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A New Lease On Life: Gastric Bypass Surgery

A New Lease On Life: Gastric Bypass Surgery

Torrance Memorial Medical Center's Surgical Weight Loss program has transformed weight-reduction procedures to life-changing events. The hospital's holistic approach embraces much more than the surgical tools so famous for quick weight loss. In fact, bariatric patients at Torrance Memorial, a certified Center of Excellence, must see nutritionists and psychologists and attend support groups-as well as undergo rigorous medical testing and monitoring months before and after surgery.

Individuals who wish to have bariatric surgery learn there is a lot of work to be done before they can even get approved for a procedure-this process isn't just a quick fix. Physicians realize that quick fixes can typically be undermined by in­grained bad habits. To have long-term success, each patient must embrace a new way of living-from the inside out.

Just ask Carmi Standish-a 56-year-old woman from Long Beach who lost 125 pounds by having gastric bypass surgery a year ago, with the help of the Torrance Memorial Medical Center team. The surgery instantly eradicated her diabetes. "This was life-changing," she says. "I did a lot of research and talked with a lot of people [around the country] who had this [gastric bypass surgery] done, and they didn't go through the same rigor­ous process as I did with Torrance Memorial. But that's what works."

The Road To Transformation

So what does this rigorous process involve? According to Standish and her surgeon, Aileen M. Takahashi, MD, FACS, medi­cal director of the Torrance Memorial Bariatric Surgery Program, a recognized Center of Excellence by the American Society for Metabolic and Bariatric Surgery, Standish needed to lose some weight on her own and go through medical and psychological test­ing before surgery. This makes complete sense, as some people may have psychological issues or eating disorders that require counsel­ing. Takahashi-also a surgeon with the Association of South Bay Surgeons-says she doesn't want to schedule a patient for surgery if, ultimately, they will regain the weight down the road. Even so, the thorough process can be initially daunting.

"I was writing down all the information during the first consultation with Dr. Takahashi and was barely able to keep up. I was required to lose 10% of my overall weight, or 27 pounds, before surgery. Then I was told I needed a psych evaluation, blood tests, a meeting with nutritionists, a chest X-ray, ultrasound of legs for clotting issues, a CAT scan, and to at­tend support groups pre-op and post-op. I was overloaded, thinking, 'Are you kidding me?'" she laughs. In retrospect, Standish is now thankful.

Gastric bypass surgery is not a simple medical procedure, and Tor­rance Memorial Medical Center strives to ensure complete safety-hence all the testing and monitoring. During gastric bypass surgery, the stomach is divided into two parts, with the smaller pouch preventing large food intakes. This new stomach is then attached to the lower portion of the small intestine, so the rest of the stomach is "bypassed" during digestion.

"Gastric bypass (surgery) is a very powerful tool. There are many benefits, but the biggest is for those with severe diabetes. With the bypass, people have better control over their diabetes before they leave the hospital," Takahashi explains.

In addition, this procedure is the oldest of the bariatric tools with more scientific research conducted about it. It can, however, leave patients with vitamin deficiencies afterwards if they do not keep up with maintaining good nutrition and taking their vitamins. To ensure safe outcomes, Torrance Memorial Medical Center always conducts multiple blood tests and studies. To better ensure that no blood clots will develop during their healing period, bariatric patients are asked to drop some weight before surgery-helping them walk immediately afterwards, she added. All of these safe guards by the talented physi­cians at Torrance Memorial are the reason why bariatric surgery is so phenomenally successful there.

And Standish is a shining example of how bariatric surgery can transform lives. I met her in early December at a coffee shop in Tor­rance. She was wearing an elegant, royal blue blouse with black dress pants. Her short, dark hair, peppered with gray, was cut stylishly, her makeup flawless. She smiled at me energetically, and I realized even before our interview began that this woman possessed a zest for life. It was hard for me to believe that just a year earlier she was 100 pounds heavier and on the verge of battling debilitating diabetes.

"My diabetes is gone," she says. "I was on three different meds the day I entered the hospital. The day I left the hospital I was taken off two of the medications. One week later, they took me off the final one. It's amazing. I did it [gastric bypass] for that reason, and losing the weight was a bonus."

As we chat about all the things Standish had to do to get qualified for surgery, it became abundantly clear that those who fare the best with gastric bypass surgery-or any other type of bariatric surgery (see sidebar)-are those who look at the procedure as just one tool on their road toward better health. "We tell our patients that they have to start lifestyle changes now, before surgery. We emphasize to emotional eaters to enter therapy first and to garner appropriate expectations [for the surgery]," Takahashi explains.

"Most patients have to lose weight before we schedule them as well, for health reasons. It also gives us a period of time-three months or longer-for us to evaluate whether they were able to make healthier choices and changes. They work with a nutritionist and go to support groups while we also conduct medical testing to ensure the surgery will be safe for them. If, during this period of time, they don't lose weight, or actually gain weight, then we must explore why or else those unresolved issues continue to plague the patient after surgery and limit their success," she says.

This is a thorough process that helps people examine some choic­es that may be holding them back. For instance, Standish says her stumbling blocks are fairly simple. She "likes to cook, entertain and eat." Luckily, she isn't a binge eater, and she doesn't have other emotional eating issues. When it came time to lose weight before surgery, she says she took a practical approach and decided to cut most carbohydrates out of her diet. Between July and Decem­ber 2009, she lost 31 pounds on her own before surgery. She also attended support groups with other people who were either trying to lose weight to have surgery or to keep the weight off afterwards.

A year after her gastric bypass, Standish still attends support groups. Why? The support helps her stay on track, and she knows how to help people overcome and/or discover their own stumbling blocks. How the procurement representative for Raytheon has time to help others and attend regular meetings is amazing, but she is clearly passionate about helping others achieve success.

"Some people just don't realize some of their habits," she says. "I was at a support group, and one person just couldn't lose the weight [necessary to get approved for surgery]. So I asked him to describe his diet to me. I realized he was eating red meat nearly every day. I sug­gested that he reduce red meat to two nights a week and have smaller portions of steak. The other nights had to be fish or chicken or pork."

With the excess weight lost, she no longer has knee issues and certain­ly has more energy. While never a big exerciser, she enjoys hiking with her partner, Sue, and riding bikes. The two are actively planning their next trip in 2012, including traveling to the Galapagos Islands and hiking the last seven miles of the Inca Trail with a guide to the Sun Gate of Machu Picchu.

Finishing Touches

Six to 12 months after surgery, when patients have lost most of their weight, many desire plastic surgery to eradicate loose skin. Standish went to Charles Spenler, MD, who helped her get rid of 12 pounds of excess skin.

"We talk about what areas bother them the most, and often times it's the tummy area. For others, it's the neck, arms or breasts," explained Spenler. This type of plastic surgery can be life-changing as well, since an excess amount of skin can cause irritations and infections even after bariatric surgery. These areas are completely healed by the operation."

The renowned plastic surgeon gave an example of a patient who was a bus driver, with a massive rash on his back due to loose skin rubbing the seat where he sat for long periods of time. After surgery, it was completely gone. For others, the biggest perk to plastic surgery is the ability to wear a belt or jeans, as the additional skin around the waist makes this difficult.

Today Standish is enjoying life to the fullest and hopes to inspire others to get there too.

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