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Emergency Room Poster: WLS Complications

I've been planning to put together a post discussing specifics of WLS risks, side effects, and complications as a follow-up to our recent series on FDA approval of the lap band for lower BMIs. I want to give definitions of the medical terms and provide links to studies. It'll take a bit of research and a bit of time to put together.

So for now, I give you this new emergency room poster, published by the American Society for Metabolic and Bariatric Surgery: Clinical Pearls for the Emergency Care of the Bariatric Surgery Patient (that's a link to the full pdf).

WLS is becoming more common, and as a result emergency rooms are having to deal with more WLS complications; serious and life threatening damage to patients' health. This poster is being provided to hospital emergency rooms so that they can recognize some of the most common issues. Let's take a quick look at what it has to say about these issues, shall we?

  • Intra-Abdominal Bleeding: "Bright Red Blood Oral or Rectal, Melena, Bloody Drainage, Tachycardia, Hypotension, Fainting" - this can end in death
  • Leaks and Sepsis: often requires surgery; can be deadly
  • Obstruction: "Closed loop obstruction and internal hernias are a risk after gastric bypass and may be lethel if dead bowel. Bowel can become ischemic in six hours."
  • Pulmonary Embolism: blockage of the main artery of the lung - can be deadly
  • Vomiting ± Abdominal Pain: "Vomiting associated with abdominal pain needs prompt surgical evaluation and observation until resolved or surgical exploration." - this can indicate a life threatening condition
  • Abdominal Compartment Syndrome: "Progressive respiratory insufficiency, Renal failure, Intra-abdominal hypertension, Associated with end-organ failure..." Yes, this can kill you as well.

And bonus! Here are illustrations of some of the things that go wrong with gastric bands:

People like to say that being thinner automatically gives you better quality of life. Increasing your risk of this list of things happening to you... that isn't an improved quality of life. It's an increased risk of death - and a barrier to living fully. Oh, sure, they can probably save you if you make it to the emergency room in time, one with competent staff that have access to this information and time to go through all the steps. But, how much extra risk are to taking on if you (for example) travel to a foreign country where you don't speak the language and where emergency room staff won't recognize these symptoms? What if you want to go on a backpacking trip, and could easily end up in a situation where you can't get treated in time?

These things don't generally happen to people whose digestive systems haven't been surgically altered. If you look at the poster, just notice all the reasons they might have to cut you open for a second, third, or fourth time. Every single one of those experiences would be traumatic, painful, and time consuming to recover from, with a negative effect on your family and work life.

As fat people, our size doesn't necessarily prevent us from travelling anywhere in the world, going on backpacking trips, skiing, scuba diving, skydiving, or doing anything else we put our minds to. If we're not disabled and can access equipment that fits and is up to spec, we can do those things if want. However, people who try to lose weight through WLS are going to have to be careful for the rest of their lives, because they're always going to have these increased risks. Fat bodies can be healthy bodies. A post WLS body is always going to have been damaged.

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vesta44's picture
March 21st, 2011 | Link | The following is a list of

The following is a list of complications that is posted every month on OSSG-gone_wrong, a WLS survivors' group to which I belong. One complication they haven't yet added is loss of teeth from dry mouth/lack of calcium and from which I suffer. Two years after I had my VBG, my partial plate had eroded the teeth it clipped onto so badly that I had to have all of my upper teeth pulled and get a denture. In the 11 years since then, I've had 2 bottom teeth pulled due to fillings falling out and the teeth having rotted from the inside out, I currently have 5 teeth broken off at the gumline (two of which are molars that have had the fillings fall out), and 4 of my 6 remaining teeth are so loose that I could probably pull them myself (and a couple of those 4 are beginning to break apart). Once I find a dentist that is willing to pull all of my remaining teeth, I'm going to get dentures - most dentists just insist that you keep your natural teeth as long as possible because your natural teeth are supposedly better than dentures. What those dentists don't realize is that once someone has had WLS, their body doesn't absorb the vitamins and minerals needed to keep their teeth in optimal condition and it doesn't matter how often the WLS survivor brushes, flosses, and uses mouthwash, their teeth will probably dissolve away. When you add gum diseases on top of that, and the fact that malabsorbtion issues mess with how antibiotics work, WLS patients dental health is compromised, and therefore so is the rest of their health, on top of all the other complications they may get:

Every once in awhile we post a list of complications told to us by people who have had WLS. These complications can happen to people without WLS but these have been confirmed by the patients
doctors as related to WLS.

Dehydration, Chronic Vomiting and Nausea, Stroke, Heart Attack, Arrhythmia, Kidney stones, Kidney Failure, Liver Failure, Anemia, Deficiencies (B-12,potassium, iron, B-1, B-6, etc.), Malabsorbtion of supplements
(calcium, minerals, nutrients from food), Blurred Vision, Muscle and Bone Pain, Loss of Teeth, Bleeding Gums, Rotting Teeth Due to Vomiting Requiring Root Canals, Hypoglycemia, Headaches, Blackouts/Seizures, Lactose Intolerant, Injury to Spleen during surgery, Coma, Paralysis/Blindness after coma, Osteoporosis, Burst Pouch, Lupus, Auto-Immune Disease, Looped Intestines, Ruptured Esophagus
from vomiting, Misfired Stapler during surgery, Ulcers, Pneumonia/Lung Problems, Arthritis, Weakness and Fatigue from Malnutrition, Overall Pain, Metabolic Bone Disease, Food Blocking Stoma Causing Severe
Pain, Stoma Needing Stretched Repeatedly, Neuropathy, Beri Beri, Put on Feeding Tubes/PICC Lines, Fibromyalgia, Chronic Fatigue, Fistulas, Atrophy of Muscles, Hair Loss, Hernias, Blood Clots, Leaks,
Peritonitis, Heart Burn/Gerd/Acid Reflux, Bowel Obstructions, Gallstones and Gallbladder Removal, Severe Depression, Anxiety, Loss of Memory, Poor Concentration, Irregular Blood Pressure, Diarrhea, Constipation, Opening Of Outer Incision-Needing Packing Until Healed From The Inside Out, Insomnia/Sleep Disorders, Unforced Anorexia and Bulemia, Gas, Silent Stroke, Vertigo, Malnutrition which is the cause of many of the above problems, Many End Up Becoming Invalids, and then there is death.

This list continues to grow.
These complications can happen right after surgery, days, weeks, months, many years, and even when taking all the required supplements.
Besides physical complications there is financial hardship and families who are devastated.

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

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