That is the question I get the most often. Some people honestly do not know what it requires. My precious and sweet 85 year old grandmother in law was scared for me to do this because she thought the surgery involved taking my whole stomach out. After I assured her I would still have all of my parts and showed her a graph of exactly what would happen, she felt better about it and gave me her blessing. But then others have misconceptions about it because a "brother's friend's mother's cousin's girlfriend's granny had it done" and "they look sick, their bowels fell out, they had to be cut from stem to sternum, and gained all of the weight back and more"....all of which I have heard from people at some point! The fact of the matter is, IF any of those things happen, it's quite rare. Gastric bypass surgery (roux en-y) is actually quite safe and is no more dangerous than common surgeries.
So what is gastric bypass surgery and how does it work?
This type of operation is both"restrictive" and "malabsorptive". It is "restrictive" in that it creates a small pouch out of the stomach, 1-2 ounces, which limits the amount of food a person can comfortably eat. It is "malabsorptive" because the stomach and first portion of the small intestine are bypassed and calories are not absorbed. So in a nutshell one eats less and absorbs fewer calories of the food they do eat. The operation is done laparoscpically through 5-6 small puncture wounds which limits post operative pain and hastens the recovery process.This procedure is currently the most common operation performed for weight loss in the United States. The weight loss is typically faster with this procedure when compared to the Lap-Band, but does require more rigorous vitamin supplementation.
I found this nice little graphic that shows what is exactly going on in the stomach of a bypass patient.
So why would someone choose WLS? For most patients, diet and exercise alone has not worked at loosing AND keeping off weight. More times than not, there are other medical conditions that prevent the person from being able to loose on their own. The surgery is not a "fix all" and you still have to do your part of eating right and having a great activity level. Any WLS surgery is just a tool and is by far the "easy way out" that some people think it is. The great thing about WLS, is most conditions get better or dissolve after surgery.
Like any surgery, there are risk. A lot of the times, when people have problems, one of a few things have happened:
1. The surgeon did not weed out patients who can not be successful and are pursuing the surgery for the wrong reasons. (i.e. "I want to be as skinny as (insert actress)." or "I want men/women besides my partner to recognize me."). This is also where we would probably put people who are "too sick" for the surgery itself. Unfortunately, there are times when a patients risk of doing the surgery is far too great to do the surgery safely. To be honest, there are doctors out there who do not care and will "chop" on whoever pays the money or has the insurance to cover it.
Question to ask: What do you do to make sure the patient is the right candidate and ready for surgery?
2. Not picking the correct surgeon for the procedure. To be honest, some people do not care, nor do they take time to research the proper wls surgeon for their procedure. I personally have known people who went to a general surgeon that has had no bariatric training to have the surgery done. Would you go to a dermatologist for a heart problem or go to a OB/GYN for a lung problem? Probably not. So why in the world would you not go to a bariatric surgeon for WLS surgery?
Questions to ask: What type of bariatric surgeries do you perform? If their answer is that they only perform one particular surgery and try to sway you that way, thank them for their time and walk out! It is ultimately YOUR decision and if they are not willing to answer your questions and guide you to the right option FOR YOU (not just "what they do", then they are the wrong surgeon. I know of doctors who ONLY perform one of the WLS and nothing else. If that's the surgery you are wanting, then by all means, go for it. If you have never thought about a different surgery, then you owe it to yourself to talk to a professional who is well versed in all of the surgeries. I am so glad that I did that, because the option I orginally pursued, turned out not to be the right one for me and had I not gone to a doctor who performs all the major WLS surgeries, I would of never known that and been pressured into something that wasn't right for me.
3. Underlying preexisting problems. Unfortunately, sometimes people had an undiagnosed health problem that causes a problem during or after the surgery. This is a great question to ask your surgeon. When I asked my surgeon how often had they had someone pass away because of the surgery. He told my husband and me. He was very honest as to what the underlying problem had been and answered every question we had for him.
4. Known health problems with no further preop testing. One of our family members had a blood clot in their leg before surgery. The doctor "thought" it had gone away when the surgeon did not see it through the skin and did no further testing. After the surgery that was deemed "successful" our family member went home. The blood clot had not gone away and went to the person's lungs. By the time, it was found, the person had passed away.
Question to ask: What pre op testing do you do for (insert your health problem here) to determine if I am capable of a successful surgery? What care do you take to prevent complications?
There could be other things that may cause a person not to be successful. To make sure that you are asking the right questions, I found this great list of questions titled How to Choose a Bariatric Surgeon. You could even print it out and take it with you so that you do not forget the questions. If the doctor acts annoyed and tries to rush you, that's probably not the surgeon for you.
Another great resource for you is from other patients! That is one of the many reasons I decided to write about my journey, is to help inspire people, but to also answer questions they may have. I personally have found a great support among friends who have had WLS and through support groups. All of these things are designed to help you make an informed decision and to be inspired to take control of your own health. If you are considering WLS, please feel free to contact me if you have questions. If I do not know the answer, I will try my best to find out for you.
Until next time,
Cass
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