Question:
Healing problems?

I have been trying to get approved for about 9 months now. I have everything but my final doctor visit. I have been working with my insurance and they have sent me several packets of info regarding the surgery and afterwards. During all this time I have been diagnosed with hypothyroidism and had to wait until that was under control. I actually gained weight once my thyroid was controlled...Yeah huh. I have PCOS and last month my OB/GYN scheduled an emergency hysterectomy. I have battled two infections because of my diabetes. My question is, if I go forward and get the bypass surgery, my insurance has said that with all the hoops/and prep I have done I am virtually guaranteed, will I have as much problem with healing. I had a full hysterectomy and one ovary removed and they did a full surgical incision. I am over 5 weeks out and still have 2 holes in my abdomen. I realize that the surgery would be lap and not a full incision but any wound can have trouble healing, has anyone with diabetes had trouble with wound healing after surgery? The reason I ask is that I have read that many people after surgery had their diabetes get much better. With that kind of improvement will it increase wound healing and decrease the probability of infection? I am at the point where I am considering not having the surgery even though I have put this much time and effort into getting it. I guess I just need to know that if I were to have issues with wound healing, would it still be worth it? Grace    — Grace C. (posted on June 21, 2008)


June 21, 2008
Grace, It comes down to one thing. Your choice. For me, it was an answer to alot of my problems. I had insulin dependent diabetes, HBP, Thyroid issues, Sleep Apnea, the meds I was on for all the illnesses was causing my weight to increase rapidly which caused my diabetes to get worse. I had the RNY and when I left the hospital 8 days later, I was no longer on any meds for diabetes or HBP. I had no problems at all with healing. On the other hand, my husband had the same surgery three years ago, and 3 weeks post op developed a major infection in the incision area and they had to reopen his wound and place him on a wound vac for approximately 4 months. He was topping out at 375 lbs. and is now at 260 lbs with no meds. He was also severe diabetic. Would he make the same choice again? Yes. RNY has saved our lives. There is no doubt. I wish you well.
   — Breathin4him

June 21, 2008
I understand your concern. I had a major operation not related to WLS when I was 22 and had a very difficult time healing and have severe scarring. I am pursuing gastric bypass and this would be my 2nd major surgery and I am very concerned about healing. I am diabetic but not on insulin. I have the same concerns but I am trying to look at the big picture of my overall health and the benefits I will gain from WLS.
   — psturgill

June 21, 2008
Hi, Grace I do not have diabetes, but i too have a hard time healing, I have had celulitas open wounds having to pack them in the past. I also had a hysterectomy in 2006 and ended up going to the emergency room 2 weeks after to have it reopened because of the infection (celulitas) I was in the hospital for 6 more days trying to fight the infection I went home with A 4 inch wide about 3 or so inches deep owey that had to be packed until it healed a couple of months later. My doctor is aware of this and he has told me that he will try not to do my RYN open because of the healing problems he said he does not see a problem as long as we are careful. I know that having diabetes it is different but I wanted u to know that I am going forward with the surgery because i know i would rather be uncomfortable for a few extra months then remain the way i am now. God Bless you and i will keep u in my prayers Tammi
   — Tammi Sandoval

June 21, 2008
I am 62 years old and had diabities for 25 years. Everyone said it would not do me much good, but my sergeon would not promise, but had high hopes there would be an improvement if not a total correction. I was concerned because I was on pills and Insulin. I took pills to cure the effects of other pill I took. I had High Blood Pressure, 5 stents, High Colestroal and the last blow for me was the recomendation from my heart doctor, saying there was a high risk for me having the surgery, but he would estimate that without drastic weight loss it would be only 3-5 years before I would pass. Pass what? Then it struct me, he was telling my surgeon, that I was going to die if I did not have it so go ahead and good luck. I had the surgery on my 62nd birthday, and was nervious for a month before, but did everything they told me. I broke three bones in my foot, but they could notoperate because they knew my foot would not heal. I asked the same question you ask of my sergeon, and he told me they would seal the wounds with what would look like crazy glue to me. They would not use stitches on the outside. There would be a small rain tube, that would be removed before I went home, and I could watch the glue it up. I did fine with the surgery, but I had a hard time getting my blood oxygen levels up, so they kept me for 5 days. Everyone else went home the next afternoon after surgery. I stayed on oxygen, and they came every 6 hours and gave me insulin shots. I heard one of the younger patients on the phone before she went home telling her freind he blood suger was normal the next day and she was told not to take any medication for diabities, and here I was getting shots as usual. When I went home they told me to try and control it with pills, but to test 5 times a day and log the results. For the first two weeks, I was in the 150's waking up and as high as 180 during the day. one week three I got up one morning and I was 110, and that day I was a high of 125, the next day 100, and the following morning 85. They told me to drop about half the drugs, but I continued to be 85-95 in the morning, so every day I drop another drug. After 4 weeks, we could not get me over 100, so they pulled all the diabitic drugs, and I have never taken anything since. That was January 15th, 2008. A week later, I bent over in a store to tie my shoes, something I could not reach before surgery, and when I came upright, I blacked out. That was the end of the Blood Pressure medication. Today I have blood pressure of 100/55 and a pulse of 55 in the morning with a high during the day of maybe 65. My A1C comes back 5.6 now, and I never could bet below 7.0. My total colestroal is 95 and it use to be 300 with medication. Two weeks ago, I cut my foot, swiming on some shells, and I when right away to my foot doctor and he was concerned because it was about 5" long and somewhat deep. A week later he check it agan and it was healing well without stitches. Totay it is totaly healed. I took months to get over a blister tw year ago on my foot. All I can say is it is your decision, but I would have RNY WLS today if I had to do it over. I have lost 120 Lbs. People that have not seem me in 6 months walk right past me. I love going to see freinds that I have not seen since surgery and knocking on their doors and realizing here is another person that is expecting me and does not reconize me. Go to a support group meeting and talk to others that have had RNY WLS and see what they have to say about their experences. I don't think you would find anyone that would not tell you to forget the insurace companies comments. By the way, I had approval from my insurance comapny, but my doctor changed hospitals, so they would not cover it when I went to have the surgery. It cost me 25,000.00 and I still would pay it all over again. I can't go on a real vacation this year, or replace my car, but I will be here next year to do thoses things then. Best of success to you.
   — William (Bill) wmil

June 21, 2008
I have diabetes and I was insulin bound and had lap band 4-16-08. The insulin went two days after surgery (oral meds now) but I had no problem healing at the incision sites at all. I have had two knee replacements and metal rods and screws in my back and I have always heal with no problems and the surgeons were surprised because of the diabetes. I figured if I did, in the long run, it would be something the doctors could repair, and my health would be better if I have the surgery. I would do my surgery all over in a heartbeat,, but sooner...Good Luck
   — dyates2948

June 21, 2008
Thanks everyone for your help. I know the final decision is mine, but am eternally grateful for the input I get here. I have told my Mom that after all the trouble I am having healing I was doubting having the surgery. She said good, she was never very supportive to begin with. I told a friend of mine who also had expressed doubts when I told him I was getting it. His response surprised me though, he said that I was "too close" to it right now. I still have two open wounds that have to be packed every day. He said I should wait until I heal completely before making that kind of decision. He was right. I have been bouncing back and forward but I believe that once I heal and give myself time I will move forward with the bypass. I am just glad that I have not contacted my surgeon and told him to take me off the list. I would hate to have to start over again.
   — Grace C.

June 21, 2008
Hi, I read your question, and want to give you some info about surgery. I had RNY (Roux-en-Y) Gastric Bypass on 02/1/2008. This isurgery, specifically cures over 90% of people with Type 2 Diabetes. CURES them. Most people see a complete eversal or a dramatic decrease in their blood sugar levels within 2 weeks of surgery. Doctors were wondering why it cured diabetes so fat, after all, patients have not lost a huge amount of weight by 2 weeks post-op.... An Italian Doctor decided to do research on it, and found it is not simply weight loss. He found that it is because what they do with this surgery to the small intestine, (the Duodenum). When they cut the duodenum during the surgery, (They attach it to the new stomach pouch), the research found it causes a change in the body that cures Type 2 Diabetes. I don't know the specifics because I can't remember what they said it does exactly, but anyway, I watched a piece on it on the show 60 Minutes with Leslie Stahl. They interviewed that Italian Doctor and another Doctor. The Italian Doctor said they are hoping to eventually develop a similar surgery, not for weight loss, but just to cure Type 2 Diabetes even in peopl who are not obese. The interviewer, Leslie Stahl, asked the other Doctor, she asked, "Gastric Bypass surgery CURES Diabetes?", and the Doctor responded, "yes, CURES." Lap-Band and other types of weight loss surgery do not cure Type 2 Diabetes. I strongly encourage you to have this surgery. You will never again have to worry about an incision healing because you won't be a Diabetic anymore....... You are going to have Laproscopic Surgery too, so that will heal faster and eaiser. I had open surgery myself... I was borderline Diabetic, had Gestational Diabetes when pregnant, and a strong family history of Diabetes. My fasting blood sugar was anywhere from 114 - 132 before surgery. Now, my fasting blood sugar runs between 90 - 104. I am so thankful, and grateful that I got to have Gastric Bypass surgery, to lose weight, be healthy, and never again have to worry about Diabetes. I feel so bad for people who don't have insurance and can't afford it, like my Mother-in-law. She is in Egypt, (she is Egyptian) and has uncontrolled Type 2 Diabetes. Her fasting blood glucose is over 200. They don't do this surgery there as far as I know, and insurance is almost unheard of there. You have been fortunate enough to have this opportunity. You are going to be so glad you had the surgery, and will be so much healthier. God bless.
   — Gina S.

June 22, 2008
I am (or WAS) a diabetic. I have had the Vertical Sleeve Gastrectomy and not the Gastric Bypass, but the weight loss surgery has turned my disease around. As long as I follow the STRICT dietary guidelines put down my NUTRITIONIST of eating a certain amount of PROTEIN and CARBOHYDRATE with each meal and NOT EXCEEDING those amounts, I have NO problems with my diabetes! I would highly recommend that anyone that has had weight loss surgery speak with a Nutritionist that is familiar with weight loss surgeries and then follow the advice given by them to help alleviate their blood sugar problems and thirst issues. They may also want to speak with a physician. Let me preface this by saying that I am not a medical expert. I am just a weight loss patient. I was taking 70 to 80 units of insulin daily and 4 pills of glucovance 5/500 prior to having the Vertical Sleeve Gastrectomy performed on me on the first of March. In only 3 WEEKS I had to DROP all of my diabetes medications! It didn't happen all at once. I kept gradually reducing my dosage as needed until I was down to only ONE pill of glucovance. Finally, at the end of 3 weeks my blood sugar had dropped down to 53 points in one day! I HAD to stop taking ALL of my diabetes medications! My blood sugars after a meal are now running about 113/140 points which are a little high for NORMAL but are still in NORMAL range. With the advent of MORE weight loss, I should get closer to normal blood sugar levels. I also suffered from FibroMyalgia, Arthritis, Migraines. Chronic Fatigue, Spastic Colon and Chronic Diarrhea. The Spastic Colon and Chronic Diarrhea have been resolved by the surgery. The FibroMyalgia, Arthritis, Migraines and chronic Fatigue have all been improved to one degree or another by the surgery and the resultant weight loss. The Arthritis was relieved almost completely almost immediately. The FibroMyalgia has not been fully resolved but has improved significantly. The same can be said for the Migraines. My Chronic Fatigue has GREATLY improved. I have MUCH more energy now than I did before. I have lost 76 pounds since March 1. My surgeon and my physicians are looking forward to watching the improvements in health as I lose the weight. I had recently been given a shot of steroids for an injury to my knee. This had thrown my blood sugar levels off some. When I had first gotten the shot, my blood sugar levels shot up into the 300's. They occasionally crept up to around 200. I had started taking ONE pill of glucovance on occasion when I noticed that my blood sugar levels had started creeping up again. I did NOT have to take the pill every day, just occasionally. The longer I was without the steroid shot, the less often I will needed the glucovance until I no longer needed it again. I am once again FREE of the blood sugar medications. Hopefully, when I reach my GOAL in about 70 pounds or so, I will not NEED the occasional booster when I get steroid shots. Hopefully, by then, I won't NEED the steroid shots! I have done some research and posted it on my Profile page. You can find it at http://www.obesityhelp.com/member/hubarlow/ . I hope this helps, Hugh
   — hubarlow

June 22, 2008
I was typeII diabetic...I had my last insulin shot in the hospital after surgery and never had a high again that I know of...My HGB A1C is still perfect 4 years later...I had open RNY and healed fine with minor complications from latex surgical strips they glued to my skin. I had a bad allergic reaction to them and the glue...and then my staple line got infected because of the latex...but I went in and they took the strips off for me and a little neosporin on the reaction site and all was fine...It took me 6 months to heal though, from the surgery...and another 6 months before I felt NO pain at all...so it was a very long recovery, but no infections or major problems...just slow healing inside...They rarely do open RNY these days anyway...so that's quite a plus for you...Good luck...I hope you find yourself healthy and happy...with whatever decision you make...
   — .Anita R.




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