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Gastric By-Pass Surgery and Full Time RVing

Patient Betty LeeAfter having retired in December 2005 at age 55, my wife and I officially started living in our motorhome full time, although we had already started this lifestyle a year earlier as we prepared for retirement.  Since I had last worked in April 2004 my weight had increased an additional 60 lbs. and I was now at my highest weight of 360 lbs. I had struggled with obesity the majority of my life and as I got older other obesity related health issues began to manifest themselves.  I knew “generally” about Gastric By-Pass surgery but I had originally dismissed it as not feasible for me due to living and traveling full time in an RV.

 

In March 2005 at an RV Resort in California I met another RVer, who was from South Dakota traveling in a motorhome. He was enroute to San Diego to have Gastric By-Surgery at Alvarado Hospital. I was fortunate to again meet up with him several weeks later after he had the surgery. This time, I spent a considerable amount of time discussing the surgery and how he came to decide on Dr. Ellner and Alvarado Hospital. I learned from him that Dr. Ellner was willing to work with patients that traveled or lived out of the area. I was impressed that he had researched Gastric By-Pass surgery for 3 years and further that he had the means and ability to have Gastric By-Pass surgery at any facility and chose Dr. Ellner and Alvarado Hospital.

I then researched Dr. Ellner’s Web Site and attended one of her lectures. Dr. Ellner was able to answer all my questions and concerns and her staff was extremely friendly and helpful in getting the surgery scheduled and approved. I had my Gastric By-Pass surgery performed on May 9, 2006 and everything initially went well. I was allowed to resume traveling on May 21st.

 

Problems

About 2 weeks after surgery, I had several incidents of vomiting. I attributed this to possibly eating to fast or not chewing enough as I was still learning to adjust to my new lifestyle and how to eat properly. Dr. Ellner gave me suggestions on foods to eat that I could possibly handle better and further provided me with her direct cell phone number to call her with reports of my condition.

When the vomiting continued, we discussed the possibility that a stricture was developing. A stricture can form due to scar tissue and is complication that occurs in less than 5% of Gastric By-Pass patients. I have had problems with extreme scarring after surgeries in the past and the possibility that a stricture was developing was not a surprise.

I continued to stay in contact with Dr. Ellner and she emphasized that if I couldn't keep hydrated, I would need to get to a hospital emergency room. This would allow me to get IV fluids until the 1 month date after the surgery, when it would be safe to do an endoscopy to fix the stricture. I went to an emergency room which was in Ogden, Utah.  Dr. Ellner advised my wife and I to have the emergency physician contact her on her direct line to coordinate my treatment.

Upon arrival at the hospital I was taken into the emergency room and the emergency room physician was provided with Dr. Ellner’s information. Dr. Ellner was contacted and initial treatment and testing was coordinated with her. As Dr. Ellner suspected, I had a stricture and I was admitted into the hospital for hydration.

On June 2nd, a Saturday, I was assigned a gastroenterologist by the hospital. I explained to the doctor about my recent gastric by-pass surgery and that Dr. Ellner wanted him to call her immediately to discuss an endoscopic dilation. The gastroenterologist was reluctant to discuss the procedure and recommended a reversal of the gastric by-pass procedure. I provided him with Dr. Ellner’s information and her direct cell phone number and I explained that Dr. Ellner was waiting for a phone call from him.

My wife and I talked with Dr. Ellner several times and found that she had also left messages for the gastroenterologist to call her and he hadn’t done so. Numerous requests were made through the nursing staff to contact the gastroenterologist and to have him call Dr. Ellner.

On June 3rd, my wife finally contacted the internist on duty and strongly requested that the doctor contact the gastroenterologist and request that he come in and see us as he had not returned since his initial visit on Saturday and had not called Dr. Ellner. The gastroenterologist still did not come in as requested however he called and spoke with my wife. During the conversation he restated his position and also disclosed that he did not support gastric by-pass surgery in general. In regards to not calling Dr. Ellner to discuss my case with her, he stated he was not going to call her on the weekend, stating the reason for not doing so was “professional courtesy.” Based on the fact that the gastroenterologist would not contact Dr. Ellner to discuss my care and my treatment, we fired him from my care.

This was discussed with Dr. Ellner and it was decided that I could either get another gastroenterologist from the hospital in Utah, or I could fly back to San Diego where she would continue my care at Alvarado Hospital. My wife and I discussed it, and decided that as it wasn’t a long flight, I decided to just go back to Dr Ellner at Alvarado.

Upon arrival in San Diego, I was quickly admitted to Alvarado Hospital as Dr. Ellner had everything pre-arranged. I was seen by Dr. Ellner and Dr. Reddy, the gastroenterologist who would perform the dilation.

Dr Ellner also arranged to be present during the dilation, even though Dr. Reddy was doing the actual procedure. The procedure was completed and the stricture opened up without any complications. I felt better immediately. Dr. Ellner and Dr. Reddy both called my wife, (who was still in Utah) after the procedure to let her know everything went well. This was appreciated by both my wife and I.

In discussing the situation with Dr. Ellner and Dr. Reddy, I was advised that the stricture could potentially happen again until I hit the 90 day mark after surgery. Dr. Ellner explained that this is because by 90 days the scar tissue tends to naturally relax.

As they warned me might happen, I experienced two more strictures before I got to the 90 day mark. Each time, Dr. Ellner discussed the situation and the procedure with the local gastroenterologists, who handled the dilations without any trouble.

On The Road Again - Problem Free

I resumed traveling and soon passed the 90 day mark with no further problems. What impressed me most during the time I was experiencing the stricture problem was Dr. Ellner being readily accessible and truly concerned with my well being. In addition to Dr. Ellner, any contact with her office was handled quickly and professionally. I did not feel that I was alone in trying to deal with the problem.

In retrospect, the first incident with the stricture, I had waited too long before finally going to a doctor. When I did go I was dehydrated and this resulted in the need for IV’s for hydration as well as vitamins and medication. Had I checked ahead where I was going to be traveling I would have located a place where gastroenterologists were familiar with the procedure in gastric by-pass patients. Apparently, this isn’t an unusual procedure for gastroenterologists to perform in other patients. The problem was that the first doctor was against the gastric bypass in general and refused to help me. The care I initially received in the emergency room at the hospital in Ogden was very good, however they should have ensured that the gastroenterologist assigned would contact my surgeon, Dr. Ellner and discuss my treatment prior to admitting me to the hospital. However, after firing the doctor in Utah and traveling to Alvarado Hospital treatment improved significantly where I was under the care of Dr. Ellner and Dr. Reddy. Everyone involved at Alvarado Hospital was great and the treatment and care was excellent.

The second and third incidents with the stricture went extremely well because the doctors talked with Dr. Ellner, and the procedures and testing were all done on an outpatient basis. Both of these incidents went much smoother than the first one. Having learned my lesson before, I sought care as soon as I got the symptoms and I worked with doctors who were willing to speak with Dr. Ellner, who was always just a phone call away.

Although it was discouraging at times while having the stricture problem, at no time did I feel like I was handling it alone. Dr. Ellner was very involved and continued to provide positive encouragement to my wife and I, as well as the necessary medical care. She further showed her concern for my well being as demonstrated by her presence during the endoscopy dilation that was done at Alvarado Hospital in which Dr. Reddy performed the procedure. Dr. Ellner, while not involved in the procedure, ensured that all went well and then took the time to call my wife and reassure her that the procedure went well. As the patient, this type of genuine concern is immeasurable.

It has now been over a year since my surgery. The only problems I experienced were the stricture problems described above. I have lost 165 lbs. and my other weight related heath issues have been successfully resolved. I previously had Type 2 Diabetes and required medication to control it. I also have a history of hypertension. Since the surgery, I no longer have Type 2 Diabetes and the medication was discontinued by the time I was discharged from the hospital. I still take medication for hypertension; however, the medication has significantly been reduced. My ankles, knees and hips no longer hurt as I am not carrying the extra weight. Having had the problem that I did, if I had to do the gastric by-pass surgery over again, would I have the surgery? YES, without any reservations.

This surgery could have been performed while I was still working and would have greatly improved my work performance as the increased energy and mobility I now have is incalculable. I did not have to wait to retire to consider this surgery. I now am more active with walking, hiking, cycling and seeing the sights that we encounter in our RV travels. Prior to the surgery I had become almost totally inactive due to difficulty in getting around due to my weight. I have now been to Niagara Falls and able to easily climb the stairs to the bottom of the falls to the observation deck, rafted the Snake River in Wyoming and parasailed and rode ATV’s in Coeur D’Alene, Idaho. Activities in Colorado Springs, Colorado at over 7000’ elevation are no longer a problem as I can easily breathe as I enjoy no longer being hindered by the excess weight. Next up will be parachuting and driving a NASCAR race car. My aspirations are no longer hindered by my physical limitations. Having my health and my life back is incredible. Dr. Ellner is truly the best!

The best advice I can give to anyone wanting gastric bypass surgery is: Do your research! Not all surgeons will take good care of us after they do our surgery. We can’t all live next door to a great Bariatric hospital like Alvarado, so many of us have to travel to get the best care. We can’t control whether we have certain complications, but we can make sure that we choose a good hospital, with a doctor who will take very personal care of us, communicate with our families, talk to our doctors, and manage unforeseen problems, no matter where we live.

If anyone would like to ask me further questions about Gastric Bypass, just email me - DUARTE8847@aol.com

Cadeucus