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

Archive for the ‘Obesity’ Category

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.

 

 

 

 

 

 

 

 

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