Wednesday, October 14, 2009

Laparoscopic gastric bypass surgery helps man shed obesity

St. Louis, MO
Two years ago, Herb Simmons tipped the scales at 497 pounds.

"As the years snuck up on me I noticed it was getting harder to get around," he says. "I couldn't leave home in the morning without soaking my knees in Ben Gay."

He was suffering from sleep apnea, atrial fibrillation and hypertension. Getting from his car to his house was an exhausting, stop-and-go process because he'd rest every few feet to catch his breath. He needed an extra seat belt on airplanes and a chair without arms in restaurants.

Simmons says he didn't eat big meals, but admits to snacking on chips and slurping sugary colas every day. He says he's been on every diet known to man.


"I once lost 100 pounds on OPTIFAST and regained 200," he says. "I was a yo-yo dieter."

In 2007, he attended a bariatric seminar to learn more about Lap-Band surgery, a laparoscopic procedure to place a silicone band around the top of the stomach. The band reduces the amount of food the stomach can hold so patients eat less. Simmons made an appointment with one of the surgeons, Dr. Van L. Wagner, of Heart of America Bariatrics in Lemay. He was surprised when Wagner recommended gastric bypass instead.

Gastric bypass uses staples to make the stomach smaller, then reroutes food past part of the small intestine. Patients feel full sooner, and absorb fewer calories and nutrients.

With a Lap-Band, patients lose only between 50 and 70 pounds in the first year then often taper off on weight loss, Wagner says. With gastric bypass they almost always lose between 200 and 250 pounds in two years.

"Bypass is usually a better option for patients who are sicker, older and have higher weights," Wagner says. "And Herb was extreme on several of those things so banding would not have provided the weight loss he needed."

Wagner performed laparoscopic gastric bypass surgery on Simmons Sept. 19, 2007, at St. Alexius Hospital.

Gastric bypass comes with risks, including developing gallstones and nutritional deficiencies.

Simmons takes calcium and vitamin pills and drinks protein shakes to prevent malnutrition. Two weeks after surgery, he began walking, first up and down the sidewalk in front of his house, then on a quarter-mile track. At first he couldn't walk a lap without stopping to rest several times. Within a few months, he was walking two miles. Now, he walks three to five miles every afternoon and bicycles three to five miles every evening.

He also eats a lot less, especially high-fat, sugary foods.

"It can cause dumping syndrome, which makes you want to lock yourself in a room for hours," Simmons says. WebMD describes the syndrome as a shock-like state that lasts for 30 to 60 minutes after small, easily absorbed food particles are rapidly dumped into the digestive system. Symptoms include a clammy sweat, butterflies in the stomach, a pounding pulse, cramps and diarrhea.

Simmons says his triglyceride and cholesterol levels have plummeted, his sleep apnea has dissipated and his blood pressure medications are one-fourth the dose they were before surgery. His legs no longer swell and his knees feel fine.

He credits ongoing counseling by Wagner and St. Alexius' NewStart program for his success. Both offer emotional support, nutritional guidance and ongoing education.

Last month, Simmons celebrated the second anniversary of his surgery by walking 3.7 miles as part of the Walk From Obesity event in Creve Coeur.

"After my wedding anniversary, my surgery date is the second-most important anniversary for me," Simmons says.

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