Bariatric surgery more than about weight loss

6/11/2012


"We’re getting ready for a party this weekend – Our daughter is graduating college,” says Nelwyn Babineaux, as she springs into her suspended wicker chair dangling on the patio. She glows with anticipation at the thought of sprucing up the yard, the swimming pool and around the house for the big day. A year ago, before her and her husband’s bariatric (weight-loss) surgeries, the occasion might have seemed like a much more daunting ordeal.

Nelwyn and her husband Michael had battled obesity problems for decades to no avail, and it was taking its toll on their health in detrimental ways. Exasperated and tired of fighting for minimal or temporary results, Michael first learned about bariatric surgery from some of his co-workers, and grew interested. He started telling his wife about it, and then one day they came into contact with someone they knew had the operation. "I didn’t recognize her,” says Nelwyn.

They became even more intrigued.

The Babineauxs had seemingly tried everything. They both participated in weight-loss programs, and lost weight, for a short period of time. "I was right above my goal,” Nelwyn says of a past attempt. "But, I went on a cruise, and had a little weight gain. I came back and said, ‘I can do this myself’, but over the course of the next few years, I gained the weight back.” Michael had embraced the program so whole-heartedly he even became a spokesman for it. But he, too, had seen his weight losses reverse with time. Nelwyn tried several different programs, and was on a variety of pill regimens. "They looked like Skittles,” she says of the pills she was taking. Some weight would come off for a while, but it always came back. The Babineauxs say they "yo-yoed” up and down the scale as many as 10 to 12 times.

By last year, associated ailments, called co-morbidities, had been racking up because of the problems caused by their excessive body mass. Nelwyn’s concerns about the growing frequency of numbness and tingling in her hands and feet turned out to be the onset of (Type 2) diabetes. This only added to the already long and growing list of medications she was taking, such as anti-anxiety, beta-blockers and anti-depressants. Michael’s diagnosis of diabetes compounded his high blood pressure, high cholesterol, sleep apnea and triglyceride medicines. "Every time I’d go to the doctor, he was finding something new,” he says. They decided together that bariatric surgery was something they wanted to pursue.

In May 2011, Michael decided to contact the doctor, Philip Gachassin, M.D., that had performed the surgery on his past co-worker, of whom she spoke highly.

Dr. Gachassin is the medical director of the bariatric program at Lafayette General Medical Center (LGMC). He has been performing bariatric surgeries for more than 10 years and helps conduct seminars for people looking to have surgery. "We look at it as a free informational, educational seminar,” he says. "At the seminar, we typically discuss the disease, the procedures we offer, and the effects on the medical problems that the procedures have. We then describe our program at Lafayette General, and how to become a patient if you want to move forward.”

Lafayette General was designated as a Bariatric Center of Excellence (BCOE) by the American Society for Metabolic and Bariatric Surgery (ASMBS) in 2011, as well as the Surgical Review Corporation. High-quality perioperative and long-term follow-up care are among the many prerequisites to obtain the prestigious title. Dr. Gachassin is teamed up with Dennis Eschete, M.D., both certified with the ASMBS. The two doctors help instruct and educate patients at the seminars. The hospital coordinates a comprehensive support network to see them through the entire process, if they qualify.

Brooke Doucet, registered nurse and Bariatric Program Manager at LGMC, describes how the center has a multi-disciplinary team to assist patients. "We have an RN on staff, a registered dietician, a behavior modification educator, a licensed practical counselor and exercise physiologist. They all work together and follow patients post-operatively to make sure that they continue their success,” she says.

Dr. Gachassin prefers to call the surgeries "metabolic surgeries” rather than weight-loss surgeries because of their metabolic effects, and this view has been bolstered by recent scientific news. These operations made medical headlines based on two studies published last month in The New England Journal of Medicine. The studies, by the Cleveland Clinic and Catholic University in Rome, established some of the strongest data yet in supporting what doctors have clinically observed for years. The surgeries appear to be vastly superior to traditional medical therapies for Type 2 diabetes treatment and other co-morbidities in patients having a high body mass index. While the benefits of metabolic surgeries have been touted for years, these two studies were the first to pair the traditional diabetes treatments up against the surgery option, Dr. Gachassin explained. The results are clear, and have rippled through the medical community. Metabolic surgeries are far beyond cosmetic, now.

"Our surgeries surely have a metabolic effect on patients with diabetes in that we can put their diabetes in remission,” says Dr. Gachassin, although he stops short of calling it a cure. The importance of metabolic surgeries is increasing, as almost two-thirds of Americans are overweight and this number is growing, especially among children, Dr. Gachassin points out.

The surgeries help reduce several other risks associated with obesity, such as certain cancers, sleep apnea, hypertension, high cholesterol, and can dramatically extend life expectancy.

The Babineauxs can testify to this first-hand. Both of them have shed medications with the pounds. Nelwyn is now down to simple multi-vitamins and other minor supplements. Michael is only on blood pressure medication, which he attributes to heredity and family history. Nelwyn says that, after some recent bloodwork results, her nurse told her, "It looks like you’ve never even had diabetes.”

One of the main hindrances to people qualifying for the surgery, aside from the medical criteria required under program guidelines, is insurance coverage. Some plans cover it, but Dr. Gachassin would like to see more people covered under the state’s major providers. Interested patients can learn about their options by attending the seminars offered at Lafayette General.

"It changes your life”, they both proclaim. Aside from a modified diet with a decrease in appetite and eating capacity, which they’ve adjusted to comfortably and happily, they both feel great. "I feel like I’m 40,” Nelwyn gleams. "I can walk, cross my legs, I want to climb a mountain, I can accomplish anything… I can conquer the world!”

The Babineauxs want to travel again. They’ve picked up new hobbies and have newfound enthusiasm for living. They want to visit places they’ve already been just so, this time, they won’t have to stop to take breaks as they go.

As for this weekend, they plan to party. Michael is preparing to mow the yard, which he can now do in one-fourth the time it used to take.

"If you would like to have a better life, go (to a seminar) and listen to what they have to say,” he says. "It’s a different life.”


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