WLS surgery complications

[firecat]

The American Society for Metabolic and Bariatric Surgery created a PDF poster describing emergency room treatment procedures for complications from weight loss surgery.

I'm glad that the poster exists, but it's scary to see all the things that can go wrong. Also I know it doesn't cover everything (such as nutritional deficiencies).

I wonder how many people considering WLS are given this information.

http://www.asmbs.org/download/er_poster/ASMBS_ER_Poster9-20-10.pdf

Local copy

Comments

[amethystfirefly]

For me, I would've been much less likely to have had it if my nutritionist had gone into the costs after surgery, like the new high-protein diet, the cost of replacing clothes, the cost of the skin tuck surgery (and it would've been nice to have known that Medicare/Medicaid no longer covers it -- I only found out about that after I lost 80 lbs and my pain levels were permanently changed) and... a lot of other things.

The info is sorely lacking. :(

[firecat]

{hugs}

[amethystfirefly]

-hugs- It's funny (not in a "haha" way). I expected to have dire consequences and complications during the healing process, not once I was all healed up...

[wordweaverlynn]

Forgive my curiosity, but in what way did your pain tolerance change?

I have seriously considered WLS, partly because it's so damned hard finding work when you're a size 30. But I've HAD open abdominal surgery once before, and I am not eager to repeat the experience. And I have such severe food allergies I might end up with nothing I could eat. And I know about the death and complication rate. And I am healthy anyway.

[amethystfirefly]

There's absolutely nothing to forgive.

I lost belly weight, which shifted how the skin tugged on my spinal cord because it's sagging a lot more. You may weigh more before the surgery, but the fat does help support the skin above it a lot.

I had a herniated disc at L5-S1 before the surgery, but my pain was manageable. I've only lost 80 lbs because the pain's now so bad that I can barely stand for more than 5 or 10 minutes, much less exercise. I found out last week that my L5-S1 disc is completely gone and I'm going to probably have to have back surgery.

Now, granted: I have degenerative disc disease, so it's entirely possible that the disc would've eventually disappeared. But I just don't know if the extra sagging skin made it happen faster than it would've happened had I not had the surgery. I do believe that the doctors should've at least told me if it was a possibility, but nobody did.

Most bypass surgeries are done laproscopically. Mine was, which made me really happy. I had open abdominal surgery in 1998, and had serious complications that kept me in and out of the hospital for 2 months and triggered my fibro. This time, I had absolutely no trouble healing, because I had 5 incisions that were barely half an inch long, instead of one massive incision. I'd do that part again. -laughs-

As far as food allergies.. I honestly can eat anything I want to at this point, with the exception of really greasy food. That makes me hork. :P I just can't eat a lot of it and some foods aren't worth the hassle of eating because the servings are so small. (Gods, I really miss potatoes -- but 1/4 cup of potatoes is a serving because they're so damn starchy. And I can't drink regular juice, unless I water it down to half juice/half water, because it's got so much sugar in it that it causes me to dump.)

The biggest problem I have with the diet is that it's high protein, which means higher costs, and I'm well below the poverty line. (I get $623 a month in disability benefits and $60 in food stamps.)

I honestly don't recommend bypass surgery for anyone who's not a Super XXL. I would look into the lap band surgery because if that goes bad, you can (AFAIK) have the band removed. Plus, you'll lose weight at a slower rate, which will make it less likely that you'll have massive amounts of sagging skin that will require a full-body skin tuck.

In fact, I wanted lap band surgery because of that, but the surgeon said that I needed to lose too much weight for the lap band to be fully successful. (I weighed ~350 on my surgery date.) I just wish they had checked to see if the skin tuck surgery was still covered before the surgery. I would have to pay ~$10K out of my pocket for the skin tuck and then they would have to fight Medicare/Medicaid to prove it's medically necessary. (And it is. I have other conditions that have been exacerbated by the extra skin rubbing against skin. The pain problem is just the big one.) Except I just do not have any way of getting $10k, unless I hit the lottery. So.. I'm kinda fucked. :/

[amethystfirefly]

Oh. Let me clarify. Being 350 didn't mean I was OHSOHEAVY. I have a ton of comorbid medical issues, so the bypass was more necessary than it would've been with someone who is completely healthy going in. In fact, the fact that I did have the health problems going in was the only reason I wanted the surgery. It's entirely possible that your doctor will go "Oh, hey. You want the lapband? No problem!" because you're healthy going in. :)

[firecat]

I lost belly weight, which shifted how the skin tugged on my spinal cord because it's sagging a lot more.

I'm sorry.

I've never heard before that WLS could make back pain worse or fail to relieve it, and it's helpful to know that.

[amethystfirefly]

Honestly, I'm not sure how often it happens. I could be the random freak or something. -laughs- I did figure that things would get worse for a while, but I was counting on Medicaid/Medicare covering the skin tuck surgery. If I had known that they changed their rules, I would've held off on the surgery. :/

[flarenut]

I'm sure people are given the information, just not in a form that makes any sense to them. One of the (many) problems with informed consents is that they load in so much horrific stuff you might as well not get hangnail surgery or a root canal. There's usually nothing about the day-to-day consequences of the possible complications, or about the likelihood of any of them. So all you really get is "Yeah, I could die or be put into horrible constant pain, the same way I could crossing the street" and whatever gut feelings the medical staff surrounding the procedure have managed to instill.

Now even without involving lawyers there are good reasons why a consent form can't give all that other information (the odds are different for each patient, each patient's perceptions and tolerances are different, blah blah blah) but that still doesn't help.

I'm reminded a little of one of the exercises in the childbirth class that J and I took way back when. Each couple got a deck of cards with options that might represent their idealized birth plan: home birth/hospital birth, water tub, midwife/OB, anesthesia/no anesthesia, classical music/elevator jazz blah blah and so forth. You were supposed to discard all the cards you didn't care about, and then keep discarding until you only had two cards left, and if those two cards weren't "healthy mother" and "healthy infant" you had just missed the point of the exercise (yeah we didn't get to keep those cards either).

Anyway, I think for weight-loss surgery (and perhaps a lot of other surgeries) that kind of exercise would be a useful one, and more useful than a standard consent form. Keep discarding cards and see where prospective clients don't want to play any more.

[wordweaverlynn]

Good strategy.

[mjlayman.livejournal.com]

I've seen those cautions in the health part of the local NBC station's broadcast, but it's probably not as good as handing out flyers.

[living400lbs.livejournal.com]

Interesting. It's focused on the life-threatening emergencies that bring a WLS vet into the ER, not general complications - but even so, it's pretty scary.

[suzanne.livejournal.com]

*shudders*