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OBGYN.net Broadcasting presents Part I of a series of presentations on Weight Loss Surgery. This project is unique in that we follow the patient from pre-op to one year post-op.
Part I - Roberta's Story
Dr. Marshall Smith: "I'm Marshall Smith, editor-in-chief of OBGYN.net, and I'm here with Roberta Speyer, someone with whom all of you are familiar. We're in Frankfurt, Germany, this morning, and we have an unusual approach and something new for you today. Roberta has traveled to Frankfurt, Germany, to have Dr. Weiner perform surgery on her. It's a bariatric-type surgery which involves gradually reducing the gastric intake, hopefully, in a result of weight loss over the next year or two. First of all, I'd like to ask Roberta something, and we're going to back up a little bit. Obviously, she's here because she feels like she is overweight."
Roberta Speyer: "I know it's hard for you to tell from this film that that's true, but believe me, it is."
Dr. Marshall Smith: "Tell us what it's like on a day-to-day basis. What are some of the things a person who's overweight actually goes through and encounters?"
Roberta Speyer: "These situations that you run into are threaded through your entire life. I've been very successful in my career as publisher of OBGYN.net, and I enjoy my job very much. I travel, I work with clients and physicians, and I have a good marriage and home life with five wonderful children. But an overriding factor that travels with you wherever you go is your weight. I started out at ten pounds at birth and weighed about thirty-five or forty pounds by the time I was a year old. Obviously, I was being fed too much, but the subsequent result of that is it starts you on a track for the rest of your life.
Being overweight is something that people judge you on before you even have a chance to open your mouth. You walk into a room and you have to come back from being behind the eight ball just to get the point where other people are, before you even begin speaking. So when I go in to do a sales presentation, the first thing that happens is someone thinks, 'oh, this is a fat woman,' and they make some type of prejudgment about my intelligence or my professional abilities. I have to work to impress them just to get back to the point that another person would be at just walking into the room.
There's a lot of prejudice, and there are a lot of other problems people have, such as alcoholism and bulimia. I'm not undermining any of these problems, but a problem with weight is a problem that people see when you're on the other side of the room, before you've every opened your mouth, and before they've every had a chance to know anything about you. There are already some predetermined opinions that they have of you. What are they? They are than fat people are lazy, out of control, not as intelligent, and many fat people are the brunt of jokes. Fat people are also stereotypically humorous - they're also supposed to be jolly about the fact that they're fat, and so they're not suppose to mind that people are laughing at them.
So you say, 'why didn't you just lose weight?' Well, it's not as easy as that for me. Some things have come easier to me in my life than others, and this has been a constant struggle. I finally got to the point where I decided I wasn't going to yo-yo diet, and I wasn't going to try to lose weight. I wasn't going to make weight the focus of my life, so I focused on my career and relationships and other things, but the weight continued to inch up - not drastically, but every year five, six, or eight pounds.
At the beginning of this year I started thinking about what options were available, and I discovered that there was something we had all heard about, weight loss surgery, which has been around for twenty, maybe twenty-five years. But this is very dangerous because they would, in essence, go in and take out a very large section of someone's intestines so they wouldn't absorb their…"
Dr. Marshall Smith: Yes, there have been several operations devised in the past for weight reduction, but they have all had major complications associated with them.
Roberta Speyer: "Yes. There were a lot of complications, and a lot of people died. Many weren't getting enough electrolytes, and other, different problems occurred. I've never had surgery in my life, so I'm very healthy. I don't have high blood pressure, and I don't have diabetes. The thought of having someone do a very drastic surgery on me was not something that I felt like I wanted to do, and then I found out about this surgery, the lap band, and I started investigating it and reading about it. I read about who was doing it, and found that it wasn't being done in the United States, except investigationally. It has been done in Europe for quite some time, and it has been done laparoscopically. It is, in essence, totally reversible, and it seemed very non-invasive, so I started looking into it more. I actually talked, first, to one of my clients who's one of our sponsors [InnerDyne, Inc.] on OBGYN.net, Ted Belleza, because it's done laparoscopically and they have a special trocar that is much safer. It's been approved by the FDA to be safer because it has an expanding sheath."
Dr. Marshall Smith: "Right, it's not a cutting trocar."
Roberta Speyer: "I mentioned to him that if I had this surgery I would want to use that product. He said, 'I know the best doctor for you to go to - Dr. Weiner.' He pioneered this procedure, and he has done many of these surgeries. Dr. Mark (Smith) is our Medical Director at OBGYN.net, and when he found out I wanted to do this, of course he looked into it very closely to make sure I wasn't going crazy, here. And you think it sounds like a good thing, right?"
Dr. Marshall Smith: "It does. The big benefit is that it's done laparoscopically, so there are far fewer complications with this approach, as Dr. Weiner will tell you in a minute. It's an excellent surgical approach."
Roberta Speyer: "Open surgery for someone that's overweight can be even more difficult to heal, is that correct?"
Dr. Marshall Smith: "That's correct."
Roberta Speyer: "Is it because there's just more tissue?"
Dr. Marshall Smith: "There's more tissue, and the blood supply is not as great. There's a higher risk of infection, a higher risk of wound breakdown, plus many other factors from respiratory to structural, such as hernias and including blood clots or thromboembolic events. So it's a much safer approach, if it can be done. The problem is, there are not many people around the world that are doing it - Dr. Weiner is one of the pioneers."
Roberta Speyer: "The surgery isn't being done in the United States, except investigationally, yet it is something that has been done in Europe for quite a long time. It's very interesting because unlike any other surgery, the lap band does not cut anywhere, other than the access point to do the surgery. I guess you refer to it as key-hole surgery."
Dr. Marshall Smith: "Or Band-Aid surgery."
Roberta Speyer: "You're opening up to get the scope in, but you're not cutting the stomach or moving the intestines and changing things around. There's no actual cutting that goes on around the digestive organs. So how am I, right now? I'm better, because I'm talking to all of you, and because before everyone showed up I was laying here thinking, 'am I crazy? Why am I laying here in this hospital away from home in Germany having surgery?' It's scary, and anytime anyone has surgery it makes them nervous. Mark and I were talking about this - it's the loss of control that is scary, and I'm a very controlling woman, so the idea of being put out and having someone do things to me is frightening to me, but I must say that I have a lot of faith. This is a wonderful hospital, and I've been treated very well here. I have a lot of faith in this procedure, and I have a lot of faith in Dr. Weiner. I really think this is going to change my life and change it for the better, and I'm really looking forward to a year from now when I can report to all of you the outcome because I know it's going to be a good one."
At this time, three years post-op, Roberta is satisfied with the outcome of her surgery and hopes you have found her story helpful in your search for answers. Please direct any questions about LAP BAND surgery to your personal physician, or email the product makers directly at: http://www.inamed.com/contact/bio_patient.cgi. Due to time restraints Roberta Speyer and the OBGYN.net team cannot respond to personal emails. See Professor Rudolf Weiner's website about Weight Loss Surgery to see if this option is right for you. Visit www.profweiner.com.