Weighty decision
September 19, 2004
By Steve Doyle
Millie Forrester says bypass saved her life but warns it's no 'quick fix'
Millie Forrester used to avoid church because she couldn't squeeze her 414-pound body into a pew.
She wore slip-ons because she couldn't reach her shoelaces. Her plump thighs were raw from rubbing against the steering wheel.
"It was degrading," Forrester says. "I thought that I had to be the most miserable person in the world."
In August 2000, the Albertville resident was hunting for a size 32 dress at Sears when a saleswoman came up.
"I don't know how you're going to take this," the woman said, "but I'd like to show you something."
She reached into her purse and pulled out a picture of herself at least 100 pounds heavier.
Forrester, who had tried every weight-loss scheme from Suzanne Somers' Thigh Master to the controversial diet drug Fen-Phen, was amazed.
"How'd you do that?" she asked.
The answer: gastric-bypass surgery.
Phenomenon
Encouraged by the dramatic successes of "Today" show weatherman Al Roker and singer Carnie Wilson, morbidly obese people are having their stomachs stapled in record numbers. Since January, U.S. surgeons have performed the risky operation on more than 140,000 patients - almost enough to fill Birmingham's Legion Field on back-to-back Saturdays.
The procedure is especially popular in Alabama, which is wrestling Mississippi and West Virginia for the title of fattest state. In Huntsville alone last year, more than 700 men and women had their stomachs surgically reduced so they would feel full faster.
Dr. Edward Facundus, a surgeon at Crestwood Medical Center, performed the bulk of those operations. His drawing card: a safety record better than those of most big-city practices.
"There is a lot of demand," says Facundus, who does about 60 operations a month. "I don't see this as a fad."
Forrester, 50, says her December 2002 gastric bypass probably saved her life. At the time, she popped a dozen pills a day for arthritis, high blood pressure and other weight-related problems. She couldn't climb a flight of stairs without stopping to rest.
Today, Forrester power-walks 10 miles a day and is a regular at Marshall County's New U Fitness gym. She's a trim 132 pounds and still losing.
She shops in the petite department.
"When I was big," Forrester says, "it was like there was a little person in there trying to get out.
"And I'm finally out."
Second chance
The vast majority of gastric-bypass patients are like Forrester: thrilled to finally have their weight under control.
As the pounds go away, proponents say, so does Type 2 diabetes, high blood pressure, backaches, sleep apnea and other health problems linked to obesity.
"For people with health problems," Forrester says, "it's no other word but a godsend."
But not every story has a happy ending. Nationally, about 1 percent to 2 percent of gastric-bypass patients die from infections or abdominal leaks. Countless others suffer complications ranging from gallstones to lactose intolerance.
The problems are sometimes self-inflicted: A Huntsville woman, for example, died of a bowel obstruction earlier this year after eating bread too soon after surgery. (Patients are supposed to have only liquids and pured foods for six weeks.)
Despite the risks, people are lining up to have the surgery. About 40 would-be patients a week file through Bariatric Wellness Institute on Whitesburg Drive. Most meet the federal Centers for Disease Control and Prevention's definition of morbid obesity: at least 100 pounds above their ideal weight, with a body mass index of 40 or higher.
But borderline-obese patients have been known to gorge themselves until they are heavy enough to qualify for surgery. One Bariatric Wellness client tried to cheat by getting on the scale with a purse full of bricks.
"To me, that just points to the desperation," says Kristi Gibbons, a bariatric counselor who had the surgery in June 2001 and is down 175 pounds. Bariatrics is the study and treatment of obesity.
"It really bothers me when people think it's the easy way out," Gibbons says. "It's not. It's the hardest thing I've ever done, but the most worthwhile."
Forbidden fruits
Imagine having dinner every night for years at a Chinese buffet, then the rules change, and you can eat only what you can fit on a napkin.
That's what life is like after gastric-bypass surgery.
Patients have to swear off sweets, beer and soft drinks - forever. Sneaking a spoonful of Haagen-Dazs can trigger a painful episode of "dumping" - cramps, diarrhea and vomiting caused by sugar passing too quickly through the rerouted digestive tract.
Carbonated drinks are also taboo, because they can
stretch the golf-ball-size stomach pouch, making it
harder to lose
weight.
Having a stomach that holds just a couple ounces of food dictates teeny-tiny portions.
Karen-lyn Parker of Harvest splits the child's mahi-mahi plate at Red Lobster with her 3-year-old - and brings home leftovers. She puts her meals on salad plates so they will look more substantial.
Forrester, who once could polish off an entire chocolate cake, now gets full after a couple bites of peanut butter.
"You become a cheap date and a cheap drunk, too," Gibbons says.
Despite consuming so little food they often lose hair from lack of protein, many gastric-bypass patients say they are rarely hungry.
One possible explanation: University of Washington researchers theorize the surgery, which sews shut about 90 percent of the stomach, curbs the body's production of an appetite-boosting hormone called ghrelin.
Bad habits
Forrester's long battle with obesity started in 1973, when she got pregnant for the first time.
She put on 110 pounds. Her body started retaining water. She got pregnant again a year later. Eighty-six pounds more.
A single mom, Forrester worked the graveyard shift at J.P. Stevens' textile mill in Seneca, S.C. Fearing she'd get fired if her production slipped, she would wolf down a burger or sandwich on the plant floor instead of taking a lunch break.
After work, Forrester slept for a few hours, then headed to her second job waiting tables at a steakhouse near Clemson University. There was no time for wholesome, home-cooked meals.
"We start a lifetime of bad habits out of sheer necessity," she says.
By the late 1980s, Forrester's body was a train wreck. Her back ached. Her hips hurt. Doctors diagnosed her with a degenerative bone and spinal disc disorder. The steroids they prescribed made her even fatter.
She stopped respecting herself. She wondered how anyone could love a 300-pound woman who binged on Three Musketeers bars and couldn't fit into a movie-theater seat.
She tried every diet that came along: Weight Watchers, Jenny Craig, pills that claimed to heat your body so you'd burn calories while sleeping.
Nothing helped.
The low point came when Forrester maxed out her doctor's 350-pound scale.
"I went home and cried like a baby."
Walk on
Forrester didn't enter into gastric-bypass surgery lightly.
Dr. Henry Laws of Birmingham warned Forrester, who had suffered three strokes unrelated to her weight, that the operation could kill her.
She made peace with God as she was being wheeled into the operating room - just in case.
After the surgery, Forrester had trouble sleeping. So she walked. Just a few wobbly steps at first around her apartment's parking lot, then longer distances at a track behind Marshall Medical Center South in Boaz. She followed the suggested low-fat, high-protein diet to the letter.
The weight came off fast: 240 pounds the first year.
Today, Forrester is an outspoken advocate of gastric-bypass surgery - but only for patients who are dangerously obese. Her daughter Brandy had the operation last October and has shed 18 dress sizes.
"People are jumping on the bandwagon thinking this is a quick fix, but it's a total lifestyle change," Forrester says. "I tell everybody, 'Don't let anyone talk you into it.'
"If you are honestly comfortable with yourself in a size 30, then that's where you need to be."
Source:www.al.com
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