I have been meaning to write this blog for several weeks now, but after my house's break-in, it got waylaid. Reading WATERMELLEN's own blog concerning bariatric surgery (here's the link) prompted me to finally sit down and put words to paper:
The main issue I have with the surgery, is many of the procedures are irreversible. I totally get the need, especially in the case of extreme obesity when all else fails, but the major component, which is the REASON for the obesity in the first place, does not seem to be adequately addressed. There are quite a few reality shows ("My 600-Pound Life", for one) that starkly televise the need for a major intervention.
I had the opportunity to observe this firsthand, when my boss at the time had the gastric sleeve, as did her daughter with the same surgeon on the same day. Her daughter at the time was seventeen and about to enter college. I totally get the mother's desire for her child to have a "full college experience", but I do have to pause when I saw what the bill amounted to for the dual surgery: Well into $40,000.00. I would love to know how much pre-counseling went into that to ensure success. I somehow doubt enough and I'll tell you why.
To be honest and fair, the daughter tolerated the procedure well, but being a typical teenager, she proved not willing or able to adhere to a regimen that was now going to be an integral part of her life, for the rest of her life. She did not stick to the plan, and did not take the necessary supplements required after losing two-thirds of her stomach due to the surgical procedure. As a result, the aftermath was predictable: She required blood transfusions because she had no iron stores to speak of. When "Parents' Weekend" at college that first year rolled around, her request to her mother was to buy Tombstone Pizza so she could stock the freezer with it.
The upside for the daughter was she did have the full college experience, and a boyfriend to boot, which, considering her morbid obesity, she most likely would not have had.
Now for the other side of the story: My boss did not tolerate her new circumstances well. She was vomiting for months after the procedure, albeit she was compliant with the new supplement regimen, unlike her daughter. Certain foods, well tolerated before, no longer were. She found that out the hard way, once the vomiting ensued.
Usually when people have this type of extreme surgery, the BMI at a MINIMUM is in the 60-plus range. My boss was an extremely tall individual and her weight for a height just shy of six feet was proportional. In fact, interestingly enough, her BMI was the same as mine at the time: 42, and I am a good nine-plus inches shorter and over fifty pounds lighter. I really have to question the wisdom of the surgeon who allowed the procedure to go forward in the first place. Was 40K something that was just too good to turn down? Yes, that's the cynic in me. But for some, that's a year's salary, or almost.
One year later, now came the time for the skin revision surgery. Again, a double for the surgeon, both mother and daughter scheduled the same day. Mom came through okay, but the daughter developed shortness of breath shortly thereafter, and it was discovered that she threw a blood clot and had a pulmonary embolism. To be fair, this was not the daughter's fault, nor the surgeon's, but one of the possible complications of surgery. Now the mother, as a nurse, was required to give her daughter injections of Lovenox, an anticoagulant.
The follow up care seemingly (I say "seemingly" because my boss never mentioned otherwise), was primarily with the surgeon. How about the therapy that was needed to make the adjustment on a psychological level?
I clearly remember telling someone about this mother/daughter situation. She has a daughter about the same age, and her reaction was visceral: There was no way she would allow her daughter to undertake such a permanent procedure. She herself had had the lapband surgery years earlier. And not too long ago, she had complications from that, that required an emergency room visit, so many years after the fact.
So, what price are we paying for radical surgery, in our quest to be healthy? An interesting paradox. I truly don't know the answer to this.
Here's the article:
Are we dying to be thin? At the very least, I think a more aggressive approach has to be taken in terms of behavior therapy, pre- as well as post-op.