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What Really Bugs Me

A patient of ours came into the office for her regular office visit and told me about a friend of hers who was about to have bariatric surgery. I was documenting in our patient’s chart, half-way paying attention but asked what type of surgery her friend was having. She said that her friend couldn’t tell her because she was not sure what the surgery was called. I looked up only to respond, “Your friend had better know, it is her business to not only know but also to be able to explain it to anyone who might be interested. It is her body and her life.” That really bugged me. It made me wonder how many people have had bariatric surgery and do not have any idea what was done to them.

Needless to say we would all like to have an avenue to vent and blow off steam about things that irritate us, I happen to have Beyond Change. So therefore I will take this opportunity to let all of our followers on the web know what bugs me.

Things that REALLY BUG ME are:

  • Patients who do not understand their surgery. They should never forget that weight loss surgery is for a lifetime not just for the here and now. If it is not understood the long-term results can be detrimental and even life-threatening. Patients should not only be able to tell others about their surgeries they should be able to draw their procedures for anyone who might be interested.

  • Surgeons who do not make it a point to educate their patients and reinforce how important it is to understand the procedure. Education should begin when the potential patient first walks in the door of the office or clinic. Visual aids are helpful. Handouts regarding diet, exercise and what the practice offers is a must. Most important is that the educational process is ongoing and questions and concerns answered promptly.

  • Patients who do not take their vitamins and minerals as recommended by their bariatric practice. Any procedure that an individual chooses does have inherent risks if proper supplements are not taken daily. Forever. Whether the individual “feels good” or not. Just ask Dr. Mason, who reported a clinical study of one woman who 14 years after her gastric bypass had iron deficiency anemia and osteoporosis so bad that her surgery had to be reversed. She stopped taking her supplements soon after her surgery because, ‘she felt good after her weight loss’.

  • Surgeons who do not recommend adequate supplements and even fail to monitor their patients for potential deficiencies (simple blood tests) that may be aggravated by malabsorption and even restrictive procedures.

  • Patients who do not attend support group meetings. It has been documented that regular attendance to support group is most beneficial in predicting long-term success.

  • Patients who complain about their support meeting being boring and becoming ‘gossip sessions’ or ‘whine fests’. It is always up to each individual to participate and make suggestions as to what would make their meetings educational as well as fun. A support group can work as a team just as the surgeon and staff works as a team.

  • That some surgeons still offer no structured support group meetings for their patients. Why aren’t they thinking?

  • Patients who do not keep regularly scheduled office appointments. Office examinations are intended to monitor each individual’s progress, metabolically as well as emotionally. To forget or intentionally not go is a direct indication of noncompliance. Noncompliant behavior can and usually does radiate out to other areas in one’s life such as: noncompliance to exercise, eating nutritionally, taking supplements, etc.

  • Doctor’s who do not have regular schedules for patient office appointments. Although it may be rare, there are cases that have been reported of surgeons who prefer for their patients to only follow-up with their primary care physician following surgery. The question is: “Do these primary care doctors really know what types of deficiencies the bariatric patient can have and exactly what tests should be done to detect deficiencies?” The wise patient should investigate this area of the bariatric practice to make sure all appointments regarding surgery are done by the surgeon.

  • That patients who have had a ‘relapse’ and have experienced some weight regain seem to fall off the face of the earth. Perhaps they are embarrassed, feel they have let the surgeon down, have betrayed their families or worse yet believe themselves to be failures. What they fail to do is to realize that going back to the surgeon before life and weight gets out of hand may be what will get them back on track. Perhaps it is something simple, the need to be encouraged and complimented for how great they have done so far. Perhaps it is something more complex such as an eating disorder that with the help of professionals can be worked on and be resolved. Whatever the reason might be it should never be ignored. Surgery, after all is a ‘tool’ and all tools must be taken care of if they are going to work well for many years.

  • That some surgeons do not focus on the long-term outcomes of their patients. Eating disorders are prevalent among the obese population. How unfair it would be for us to not provide assistance for our patients in this area if disordered eating is the underlying cause of an unsuccessful surgical outcome. After most surgeries it is only natural for the surgeon to feel relaxed and thankful that a complication did not occur, but complications do not have to be surgical in nature rather they could be ‘surgery related’ in many ways.

Are these the only things that bug me? Of course there are many more but these are the most significant ones that I can report. (Besides, my husband would not let me mention his name.) All of them are pertinent to ethical standards of patient care from the aspect of the patient and from the surgical support team. I hear about many of these problems from people all over the United States on a daily basis. There is something that can be done to rectify these problems; it calls for personal responsibility in most every case.

Bariatric surgery is without a doubt one of the most complex elective procedures available. Complex in that it is a risky surgery that could very well be life ending rather than life-saving but most complex in regards to the long-term emotional and physical recovery. We must always place higher emphasis on the long-term recovery process and not just focus on the here and now.

Anyone who plans to have or has already had bariatric surgery should also be bugged by what bugs me. Let me know your thoughts about what bugs you regarding bariatric surgery and we will share them on our website.

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