It's not what you are eating, it's what's eating you…

Archive for the ‘#GastricBypassReversals’ Category

So that a cyclical vomiting fat patient NEVER gets treated horribly by an ER doctor, especially the same one, THREE times in the last 9 1/2 years at #FairviewHealth…

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(Above picture taken 2004/2005 when in school to become a NASM CPT after discovering a love of exercise 3 years status post rny, loving the endorphin high first and the results from being fit, 2nd, even though I had duodenal ulcers than, severe nutritional deficiences and severe reactive hypoglycemia )

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(picture of me 11-2016, when I still walked 5-10 miles a day 3 to 4x a week, stopped a year later when pain levels caused falling risks, nothing compared to how much I’ve fallen, thrown up, can’t eat much, in the last year, 6 years status post reversal at the time of picture, 9 years post reversal, 18 post rny, now and I look much worse now and can’t care).

Important Disclaimers: I am not a clinically trained medical or mental health professional. I am considered and recognized favorably in my activism that has saved other people’s lives when in medical and mental health crisis that is rooted in horrific gastric bypass complications.

I also do activism that is centered around physicians, other healthcare workers, first responders and police officers to be safe in their workplaces.

However when  obesity bias and potentially other biases effects the potential medical and psychological wellbeing and could be a threat to a patient’s life, I have a problem and grievance wise, so should the attending physician who I saw earlier today, who didn’t remember me, but will hopefully will NOT forget me and what he did past and present, now.

***

Dr. Klos,

This is about my visit 12-4-2019 and other visits in 2010 where unfortunately for the both of us, I had to deal with you thankfully just once yesterday  around 12:20 pm when you let me know you were discharging me.

You came in after 2 hours of my being at Fairview, after coming in complaining of left quadrant pain, severe abdominal vomiting last weekend, which I wasn’t going to go the ER during a long holiday weekend that had winter weather hazards that caused tons of car accidents and other seasonal related injuries and my birthday  on Monday (which I’ll explain in greater detail, as I go along).

The original resident I saw was kind. I think all the hospital staff was kind except you.

The issues of bouncing back with the vomiting, not being able to eat much for the last year and that left sided abdominal pain that I get whenever I eat and the labs I had being normal, when I kind of copped an attitude of why I was in the ER earlier today, you used my labs being normal, as well as the abdominal x-ray being normal without a lot of patience or kindness.

I said that I waited til today, went NPO after 8pm, which I had to explain several times to your staff, as I know what NPO means, didn’t drink any liquids, take any meds and ate very little yesterday or ingest anything orally.

I knew fairly early like an hour within my getting roomed, I wasn’t believed, as even when I was given an IV and being clear that I was nauseous and couldn’t give a urine sample due to how little I ate and drank yesterday and that I felt I was dehydrated that I wasn’t even given a bag of fluids and I didn’t ask for anything else except a diagnostic, which I did get an x-ray which ruled out acute pancreatitis.

As we were rounding out our conversation with you both and the resident and I made a comment about just quitting eating and drinking as I could do that for a long time, as I have in the past, it just leads me to faint and fall on a regular basis you made the comment “well don’t quit drinking fluids”.

I would’ve been more devastated, except in the last year especially, my weight while I’ve lost over 40 lbs without trying, I’m very bloated and am significantly larger at this weight in size than I have been in the past, while I have a obese bmi, I look closer to being morbidly obese, even though I still haven’t had any co-morbidities due to obesity, ever.

I saw you in the ER in June of 2010, I had horrible labs then, I had duodenal bleeds you did nothing about, even though I had been admitted 2 weeks before that visit, which was either my 2nd or 3rd admission and I was directly admitted a few days later by my bariatric surgeon due to intractable abdominal pain and projectile vomiting dozens of times a day even though I was obese then.

When I ended up seeing you the day before Thanksgiving in 2010, I honestly thought you’d take me more seriously, I was almost 3 months post open rny reversal, still with severe abdominal pain and intractable vomiting, it took you hours after begging to order diagnostics and after they were done, I had been there for so long, I unhooked my IV and quietly left the hospital, not trusting that I’d be helped anymore, as I had to fight too hard and for too long that day to get the help I did.

Then the day after Thanksgiving 2010, received a phone call saying I needed more diagnostics and ended up 12-2-2010 on my 41st birthday still with intractable abdominal pain and projectile vomiting of not being able to go through with a scheduled EGD by my bariatric surgeon who ended up having to order a PICC line, as I still had bad labs and was so dehydrated, as no one could get an IV in me that day, after 3 people trying 5 times.

You Dr. Fat Phobic are a dangerous physician to any female with a bmi over 24. I could understand having some kind of issue with a patient who’s had similar symptoms over the last year that are only getting worse.

I cannot though understand you thinking fat patients should never be able to eat again.

Or not believing even though I have normal labs now and am absorbing the little I can eat and drink, you didn’t take me any more seriously over  NINE years ago.

I did become suicidal and did try once in August of 2008 to intentionally overdose after living with intractable abdominal pain and intractable vomiting for 6 years.

I was also again suicidal in 2010, because of my awful bariatric surgical complications but  I had a parent lose a sibling 6 months prior to reversal and already knowing what trying to commit suicide did to my family, fought much harder than I should’ve had to had to, to stay alive in 2010

I do not make myself get sick on purpose, I don’t go to the ER because I’m bored or lonely or looking to score opiates. I very seldom seek medical attention at this point, filed a DNR 9/2018 with my absolutely amazing long term  Fairview PCP in Princeton and filed a body bequeathment to FUMC, realizing as a long term smoker (not saying I’m perfect, but it’s hard to think of quitting smoking when I can’t really do anything else) earlier this year vs. being an organ donor, so even in hopes after my death I can help physicians.

My life though is dedicated to helping patients in crisis. I have people all over the world who are in bariatric crisis, need a reversal, are terrified about getting fat and I’m really good at helping them get through the reversal process, so that they can remain ALIVE and after reversal navigate through that.

I’m really good at helping bariatric patients who have bariatric surgical regret, mourn using food as a coping mechanism, become suicidal, who want a reversal to explain why it’s not going to be done and can get them with other help, to see the good things about the weight loss process and that they will lose the bariatric surgical regret and enjoy the good things that can come from having a bariatric surgery and weight loss.

I’m good at helping patients who become suicidal due to bias with obesity and chronic pain, to get professional help but not let the bias by physicians realize they aren’t alone, especially for those like me where I’ve had issues with weight gain not being able to eat and having very few doctors believe me, but my bariatric surgeon at U, did believe me.

I hope there is an adminstrative process, as if I have to adapt to not eating anymore, having to give up that a normal weight loss process will follow and having to deal with a life that leaves me homebound, in an enormous amount of pain due to not being able to take in fluids, meds and food, I guess so be it.

But I’ll be damned that I survived what I did and to let you do a THIRD time to me, to another patient who DOES NOT have a voice or any recognition of just despicable your attitude towards fat patients are.

And not only is despicable but it’s potentially deadly should a heavier patient in medical crisis and/or mental health crisis, have to be dependent on your flawed judgement due to your bias for their care and it potentially ruin their life, if not end it.

I really hope that Fairview Health makes this right so that no other patients ever have to go through what I’ve done with this physician, not saying physician should lose their job, but is in dire need of the dangers of their severe fat bias.

Alissa “Lisa” Kasen /”unstapledlisa”  d.o.b. 12/2/1969, my email and phone are correct in mychart, if anyone wants to address this at Fairview and hopefully this WILL be addressed with attending….

Important Editorial Note: After 5 hours of publishing, I know with the attending I saw earlier today, that I did see him 2 other times in 2010. The time and circumstances I haven’t gone back and verified yet on my medical records as far as the June 2010 instance, even though I did see him then and it could’ve been in the first admission I had in June of 2010, but I do remember not being taken seriously being an obese patient who was super sick in an ER and how devastating that was.

I will edit when I have the time and hopefully feel slightly better to clear up dates. As many doctors I saw with 6 admissions and countless ER visits in 2010, I do know how bad that particular ER doctor made me feel and how unlucky I felt that I had to deal with him twice in 2010, how much shame and sadness my encounters made me feel then, only lessened today as far as shame because it’s not mine to bear and I should’ve never had to worry when I having the labs of a starving person in 2010 and prior, to have an ER doctor justify that because my bmi fell in the obese category and I was clearly not aesthetically pleasing as well as credible about how bad my complications were, even though they were in my medical records at that time.

Additional Important Edit/12-5-2019 After seeing past reviews when researching attending physician this morning  and reading about him engaging in unacceptable ways with trauma patients, which I was NOT, while I knew I’d make an inquiry to file a formal grievance with the U of MN, as well as I’m not protecting his clearly misogynist fat phobic tendencies so I’ve actually added his name and hopefully through the right process future patients will not be at risk for further potential medical and psychological harm by this physician, at least in Emergency Medicine.

I also was not able to access my 2010 records electronically, hopefully they will get pulled during the grievance process, or that they exist somewhere if not online.

A little over 9 years status post #gastricbypassreversal , was it worth it???

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Very Important Disclaimers: I am NOT a clinically trained medical or mental health professional. Anyone who’s had bariatric surgery and is in medical or mental health distress, needs to be evaluated and treated by  qualified clinically trained professionals (i.e. physicians, surgeons, psychiatrists and other type of medical and mental health professionals) in person and depending on degree of medical and mental health distress, in an acute care facility (i.e. hospital).

It will however be very apparent, in my blog why I borderline practice medicine and psychiatry in my blog when presented with a patient in some kind of crisis, with above disclaimers being made very clear.

***

The *MOST*  frequent question I get asked by people when they hear I’ve had a gastric bypass reversal is that if I have any regrets of having my reversal.

It still kind of shocks me, because people ask that more than if I have any regrets over having a gastric bypass.

I don’t regret having a gastric bypass reversal, I would’ve died in 2010 without it.

The next most frequently asked question I get, is will one get fat after a reversal.

That’s a tougher question and that question probably is the reason why I end up having to borderline remotely practice medicine and psychology, even though I have no formal education or licensing, in either specialty.

There’s a devasting desperation in patients like that, though.

Whether it’s a patient who’s been told by a bariatric surgeon that they need one to save their life, they have peers and possibly other clinically trained professionals who pose that question to a patient in medical crisis and potentially mental health distress, in a patient who’s already worrying about that, in the first place.

Or they have a bariatric surgeon who won’t perform a reversal, even though their patient is at risk of death.

Well, if you’re dead you won’t be at risk of getting fat.

You could possibly be buried in a very  teeny tiny coffin.

Above 2 sentences are definitely NOT  my original replies to that question obviously, to a patient in crisis, it’s more of an attempt for a patient to see the gravity of their situation that they’re in, that’s after my  getting an idea if and what any trauma led to a gastric bypass as a medical intervention and what trauma post gastric bypass a patient has experienced, and in my case I’ve written in several blogs what personally happened to me, where I was of heavier weight than most reversal patients and what played into that.

Would you do it again?

Do what, again?

My gastric bypass or reversal?

Reversal.

Yeah, it was the only alternative to, like,  NOT  dying.

Well, what about then, would you have a gastric bypass again???

Um, no.

I don’t regret having a gastric bypass.

I couldn’t have  and no one else at the time I had it in 2001, could’ve forecasted my complications.

I stopped asking why my complications happened to me, a long time ago.

The why, doesn’t help anything or anyone, including me.

The hardest thing is, at almost 9 years post reversal, is how cyclical my ability to eat and/or the rare time I try or don’t even try that it’s much harder to lose weight, even though, I’ve had years, like this one, where it’s very hard to eat again.

And when I can’t eat, my reactive hypoglycemia comes back again, so I’m experiencing fainting and falling again, kind of frequently.

My labs though, just recently in the last 9 years are oddly normal, for how hard it is to eat again, especially in the last year.

While I’m recently showing signs of an ulcer, it doesn’t feel like multiple duodenal ulcers which I had for several years, prior to my reversal and can’t say that is bariatric surgically related.

I turn 50 in 12 days.

I had my gastric bypass, 3 days after my 32nd birthday.

I live my small life, looking that I’ve been on borrowed time in the last 11 1/2 years.

Not everyone though has let their complications, a need for a reversal, ruin their life like I let it ruin mine.

Chances are, while I know people who had more of a difficult long term recovery medically and mentally, most people do well long term, post reversal.

The other population of people that I help wanting a gastric bypass reversal bears mentioning it again, as I have discussed them in past blogs:

That is patients who have bariatric surgical regret, not fully realizing that the limitations, at least initially in the first year, possibly 2, that they can eat, but is within the range of normal for a gastric bypass patient.

The reason why it bears repeating, as again, I end up again having to borderline practice medicine and psychology with patients like that.

And there’s sorely lacking of peer and professional support, where when so many patients are happy with the drastic changes they have to make in eating to support their surgeries and cannot understand the regret of a few of their peers.

In that scenario, actually ALL of them, eventually lose their bariatric surgical regret.

Every patient who has found me, who was suicidal due to the realization of what they did to their digestive system, not only eventually do they find peaceful acceptance where they had surgery, most  ended up happy that they did.

But it’s crucial  to acknowledge that feeling of loss, that they aren’t an isolated case, mourning not being able to use food as a coping mechanism.

Because it’s an isolating and devasting feeling that needs to be acknowledged, if  a patient is going to have any chance of acting in a manner that best supports their medical and psychological needs, when experiencing  bariatric surgical regret and it goes unsupported, if not stigmatized by professionals and fellow peers.

No bariatric surgeon wants to do a reversal.

They won’t do it, if it’s NOT medically indicated.

Absolutely NO  pre-operative gastric bypass patient should ever think that a gastric bypass reversal is ever done for reasons like that, not just because of my experience, but because a long term post reversal outcome, is just too unpredictable.

It will save a patient’s life, with all of us who had reversals having unique outcomes on what we’re able  do with those lives, which will vary.

I’m sorry for those who were looking for an update, that you had to wait so long.

I’m sorry for those who are need of a reversal, that you’re going through what you are.

I’m glad that there is more avenues for support, such as support groups on social media and  internet, as well as more reversal peers are also blogging and vlogging about their experiences.

I hope this helps and if it doesn’t, that those in need seek out support, as it’s out there, both online and offline.

As well as I’m dedicated to supporting the gastric bypass reversal community, as long as I can do it justice and that’s why I’ve talked about as long as I have, in case if I’m not  be able to do this any longer, I’m hoping I’ve given others, the tools they need, with other peer and professional help, to not only survive a gastric bypass reversal, but thrive.

Note: Anything that isn’t constructive to myself or any patient population mentioned in blog, will NOT be posted.

 

 

Why #BillMaher going forward, is gonna have a lot of trouble convincing me that he ain’t Trump’s mean little bitchy wanna be brother, from a different mother…

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Important Disclaimers/Trigger Warnings: I’m writing this to achieve  activism goals that I really shouldn’t have to make, but unfortunately feel compelled to, after watching a segment on a Real Fucking Shame, oops I meant Real Time with Bill Maher early yesterday morning.

IF body politics, real politics and profanity offend you, please stop reading this, like NOW.

Also no intention meant to offend any orangutans is intended, as they don’t hate on humans based upon weight, looks, gender and age, like other humans do to each other.

***

I’m NOT supposed to be writing THIS.

I’m supposed to be writing a blog about how yesterday, the 9th anniversary of my fucking gastric bypass reversal, how I’m doing, well, like 9 years later.

Which I really didn’t want to do, either.

If I’m gonna be honest…

However, my gastric bypass reversal and suicide prevention blogs are the most read blogs of mine, ever.

And not just exclusive to the United States or North America, they get quite read regularly on all 6 continents except Antarctica.

Here’s the thing…

As someone who does serious activism as a blogger, who lives an unrecognizable life that did a 180, 16 years ago and who leans on the liberal side (clearly with a conservative streak, as exhibited in my LAST blog) I count on weekends that air a new Real Shame with the funny but I knew didn’t love fat people but looked away Bill Maher, as long as he didn’t constantly remind me of that.

As I needed the distraction of his non fat bashing humor to distract from all these sad, scary and intense news cycles.

I can’t give though Bill Maher a pass any longer on his fat people hatred.

I know too much that plays into trauma that leads to people being of excess weight and too little weight.

I know the desperation that a lot of people feel from being hated on by being of fat that at best, depending on how much they weigh, leads them to drastic interventions like bariatric surgery which I’m NOT against, knowing people who died from both severe morbid Obesity complications or suicide, when wanting a surgical intervention they couldn’t have.

Although, I am better suited for helping those in crisis medically and mentally for those who’ve had catastrophic gastric bypass complications that might lead to a need for a gastric bypass reversal in patients, who also have in real life medical and mental health professionals treating them.

And  how difficult it is, after having talking to many of those people who may need it, into a reversal, who don’t want one because they would rather be dead than fat again and how devastating and terrifying that is for a patient and any of their providers, myself included having that responsibility on them/us.

Bill Maher didn’t have to throw fat people to the wolves, or anyone, to make a point about things that are taxing our health care system.

And clearly he has never worked in health care or in insurance, like I have, where things like a rehab for non professional athletes with serious sport injuries or people with addiction issues, is also expensive.

I know this blog will be read and disliked  for multiple reasons.

And I do defend Trump supporters and don’t think they are bad humans.

Up until yesterday, I  could defend Bill Maher.

That’s until he proved he is dispositionally just as dangerous as Donald Trump is.

Donald Trump has never pretended other than in election cycles to like  people who aren’t thin and pretty and who aren’t poor for the last several decades.

So I can’t and I won’t shame people who still will support Bill Maher in any way, just like I don’t with Trump fans.

It’s not up to me, nor do I feel uncomfortable wishing harm upon anyone, I think people doing that so freely, who do feel comfortable,especially in the digital era they are and it is so dangerous and I’m not capable of it, even though I’m no longer wishing Bill Maher a super great life, either.

And at  least I don’t feel bad now, for at least hoping that Bill Maher, has a prescription in high doses of Zyprexa and Seroquel in his future and would love to see how that works out, especially with his love for weed and would love to see how he would fare, in regards to his weight.

For the fucking love of everything holy, please don’t generically fat bash anyone, John Oliver, those of us bigger liberals with a BMI over 30 are counting on you…

Note: Anything that’s hateful may or may not  be responded to, depending on how stupid it is.

Anything that is direct threat to my or anyone’s life, will be reported to the proper authorities.

How an episode of #HouseMD on You Tube, can give life saving insight on how pervasive and damaging #Obesity bias and bigotry is, way more than the disease of Obesity in itself, not just bariatric patients but in the case of #gastricbypassreversals …

 

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Important Disclaimers: WHY DO I KEEP DOING THIS???

Nope… The above is an unfinished, crappy and nonsensical disclaimer.

I’m going to try again.

Important Disclaimers: I’m an ASBMS and ABMS board certified bariatric surgeon and also a licensed attorney specializing in tort law, where I concurrently hold licenses to practice medicine and law  in CA, MA, MD and MN.

Graduated high school at the age of 12, 1st in class at Harvard Law, 2nd at Harvard Medical School (which I had to sue, to block public access to my academic records and the age that I achieved them), surgical residency John Hopkins and employed as a physician at Mayo Clinic, while on sabbatical, as I just finished up my residency at Stanford, in Neuropsychopharmacology.

I believe though that patients and clients need both in person evaluation and plan of action by a licensed  practitioner   who oversees them in person…

Okay… Above 2nd attempt at disclaimer and CV is PURE fiction.

And was WAY more FUN to write!!!

As well as real life human stuff, as heartbreaking to write about, is way more interesting, at least to me, especially given the fact I’m doing this for free, but when I help be a part of saving someone’s life, that’s the reward.

IMPORTANT DISCLAIMERS: I am NOT a clinically trained medical or mental health professional, nor in public safety or law enforcement. IF you or someone you know is in medical and/or mental health crisis, please seek immediate help in an appropriate facility by an appropriate credentialed expert and/or contact emergency services.

Alright, 3rd attempt I got out what I needed to.

Now, I can start this blog.

YAY!!!

NO, not really!!!

It kind of sucks, that the activism that I’m good at, that my attempt to arrest bias and bigotry which can be deadly to someone, is like trying to empty out the ocean with a freaking thimble.

***

“Not many people would have the guts to admit that they would rather be PRETTY than HEALTHY… “-  the awesome fictional  Dr. Gregory House- from t.v. show House M.D. Season 5 Episode 10 “Let Her Cake”.

“All I need to start with, is patients who are ALIVE, in my specialty of medicine, and by the time my patients find me, they’ve already been quite medically and mentally compromised by medical interventions that were meant to help save their lives, if not make them much better off in quality of life, both physically and mentally.

And if that medical intervention failed them and most of the time, a ton of psychological duress, circumstantial trauma that proceed interventions that usually led to their obesity, and/or continue on after them and most of my patients due to stigma and how people have no idea of how pervasive and damaging Obesity bigotry and bias REALLY is, but horrifically still quite awfully, still so acceptable, unless they’ve suffered it, that the suffering by post bariatric surgical patients, in dire circumstances, pales against it.

AGAIN, even in bariatric surgical patients who had the most catastrophic bariatric surgical complications.

BECAUSE, no one wants to hear how Obesity bias, even by the most well intentioned person, whether they be a physician, family member or friend, can be soul crushing in certain circumstances and in others, such as in my specialty can be deadly to a patient, if not then cause them irreversible physical and psychological harm. ” ajk/UnstapledLisa

If you think so far, this blog is a wordy nonsensical trainwreck, like I am, think again.

Most people if they choose to do activism, especially medical, where to the degree that I am, that I am trying to help save people’s lives, they had to fight an enormous medical (and usually mental health) battle by the time they find me.

The reason why I posted above House M.D. clip, is that it highlights some of the biggest obstacles that I face when I help people when dealing with the medical and psychological ramifications of serious, potentially life threatening bariatric surgical complications.

It also in the worst way possible, shows why I will never NOT be supportive of a bariatric surgical intervention, as a last resort.

I get that House M.D. , is a fictional medical drama that’s meant to entertain.

Unfortunately, there’s quite a few of us, who have in common in the episode, with the character Emmy, where we’ve been told that we need a gastric bypass reversal to save our lives or dramatically improve it.

And while like Emmy, I found exercise to be a great thing for me, as I found I got endorphin highs with intense exercise, thought I could help others with their medical and mental health find some kind of exercise could help people and that’s why I got my certification, as a personal trainer, 14 years ago, that’s all that I have in common with her.

As in my case, by the time I was told by my surgeon who suggested a gastric bypass reversal was necessary to save my life, I was ready to die and I’ve touched upon where I was medically and mentally in 2010, at the time of my reversal and will blog update how I am doing almost 9 years status post gastric bypass reversal, shortly.

But not today.

This is the deal though, in most cases, it won’t help a bariatric surgical patient who had a long term positive outcome or even a person who’s bigger, who would never have bariatric surgery watch the video.

And it will be soul crushing for anyone who’s sensitive to fat shaming and thin shaming to watch the video and read the comments on You Tube.

And this is where we are as a society, as I know full well both personally and professionally of how damaging, if not deadly the pervasiveness of fat shaming can be to anyone, but especially when someone is already in medical and/or mental health crisis after a surgical intervention for Obesity went wrong and they find either my blog or me on the internet.

Because I am to an extent, practicing both medicine and psychology without formal training and licensing, while I consider people like that, “my patients” , in the way it matters the most (to help save their lives and I don’t tell them I think of them as patients, except now you all know) , I also ask of them to be under the care of physicians, surgeons and mental health clinicians, which usually by medical crisis alone, they are.

As while I can help them navigate the unchartered experience they are having, but I don’t have the experience to have their lives soley in my hands, I don’t have the right to do that to anyone (nor do they have the right to do that to me, as it’s a enormous responsibility), no matter how well intentioned I am, no matter how high the standards I have for their lives and care.

The above paragraph would be in direct violation ethically of everything that I try to stand for as an activist and someone who wants a clear division, as physicians, surgeons, psychiatrists, psychologists and/or all or any kind of licensed/credentialed professionals who have extensive education, training before they treat patients, is what a patient in medical and mental health crisis, bariatric related or not, needs the most .

Here comes the BUT why I still do it anyways (online ONLY and with major warnings about my limitations, by not only being NOT a clinical professional but that they will need care and support from their families, friends and the reversal community that’s now online but wasn’t when I had my reversal, as well as a professional credentialed care team of physicians, surgeons and possibly psychiatrists and psychologists)  :

After dozens of times of having gastric bypass (most of them, a few of had bpd/ds, vsg, adjust lap gastric band and open non adj gastric banding) patients tell me they have major complications and their labs are in the toilet, find me because they have no quality of life or think they are going to die and their bariatric surgeon won’t perform a reversal.

Even if they have other physicians in their care team suggesting it.

Because their surgeons are afraid of them getting fat again, in physician/surgeon speak “great concern of the co-morbdities Obesity becoming a factor in declining health”.

OR

Patients who find me, where their experiencing potential life ending medical complications and want to know my reversal experience and have no problem admitting they are terrified of getting fat again.

Remember, where I said at the beginning of this blog, about 1000 words ago, I need “my patients” to be alive???

There’s only a few of us, I’m guessing, I’m really the ONLY person I know, on the internet, who’s discussing in great detail, the medical and psychological ramifications of gastric bypass complications and reversals.

There’s others, but only a few, who blog and vlog about their gastric bypass complications and/or their reversals.

The House M.D. video, could really hurt someone, if they are researching gastric bypass reversals and see the video and/or  the hateful comments directed at fat people and bariatric surgical patients, if they find that video first without finding support that exists, first.

I’m not sorry though the video exists, it gives people a terrifying glimpse, if they care about human beings and aren’t aware of trauma that usually factors in to Obesity and Anorexia, not just in the bariatric surgical community, but outside of it. It just doesn’t tell people what led to their personal experiences prior to an intervention.

You can’t legislate or hate that away and when people are hated for appearance issues, especially when it comes it comes to bariatric surgical patients, those comments on the video, are shockingly accurate of the frequency and level of hate that people experience everywhere else on social media and online and off it, as well.

Not just from their peers and family but sometimes innocently and not so innocently licensed physicians, surgeons and psychiatrists who took an oath not to do any harm.

I shouldn’t be the only to be terrified, that a fictional diagnostic team, even with a ton of snark, in the end, handled a bariatric surgical patient in medical crisis, sometimes better than they are treated in real life.

Even in the most well intentioned people, physicians or not, who do not know how to appropriately address the complexity of emotions, as well as the complexities and medical and mental health issues, that have to  be addressed in this population of people, makes it so much harder on those of us, physicians or not, who are trying to save these patients’ lives with them having the best possible short and long term outcome medically and mentally.

I’m not saying that Obesity doesn’t provide a valid reason for their to be health discussions for prevention and treatment when it happens, if a patient wants it.

But Obesity is just NEVER an acute issue in pre-operative gastric bypass reversal patients.

Note: Constructive feedback is welcomed. Please don’t waste my time or yours with not honorable intentions. Thanks!!!

Edit Note: Update on 5/25, blog needs to be overhauled, I get that it’s kind of wordy. It would be less careless for me to pull it though until it’s reworked than for me to leave it up.

Unless you’ve had to on multiple occasions have to coach a bariatric surgical patient in crisis medically (and sometimes mentally) who even after a weight loss of 200 lbs, has a bmi of 20, but that’s only because they didn’t have any reconstructive, they have a clinically trained professional in their care team, whether it be medical or mental health not show a level of compassion or actually believes that Obesity is the acute medical issue in these patients, when it’s clear that it’s not, you’d understand better why I had to go and be so hardcore, of what at stake with all this body shaming both in the bariatric surgical community or where I’m having a conversation with someone is in recovery or struggling with Anorexia who thinks everyone hates them, including fat people, which isn’t the case.

And if you haven’t done this kind of work, you wouldn’t understand just how complex it is to try and be of some kind of help to save someone’s life, in these circumstances.

Just saying be kind isn’t enough, sadly.

 

 

 

 

 

 

 

 

Gastric Bypass Reversals 501- ADVANCED/ Important information regarding Gastric Bypass Reversals…

masters-are-not-experts-because-they-take-a-subject-to-its-conceptual-end-they-are-masters-because-quote-1

Disclaimers: I’m NOT  a clinically medical or mental health professional. PERIOD. I have some leeway, over other bariatric patients in the bariatric community as a whole, because given the length of time I’ve been helping people when it comes to subject matter. While I will always tell people in medical and/or mental health crisis to seek clinically trained guidance, when it comes to anything, including a gastric bypass reversal, I have some leeway, given that I’m so public about my reversal and for how many people I’ve helped.

For as much as I’ve been blogging, I’ve noticed a strange trend on here, as of late.

While I’m fully aware, that most of my topics are relevant usually to Americans, usually my bariatric surgery related blogs, reversal themed or not, get read a lot in outside the United States, primarily in Europe.
A strange trend though has taken place, in the last several months, though.

A lot of my reversal blogs are being read in Asia and Africa.

Without a followup personal query.

Which is leaving me quite perplexed.

As there is only really a handful of us, who’s talking about gastric bypass reversals, where it reaches a global scale.

That would be myself, my social media bud Sue Joan (who helped me enormously when I had my reversal) and Frankenbelly Misty Trask, who also vlogs and blogs about reversals, and is an amazing ally in support, as well as her desire to help, has led her to start a dedicated reversal support group on Facebook, for the last several years that she runs.

There are other people of course, but us 3, are usually the ones who are contacted the most, globally.

As well as the book that Dani Hart wrote, well over a decade ago, regarding gastric bypass  reversals, but I haven’t found her on social media, at all.

Most people, if they have any kind of curiosity about a gastric bypass reversal, would be surprised to know that I spend almost as much time equally talking someone OUT of wanting a gastric bypass reversal, than into one.

Also, while I had a bariatric surgeon who was nationally AND globally ranked (as he teaches procedures outside of the U.S. or at least he used to) and regarded who did both my gastric bypass and reversal, I absolutely KNOW nothing that might translate well, in helping others, who and/or where the surgery procedures for both bariatric surgeries and takedowns of them in other countries/continents (other than vertical sleeve gastrectomies which are not reversible but they also are usually considered the least invasive of bariatric surgeries, even with approximately  80% of the stomach being removed), that there is some kind of irony, that my reversal has gotten so much global attention.

This though, is NOT why I’m writing this blog.

I’m writing it, because I do have a desire that NO ONE goes through the reversal process, if surgically indicated that it’s necessary, alone.

But truthfully, this is where the “advanced” but doesn’t mean squat, comes in.

I couldn’t tell someone from a different country or continent anymore about any potential of a  predictable outcome because there’s no such thing, for a reversal, out of the country or continent, than I could if they were in North America or the United States.

I’m definitely NOT saying that I don’t possess the skill sets, even as a non clinically trained provider to metaphorically “hold someone’s hand”, while they go through the process.

I just can’t, just like NO ONE can, guarantee the length of recovery or what their recovery and ultimate  long term outcome can and/or will be or what it will look like.

That doesn’t mean that I’m going to not help people regardless of country or continent they reside in, of trying to help when I can.

The very nature of a reversal being needed, as I’ve tried to state, makes any kind of prediction on how an outcome, well, unpredictable.

That though is in no way expressing, that if a surgeon is recommending a reversal, a patient should not go through with it, because the outcome is unpredictable, it’s unpredictable but it’s life saving and life enhancing compared to the risk of potential deadly complications and or life ruining ones, if a serious intervention like a reversal doesn’t happen but it’s needed.

Just because I had a reversal from such a brilliant surgeon who teaches procedures all over the world, doesn’t make me an expert in all things regarding gastric bypass reversals, especially the physiology component.

I didn’t go to medical school and I’m NOT  a surgeon.

I just because of irony, bad luck and a desire to help others, possess the knowledge that very few peers would have, when it comes to this topic, that’s it.

It’s A LOT though.

Given how many people I’ve enormously helped in the last 7 1/2  years.

What may I suggest for sources of support and/or information, if a surgeon regardless of country and/or continent of residence in a bariatric patient suggests a gastric bypass reversal:

And unfortunately I can’t copy and paste links.

Use both search engines (i.e Google) and You Tube and there’s a ton of information in articles and videos.

While the surgeon videos are helpful, it’s also extremely helpful on You Tube to hear from others who’ve had reversals.

Note though, that there are patient limitations, as well as professional ones, on how much we can help specifically, for multiple reasons.

Such as our beloved Grace, who has videos on You Tube and various bariatric community threads and I’ve seen people write nasty things because she didn’t respond back on her videos and/or threads online.

Grace sadly passed away a few years ago, non reversal related.

People like Frankenbelly Misty Trask, she vlogs on You Tube and blogs, as well as admins that reversal support group on Facebook.

If you use a search engine you can find Sue J. ‘s work who’s been helping people with bariatric complications for many years by “googling” suesaysthings.

I blog about about reversals on this blog site and at Obesity Help.

But respect our limitations, OK?

We help because we believe in comprehensive  support. While nothing I do is monetized and I can only speak for myself, even for those who can monetize their support services, they aren’t making very much, if ANY money, if it’s peer support driven.

Be honest when asked questions by someone who’s trying to help you in this capacity, as far as one’s gastric bypass reversal.

We’re NOT asking because we’re nosy. I ask detailed questions, to a potential reversal patient, even though I’m NOT a clinically trained provider, to give the best support and insight as possible.

I can’t do that, if certain questions aren’t answered, when I ask them.

But if you choose to lie, realize whether it’s one of us peers or a clinically trained professional, most of us, have done this long enough, to know when someone is NOT being truthful.

For those who contact others about needing support and information, be RESPECTFUL.

I’m not, nor is others doing it for our own sake, other than wanting to provide valuable support.

I put boundaries that are necessary for everyone’s safety, both yours and mine.

As an activist especially, I have a duty to warn and protect and I take that very seriously.

IF I suspect that someone is behaving in a manner that could be harmful to themselves or others, I can’t nor can any peer or even clinical professional, resolve that, in an acute sense, I’m going to have to report any kind of suspicious or dangerous thinking and/or behaviors to emergency responders in one’s location.

That’s why I limit helping people to email queries, exclusively.

Although I’m pretty saavy on being able to find people, if I have their email address and I suspect they possibly will self harm.

I don’t give my phone number out any longer, because it/and myself was verbally abused, a long time ago.

For my sake, while I will try to participate when I see queries all over the internet, I’m NOT on social media, much.

But my blog is one of the first gastric bypass reversal resources that exists, when one uses a search engine.

The last thing and most important, know if you contact me, among others that I both named and not named, all of us try to help.

I know for me, I will with boundaries stated above, help someone to the best of my ability, for as long as it takes, to see them go through the reversal process with support and/or the opposite, where if someone has bariatric surgical regret, wants a reversal and they aren’t a candidate, because they mourn food as a coping mechanism, and I warn pre-ops they shouldn’t ever expect that their bariatric surgery can be reversed and support those who mourn food, in positive redirection knowing that a reversal may not guarantee an ability to return to eat normally, because those patients aren’t going to get one for that reason, as well as the other risks.

I don’t expect anything more except hopefully, respect and possibly a thank you for those I go out of my way to help.

But if I invest my time and my caring, just like any of us, to talk to someone for several months or if not several years on the internet and if one can’t be bothered to be respectful or grateful (luckily those people are few and far between) don’t get mad when you’re not in acute medical and/or mental health crisis, any longer, that I will sever contact at that point.

I don’t mind helping as much and as long as it takes to help someone, especially if they’re appreciative.

I do mind, and so will your surgeon, as well as it will set off warning bells, if one is belligerent to a person trying to help another.

As not only do I have my own problems, as well as other people I help who are in crisis but  grateful for my help,  a bariatric  surgeon will be concerned on doing any kind of surgery on a patient where they’re questioning a patient’s mental fitness and potential compliance of what a reversal takes, if a patient comes off rude, mean and/or a know it all.

I know this was wordy, but given again, the nature of how much this topic is still being researched, I figured it deserved another blog on how to best help patients when they need a gastric bypass reversal.

And when they don’t.

Note: I don’t mind constructive feedback. Any rude comments will NOT be addressed. Thanks!!!

 

 

 

 

 

 

 

 

 

Gastric Bypass Reversals-101

Disclaimer: I’m a medical and mental health activist, NOT a clinically trained medical or mental health professional. When in medical and/or mental health crisis, please seek medical/mental health treatment, in acute care facility, immediately.

However, the nature of this topic which is gastric bypass reversals, while it’s not something I’m concentrating my activism as a blogger, on, as of late, it’s something I’m always “on call” for, because I’m probably the most public person out there, who’s farthest away from my reversal, being almost 7 1/2 years status post open roux-en-y gastric bypass reversal and over 16 years status post laparoscopic roux-en-y gastric bypass.

While nothing I ever say, SHOULD EVER be taken in lieu of professional medical or mental health issues, I have a little more leeway in this topic and credibility, as far as giving my opinion, at least about reversals of when they should be done and when they shouldn’t be.

For one, I can’t do ANY of the  bariatric surgeries or a take down of them.

I can only tell people when I think they are necessary and when I think they are NOT.

Or agree and/or disagree and give my opinions when the topic of gastric bypass reversals come up, that’s it.

Gastric bypass reversal outcomes, if you use a search engine, there is clinical medical data out there, but it’s VERY limited.

The nature of a reversal being needed, makes it the outcome pretty difficult to predict, other than that it will usually save a person’s life and/or now, when they are being done, when the quality of life of a gastric bypass patient, is so reduced, more so than the potential that any of the co-morbidities of Obesity and Super Morbid Obesity, could ever present to a patient, that it will improve their quality of life and or at least arrest certain complications, like long term nutritional deficiencies that can cause serious and irreversible complications from getting worse (I’m not talking about patients who don’t take their vitamins, I’ve addressed this topic in other blogs).

With some caveats, which I will explain as I go along.

Most people are surprised to find out that I am bariatric surgery “positive”, without serious promotion of it.

I am a medical activist and advocate, I do believe that bariatric surgery, up to and including gastric bypass, are the Obese and Super Morbidly Obese patients best chance of losing a lot of weight and keeping it off, long term.

I am not digressing when I say the same, with Opiates, I believe they for those who have severe chronic pain, have exhausted all other treatment options for pain.

That being said, I obviously, like most medical providers and medical activists , believe that to be true, both with bariatric surgery and opiates, ONLY as a last resort, because of complications and things that can go wrong, even when the most qualified medical professionals are involved, with the most compliant patients.

There are many reasons why a bariatric surgeon will tell a patient that they need a reversal, the reasons are varied and that should NORMALLY be between a surgeon and/or another medical professional and a patient.

Because those reasons are complex and too numerous for me to list, I’m not going to bother putting all the reasons why a reversal is sometimes needed.

However, when it comes to a patient wanting a reversal for medical reasons (I’m about to make another point, bear with me) but a surgeon NOT wanting to do a reversal, there are cases, which I get contacted about, because a surgeon doesn’t want to do a reversal, not necessarily for the right reasons.

Meaning, I will get bariatric patients who find me, are going to die from their complications and the ONLY reason they are given for a reversal not being done, is because of a surgeon’s fear of of a patient gaining all their weight back.

My surgeon wisely told me, as he did both my gastric bypass (2001) and reversal (2010) that my complications which I would’ve died from, posed a greater threat than the co-morbidities of Obesity ever could present to me and for how much sicker I got drastically (I had complications from 2002, 1st hospitalization in 2004, many from 2006 to 2010, especially in 2010) I wouldn’t have lived long enough to gain all my weight back, like I actually did, in my super unusual case for a patient who had long term severe complications from late 2007 to late 2009 due to meds, even though I couldn’t eat very much and projectile vomited anything and nothing I ate due to those pesky ulcer bleeds.

Usually, when patients find me who are are super sick from their complications, have had many complications and are in and out of the hospital most of the time, quite a few have feeding tubes, chances are, they are NOT going to live long enough to have to worry about co-morbidities that are typical of Obesity.

I usually tell them to find another surgeon. Because usually in these cases, their lives depend upon that.

And usually they do find a surgeon, where if a reversal is the best option, who perform them, successfully.

I also have to deal with gastric bypass patients who are TOLD to have a reversal, but don’t want one, because they are afraid of getting fat again.

I don’t take that personally, even being unusual, being heavier of needing a reversal to save my life.

It usually goes beyond the scope of most bariatric patients that if they have gastric bypass or any other weight loss surgery to lose weight and become healthier, that it’s inconceivable to them, they could possibly become sicker and/or die, than the co-morbidities of Obesity, could ever present, like I said before, quoting my surgeon.

Those patients, I can usually only take so far.

While I help quite a few of them, because I’m quite blunt in saying, that they are going to DIE, usually in their cases, they won’t live long enough to get fat again and I urge them, like I urge anyone that I help to get both medical and mental health help that goes beyond acute care.

Although acute medical and mental health professional help, is needed in most of those patients.

Also,  I have to explain to a lot of patients, whether they had an ideal outcome, but especially in catastrophic ones, they aren’t (on rare occasion, there is extreme self sabotage or they weren’t ideal candidates and should’ve never made it through the pre-operative bariatric surgical process) to blame for their complications, moderate to severe.

Bariatric surgery, all of them, is a supposed to be a tool, not a form of torture.

While it’s not meant to be comfortable, it’s not meant to be agonizing, either.

Which brings up, the last few populations of bariatric patients (or their families) I get queries from, who want and or need help.

Those who don’t have complications that aren’t anything that’s considered abnormal in the realm of having bariatric surgery, in the first year, that any competent surgeon (which I realize, there are some bad surgeons, but there are a lot of good ethical ones, too) and their teams would’ve warned them from the start.

Such as how little one person can eat after a gastric bypass and while I know most patients are warned and are prepared, some can’t deal with it, after the fact.

Or there are a few who weren’t actually warned.

We were warned 16 years ago of what to expect, as far as having to re-learn how to eat again, in my pre-surgery process and it’s way more extensive now, as far as preparing a potential bariatric surgical patient of what to expect and the fact that complications including death, can happen.

But a reversal isn’t done, in cases where patients are truly devastated about how little they can eat, right after surgery.

Lastly, here’s a few other major things people need to know about gastric bypass reversals:

NO pre-operative gastric bypass patient should think that they can easily be reversed.

They can’t easily be reversed and they aren’t reversed, due to “buyer’s remorse”.

I get pre-ops who find me, who want that as an emotional insurance policy, that if they change their mind, after the fact, that they can just  “get it undone” .

No, gastric bypass pre-operatives should NOT assume that a reversal can be done, in cases of bariatric surgical regret (without complications) , because it IS risky (but needed as I’ve tried to explain in this and other blogs).

No bariatric surgeon, for that reason, among many, is willing to do a reversal, unless someone’s health or life, dictates it’s necessary, as a last resort for reasons, that I’ve stated and that a surgeon can elaborate on, should the topic come up between patient and provider.

I try to help anyone, who’s receptive and honest with me about their circumstances, again, with urging them, if it’s necessary, to be under the care of multiple clinical professionals, other than a surgeon and their team.

I do in these cases, because for one, not only do I know people who’ve done well long term after gastric bypass, I’m actually biologically related to one.

I also know that usually with time, when people have “bariatric surgery remorse” that isn’t complication driven, they usually get over it, in time, when they start to experience all the good things that their gastric bypasses will bring them (i.e. the positives of major weight loss)  and usually they get past devastating regret.

Which requires above, 2 separate support systems, truthfully as far as peers, as most people don’t understand initially, that bariatric buyer’s remorse does happen and aren’t as supportive as they could be.

On the flip side, when patients do accept their surgeries and what’s good about it, it’s still life changing, in under the most optimal circumstances, so that’s where the peers of the weight loss surgery community can help, life long, for those people.

Sadly, the very hardest population of people that I have to help, are people who’ve had such catastrophic complications, they couldn’t be reversed and either have died, or are in long term care facilities, and their families contact me, in wondering if a reversal would’ve or could’ve helped saved their loved one’s life.

Or there are a few patients, where either due to a bad surgeon or a good surgeon’s bad judgement, or just plain horrible luck, they had either such catastrophic complications and multiple revisions and can’t be reversed and are waiting for a stomach transplant or some other extremely rarer intervention than a reversal, and they are spending the rest of their lives in acute care setting (usually a hospital) because they are too medically complex and fragile, to be anywhere else.

Again, not being a clinically trained professional, but after having some idea of being exposed to so many people’s stories (thousands, in the last 7 years!!!) , I have to usually go by what patients tell me what happened, what their surgeons (if it’s the original surgeon or someone else who’s cleaning up another’s surgeon’s mess or if someone had unexpected complications and the surgeon retired, i.e.) said, but I don’t believe all bariatric surgeons are bad or negligent.

Most bariatric surgeons are good and intend to do good, with the medical and mental health long term outcomes of their patients.

And I do defend bariatric surgeon’s judgements on a individual basis, whether they recommend or NOT  recommend a reversal, depending on the individual circumstances, all the time.

Unfortunately, initially, that does put me in a unique position. I get where so many people when they need or want a reversal come up, either for medical reasons or mental health ones, where I can say things (very,very, VERY carefully!!!),  that a normally much better qualified in any other topic, medically and mentally trained clinically professional, sometimes can’t for the reasons I explained in this blog.

Bariatric surgeons are sometimes can be likened to  mechanics, they  can possibly fix medical problems, if we are equating a body (which is a lot more complicated) than a car, if we use a car analogy.

Psychologists are like the emotional mechanics, of why people need help with “car repairs” if they keep “crashing their cars”, that can beyond the physical.

But this is a tricky instance, where if  patients have had mental or medical health issues due to being fat, have unresolved eating disordered issues, where medical and mental health interventions AND peer support with people who’ve been in a similar situation, can really only help when it comes to the bariatric community, with obviously a lot of clinically trained medical and mental health support, too.

And/or if you need a gastric bypass reversal, where our particular community is limited on what we can predict as a reversal outcome, but extremely peer supportive, given the unique circumstances that require our surgeries being reversed.

I have touched upon the things people need to know about themselves, the limitations of both patients and providers, as well as the fact, that most people, their lives are saved, when a surgeon says they need a gastric bypass reversal, or they do have a better quality of life.

It’s usually though not right away, especially for those who live and nearly die longer (i.e usually within 3 years status post rny) than those of us, who had a reversal, later.

I did have a better outcome than a lot of people, but NOT right away, it took years. And all of us who I know who had straight takedowns (there is a trend of surgeons now reversing and then doing a vertical sleeve gastrectomy, that’s not weight related) but had complications longer, usually have something.

In my case, I have gastroparesis, like most, but not bad. It took years for my labs to come back to a low side of normal. I can eat without getting sick, usually. I have though severe heartburn, the second I eat or drink anything.

I never regained a sense of hunger, even though I did regain a sense of satiation. I can eat quite a bit. But not often and not for like 4-6 hours at the very earliest, from waking up.

But there are still foods I can’t eat (hamburgers or meatballs, cruciferous veggies) without getting sick. My severe reactive hypoglycemia does come back  and I do start blacking out, if I forget to eat (which does happen) and/or wait too long. Or calorically go too low, which is like 1200 calories or under.

So while I can eat a lot, it’s usually infrequent, that I do so, because it’s uncomfortable to have too much food in a sluggish digestive system.

But medically, it took at least 2 years, to really heal from reversal….

But all of us vary, who’ve had a gastric bypass reversal, in both what our short term and long term outcomes were.

I hope this helps. I am putting this out here, knowing that this blog is really wordy and while my blogging activism, as well as having personal issues, not within the realm of my control, didn’t make writing this NOW, an ideal time, as far as being concise.

But apparently is needed, now, for what people are searching for in on search engines, the realm of what to expect and when a reversal is needed and why bariatric surgeons, medical professionals and seasoned reversal patients can’t forecast another’s outcome post-reversal.

I can be contacted here or my private email address or on Facebook, as Lisa Kasen (not on social media much, here is better) as well as there is a gastric bypass reversal group on Facebook, for those looking for more information, from a peer perspective regarding a gastric bypass reversal.

Note: PLEASE don’t make defend both my advocating for those who have had complications, bariatric surgery regret, as well as defending those who are happy who had weight loss surgery whether they had an ideal outcome or not.

In my case, I have to ethically do what I feel is right, as a non clinically trained medical and mental activist,  knowing people who died waiting for a surgical intervention for their Obesity and died of Obesity related co-morbidities, but also knowing people who’ve died as a result of catastrophic complications, post bariatric surgery from their gastric bypass complications.

Thanks…

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