Question:
How did you reconcile the rare, but real, risks of RNY surgery to benefit?
I am going through pre-op approval at a WLS Center in Massachusetts. I received an email from another WLS candidate this morning, who is an RN for a visiting nurse association. Whe was called last night to see a patient in distress after a gastric bypass. The patient is a 32 year old girl who had RNY September 08; and at that time spent 4 days in ICU, bleeding internally and needed transfusions. She now suffers from kidney problems, malnutrition, and is down to 102 lbs and still cant eat or drink; has been on IV TPN for nourishment. The nurse was called to remove the IV because of blood clots in her arm and now may need a feeding tube. This patient, of course, goes to the weight center we attend. She told the nurse that when she walks in the waiting room, they call her right in, they don't want her talking to any patients. She also said they never said there was an error, but they have not yet given her primary MD a report on what went wrong. They told her she was a perfect candidate and passed all tests with flying colors. While this is rare, it is reality, and we share this scenario with others who would understand the risk and have made the decision to have RNY anyway. We have asked how many complications our surgeon has had and were told the two surgeons had one serious complication each. Both have had done at least 500 RNY laprascopic sugeries each; both have had 9 months of specialized training at great teaching hospitals. But it makes us wonder do we mess with this or live lives to the fullest, and be happy"????? Can anyone share their thoughts? — Annette M. (posted on July 21, 2009)
July 21, 2009
This is my third attempt at answering this message so if there are any
incomplete ones, I apologize.
I too had complications of CHF and early kidney failure as a result of too
much fluid being administered during my surgery to raise my blood pressure
which had gone dangerously low.
I spent the next three days in ICU and went home finally on the sixth day.
Any professional will tell you that there are risks involved in any surgery
and this is an example of one of them.
Would I do it again, you bet, in a heartbeat. I have not felt this good in
a very long time. 1-2 problems within over 500 RNY's is not bad. Most of
us are really not in the best of health to begin with.
I too was told I was a perfect candidate.
— mmartel1
July 21, 2009
My feelings probably differ from many others but here goes--in general the
more cases the surgeon has done the less chances of post operative
complications. My surgeon has done over 1200 RNYs. Its also important to
have your surgery done at a Bariatric Center of excellence.The staff is
trained to care for morbidly obese patients having WLS..This is a heart
breaking story to hear about.They should NOT hold the details of her
current health from her primary care provider.He/She should be involved in
her care. I think sometimes we forget serious complications can happen
after any weight loss surgery and need to do our homework before picking a
surgeon and type of WLS.
— gay_
July 21, 2009
for me it wasn't even a question. i was thinking prior to having surgery,
"gee, i could die". and i decided i would rather be dead than
living my life this way forever. so it was worth it to me!
— greenpunchbuggie
July 21, 2009
I posted on my profile that I really liked my Bariatric Surgeon. I checked
him out, reviewed his statestics and he said that if a person is going to
die from the surgery it will either be on the o.r. table due to problems
with anethesthia, that is why they ask you if you have ever had problems
with it. The other is a person is going to die from the WLS within the
first week. Anything after that is usually and I use the word usually very
loosely due to other issues but not from the surgery itself. I thought
about the pros and cons. All doctors tell people what the risks are prior
to surgery so we understand we CAN die from the surgery. But I bet if you
were to take a poll, 99% would rather die than live as a heavy person if
they have a choice. That is why we have this surgery is to gain our lives
back. If we aren't living life to the fullest, then our attitude is, I
might as well be dead. Only a person that is overweight can ever
understand what it is like to be overweight and try everything only to
become a professional yo-yo dieter. So to answer your I would do it all
over again. I had such a great doctor that did a wonderful job on my RNY
3.5 yrs ago, I have never had any issues other than not chewing my food
good enough and throwing up. But my surgery went perfect. I was out of the
hospital the next day, drinking my liquids and walking, so they said there
is nothing else they can do for me. So I went home the next day. I would
always recommend that a person considering wls should always go to a doctor
that specializes in morbid obese patients, you know a Bariatric surgeon.
Never go to a dr (general physician) that has only had 40 hours of training
to do a gastric bypass. This is the best tip or advice I could give to
someone seeking wls. I highly recommend if a person is thinking about
having wls done, stop thinking about it and do it. It will be the best
choice you have ever made. I hope I was able to share my thoughts enough to
say I am happy with my decision.
— Kristy
July 21, 2009
I was told that my risk of dying from comorbidities of being morbidly obese
was six to nine times higher than my chances of dying from the surgery.
Nonetheless, there is a certain percentage that will have awful
complications or even die from the surgery. The risk involved is way way
less than the risk of driving anywhere in your car and dying in a car
accident. Still, there are very few people that will not get into a car
for this reason. I think it is all very subjective - peoples' fear of the
surgery is not necessarily statistically based, and anyway - who is to say
that you or I will not be that .01 %? For me it was very reassuring to
remember that G-d does not make mistakes and that if I have to go from this
world - then it was meant to be. I wish you the best of luck in your
decision making. I remember how hard it was for me too - hindsight always
has 20/20 vision...
— zimra
July 21, 2009
I am 56 years old. I used to be 5'9", and I've been obese since I was
23, with my normal weight of 175 pounds skyrocketing after I had my second
child. Heck, after my FIRST child, who was so big that I had stretch marks
from side to side, and from my pubic bone all the way to 6 inches above my
belly button, I developed what they called a "fat apron" that
they said would never go away. It's just been getting bigger and bigger. I
topped out about 5 or 6 years ago at about 312# (I THINK), because I
wouldn't get back on the scale after that. I was an active mom, a Girl
Scout Leader who took the troop on campouts and hikes and to vigorous
trainings, but my weight was a definite drawback, as in when I blew out my
knee jumping off the hood of my car after packing gear on the top. I lost
the entire ACL and most of the meniscus. Then, with the weight and the
lateral instability making me unsteady on my feet, I blew it out again
several years later and lost more of the meniscus, now making it largely
bone-on-bone. Then, I did it to my other knee. Now, both knees are
severely arthritic. But that's not the bad part. The weight of my stomach
pulled my spine forward, causing lumbar spinal stenosis about two years
ago. It manifested itself as severe and unrelenting sciatica. I couldn't
walk without severe pain in my left buttock and running down the length of
my left leg. Then, it started to get worse. Both legs became involved,
and I was told I had severe arthritis in my lumbar spine as well as a
vertebrae that had tipped forward, contributing to the compression of my
spinal cord. After years of yo-yo dieting and losing the same 50 or 60
pounds over and over again, I finally decided that I needed to do something
radical to lose the weight and get out from underneath the pain. I had my
surgery in early March, and in another 7 pounds I will have lost 100
pounds. I have 45 more to go to get to my surgeon's goal for me, or 65 to
get to my own goal. Before the surgery, I was using a walker to get from
my bedroom to the bathroom at night or I wouldn't make it. I was using the
handicapped carts in the grocery stores to do my shopping. I had a
handicapped sticker for my vehicle. Now, although the weight loss itself
hasn't totally eradicated my pain, the loss PLUS
— Erica Alikchihoo
July 21, 2009
sorry....hit the wrong key and my unfinished answer posted unexpectedly.
Anyway, the weight loss PLUS a series of epidural pain shots have made me
virtually pain free, and I've gone from only being able to walk 100 feet
without stopping and huffing and puffing for 10 minutes, to walking a mile
in 24 minutes on the treadmill (or on good days, around a beautiful lake).
I've gone from only being able to ride a stationary bike for 5 minutes at
an intensity level of ONE, to riding it for 30 minutes at an intensity
level of SIX. I'm using a rowing machine for 15 minutes. I'm using an
"arm bike". I'm using the ellipitical machine, which is REALLY a
workout. And I'm doing weight training and beginning Pilates. And I'm
happier and healthier than I've ever been. People don't even recognize me
when they see me. My surgeon has done over 2,500 WLS surgeries, and has
also developed the "FullBar" and "AquaFull" drink. His
picture is seen in GNC's all over the country.... and my Hospital is a
Bariatric Center of Excellence. We have pre-op and post-op support groups
that are ongoing. We all know the risks. We all chose to take a second
chance at life. I know that I would not have wanted to live like I was.
But, I never had a moment's fear that I might die, or have complications,
or anything else. I have a deep spiritual strength that sustains me, and I
think that can be just as important as any other part of this process.
— Erica Alikchihoo
July 21, 2009
There are risks to everything in life. Some women die doing a very normal
body function like giving birth. People get killed just for crossing the
street, car accidents, house fires, and the list goes on. Does that mean we
just sit and die? Hell NO!!!!!!!!!! Whatever the risk to wls, I'm willing
to take it. If I don't, I will surely die from my co-morbidalities. If, God
forbide, something happens,I want to go down fighting.
— Kathleen W.
July 21, 2009
Not to sound cynical, but if i had stayed fat, I would have died in a few
years. It put me back to 40 instead of 50 and a healthy 40 at that. I am
very pleased and thankful everyday for the opportunity of the chance to
have the god given chance of modern medicine.
— lesleigh07
July 21, 2009
There are risks to any type of surgery, for me it was a matter of comparing
the risks to the real possibility of an early death or years of suffering
because of the medical problems I had started to encounter. I was terrified
at the thought of RNY at first, but gained confidence as I researched
surgeons, went to their seminars and spoke personally with them. My surgeon
had done thousands of RNY's and openly discussed the possible risks vs. the
benefits. I was unable to 'live life to the fullest' the way I was. I'm now
5 months post op, have lost 110 lbs and am about 50 pounds away from my
goal weight. I walk 30 minutes a day, before surgery I couldn't walk for
more than 5 minutes. I have so much more energy and my medical issues are
either gone or under control. For me it was the right decision, but it's
definitely a personal decision that you need to be comfortable with before
surgery. Good luck!
— jeannefitz
July 21, 2009
Like all the others, I would do WLS over again in a heartbeat. At Age 59,
my quality of life was so bad and I couldn't bare to continue to live any
longer like that. I went to bed every night thinking, "is tonight the
night, I won't wake up????" I couldn't breath, stand, walk, and
constantly felt like an embarassment and burden to my kids and family. My
brother even took off of work, showed up at my door with a book that he
demanded I read because he was scared I was going to die if I did not shed
the weight. I was 5' 3" and weighed 333 lb. I did read his book, but
it was just another diet. Like others, I had YoYo dieted my whole life.
When I decided to do the surgery, we all knew there were risks. But, my WLS
doctor assured me he had operated on many more patients who were actually
worse off than me and they came through with flying colors. My vital signs
were strong, so for me, it was a no brainer. Well, I am 60 years old now
and a 100 lbs lighter. EVERY single ailment I had is gone except my
Hypothyroidism. I walk, ride my bike and do everything I missed out on all
those years. It is the best thing I could have ever done for myself and I
am sad I didn't do it sooner. As far as weighing the risks - It is a very
personal decision and you must decide what is better - a quality of life
that is worse than living or a 2nd chance at life by losing the weight you
were never able to do through dieting. Good luck!
— BonnieP
July 21, 2009
Hi Annette,
It sounds like your friend is going through a VERY rough time. Medicine is
never an exact science and it sounds as if she did her "due
diligence" before hand to make sure she was in good hands.
Even the best of surgeons can make a mistake, the important thing is they
find out what's going on and get it corrected.
I have a personal example where my dad had a melanoma in his upper groin
that needed to be removed. He had PET scans which showed exactly the
location and a pathologist's report. What noone had seemed to realize is
the report said the cancerous lymph node was below a "certain internal
marker" when it was above this marker. They don't know if the
radiologist made a mistake during his dictation and said below instead of
above or it was transcribed incorrectly. The surgeon didn't look at the PET
scan during surgery just the report. Long-story short, my dad had to
undergo a second surgery to remove the still-in-place lymph node two weeks
later.
Personally I feel the benefits far outweigh the risks. I was on five blood
pressure meds before my surgery and now 18 weeks later am on one. My
insulin use has gone from 230 units/day to 20 units/day, my sleep apneia is
gone, I have no more joint pain. I feel many years younger than prior to
surgery.
If you have concerns address them head on with your surgeon, I also suggest
you have someone else with you when this is done so that he knows he's
telling this to more than just the patient. If you are not satisified with
the answer press on until you are. If he can't satisy you then find another
surgeon.
Hope this helps somewhat.
Best of luck to you!!!!
— rkurquhart
July 22, 2009
Everyone who has answered your question has told my story to a 'T'! All I
can really add is that I figured since I already wanted to be dead, if I
died because of WLS, then my 2nd major wish in life had been granted. But
if I lived, then my number one wish in life would be granted: to LIVE life
without constant pain, embarrassment, and shame. My faith and my God-given
determined nature to conquer life's obstacles are my primary sources of
sustenance and were what led me to follow through with having WLS. Living
involves risk. The question I asked myself is would I rather die taking a
risk or wasting away in barely tolerable existence, quickly approaching
intolerable? If you are able to live life to its fullest as an obese
person, than live it. But if you are not able to live life to its fullest,
for whatever reason, do whatever it will take to change it. My only
caution to anyone considering WLS is DO NOT EXPECT WLS TO CHANGE THE CORE
OF WHO YOU ARE. Only you can do that. But WLS can give you more years in
which you can become the person you want to be.
— rebalspirit
July 22, 2009
You can step out from your house and get hit by a bus. When your number is
up - it's up. When the big guy calls you home - you go.
Having said that - my decision to have WLS over shadowed the "what
if's", the "it could happen to me", etc. etc. etc.
I pulled up my big girl panties (an expression my mom used to tell us to
get up and on with it) and drawed upon my spirituality and my desire for a
better life.
It all worked. I had WLS on 2/15/07 - going on three years. I am 38 years
old. I am 5'8". I weigh 150lbs. I wear a size 4/6, XS or S in my tops
and 6/8/10 in pants depending on the cut, the designer, etc. I weighed 286
at my very highest and wore a size 26 pants and a size 18/20 top.
I just went to my 20 year high school reunion and knocked them all dead.
LOL.
Good luck with your adventure. Yes it is important to know the risks, but I
think it's more important to "want" this and get your mind
wrapped around being prepared and ready for your life style changes.
Positive thinking goes a long way.
— jammerz
July 22, 2009
Annette, everyone said all the things for me. I just want to add I was
nervous going into surgery, just as I am nervous when flying a plane (I
drive everywhere I can). Also my insurance would not cover the surgery so
my young adult sons and myself split the bill 3 ways and I am now broke as
a church mouse but happy and getting healthy. I am 2 months out and 45
pounds lighter and poor and happy and ailments gone. Thank God for blessing
me with a way to have the surgery!!!
— sallie H.
July 23, 2009
On the day of my surgery I didn't care if I lived or died. That said: make
sure you check out your surgeon throughly, go to the state medical board,
google, all of that. Make sure the doctor knows all your health issues. I
have heard some people not telling docs about things because they are
afraid they won't perform the surgery. On the day of my surgery I didn't
care if I died, but somehow I new I wouldn't. My mother was getting upset
as I went into the OR, and I told her not to worry, that I'd be back. The
point I'm trying to make is listen to your intuition, If you have a bad
feeling, don't do it. Not to mention, sometimes things just happen
remember, surgery is not something the human body was made for so
occasionally it doesn't work out you know what I mean.
— Nicole W.
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