Gastric Bypass - Is it for You?

For most of my life, I have had weight issues and in recent years have come to term with the fact that I will always have to watch not only what I eat but how much. Also, I have to honestly determine how tired I really am after punching a clock. Will it hurt me to do a little timed (30 minutes or less) housework, a few stretches or a short walk? Like everything else, I realize that if I spend too much time debating it, then I might as well do it before it comes time to begin another work day.

I have also come to terms with back-handed compliments as well as comments that were just vicious and cold. While I can be assured that I live my life like most anyone else, those who carry around an extra one hundred pounds or more may not be able to make such a claim. It goes without saying that they have had difficulty doing everyday things such as going up two or more flights of stairs, repeatedly bending over or playing most outdoor sports. If one is considered morbidly or grossly obese by medical standards, then eating right to lose weight may be easier said than done. Turn on any Discovery Channel giving a first-person account of how different diets have been tried and failed because they did not have the physical stamina to routinely exercise and thus reverted back to eating what they wanted and being complacent or not burning enough energy to reduce body mass.

History

The first gastric (or bariatric) bypass surgery was performed in the 1950's under Dr's. Kremen and Linner and was known as the jejuno (or second section of the bowel) -ileal bypass. This consisted of connecting the upper small bowel to the lower small bowel and bypassing the middle so that the area that would normally absorb calories could be reduced. The post-surgery results were diarrhea, gallstones, night blindness, hair loss, kidney and liver failure as well as other problems. In 1966, Dr. Edward Mason pioneered in making great improvements in the procedure by creating a gastric pouch out of the stomach that would limit food intake and making a "loop" of the small intestine to be placed around the bowel to limit caloric intake. Though this procedure still had its flaws, more surgical improvements came along and some are still practiced today.

Methods

- Duodenal Switch - the most controversial yet has the highest success rate in permanent weight loss. This procedure involved reducing the stomach by about 1/3 of its original size and the stretching of the small intestine for decreased absorption of food.

- Gastric Banding - this method has proven the slowest weight loss but one of the least risky. An adjustable band is placed around the stomach dividing into a smaller and larger sections.

- Laparoscopic (or Roux-en-y) - this method varies by physician but small incisions are made from the breastbone down to the navel and video cameras are inserted through the abdominal cavity and the doctor uses an overhead high-resolution video monitor to see exactly where their instruments are to reduce the stomach as well as intake of food. The cameras as well as minimal cutting reduce the amount of post-surgery pain but patients must follow a strict diet afterwards to avoid an internal fluid leaking or "dumping". There is also a "mini" version that takes around half an hour to perform.

- Stomach Stapling - another name for Gastric Bypass yet similar to gastric banding except surgical staples or stitches are used to make the stomach smaller.

After the Operating Table
In my research, I found that basically all of these methods came with risks - as most surgeries do but the common results found were iron deficiency (anemia), vomiting, bowel obstruction, infection, pneumonia, weight re-gain, abdominal cramps and death. On the positive side, some patients reduced their risks of gallstones, their insulin was either controlled or diabetes went into remission and their blood pressure dropped enough to where medication was no longer necessary.

Costs
Not to be confused with a tummy tuck that costs somewhere between $3500 and $5000, the average median price is $35,000. This usually includes pre and post-op treatment and most medical insurance will cover anywhere from 50-80% of the costs

Like most folks, I hate going to the doctor and what does not help is that when I open the Los Angeles Times newspaper, there is either a malpractice suit, a public hospital in jeopardy of losing their credentials or something lets me know that a procedure I may need (i.e., removal of a tumor, replacement of an organ) in the future does not guarantee my life once the anesthesia has worn off. It is understood by some of us that being morbid or grossly obese does not necessarily come from glutton-like behavior or an extreme love of starchy foods but can be the result of some other unforeseen trauma that may be emotional, mental or physical. I do not promote nor condemn this procedure but I would recommend seeking other options and getting more than one medical opinion.

For more facts regarding this serious procedure, please contact the American Society For Metabolic and Bariatric Surgery or a trusted healthcare profession .