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Wednesday, August 10, 2011

Life After Lap-Band Surgery: It's Complicated

Posted By on Wed, Aug 10, 2011 at 11:30 AM

Marilyn Wann - MARK RICHARDS
  • Mark Richards
  • Marilyn Wann

This is the second of a two-part commentary on the surgical procedure used to promote weight loss known as laparoscopic adjustable gastric banding, or lap band. Read the first part here. -- Eds.

Surgical procedures designed to help people lose weight are becoming more prevalent, but there aren't many comprehensive, controlled, scientific studies on the effects of these, including the lap-band method. This is where a band is surgically inserted and can be adjusted to regulate the amount of food one's stomach can hold. I refer to it as stomach-binding.

Here are a few things I've found on the procedure:

A European study published in July followed stomach-binding recipients for a decade or more and found that 28 percent experienced "band erosion" after about four years, and half had the lap band removed, either because of problems or because they didn't lose weight. (A 2006 study also found 5-year band removal rates of nearly 37 percent, prompting researchers to say that lap band surgery "should no longer be considered as the procedure of choice." They didn't stop to wonder why a healthy digestive tract needs surgery at all.)

A Pennsylvania study cited in the New York Times shows researchers were surprised to find higher rates of suicide among survivors of all types of weight-loss surgery. Here's a story about Lisa Marie Sohr, one face of the phenomenon.

Dutch researcher and physician Edo Aarts of Rijnstate Hospital in the Netherlands says an increase in surgeries, which have up to 90 percent complication rates, "could lead to a tremendous burden on the health care system." Without admitting any down side to the procedures, the professional association for weight-loss surgeons has created a colorful poster to hang in

emergency rooms, describing how to treat such patients safely. Surgery survivors must carry a card with similar info.

If you're not skeptical about stomach binding based on the data, consider satire.

Stephen Colbert suggested a low-budget alternative, "the world's first external diet collar" called the Vacsa Band. As he tightened a leather belt around his neck, he warned, "Side effects may include stoppedness of breath, facial blueing, and auto-not-at-all-erotic-asphyxiation."

Better yet, here's my smart-funny-handsome friend Michael's story:

Michael tells me the worst part of having the lap band was not starving for a month post-op or the intense pain every time his belly got bumped or his muscles contracted in a way that hurt the spot where the inflation port was embedded in his abdominal wall.

"I was terrified of crowds," he says. "If someone's hand moved toward my belly, I'd flinch. I stopped all exercise except walking, and for the first time in my life I felt weak and broken -- a feeling that would continue until the day the band was removed. There were so many activities that could randomly and unexpectedly cause me pain."

And Michael describes the worst part as:

"If I ate too quickly or I ate the wrong food or I chewed too slowly or if I was on an airplane [where the band tightens due to altitude] or if it was too early in the morning, food could get lodged in the lap band constriction. The feeling of discomfort was so bad that I wanted to die. I needed to throw up but I couldn't. The discomfort would increase in intensity and I'd start spitting up thicker saliva.

"This type of episode would go on for between 10 minutes and half an hour. More than once during these episodes I considered trying to cut myself open with a butter knife just so I could rip the lap band out. I began to fear food. I feared eating. I found a few foods that worked and I ate only them.

"Going out on a date was impossible, and travel was scary. Needless to say, the 30 pounds of weight I lost did not improve my social life enough to make up for lost opportunities due to fear."

Michael won't be on any surgery billboards. He had the lap band removed. He feels great. His doctor envies his numbers. He just rode his bicycle in the 545-mile AIDS/Lifecycle ride to raise money to help end HIV/AIDS.

Sweet dreams!

Marilyn Wann mourns Amy Winehouse's death and sings, in her honor, "They tried to make me get a lap band and I said, 'No!' 'No!' No!'"

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