Dr. Timothy Jackson: Welcome back, let’s continue to part 2, where I’ll explain the
benefits and risks of bariatric surgery.
Let’s start with the benefits.
After having bariatric surgery you’ll need to make healthy lifestyle changes to lose
weight and to keep the weight off after surgery.
Most people see major improvements in their overall health, especially if they have had
weight related health conditions.
One of the most common health improvements is lower blood pressure.
Your doctor may bring down your blood pressure medication doses, or even say you don’t
need to take them anymore.
Having a normal blood pressure will lower your chance of having a heart attack, stroke,
or heart failure.
Another major benefit of bariatric surgery is that it improves or even resolves type
2 diabetes.
Most people need to take less diabetes medication after the surgery.
The improvement of diabetes will lower your chance of having damage to your heart, blood
vessels, nerves, kidneys, and eyes.
If you suffer from sleep apnea, your symptoms, such as insomnia, daytime sleepiness, anxiety,
irritability and headaches may greatly improve after bariatric surgery.
Your sleep apnea may even go away completely.
Bariatric surgery has also been shown to lower cholesterol.
This means healthier arteries and a much lower chance of having heart disease and heart attack.
Many people are able to take fewer cholesterol medications, or even none at all.
Losing weight after bariatric surgery places much less stress on your joints.
You’ll be able to move more easily.
Also, you’ll feel less strain while exercising, and joint pain will no longer be a roadblock
to leading a more active life.
There are many benefits of bariatric surgery.
Besides lowering major health risks, almost all patients tell us that their overall quality
of life greatly improves.
But you don’t have to take my word for it.
Let’s introduce you to some patients who have had bariatric surgery and want to share their
stories with you.
Colleen: I've struggled with my weight for about 20 years and I just sort of felt like
my ability to enjoy life and do the things I wanted to do was being minimized.
Barb: I didn't want to be in public and I didn't want to go and do things and I didn't
want to put my face forward.
Pat: I didn't really have much of a life because I couldn't walk very far.
A couple of blocks and I would be in pain, and every time I wanted to go somewhere I
was [thinking], 'Can I get there and get back?'.
I had a lot of issues, I had diabetes, high blood pressure, and I felt that if I didn't
do this I was shortening my life.
Cory: I tried my best.
I went to the gym, I tried to eat healthy, nothing seemed to work for me.
Pat: I no longer have diabetes, I no longer have high blood pressure, my cholesterol medication
has been cut in half.
I walk everywhere, I love walking.
I still have arthritis because I've done in my joints over the years, that can’t be
reversed, but it's nowhere near what it was like before.
Barb: Just this Monday, I went to my sleep study doctor and I got the results of my sleep
study and I put my sleep apnea machine in the basement because I don't ever need to
use it again as long as I don't gain any weight.
Cory: Life is kind of easier in a way.
It's much harder in other ways but, you know, I can move around and do things that I'm not
afraid to go and do something.
Barbara: Before my surgery I was taking 3 blood pressure medications, and they weren’t
really doing the job.
And I had high cholesterol.
The high blood pressure is gone, the cholesterol is gone.
Shane: The cholesterol and the gout, and actually within 3 months I was off all my medication.
And all my blood levels have returned to normal which they’ve never been.
Colleen: I feel that I’ve regained a whole new life.
Cory: This isn’t a quick fix.
I think that it is a tool that can help people who are struggling with weight.
I’ve used this tool now to achieve my goal, it’s a lifelong goal, and it will continue
throughout my life, and it’s certainly not easy, it’s a journey that I’m on, and
it’s hard but it’s good.
Dr. Timothy Jackson:
Now that you’ve heard about the many benefits from surgery, let’s talk about some of the
risks and complications, or problems, which can happen with both the Roux-en-Y and sleeve
surgeries.
Risk refers to something that can go wrong after the surgery.
One of the more common risks after having bariatric surgery is developing an ulcer.
An Ulcer is an area where the protective lining in the stomach has eroded away and the layer
underneath is sensitive to stomach acid.
People may feel nausea, and pain just below the ribs.
Usually with medication, these ulcers will heal in a few months.
Who is at higher risk to develop an ulcer?
People who smoke, drink too much alcohol or take ibuprofen or other anti-inflammatory
medications.
The chance of getting an ulcer doesn’t decrease over time, so you’ll have to quit smoking,
avoid taking anti-inflammatory medications and drink less alcohol for the rest of your
life.
Another possible risk of Bariatric surgery is known as a stricture.
A stricture happens when the passageway that connects the new stomach pouch to the small
intestine becomes too narrow.
This makes it difficult for food or water to pass through.
People usually feel that it is hard to swallow or get their food down.
Sometimes they vomit.
When this happens, a short procedure can be done to make the area wider.
A Gastric leak is another possible complication.
It happens when stomach contents leak into the abdomen.
This rare but serious complication happens most often within the first two weeks after
surgery.
If it does happen, you may have a fever and stomach pain.
Sometimes, you may need another operation to close the leak.
Having bariatric surgery will change the way you need to eat, and how you absorb your food.
You could get vitamin and mineral deficiencies.
To prevent serious complications such as weak bones, low iron or vision loss, you will need
to take supplements every day for the rest of your life.
Losing a large amount of weight can cause loose skin.
The amount of loose skin is different for everyone and there’s no way to know how
much you may have.
Unfortunately exercise will not help reduce this.
Some people don’t see it as a big problem but for others, it can be quite upsetting.
You can have extra skin removed, but this procedure is not covered by OHIP.
Having bariatric surgery can be quite stressful and may trigger some mental health difficulties,
especially for people who have had similar challenges before, such as depression or anxiety.
People who have had bariatric surgery are also at risk of developing addictions.
This includes both alcohol and other drugs.
This is one of the reasons we recommend drinking less alcohol.
Now that we’ve covered the most common benefits and risks of bariatric surgery, let’s check
in again with some patients who would like to share some of the challenges they’ve
had to overcome.
Shane: I didn’t have any complications during surgery at all.
It went as textbook, planned.
Barbara: It's been a big success for me.
But you have to know that there are complications for some people and you know, know what they
are.
Cory: I had a major complication where I was bleeding internally.
I had the surgery in the morning and by midnight that evening, I was losing lots of blood and
my surgeon who performed the surgery was there.
They clamped it and fixed it all up but that was certainly an issue and I mean there's
risks with everything.
Catherine: First I had was the leak.
My heart rose to extreme highness, so it was a very scary thing for my family.
Barb: 10 minutes or whatever, after whatever I ate or drank, I would throw it up.
I had absolutely no pain.
I just couldn't keep anything down.
If I wouldn't have been throwing up I wouldn't have known.
They kept me overnight, did a scope and they said they found an ulcer.
I had a three-month follow-up, everything was fine, I didn't need any of the medication
again, and, I'm great.
Catherine: I had difficulty with the diet basically.
So they opened the stricture, they opened up the tube so that I could get more food
down.
It was wonderful. I could eat.
Barbara: Well, remembering to do them and being faithful to doing them, the vitamin
and mineral treatment post-op is, you know, it's a constant new habit to build.
But, it's a small price to pay for what you get.
Pat: It's very common right after the surgery to have some depression and buyer’s remorse
is one of the ways it's put.
I felt a little bit of that but I got over it fast.
I think that's part of the fact you just had major surgery.
Colleen: I mean, for me, I lost my weight very quickly.
And so there was this one day looking in the mirror and kind of going, "Oh my God. Who am I?"
It was such a shock.
I didn’t really recognize myself, and I had to reacquaint myself with this
new body.
And that took some adjusting.
Shayne: Throughout the weight-loss, I mean, it appeared that there was going to be more
loose skin and that type a thing, just because of the drastic weight loss.
Laura: I try to hide it is much as I can.
But, that's going to be an issue because I'm still losing weight.
And I know it will be an issue and I'll probably have to have some surgery to
correct it.
Barb: I look OK with clothes on, and I don't take my clothes off in front of anybody who
doesn't already love me to bits.
So, you know, there you go.
Colleen: So, like everything I think it goes through a phase, where you kind of look at
it like, OK but I'm healthier and I’m happier and I’m able to do so much more.
Cory: The outcome today looking back was worth every complication.
I would rather have gone through all the loss of blood and the scary times and the procedures
and the ulcers to be where I am today.
Dr. Timothy Jackson: As you can probably tell from those who have
shared their stories, surgery was just one step in their weight loss journey.
It’s important to remember that every person’s experience with surgery is unique.
Together, we will need to consider your specific situation and review your benefits and risks.
This is the end of part 2.
Again, if you have any questions about the benefits and risks of bariatric surgery, make
sure to write them down and ask the bariatric team.