 193) and not really at optimal health because I've lost weight so quickly that my body is having a hard time adjusting. I look fine (thanks mom, for the elastic facial skin!) but my bones are all out of sorts. I can feel my ribs shrinking and it hurts. My back and shoulders are "clicky" and hurt all the time from adjusting to holding less weight. And my butt, well, let's just say, it looks anorexic. I feel like after I gave birth and my upper torso had to snap back to normal.

If anyone ever asked me if I was sick, I would be so mad! I think it just shows how you defied the odds. Most people have probably never met anyone who was as successful with their weight loss as you have been.

Janine

To piggyback on this conversation, I totally understand the situation. After losing the majority of my weight (went from 200+ to a healthy 130) I went in for an annual checkup at my doc's office and he looked at my lightened frame and basically insinuated that I was anorexic. Of course he didn't say it per se, but the insinuation spoke volumes. I was enraged! I worked my butt off (literally!) for years to get to where I was and he had the nerve to insinuate that I just don't eat? It frustrated me; hang in there!

[JLx]

MSNBC had an article about this recently, transplanted from Self magazine:

The miracle weight loss that isn’t: Risks of gastric-bypass surgery are often underplayed, some experts say


http://www.msnbc.msn.com/id/26076054/

On their message board they invited people who have had the surgery to comment:

http://boards.msn.com/MSNBCboards/thread.aspx?threadid=751358

As I read through that thread, I found myself wondering how this surgery will be viewed historically. 100 years from now will it appear barbaric? Something akin to lobotomy? Which incidentally, the inventor of which co-won the Nobel Prize for Medicine in 1949. Lobotomies too, helped some people.

[jschwab]

What do they mean reversing? Can the people eat cherry cheesecake and snickers and not raise their bg? If so, I might consider it. ;)

Ha ha ha ha!

[jschwab]

To piggyback on this conversation, I totally understand the situation. After losing the majority of my weight (went from 200+ to a healthy 130) I went in for an annual checkup at my doc's office and he looked at my lightened frame and basically insinuated that I was anorexic. Of course he didn't say it per se, but the insinuation spoke volumes. I was enraged! I worked my butt off (literally!) for years to get to where I was and he had the nerve to insinuate that I just don't eat? It frustrated me; hang in there!

Sometimes I get the feeling that people at work might think I have an eating disorder, but I think they see me eat enough that that would never cross their minds.

[LessLiz]

I don't know about the lap band but the duodenal-jejunal bypass -- which doesn't induce weight loss -- appears to reverse diabetes within hours of being performed. So far it is still a research item. And reverse means exactly what it says: no longer type 2 diabetic. It has the same malabsorption effects as a gastric bypass.

[jschwab]

I don't know about the lap band but the duodenal-jejunal bypass -- which doesn't induce weight loss -- appears to reverse diabetes within hours of being performed. So far it is still a research item. And reverse means exactly what it says: no longer type 2 diabetic. It has the same malabsorption effects as a gastric bypass.

That's really interesting. This is the kind of thing that makes me think they might start using these procedures on thinner people.

Janine

[LessLiz]

The test procedures were done on normal weight Type 2 diabetics.