Weight loss surgery transforms woman’s life – odessa american_ health

Bariatric services

Medical Center Health System became an American Society for Metabolic & Bariatric Surgery Center of Excellence in 2011 and recertified March 2015, which is now called a MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program) Certificate of Accreditation.

On April 1, 2012, the American College of Surgeons and the American Society for Metabolic and the Bariatric Surgery combined their respective national bariatric surgery accreditation programs into a single program to achieve one national accreditation standard for bariatric surgery centers, the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

MCHS Bariatric Services became Joint Commission Accredited in August 2012 and remains one of the five accredited centers nationwide, according to information from Bariatric Services.

Two years ago, Karla Legarreta weighed 265 at 4 feet 9 inches tall. But after undergoing a sleeve gastrectomy, she’s now 150 pounds and feeling like a whole new person.

Legarreta said, in Spanish through a translator, that her self-esteem is high and she feels beautiful.

“You’re able to do a lot more stuff,” Legarreta said.

With a family history of diabetes and heart attacks, Legarreta decided to have the procedure done. Before the surgery, performed by Dr. Don Porter, she said she didn’t have any illnesses, but had pains in her arms and feet. Those have since stopped, she said.

Legarreta said she tried a lot of diets before deciding to proceed, but she would lose the weight and put it back on again. She and her husband, Jesus Garcia, have two children, 16-year-old Kehyla Garcia and 10-year-old Diego Garcia.

Legarreta said she went through about a three-month process before the procedure. Fifteen days before surgery, she was put on a clear liquid diet and it’s the same process after the procedure starting with clear liquids, moving up to soft food and then a certain diet, Erika Sanders, project manager for marketing and communications at Medical Center Hospital, said.

“You start to adjust and you start following the plan,” she said. “That’s how you start to lose the weight.”

Her family didn’t expect Legarreta to be as happy as she is. “Her husband is like, ‘Is that really my wife?’ because it’s completely changed her,” Sanders said while translating. She added that Legarreta’s family is very supportive.

Prior to surgery, Legarreta said she wouldn’t sit down and eat a big meal, it was more like eating a piece of bread and coffee at one time and a lot of desserts. She makes cakes and other treats on the side that she sells to family and friends.

Now she said she eats completely differently and has changed her family’s eating habits.

In the past eight months, Legarreta said, her weight has stabilized. She wants to lose 30 more pounds and has started exercising.

She said she uses a personal trainer and employs weights and exercise machines.

Along with increased health, Legarreta said she can now wear heels. “Now she’s got about 50 pairs and she loves them,” Sanders said.

Although gastric bypass, or metabolic surgery, is widely available, Dr. Artun Aksade said surgeons touch only about 5 percent of morbidly obese people.

Part of the reason is that employers don’t make the procedure part of their benefits package. In his mind, Aksade said that means some businesses are denying employees a basic health benefit.

Aksade, who specializes in minimally invasive bariatric robotic surgery, said morbid obesity is a disease and companies and employers are choosing to ignore it.

The disease also has an economic impact. Aksade said morbidly obese women lose about $8,000 a year in lost wages, doctor’s visits, medication and not being able to advance in their careers.

Morbidly obese males lose about $5,000 a year, Aksade said.

Multiplying those figures by 30 years, “it’s a staggering number,” Aksade said.

“That’s our next step to fight for the employers to include this. It’s just like including basic care for diabetes,” he added. “This disease kills four times the amount of people than heart attacks every year.”

Aksade said he thinks it’s ignorance in medical circles that more bariatric surgery is not available to patients. If someone walks into his office with blood pressure of 180 over 100, he said he makes sure they see an internal medicine doctor or cardiologist because of that hypertension.

Aksade said other doctors don’t tend to ask morbidly patients about their weight, partly for fear of offending them.

New statistics show that if someone is morbidly obese, the chance of them seeing age 65 is 35 percent. “So two-thirds of people who are morbidly obese die before they reach the age of 65,” Aksade said.

Most of the people Aksade and his colleagues see are at least 100 pounds over their ideal body weight. They also have tried other methods to lose weight before considering metabolic surgery.

He said people who eat just to eat can be doing something else, like knitting or gardening. And people should drink eight to 10 glasses of water a day, because chances are if you drink a glass, you won’t feel hungry afterward. Aksade said he does a psychological survey before surgery.

Roux-en-Y gastric bypass surgery has been around since 1960 and the gastric sleeve procedure is about 10 years old, Aksade said. Both work equally well, he said.

According to the Network of Care website, 38.1 percent of people are considered obese. The measurement was made from 2006-12. The state percentage is 29.6, the site said.

Aksade said bariatric surgeons follow National Institutes of Health criteria to determine candidates for the procedure, such as people with a Body Mass Index of over 40 without any medical conditions that are associated with diabetes, or a BMI of 35 with a medical condition that is related to obesity.

Gastric bypass takes two to two-and-a-half hours to perform and the gastric sleeve takes about an hour, he said.

Aksade said gastric bypass is a combined procedure. It’s restrictive and malabsorbptive.

Malabsorption is when you don’t absorb all the nutrients you’re ingesting.

Usually within a year or a year and a half, Aksade said, the body absorbs nutrients better, so patients will get the same amount of calories they ingest. Gastric bypass patients have to take vitamin B 12 and iron for the rest of their lives.

The vitamins are not needed with the gastric sleeve, he said.

“The maintenance part of it is the restriction part, not the malabsorption part,” Aksade said. “The malabsorption basically lets you lose the weight fast in the beginning, but then restriction is the maintenance so you make a small stomach pouch, you divide the small bowel, connect the stomach and the small bowel in a different way than what it was normally anatomically.”

Aksade said the procedure cures acid reflux 98 percent of the time almost immediately and diabetes goes away in a week about 85 percent of the time.

He added that the procedure is being performed on people of normal weight in South America to treat diabetes, but the U. S. Food and Drug Administration or the insurance companies “haven’t caught up yet.”

With gastric sleeve, Aksade said, the patient’s physiology doesn’t change a lot.

With gastric bypass, a lot of the physiology is changed because the gastrointestinal system is rerouted, Aksade said. “It does give quicker and more durable results, but not everybody needs that gold standard,” he said. “So if you don’t have a lot of reflux and you’re not badly diabetic, we don’t have to reroute your GI system. You can get a vertical sleeve gastrectomy.”

“It is portion control because we do make your stomach the size of a small banana, so to speak, three to four ounces with the opening into the stomach and out of the stomach the same as it normally is,” Aksade said.

“The second thing it does is there is a hormone called ghrelin. Ghrelin is the only hormone that we know of that controls hunger and it’s produced all over our GI tract. The place where ghrelin is most actively produced is the fundus (or bottom) of the stomach,” he added.

Including the fundus, 80 percent of the stomach volume is removed, Aksade said. Once that part is out, ghrelin levels go down and you’re not hungry between meals anymore, he added.

He said the surgery is not conducted for weight loss, but health reasons to control diabetes, hypertension, sleep apnea, arthritis, acid reflux and migraines, to name a few. Cholesterol levels decrease and 80 percent of environmental allergies disappear, Aksade said.

Weight loss is a side effect, Aksade added.

Aksade said in an email that he has been performing bariatric surgery since 2007 and since 2013 at Medical Center. He added that he uses the daVinci surgical robot for Roux-en-Y gastric bypass. Technically, he said, all robotic surgeries are laparoscopic. He performs the vertical sleeve gastrectomy laparoscopically, but I will start doing that robotically this month also.

He has been performing daVinci robot surgery since 2012 and has done more than 300 cases with the surgical robot.