"This is Us" Show - WLS Risks

I watched the most recent episode of "This is Us" last night. Kate and her Mom had a meeting with someone in the surgeons office about the risks of RNY (such as dumping) and talked a little about her behaviors.  Though I thought that what Kate said about her behaviors resonated, it bothered me that the emphasis was on the risks of surgery.  I felt that it should have been more balanced: risks AND benefits.  There was no discussion about how to avoid dumping (or the percentage of people who get it). If I didn't already know what I know about WLS it would have scared me away. If you saw the show, what do you think?

I'm not sure what the general audience who knows nothing about WLS who saw the show would think. But that scene was what a surgical consult should be. They weren't trying to sell a surgery, they were talking about the risks of surgery, and the requirements to be successful. Those unfamiliar with WLS might have been scared off though.

There were some eye openers. When the doctor showed her the paper and asked her is that was her current weight, her mother looked shocked. I think most normies have no concept of a number that large.

I agree that it is what would be expected from a surgical consult, but I wondered what the general audience would get out of it since it only had that part and not any of the rest of the conversations.  I agree with you on the weight reaction - People are always saying "I never thought you were THAT overweight"... 

Long time ago -- I weighed about 330 -- my office mate and I were talking about weight and he said something that made me think he had no concept of weight (He is about my height - 6'3"ish - and weighed 220 I think).

After giving him the standard "you can't insult me with your guess," his guess was 275-280 -- if only i was 275-280.  No concept of weight.

I thought the person doing the consult was more concerned about getting the appointment over with- she kept referring to "so we can get our holiday started". That would have annoyed me if that had been my consult. 

I never brought anyone with me to my appointments, this made me glad I didn't. I'm a 'fly solo' personality anyway- I even bought my wedding dress by myself. 

This was kind of like my consult.  The surgeon was very clear on these things:

• risks
• average expected weight loss for someone my size with my surgery
• success will be aided by the surgery, but success will come from, or be restricted by, behavior and effort
• alcohol, nicotine, caffeine, sugar, carbs = bad

Even during his seminar (which was attended by 100s) -- risks were #1, exercise and diet post-operatively #2, benefits #3.

I caught up on the show yesterday and I had no idea she was doing this because I was behind.

I'm conflicted on her appt - I think that the risks were totally reasonable to discuss like they did and is what an appt should be like. And the conversation with her mom about the risks was so incredibly similar to my own. I don't know that my Mom has any clue what my highest weight was. 

But why on earth did she bring her mother! I didn't even want my DH there at the appointments that I really needed a driver for. I can't imagine that appointment and how that would be for me.

But that Dr definitely appeared to be rushing her off. And my doctor never told me anything about how to avoid dumping or the percentage of people who get it so that part didn't bother me at all.

I've given up on Hollywood even trying to be accurate when it comes to anything medical. They have to crank up the drama for everything, and there's only so much "shocking" of a character  with asystole that a critical care nurse can take before developing a complex. The closest they've come to accuracy was the show "Scrubs". So, I don't even get my hopes up anymore.

As clinicians, it is we who fail patients when we don't warn them, and when we approve people too easily.  That is entirely our failure.

Most people who go to surgical consults have already been told about the benefits of their surgery, either from the information sessions required, or from their PCP.  Or the internet. :)

My surgeon opened up our first meeting with, "It's very important for you to understand that while unlikely, it's possible I could kill you with this surgery."  We then reviewed risks, issues, problems, and then talked about benefits last.  That is how it should be in my opinion.  The surgeon needs to vet people who are not going to be successful.  Far too many people get WLS than should before more counseling and support.  Far too many people are not told about about weight gain after surgery, about how they should get counseling BEFORE and after, and many other things.  

Sometimes it's good to be scared away.  Surgery is absolutely not ideal for everyone.  Sometimes we need to be scared about how serious things are.  There are too many people who are set up for failure, or get the wrong operation, out of staff eagerness.

When I sit down to do assessments, I do preface what I say with a few benefits, however I review all the risks in far more detail, as well as the lifestyle change.  My job is to spare people unnecessary agony and angst. I have seen the damage of people getting WLS when they shouldn't far too often, and it is a sad and horrible thing.  Many cannot get revisions or a second operation because their insurance will not cover it.  They are full of guilt, loathing, and heart ache.  Or, there's the one RNY patient who is taking 10x the normal dose of Advil and Naproxen daily because, guess what, they never told her no NSAIDs.

It may be frustrating on our end as patients, however having had to start repairing the broken people after poor medical screening goes awry 10 years down the road... I'll take the tougher approach to start. If someone is scared away by surgical risks then surgery is absolutely not for that person.