Dumping and Excess Skin: A byproduct of gastric bypass surgery

There aren’t any good jokes about this subject.  I was hoping there were, so I could start out with one or two. But alas, I must research this instead.  You may notice I went a little hyperlink happy today.  These are all short articles that apply to today’s topic.  They’re good, and as far as I know, virus-free.  They will all open in a new window so you won’t lose your place in this riveting blog.

Dumping – It’s Not Just For Breakfast Anymore

University of Rochester Medical Center, in an online article reviewed by Joy Fincannon, RN, MN, say healthcare providers don’t really understand why dumping happens. Dumping happens when the solid part of the food we eat gets automatically dumped undigested into the small intestine because the stomach is now too small to handle the food. It can result in a serious nutritional deficiency which can have long-term effects on your health.  Dumping syndrome affects 15 – 20% of post-surgical gastric bypass patients, and a small amount of people can’t get rid of the syndrome once they have it.  So if I’m understanding them correctly, it’s like herpes of the stomach.  Are you reading it the same  way?Hart Dumbass

Dumping syndrome is broken up into to categories: early dumping and, you guessed it, late dumping. Easy dumping happens anywhere from 10 – 30 minutes after a meal, and late dumping happens 1 – 3 hours after eating.  I’m reminded of Cosmo Kramer in the Seinfeld episode The Pilot.  Elaine asks Kramer, who is backed up and resistant to an enema, if he is going to the taping of Jerry and George’s “show about nothing” pilot.  Kramer says, “No. No.  I’m gonna stay home.I want to be close to my home base in case there’s any news from the front.”  Great episode, and you can read the script here.Kramer gif

Anyway, it’s enough to scare some people away from gastric bypass altogether. Typical symptoms of early dumping include bloating, sweating, abdominal cramps and pain, nausea, facial flushing (is that an intentional pun?), stomach growling or rumbling, an urge to lie down after the meal, heart palpitations, dizziness or fainting, and eventual diarrhea.  Eventual. Like you’d be praying for the relief that diarrhea brings. I don’t know.  It sounds like the moments after a meal at Applebee’s to me.Applebees

 

 

The treatment includes splitting your caloric intake into six smaller meals, not drinking any liquids until 30 minutes after the meal, and lying down for 30 minutes after you eat.  Like I have time for that.  “We’re cleaning up.  Where are you going?” “Um…I have to lie down for a half hour.”  Yeah. Let’s see how that plays in Peoria.  Complex carbs can help, and watching what you eat is the best way to avoid dumping.  Dr. Fred Pescatore says avoid the surgery totally, thinking it completely unnecessary and a quick fix by us fat folk. Read his thoughts on the subject for yourself and tell me what you think.  I think dumping is worth the risk.

Stomach Cramps

Causing a Flap: The Excess Skin Problem

Excess skin, on the other hand, is absolutely going to happen.  It is a natural byproduct of rapid weight loss, and the one that really gives me pause. Think Adam Sandler in the dream sequence in Click. Boston Medical Center sees it as an inevitability, and even says exercise won’t shrink it because most people of the size to be considered for gastric bypass have already stretched their skin to the point it will never tighten. Read the article here.  Here’s the other thing:  you can get plastic surgery, but insurance typically won’t cover it.  One of the speakers at my information session said she saved and took out a small loan to pay for it, and it was completely worth it for her.  She said it cost about $10,000.  Leslie Alderman writes in The New York Times (2010) that the costs can reach $20,000 or higher.  Perhaps that’s a good article for another time.Money

It should be noted that I met a gentleman a few years ago who lost somewhere along the lines of 400 pounds through diet and exercise.  He had to have two skin removal surgeries.  For the record, he looked great, so it does do the job.  Just do yourself a favor and find a highly qualified plastic surgeon.  Do your homework.  We’ve all seen the pictures and the shows on TV.

I think you’ve reached your limit for this today.  If you’re curious, I ate with some coworkers at Applebee’s today.  I was not good.  2 Chicken Won-Ton Tacos (255 Calories), Chicken Caesar Salad (side-320 Calories) and a lunch size of the 4-Cheese Mac & Cheese (640 calories).  It was cold, snowy and I wanted comfort food.  I have to stop “slipping.”  Really it’s falling.  And it’s intentional.  I don’t know why I would want to sabotage myself.  It’s stupid and dangerous.  That is the kind of mental space that leads to dumping!  And we’ve now come full circle.  Here’s a picture to show how dangerous it is to ride the fence.Fencesitters

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