gastric bypass?

Question

has anyone had gastric bypass? and if so how has it worked for you?

Answer 1

Complications
Any major surgery involves the potential for complications — adverse events which increase risk, hospital stay, and mortality. Some complications are common to all abdominal operations, while some are specific to bariatric surgery. A person who chooses to undergo surgery should know about these risks and has implicitly accepted them.

Mortality
Mortality occurs in about 0.5% of patients, after GBP. Mortality is affected by complications, which in turn are affected by pre-existing risk factors such as degree of obesity, heart disease, obstructive sleep apnea, diabetes mellitus, and history of prior pulmonary embolism. It is also affected by the experience of the operating surgeon: the "learning curve" for laparoscopic bariatric surgery is estimated to be about 100 cases, and inexperienced surgeons have been shown,in several studies, to have a significantly higher rate of complications and mortality. Unfortunately, the way a surgeon becomes experienced in dealing with problems is mostly to have problems to deal with.

Complications of Abdominal Surgery
Infection
Infection of the incisions, or of the inside of the abdomen (peritonitis, abscess) may occur, due to release of bacteria from the bowel during the operation. Nosocomial infection, such as pneumonia, bladder or kidney infections, and sepsis (bloodborne infection) are also possible. Effective short-term use of antibiotics, diligent respiratory therapy, and encouragement of activity within a few hours after surgery, can reduce the risks of infections.

Hemorrhage
Many blood vessels must be cut, to divide the stomach and to move the bowel. Any of these may later begin bleeding, either into the abdomen (inra-abdominal hemorrhage), or into the bowel itself (gastrointestinal hemorrhage). Transfusions may be needed, and re-operation is sometimes necessary. Use of blood thinners, to prevent venous thromboembolic disease, may actually increase the risk of hemorrhage slightly.

Hernia
A hernia is an abnormal opening, either within the abdomen, or through the abdominal wall muscles. An internal hernia may result from surgery, and re-arrangement of the bowel, and is mainly significant as a cause of bowel obstruction. An incisional hernia occurs when a surgical incision does not heal well; the muscles of the abdomen separate and allow protrusion of a sac-like membrane, which may contain bowel or other abdominal contents, and which can be painful and unsightly. The risk of abdominal wall hernia is markedly decreased in laparoscopic surgery.

Bowel Obstruction
Abdominal surgery always results in some scarring of the bowel, called adhesions. A hernia, either internal or through the abdominal wall, may also result. When bowel becomes trapped by adhesions or a hernia, it may become kinked and obstructed, sometimes many years after the original procedure. Usually an operation is necessary, to correct this problem.

Venous Thromboembolism
Any injury, such as a surgical operation, causes the body to increase the coagulation of the blood. Simultaneously, activity may be reduced. There is an increased probability of formation of clots in the veins of the legs, or sometimes the pelvis, particularly in the morbidly obese patient. A clot which breaks free and floats to the lungs is called a pulmonary embolus, a very dangerous occurrence. Commonly, blood thinners are administered before surgery, to reduce the probability of this type of complication.

Complications of Gastric Bypass
Anastamotic Leakage
An anastamosis is a surgical connection, between the stomach and bowel, or between two parts of the bowel. The surgeon attempts to create a water-tight connection, by connecting the two organs with either staples or sutures, either of which actually makes a hole in the bowel wall. He relies on the healing power of the body, and its ability to create a seal like a self-sealing tire, to succeed with the surgery. If that seal fails to form, for any reason, fluid from within the gastrointestinal tract can leak into the sterile abdominal cavity, and give rise to infection and abscess formation. Leakage of an anastamosis can occur in about 2% of gastric bypass procedures, usually at the stomach-bowel connection. Sometimes leakage can be treated with antibiotics, and sometimes it will require immediate re-operation. It is usually safer to re-operate, if an infection cannot be definitely controlled immediately.

Anastamotic Stricture
As the anastamosis heals, it forms scar tissue, which naturally tends to shrink ("contract") over time, making the opening smaller. This is called a "stricture". Usually, the passage of food through an anastamosis will keep it stretched open, but if the inflammation and healing process outpaces the stretching process, scarring may make the opening so small that even liquids can no longer pass through it. The solution is a procedure called gastroendoscopy, and stretching of the connection by inflating a balloon inside it. Sometimes this manipulation may have to be performed more than once, to achieve lasting correction.

Dumping Syndrome
Normally, the pyloric valve at the lower end of the stomach regulates the release of food into the bowel. When the Gastric Bypass patient eats a sugary food, the sugar passes rapidly into the bowel, where it gives rise to a physiological reaction called Dumping Syndrome. An affected person feels his heart beating rapidly and forcefully, breaks into a cold sweat, gets a feeling of butterflies in the stomach, and has a "sky is falling" type of anxiety. He usually has to lie down, and is very uncomfortable for about 30 to 45 minutes. Diarrhea may then follow. The dumping syndrome is a response to a behavior which the patient should not be doing anyway: eating sugary foods. It is not life-threatening, and may assist one in making healthier food choices.

Nutritional Deficiencies
Hyperparathyroidism, due to inadequate absorption of calcium, may occur in over 30% of GP patients. Calcium is primarily absorbed in the duodenum, which is bypassed by the surgery. Most patients can achieve adequate calcium absorption by supplementation with Vitamin D and Calcium Citrate (carbonate may not be absorbed - it requires an acidic stomach, which is bypassed).
Iron frequently is seriously deficient, particularly in menstruating females, and must be supplemented. Again, it is normally absorbed in the duodenum. Ferrous sulfate can cause considerable GI distress in normal doses, and I therefore recommend Ferrous fumarate, or a chelate. Occasionally, a female patient develops severe anemia, even with supplements, and must be treated with parenteral iron.
Vitamin B-12 requires intrinsic factor from the gastric mucosa to be absorbed. In patients with a small gastric pouch (like me), it may not be absorbed, even if supplemented orally, and deficiencies can result in pernicious anemia and neuropathies. Sub-lingual B-12 appears to be adequately absorbed.
Protein malnutrition is a real risk. Some patients suffer troublesome vomiting after surgery, until their GI tract adjusts to the changes, and cannot eat adequate amounts even with 6 meals a day. Many patients require protein supplementationduring the early phases of rapid weight loss, to prevent excessive loss of muscle mass.

Answer 2

No Gastric Bypass! OK, I had problems with the hole diet thing. So I tried Nutrisystem, I LOST WEIGHT! If you don't have that kind of money, portion your foods. Go for walks often. From Nutrisystem I lost around 40 Ibs. I learned that it is about portion control. If you want something sweet, sure you can have it, but only a little bit instead of the whole thing?? Make sure to get your fruits and veggies in too! Good luck!

Answer 3

This Site Might Help You.

RE:
gastric bypass?
has anyone had gastric bypass? and if so how has it worked for you?

Answer 4

It works 60% of times...it takes a lot of discipline though!

Answer 5

Please see the webpages for more details on Gastric Bypass.

Answer 6

I would never let anyone cut on me I would try self discipline. Eat to live not live to eat

Answer 7

i havent had it --cuz my metabolism gives me a slender shape but i wood have to be very very desperate for someone to cut me open and bypass my stomach.

Answer 8

Yes I have! but for a totally diferent cause.
and here is a longish answers:

I am reciting some of my experiences here – they are not meant to be boastful, rather I would like to inspire as many people who are suffering from cancer as possible – I would like to tell them – you can live normally! My best wishes to all, their families and friends! This is a long message so please do bear wtih me!

The stage grouping for my tumor was IVA (T3N0M0)

I ran a manufacturing plant in Mumbai (Bombay) and then moved to another city. I am a father of three beautiful kids- a son (age 20) who’s doing Engineering - Computer Science, a daughter (age17) who’s doing a pre-university science course and a school going younger son (age 10), and am very much in love with my wife of 25 years. We'll be celeberating our Wedding Siver Jubilee soon!

On August 30, 2002, I was diagnosed with cholangiocarcinoma - lower end common bile duct - by an MRI scan, I was 43 years old then (I married young), a malignant tumor was present at the joint between the head of my pancreas and the bile duct. This was further complicated by a scratch in my pancreas caused during ERCP on September 2, 2002. Though I have a high threshold of pain, the ERCP injury was almost intolerable and I had to be kept under sedation until surgery which took place on September 7, 2002. –. Whipple’s procedure.


My gall bladder, omentum, part of my stomach, part of my pancreas (about 1/3rd),duodenum and the bile duct were removed. The margins were all clear. Right from September 1, 2002, when I had my last meal for quite some time, I was not fed anything at all, not even water. I was fed intravenously (I digress).

Reconstruction was carried out. I was in the operation theater and under anesthesia for almost 11 and ½ hours. Everything was fine until September 15, 2002, when excessive fluids started leaking out of the two drain holes made on both side of my abdomen. On that day in the morning I was fed with a low fiber diet with a tube connected directly to my stomach. I was very sick. My bowels gave away suddenly, and I lost control over my bladder. I started shivering violently and then suddenly felt very hot, I started sweating profusely and breathing was difficult even with an oxygen mask which had not been removed after surgery. Though in distress, my mind was very clear and lucid. I could see the expressions on the hospital staff and the doctors’ faces and understood that any second could be my last. That did not worry me or scare me, what worried me was my family’s fate after me, though after all the pain death was not an option that I wanted to reject outright.

I realized how serious I was, when experts advised that I be shifted to another hospital with better facilities a few miles away, and the doctors attending upon me, including the surgeon who’d operated on me and the anesthetist personally lifted me up and put me on a gurney to wheel me to the ambulance, rather than wait for the ward boys to come in. I remember the doctors periodically checking upon me by asking how I felt during the ambulance ride. I knew they wanted to know the level of my consciousness. I remember feeling the ambulance speeding and constant sound of the siren - not klaxon.

I was quickly taken for an MRI scan and later my gurney with me on it was kept outside the hospital room, in a very safe and sterile place until the fate of my scan and probably, the doctors wanted to see if I would survive before admitting me into the hospital, Probably, if I know the law correctly, if I’d died within 24 hours of admission to a hospital a Post Mortem procedure would be mandatory. I understood all this while I was waiting to be admitted to the better hospital, as I said, my mind was clear and lucid all throughout, I was very much aware of my surroundings, the people, the sounds and noises.

At that time I remember feeling quite pleasant, not hot at all and there seemed to be cool breeze wafting around me cooling me up.

I was finally taken to ICU after about an hour; the MRI scan showed that the leakages were not as serious as had seemed earlier. Slowly I recovered, though there were two or three serious hiccups – one I remember dreaming that my gurney was being pushed faster and faster an then suddenly it had stopped in a great green field with a lot of sunflowers and then there was a bright light, towards which I was walking, when suddenly I woke up to the doctors repeatedly yelling out my name – My heart had stopped, I was later told. I think the doctors could not try the conventional re-sustication methods because of the extensive surgery on my abdomen and part of my chest. I remember dreaming when I could sleep and some of the dreams are quite vividly etched in my mind.

Another bad hiccup was when my lungs got immersed in bodily fluids and the doctors made me bend forward and withdrew more than a liter of fluids each time with a syringe they poked into my back. Believe me, it’s one of the most difficult things that I had to do, bend forward with my torso cut and recently stitched up, so that the doctor could draw the fluids out.

Soon I was on road to recovery and on 25th September 2002, I was shifted first to a shared room and later to a separate room, once it was available. On the same day, I started walking with support, my first steps after I was admitted to the new hospital. Soon by the first week of October 2002, I was walking without support and could manage all of around 100 meters at a stretch (I assume this was the distance, since I was a medium distance runner – 1500 m and 5000m and have been a mountaineer) in my youth and had taken part in district level competitions. I spent the better part of the day and night watching English movies on the TV, at night I had to keep the volume low so that my wife who stayed in the room with me could sleep. Also starting the first week of October, I was allowed to have a liquid diet – the first mouthful that entered my mouth after almost a month- the thought was terrifying, and I was afraid even to swallow.


I was discharged from hospital on October 7, 2002 and had my first solid morsel of food a couple of day later. Subsequent to this I was advised rest for almost two months, though; my doctor did allow me to start driving my car on November 8, 2002.

Bad things happen in pairs, a few days before I was diagnosed with my ailment, I lost all my capital due to bad decisions, so while resting, I decided to study and pass exams to enable me to be an insurance advisor. I stood first in my division and the second overall among the many hundreds who had appeared for the exam, the girl who stood first bettered me by one mark.

Later I appeared for another exam to enable me to sell mutual funds, here too I did far better than most of the other candidates, and this was a course I studied on my own, without approaching any institution for guidance. Over a period of time I have started doing well in both these businesses, and have added another income source –that of writing. I write for an online television portal and a business magazine in Bangalore and will shortly start writing for another real-estate magazine also based in Bangalore. (Do pardon the mistakes in the language and spellings, I hate to spell-check and can type only by the hunt and peck method)

I have not had to undergo chemo or radiotherapy so far. Every six months I get myself checked up – ultrasound scan and blood tests. So far alls’ been well and I am optimistic. The doc says that now the chances for a recurrence are as much as those of any other human’s. (Is this correct?)

On the physical front, my libido has increased a lot and I have no complaints on the sexual front. I have driven down to Mumbai (my birth town) and back. I have trekked in the Himalayas, in one day I climbed up and down steep slopes totaling around 30 kms (18 miles) and except for fatigue during that first night after the trek and a little bit of pain in my calf muscles for couple of days afterwards was no worse off. My wife who came with me could only walk half the journey, (the rest on horseback, while I walked).
I now sometimes end up working for almost 14 hours a day, though the energy level are low sometimes, I still force myself to work – I used to do this when I ran the factory in Mumbai.


I think that the following have greatly contributed to my recovery::-
My family, this includes my parents who left everything in Mumbai and lived with me during my illness, most importantly - my wife who never shed a tear in my presence-she always has been the strong one and repeatedly kept on assuring me that things would be fine – If she’d shed even a tear, I think that would have been the end of me – I wouldn’t be able to take it and would not be writing this, though now after more than three years, some relations have revealed that they had seen her cry on the sly, but I never did at that time and neither did my kids.

My Surgeon and my anesthetist are also the most wonderful people who are responsible for my survival. The older kids my older son and daughter, though school going themselves took good care of each other and their younger brother who was just six then – God bless them, were another major factor that wanted me to live.

My waist and a part of my abdomen are still numb, sometimes I feel pins and needles around the scar area of my surgery and my lower back. I do feel gassed up quite often and then my surgery scars expand and I feel like I am wearing a tight band around my waist. Recently, I have noticed that when I eat lunch or dinner outside, the bile juices rise up and I can taste them, but I’ve never puked since surgery, though sometimes the sensation to vomit does happen. I eat more frequently and a larger amount of food than I used to, otherwise I start feeling discomfort around my stomach and waist area. (Is this normal?).

I don’t take any medication at all, not even insulin, since my residual pancreas are doing the job so far, except for one vitamin B-complex capsule every night after dinner, and a tablet for hypertension when I wake up in the morning which I was re-diagnosed with in Aug 2005 and medication re-commenced since then. I am on a normal diet (I have been a vegetarian since the past twenty years or more and am a teetotaler). I do try to control the oil (fried stuff) and the spices. I also now need reading glasses, but my doctors assure me that this is age related and normal for persons in their mid to late forties. I also sleep less than I used to and I walk around 3 to 5 kms (1.8 to 3 miles) practically everyday.

Post surgery, I had gone down from 93 kgs (205lbs) to about 69 kgs (152 lbs) when I was discharged from hospital. I am now overweight at about 83kgs (190 lbs) at 178 cms height (5’10”)
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