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Bipolar disorder, weight gain, and gastric bipass surgery
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reneegigliotti posted:
There has been some discussion on this site about managing weight gain caused in part by our bipolar disorders and medications. This is a subject I have a unique perspective on, so I thought I'd share my 2 cents just in case anyone has had or is considering gastric bypass surgery as a weight reduction tool. Just prior to my surgery in 2009 I weighed 302 lbs. I now weigh 147 lbs. Also, as the result of having GBS, I was able to hold off having to have complex and high risk open heart surgery. Those are the positives of having the surgery, in my case. There are, however, some significant downsides and complications to this surgery for me. When my cardiovascular surgeon recommended GBS to me in 2008 it was because I was in serious need of a complex heart surgery that because of my weight he felt would be too risky to perform. He wanted me to lose a significant amount of weigh, lower my open heart surgery risk factors, and then see where I was medically at least 100 lbs lighter. He knew I had severe bipolar I disorder and wanted me to first discuss the surgery with my psychiatrist of then 14 years (now 18 years). Dr. G and I looked at all the medical and psychiatric complications to undergoing GBS. He said the following to me: Medically, post-surgery care is a lifetime commitment that requires being diligent and responsible about diet, nutrition, medical follow-up, and complication awareness. Try doing all that psychotically manic or suicidally depressed. You need help. Second, your GI tract will severely alter the way it processes and absorb medication. All the medications doses that we have worked for you before surgery may not work for you after surgery. Also,biochemically your body will be different both nutritionally and hormonally. The likelihood of the onset of more frequent and more severe bipolar episodes is possible. After doing a serious risk/benefit analysis, we came to the conclusion that the surgery was still worth doing. The difference with he and I, we knew what we were potentially getting into. I then researched 3 surgical programs. One I dismissed outright. They treated patients like it was a cattle call. Piling everyone in an auditorium, handing out pre-printed medical information and diet instructions. No individualized care and you never met the surgeon until a week before the surgery. My psychiatrist and I said "no way" "this is a recipe for disaster for me". The second program I actually met the surgeon and had an intake appointment. He, however, was a bit too cocky and a bit too dismissive of my circumstances. His answer to me after I carefully explained my medical and psychiatric situation was "I can handle anything". Hmmm. I didn't want to be the first time he couldn't handle something. The third program left me impressed. The surgeon had actually read my medical file before I came for my intake appointment. He had legitimate questions and concerns. He was concerned about my cardiac status and he was concerned about my long term ability to follow through with GBS treatment. I signed releases so he could consult my psychiatrist, cardiologist, and heart surgeon. Ultimately, everyone agreed that the surgery was my best option. So, in December 2009 I had the surgery. Everything Dr. G said might happen psychiatrically with my bipolar disorder, happened. It has been extremely difficult to medicate. Severe and frequent manic and psychotic episodes, and I have more than once gotten into severe malnutrition situations because of lack of self care. He hangs in there with me. I see my psychiatrist weekly and my psychologist 3x weekly. However, I work full time and I have a meaningful life. GBS is no easy fix but for me the benefits outweighed the risks. Just points to consider.
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sandtiger responded:
I was thinking seriously about GBS at one point, but had similar fears. Thank you so much for posting this - I think I'll have another talk with my psychiatrist and psychologist both about it.
Thank you so much!

~ San
:: Living is more than just being alive - Anberlin ::
 
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reneegigliotti replied to sandtiger's response:
I'm not saying don't do it, however, if your treatment team isn't 100% on board with it and ready for all the potential complications I'd say it's not a good plan. For me, the complications are being weathered because I have an amazing psychologist and psychiatrist. To have gone through this alone, I probably wouldn't have survived some of the complications. Good luck with your treatment team. I hope the conversation goes well. Let me know. I can give you my email address if you want to talk more frankly. I care about this subject deeply.


Renee


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