What no one tells you when you at consultation is that sometimes, it doesn’t work. I also found that when it didn’t work for me, there was very little backup or aftercare.
I believe the reason bypass didn’t work is because when they cut away part of the stomach, removed part of my intestine and created a new opening between stomach and intestine (the stoma), they created my stoma too big!
Studies show that it should be a diameter of 10-12mm, keeping food in the now smaller stomach (pouch) for longer. One of the main aims is to decrease pouch size so people feel full-up with much less food (restriction).
My stoma is up to 20mm in diameter and whilst I now have a small pouch, I believe the stoma is so big that food simply sails through, meaning I don’t feel full.
Restriction was the reason I wanted the bypass and I told them this at consultation. I don’t like the feeling of being full and so I stop eating; that’s why the bypass seemed perfect for me!
There are remedies available to decrease stoma size. However in my case, I understand that because none of my surgeons had ever performed them before - they were not offered to me.
In a letter from Spire they said “there are a group of individuals for which this procedure has not worked and we may need to consider as to whether you fall into this category”.
I didn’t know such a category existed and feel I was not only misinformed but that I’ve been put into this group without an answer as to why and without any kind of remedy - not the aftercare I was lead to expect.
They told me that the bypass is known as the gold standard of weight loss surgery. I had the op. on 10th October 2013 and followed the post-surgery diet to the letter. However, as soon as I was back on solid food, I could tell I had no restriction.
Weight Loss Surgery Scotland confirmed that “the problem had to be physiological” but I was offered no tests to see what this might be. They said they could see from x-rays that the pouch was emptying rapidly and that the diameter of the stoma was probably around 20mm. From everything I’d read, I knew that this was too big.
Almost a year later, I had a second opinion from a Consultant Surgeon in Harley Street. I chose him because his practice International Centre of Excellence in weight loss surgery and he also specialises in bypass surgeries that go wrong.
He and his Radiologist colleague confirmed in their report that they estimated the stoma to be 15mm-20mm in diameter and confirmed “we would both emphasise the lack of functional effect at the site, i.e. no hold up” - No restriction!
He also reported that in his opinion the x-rays showed “the presence of a hockey stick, which may be responsible for the lack of restriction. The other possibility from an anatomical aspect would be a gastric fistula though not demonstrated on the barium meal, I would certainly suggest that an endoscopy be performed to rule this out” - No endoscopy offered!
He went on to say that if that if further x-rays “confirm an anatomical problem with a hockey stick, then there is the possibility of offering her revisional surgery resect the hockey stick, which may lead to return of restriction” – No further tests, no revisional surgery offered!
My own team saying the problem had to be physiological, plus the second opinion reporting that there is ‘no functional effect’ at the stoma site, would seem to confirm the problem was surgical.
Even though I felt I finally felt I had some answers, my surgical team ignored it. In fact instead they offered a theory about bypass surgery I’d never heard before, saying restriction was irrelevant.
Finally, they moved to a ‘blame the patient’ defence. They readily admitted I’d followed my post-op instructions to the letter and even texted the bariatric nurse to ask if certain things were allowed.
They did however tell me that “There is a bright side. For someone who has had a bypass, you haven’t got any of the nasty long-term complications that make your life a misery, like dumping syndrome, or persistent nausea/vomiting, or Diarrhoea, or un-correctable vitamin deficiency or chronic pain or drain tubes or leaking wounds etc etc.” – True but £11,500 for no benefit?
Anyone who considers bariatric surgery will have tried everything they can to lose weight on their own. Bariatric surgery is supposed to offer something different - something to help.
Finally, imagine how shocked I was when post-op I had a visit from a man I’d never heard of who said he performed my surgery! Usually patients can speak with, research or ask questions about their surgeons. This was a betrayal of trust and I still wonder why I wasn’t told they switched. The hospital offered me £1000 as a goodwill payment for this - which I didn’t accept.
If, as the team seem to believe, the problem is not the stoma, then what is it? Why no restriction and why hasn’t the surgery worked? I’ve simply been sent away with no answers and no remedy.