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Tuesday, December 25, 2012

Gastric Bypass Surgery Death Rate

Gastric bypass surgery, the drastic procedure used to help some obese people lose weight, continues to grow in popularity. 

It's estimated that 140,000 people had this procedure in 2004, with the number expected to grow even higher this year. And for the majority of patients, this surgery is a lifesaver, but not for all, reports The Early Show correspondent Melinda Murphys. 

Like many people who seek out this surgery, Dave Weindel had been morbidly obese for most of his life. So he was eager to have surgery to help him lose weight, get healthy, and live longer to watch his four young children grow. 

"I graduated from eighth grade a couple years later," Christy Weindel says, crying. "And he wasn't there for that. And he wasn't there for prom. And I just got married in September. And he wasn't there for that. It's really tough.

Christy Weindel lost her father when she was 12 years old. Dave Weindel died three weeks after having gastric bypass surgery. 

"I had to come home and had to tell the kids that their dad died. Was very, very hard," says, Cathy Weindel. According to Weindel's wife, it wasn't supposed to turn out this way. 

She says, "Well, they told us it was major surgery. But they said, 'You know, you're going to be home in three days.' "

Weindel's surgery was July 17, 1998. His stomach was reduced to the size of an egg and his intestines were re-routed. The surgeon told Cathy Weindel the operation went well. But within days, Weindel's health worsened. 

He was transferred to a second hospital, where a CT scan revealed a large abscess. Weindel was treated, but his health continued to decline. 

Cathy Weindel says she thinks her husband knew what was happening to him. 

"I still remember, and I still see this in my mind," she says very emotionally. "When they're shutting everything down and there was nothing else they could do. I was talking to him. And I saw a tear come out of his eye. And, I mean, it still stays with me."

Dave Weindel died three weeks after his surgery. He was 38. The official cause of death: abscess, pneumonia and a pulmonary embolism.

Was Dave Weindel's case a complete anomaly? Not really. 

A recent study by researchers at the University of Washington found that 1 in 50 people die within one month of having gastric bypass surgery, and that figure jumps nearly fivefold if the surgeon is inexperienced. 

Attorney Herman Praszkier says, "You want to know, basically, as much information about the surgeon's background as you can. Anyone who evades your question, get up and walk out."

Praszkier represented Cathy Weindel in her lawsuit against her husband's surgeon and the hospital. It was settled days into the trial and was the first of a dozen gastric bypass malpractice cases he's handled.

Praszkier explains, "The most common problem in bariatric surgery in the cases I take (which are only death cases) is that the post-operative care was insufficient." 

Nora Malone is Praszkier's most recent client. She tried to talk her husband, Ron, out of the surgery.

"I said, 'Let's go. Let's just go.' And he said, 'Oh, I'll be OK, honey. You'll be so proud of me when I get out of here,' " Malone recalls.

Nora Malone met her husband when he was a naval officer stationed in the Philippines in 1973. They had three daughters. 

Their daughter. Liberty. says, "When they went to talk to the doctors, they came back thinking it was a good thing. You know, he'd get off his high blood pressure medicine, his diabetes medicine." 

Malone had laparascopic gastric bypass surgery just before Thanksgiving 2003. 

"They said there's no risk," Nora Malone says.

But days after the surgery, Ron Malone became very ill. Doctors told his family there was a leak - and operated again. He didn't improve. 

Nora Malone recalls, "And I said, 'I think you have to do something, doctor.' And he said, 'Mrs. Malone, trust me, your husband is OK.' " 

On Dec. 9, 2003, Ron Malone died during his third surgery. The official cause of death: cardiac arrest. More accurately, Malone died from complications of gastric bypass surgery.

Dr. Harvey Sugerman says, "There is a risk of a leak following gastric bypass that can be fatal." 

Dr. Sugerman is a retired bariatric surgeon and the president of the American Society for Bariatric Surgery (ASBS). He says early diagnosis of a problem is the key.

"I think some doctors got into it without adequate training and experience and felt that they could do this," Dr. Sugerman says, "The ASBS is very concerned about deaths after obesity surgery. And we are doing everything we can to improve quality care by establishing the Center of Excellence program." 

This program will have stringent guidelines that must be met in order for a bariatric surgery facility to be called, "a Center of Excellence." When the program launches in June, information will be posted on a Web site to help patients find quality doctors and hospitals. Unfortunately, it comes too late for Ron Malone.

And too late for Dave Weindel, whose wife no longer believes in the surgery. 

"I don't think it's worth it," Cathy Weindel says "It tears your family apart."


CLICK here to watch gastric bypass video 




Still not convinced? 

More on the Actual Gastric Bypass Death Rate

A helpful blog reader send me the full PDF version of the study of the long term outcome of weight loss surgery in Pennsylvania which was cited in the previous blog post.

Death Rates and Causes of Death after Bariatric Surgery for Pennsylvania Residents 1994-2004. Bennet I. Omalu et. al. Arch Surg. 2007;142(10):923-928.

Typically when a surgeon tells you the mortality rate for a surgery, he tells you only the percentage of those who died within 30 days of the surgery. This study looked both at the actual deaths within 30 days after surgery and in the death rate in the years after the surgery.

As the study reports, in the 16,683 people who had weight loss surgery in Pennsylvania between 1994 and 2004, .9% died within 30 days of the surgery. That translated into 150 people.

But wait. That statistic was taken from the group as a whole. When the population is broken out by age, a much scarier statistic emerges: In the age group 55-64 1.53% were dead within 30 days, or 15 out of 1000 who had the surgery. And for the age group of those 65 and older, 3.1% died within 30 days, or 3 out of every hundred.

But that was just in the first 30 days after surgery. The study looked at time since surgery, and with each passing year the number of dead grew greater.

By one year after surgery, 2.1% of the group had died. (Twenty-one out of every thousand.) By two years, 2.9%. Then things got worse. Three years after they had had the surgery, 3.7% were dead. By four years, 4.8% and by five years, 6.4%.


The authors of this study remark that they did not follow up on the results of subsequent surgeries. But other studies have found that many people who have weight loss surgery require one or more follow up surgeries in the years that follow the initial surgery. It is likely that each subsequent surgery raises the risk of further complications and death.

Another chilling statistic emerged from the analysis of this data. In a population of the same size of the same demographic make up, the expected number of suicides would be 2. However, in this group, there were 16 suicides and an additional 14 drug overdose deaths. Most of these occurred at least one year after the surgery. The authors of the study speculate that many of the drug overdoses were probably suicides too, and flag this as a serious problem that requires more study.

What was missing in this study was one important piece of information: the weight loss achieved by the people who died. The authors assume that the high death rate is due to health conditions contracted while obese or due to weight regain. But this is only speculation. They did not review any statistics about the size of the people at death, which would have been difficult to do since only about 1/3 of these victims were autopsied.

But based on stories I have heard and cases like Mrs. Yamin's it may be premature to assume that the deaths were caused by obesity. Mrs. Yamin weighed 100 lbs at her death. Instead deaths may have been caused by long term malnutrition--i.e. starvation. Though the most common cause of death listed on death certificates after a year was cardiovascular (i.e. heart attacks) that is what kills a lot of people with anorexia and starvation. When the body is no longer absorbing nutrients the electrolytes can become dangerously unbalanced and that causes heart attack. Without independent autopsies, it is very hard to know what really happened.

Doctors don't like autopsies, because a patient who didn't have an autopsy is a patient whose family is going to have a much tougher time suing for malpractice. So if a heart stops beating, well, write it down as cardiovascular death, and since the person was once fat, who is going to challenge it?

But folks, please take these statistics seriously. And please note that the things that killed people within the first 30 days were NOT necessarily caused by obesity. Among the biggest killers were pulmonary embolism (20.7% of all early deaths)and sepsis (i.e. infection that spread through the body causing organ shut down). Sepsis killed 11.3% of those who died in the first 30 days. One out of four died of vaguely specified "therapeutic complications" which is a catchall term entered on the death certificate that included things like sepsis, bleeding, ruptured surgical wounds, etc.

One last word. Many people erroneously believe that before a doctor can perform a specific kind of surgery, that surgery must undergo the same kind of safety testing and approval process that drugs get. This is not true. Surgeons can perform any surgery they want, as long as they are licensed surgeons.

There is only one limitation on what kind of surgeries are performed: whether or not insurance companies will pay for them. Most insurers won't pay for operations that have a poor safety record--once they have enough data to know that the operation isn't safe.

But weight loss surgery is usually NOT paid for by insurers. Like plastic surgery, it is a surgery that patients pay for out of their own funds. This is one reason surgeons promote it so strongly. There are no forms for them to to fill out, no limit on what they can charge, and most importantly, no evaluating the patient's suitability for the surgery by pesky insurance review boards. All the doctor has to do is sell the patient on the operation, and the fun can begin.

So don't let yourself become a victim of a surgeon who has found a dandy way to make himself a multi-millionaire. And don't trust that the doctor who stands to make $25,000 for a few hours of work has your welfare in mind when he assures you that a surgery is no more dangerous than crossing the street. Remember, surgeons rarely track the outcome of their surgeries beyond six weeks. But as the Pennsylvania study suggests weight loss surgery keeps on killing for years after the initial surgery.

12 comments:

  1. Inhuman! Greed kills!

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  2. This is one more example of the criminal medical industry.

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  3. Guess what - some insurance companies now pay for gastric bypass surgeries, as do Medicaid and Medicare (if you're fat and disabled, they'll pay for it, thinking that once the weight is lost, the person will no longer be disabled and can get a job and get off of welfare/SSI/SSDI - like the only reason a fat person could ever be disabled is because of their fat). So the fact that this is an untested, unproven operation has nothing to do with who will pay for it. Insurance companies may not pay for gastric bypass simply because they see it as an optional surgery, not a necessity (and how many life-saving surgeries do they deny every year?).

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    1. The truth is gastric bypass works, Star Jones, Sharon Osbourne and Al Roker are examples. The question is is it worth the cost in lives. The other question is is gastric bypass medically ethical and I would say that destroying a perfectly healthy digestive system simply because someone will not behave themselves when it comes to eating is a form of torture and probably should be illegal.

      I will not dispute the fact that America is a nation of gluttons. Gluttony seems to be in our DNA and while I don't have a whole lot of sympathy for fat people with diabetes and all the other comorbidities that go along with obesity I can't say that they should be punished with a procedure that kills more than one and 50 of them and maims most of the remaining survivors.

      Americans are pretty weak, greedy and irresponsible and they have a lot of help being that way. America is a food centric nation full of enablers. If doctors refused to treat the comorbidities of obesity based on patient noncompliance we would see the obesity rate drop dramatically.

      There are safer alternatives to weight loss surgery. Some countries offer something called gastric pacemaker which send signals the brain that control hunger. There is also behavior modification, acupuncture and good old-fashioned diet and exercise. Marie Osmond, Valerie Bertinelli, Kelly Osbourne, Jordan Sparks and Carrie Fisher are examples of people who simply took the bull by the horns and ceased their gluttonous behaviors.

      For those who say that obesity is raising the cost of healthcare in fact the opposite is true. Because that know these people have shorter lifespans and die relatively young the end up using less medical resources than their lean and fit counterparts because many of them never become elderly. Since most of them don't qualify for joint replacements due to the fact that current replacement surgery is contraindicated for obese people that is one major cost that is avoided.

      Managing diabetes is relatively inexpensive as our diabetic amputations, angioplasties and other treatments for the the comorbidities associated with obesity.

      There is one upside to obesity and that is the highest obesity and smoking rates are in the red states which are the parasite states as governor Chris Christie pointed out. The lower life expectancies in those states has positive political implications for the country. When stupid fat people eat themselves to death it's never a bad thing. I do wish the governor Christie would overcome his gluttonous ways because he's one of the few Republicans in the country that is not a total ass hole.

      Gastric bypass does work for some people. Nearly everyone who hasn't does lose the weight and keep it off because after gastric bypass it becomes very difficult to even maintain a normal healthy weight. So I would disagree with Festa 44 that is an unproven and untested procedure. It has been around for over 40 years in various forms. Unfortunately today's methods are more dangerous than the more invasive methods because essentially the surgeons are operating with chopsticks and most bariatric surgeons are a greedy bunch who are sloppy and hurry through the procedure to get to the next one.

      I'm glad that there is a website warning people about gastric bypass. From everything I've read the data suggests that the increase in life expectancy after gastric bypass is only 18 months when you factor in the high mortality rate during and after the procedure. Open-heart surgery has a much lower mortality rate than gastric bypass and even laparoscopic band procedure.


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    2. Vesta and Anonymous, you both make some very good points but I would like to chime in with a different perspective.

      Gluttony is a choice and many of us that people think is a good choice because enjoying food is one of the great pleasures in life and to our way of thinking it's not the quantity of life but rather the quality of life.

      It gastric bypass or a safe procedure that I would have no problem with it. But the honest scientific data points to the fact that gastric bypass is in extremely high mortality rate and if you talk to people who've had it a very large percentage of them regret doing it because of all the adverse side effects. There is also psychological component to changing the behavior by force rather than by will. There is an extremely high suicide rate among gastric bypass surgery survivors; you notice I don't refer to them as patients and will I don't like to call people victims it is up to them to decide whether they are victims or survivors.

      If in their heart of hearts that people wanted to be thin or lean than they would eat less and move more but the payoff of today's delicious food more than trumps the idea of fitness, good health and an attractive appearance. This goes what I've been saying all along, GLUTTONY is good! The decision for gastric bypass or any other kind of weight loss surgery cannot possibly be a rational decision. While I will not force my personal views and others I would rather die the full belly of delicious food rather than spend the rest of my life missing out on the food I love, vomiting every time I eat and crapping my pants become a fart not to mention the nutritional deficiencies that cause tooth loss, bone loss, hair loss, gallbladder disease, ketogenic psychosis, various cancers and wrinkling and sagging skin. Another problem with gastric bypass is that you have to live in protein shakes and you cannot get enough nutritional food like fruits and vegetables and carbohydrates like bread or other grains and as a result of this your body is in a constant state of ketosis and that makes you smell bad. A lot of fat people are not the most hygienic to begin with but with gastric bypass your breath will smell like a fart and gastric bypass victims inadvertently pass gas all day long.

      While I will not judge anyone who diets to lose weight or has any other weight loss procedure I do warn you that bariatric surgery and all of his current forms is in my opinion and judgment not even close to being worth the risk. As a true fat accepter and gluttony promoter I don't necessarily want everyone to be fat. My readers know that I prefer boning skinny chicks as opposed to porking fat girls and besides fat girls prefer skinny guys for obvious reasons. The only thing sadder than a skinny person in a fat body is a fat person in a skinny body. Some people just are not supposed to be disciplined. We fat lings are free spirits. If we decide that an extra 10 or 20 years of life is worth it than most of us will eat rabbit food and restrictor calories down to 1500 to 3000 day depending on our age weight gender and level of physical activity.

      Some people like to run marathons but how stupid is that? If I move do any kind of a marathon it'll be at an all-you-can-eat buffet. And I suppose the marathoner would look at daredevils like me and my fat colleagues and think it is not worth the risk but to each their own. We fatties are the evil Knievel's of food. You see us with our canes, power chairs, diabetic meters, open-heart surgery scars, butt wand and seatbelt extenders etc. and you know that deep down inside and in spite of all the shaming we are damn proud of who we are and what we do just the same as the guy who runs a marathon or spends time at a gym getting those six pack abs. We are indeed bodybuilders but we build our bodies good old-fashioned American blubber. What can be more American than that?




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  4. I hope that our good friend Dr. Gerald "Teddy" Bear chimes in on the subject. For those of you who don't know, Dr. Bear is a bariatric nutritionist. Our other dear friend Rev. BLA is the coinventor of the Grazenhiemer technique which has quickly supplanted Linda Bacon's HAES (health at every size) with EATT (eat all the time) and FATT (food all the time). The good Rev., not to be confused with big fat RRRRRRRRRRRR Rev. Burn is also opposed to any form of weight loss surgery in most cases. However, it is rumored that his youthful ward Belly Boy went to Thailand for some sort of mini gastric bypass and testicular regeneration. While in Thailand Rev. BLA and belly boy spent in leisure time dating beautiful Thai lady boys.

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  5. Some people think that gluttony is the moral failing that causes obesity. Some people actually think that people have a choice as to what they eat..

    Some people see obesity as the result of gluttony and they see gluttony as a moral failing.

    Pride is one of the 7 deadly sins. Fat people are often pride full. What people call shame is a much needed dose of humility.

    Thin Shaming vs Fat Shaming Click Here to see what is worse

    Many people accused of fat shaming are worried about the fat person's health.

    Click HERE to read why people think The Bible Belt is the FATTEST and most SINFUL

    Gluttony is one of the 7 deadly sins.

    Philippians 3:19 Their end is destruction, their god is their belly, and they glory in their shame, with minds set on earthly things.

    Proverbs 23:20-21 Be not among drunkards or among gluttonous eaters of meat, for the drunkard and the glutton will come to poverty, and slumber will clothe them with rags.

    Proverbs 23:2 And put a knife to your throat if you are given to appetite

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  6. Some people think that gluttony is the moral failing that causes obesity. Some people actually think that people have a choice as to what they eat..

    Some people see obesity as the result of gluttony and they see gluttony as a moral failing.

    Pride is one of the 7 deadly sins. Fat people are often pride full. What people call shame is a much needed dose of humility.

    Thin Shaming vs Fat Shaming Click Here to see what is worse

    Many people accused of fat shaming are worried about the fat person's health.

    Click HERE to read why people think The Bible Belt is the FATTEST and most SINFUL

    Gluttony is one of the 7 deadly sins.

    Philippians 3:19 Their end is destruction, their god is their belly, and they glory in their shame, with minds set on earthly things.

    Proverbs 23:20-21 Be not among drunkards or among gluttonous eaters of meat, for the drunkard and the glutton will come to poverty, and slumber will clothe them with rags.

    Proverbs 23:2 And put a knife to your throat if you are given to appetite

    ReplyDelete
  7. I don't care how medically advanced our world gets. It still won't bring back my dad. 17 years this past August and it still feels like yesterday. Love you always Dave Weindel.

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    Replies
    1. Sorry for your loss. The medical industry in the US kills over 1 MILLION people each year.

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