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I believe it is a true article, however, we don't really know the underlying

issues. I thought I had read were she had untreated hernias which had broken

through her intestines. Not knowing her medical treatment and her

relationship with her doctors, who knows how she may have had them. With proper

treatment she and the baby may possiby have survived.

Laurette

4/23/04 open rny

309/290/237/150

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I just copied it off a previous post so that you could read it too.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

______________________________________________________________

An obese Massachusetts woman and her 8-month-old fetus died of

> complications 18 months after stomach-stapling surgery, an

apparent

> first that is leading to warnings about the risks of pregnancy soon

> after the surgery.

>

> The deaths raise concerns because most of the 110,000 people who

> have gastric, or stomach, bypass surgery each year in this country

> are women in their child-bearing years, say doctors at Brigham and

> Women's Hospital in Boston who tried to save the mother and baby.

> They reported on the case in a letter in Thursday's New England

> Journal of Medicine.

>

> Brigham surgeon Dr. E. Whang cared for the 41-year-old

woman

> nearly two years ago, when she was brought to their emergency

> department after two days at another hospital, where the cause of

> sudden pain in her upper stomach was misdiagnosed.

>

> " She was nearly dead, " said Whang, who noted the woman had the

> gastric bypass and prenatal care at other hospitals.

>

> After tests and symptoms indicated a massive infection, Whang did

> emergency surgery. He found most of the woman's small intestine

had

> slid through a hernia, or tear, in an adjacent membrane, a defect

> sometimes left after the intestines are rearranged in the bypass

> operation. The hole choked off blood to the stretch of intestines,

> and the tissue turned gangrenous.

>

> By then the fetus had died. Whang repaired the intestine, but the

> woman died within a few hours. She still weighed 440 pounds; her

> original weight was not available.

>

> " This is a tragic case, but you need to look at the overall risk-

> benefit of the surgery, " said Dr. Harvey Sugerman, president of

the

> American Society for Bariatric Surgery, an educational group for

> obesity surgeons.

>

> Sugerman said three studies show extremely obese patients have

death

> rates as much as four or five times lower if they undergo gastric

> bypass surgery, compared with those who don't, and other research

> shows lower rates of pregnancy complications after the weight-loss

> surgery.

>

> Sugerman estimated more than 110,000 gastric bypasses will be done

> in the United States this year. Complications strike as many as 1

in

> 5 patients, and it is believed that for every 200 patients, 1 to 4

> will die.

>

> Sugerman and other doctors said they know of no other mother-baby

> deaths after the operation.

>

> But Whang said about 85 percent gastric bypasses are performed on

> women, most of childbearing age. He advised any pregnant patients

> with sudden pain to see a bypass expert quickly.

>

> " Most doctors recommend contraceptives for two years after the

> surgery " to avoid pregnancy until the woman's weight stabilizes,

> said Dr. Sattar Hadi, who runs the high-risk obesity clinic at

> Vanderbilt University's Center for Human Nutrition.

>

>

> Hadi said it's unclear whether the Massachusetts woman's hernia

was

> due solely to the surgery " or the fetus pushing onto the

intestines. "

>

> Dr. Mark Tucker, director of bariatric surgery at the University

of

> Medicine and Dentistry of New Jersey in Stratford, said such

hernias

> are not uncommon and can happen up to five years after the

surgery.

> Because fertility increases with major weight loss, he said,

reports

> of pregnancies within a year of surgery are becoming more common.

>

> In the standard type of gastric bypass surgery performed on this

> woman, a small pouch at the stomach's top is separated from the

rest

> using staples. Moving down the small intestine a few feet, the

> surgeon then cuts it in two, pulls the bottom segment up and

> attaches it to the new pouch. The dangling upper segment, which

> carries digestive juices, is then reattached to the lower segment.

>

> Patients then lose weight because the new pouch holds a few ounces

> of food at a time, and some calories and nutrients are not

absorbed

> because the food bypasses much of the stomach and small intestine.

> Patients must take protein and vitamin supplements to avoid

> malnutrition.

>

> Since the start of 2003, three other Massachusetts patients have

> died after gastric bypass, and the state is developing guidelines

to

> increase safety.

>

> The federal Medicare program has paid for stomach bypass surgeries

> for a few years, but only in people with related medical

conditions

> such as diabetes. It covered 7,801 operations in 2003, about

double

> the number in 2001.

>

> Dr. Steve Phurrough of the Centers for Medicare and Medicaid

> Services said the agency recently ruled obesity can be considered

an

> illness on its own, so an advisory panel this fall is to recommend

> whether Medicare should cover the surgery in people without

related

> conditions. He expects the panel will urge waiting until there's

> more research on the surgery on the elderly.

>

> " We have significant concerns about the risks, " Phurrough

> said. " People die from this procedure. "

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I am not being mean or anything, but the woman weighted over 400

pounds, even without the surgery pregnancy at that weight seems like

suicide. The article doesn't tell us how much she lost or if there

where other complications.

Pat in RI

> I just copied it off a previous post so that you could read it too.

>

> Dora in Tennessee

> Lap/Open RNY 9/20/2004

> Vanderbilt Hospital

>

> ______________________________________________________________

> An obese Massachusetts woman and her 8-month-old fetus died of

> > complications 18 months after stomach-stapling surgery, an

> apparent

> > first that is leading to warnings about the risks of pregnancy

soon

> > after the surgery.

> >

> > The deaths raise concerns because most of the 110,000 people who

> > have gastric, or stomach, bypass surgery each year in this

country

> > are women in their child-bearing years, say doctors at Brigham

and

> > Women's Hospital in Boston who tried to save the mother and baby.

> > They reported on the case in a letter in Thursday's New England

> > Journal of Medicine.

> >

> > Brigham surgeon Dr. E. Whang cared for the 41-year-old

> woman

> > nearly two years ago, when she was brought to their emergency

> > department after two days at another hospital, where the cause of

> > sudden pain in her upper stomach was misdiagnosed.

> >

> > " She was nearly dead, " said Whang, who noted the woman had the

> > gastric bypass and prenatal care at other hospitals.

> >

> > After tests and symptoms indicated a massive infection, Whang did

> > emergency surgery. He found most of the woman's small intestine

> had

> > slid through a hernia, or tear, in an adjacent membrane, a defect

> > sometimes left after the intestines are rearranged in the bypass

> > operation. The hole choked off blood to the stretch of

intestines,

> > and the tissue turned gangrenous.

> >

> > By then the fetus had died. Whang repaired the intestine, but the

> > woman died within a few hours. She still weighed 440 pounds; her

> > original weight was not available.

> >

> > " This is a tragic case, but you need to look at the overall risk-

> > benefit of the surgery, " said Dr. Harvey Sugerman, president of

> the

> > American Society for Bariatric Surgery, an educational group for

> > obesity surgeons.

> >

> > Sugerman said three studies show extremely obese patients have

> death

> > rates as much as four or five times lower if they undergo gastric

> > bypass surgery, compared with those who don't, and other research

> > shows lower rates of pregnancy complications after the weight-

loss

> > surgery.

> >

> > Sugerman estimated more than 110,000 gastric bypasses will be

done

> > in the United States this year. Complications strike as many as 1

> in

> > 5 patients, and it is believed that for every 200 patients, 1 to

4

> > will die.

> >

> > Sugerman and other doctors said they know of no other mother-baby

> > deaths after the operation.

> >

> > But Whang said about 85 percent gastric bypasses are performed on

> > women, most of childbearing age. He advised any pregnant patients

> > with sudden pain to see a bypass expert quickly.

> >

> > " Most doctors recommend contraceptives for two years after the

> > surgery " to avoid pregnancy until the woman's weight stabilizes,

> > said Dr. Sattar Hadi, who runs the high-risk obesity clinic at

> > Vanderbilt University's Center for Human Nutrition.

> >

> >

> > Hadi said it's unclear whether the Massachusetts woman's hernia

> was

> > due solely to the surgery " or the fetus pushing onto the

> intestines. "

> >

> > Dr. Mark Tucker, director of bariatric surgery at the University

> of

> > Medicine and Dentistry of New Jersey in Stratford, said such

> hernias

> > are not uncommon and can happen up to five years after the

> surgery.

> > Because fertility increases with major weight loss, he said,

> reports

> > of pregnancies within a year of surgery are becoming more common.

> >

> > In the standard type of gastric bypass surgery performed on this

> > woman, a small pouch at the stomach's top is separated from the

> rest

> > using staples. Moving down the small intestine a few feet, the

> > surgeon then cuts it in two, pulls the bottom segment up and

> > attaches it to the new pouch. The dangling upper segment, which

> > carries digestive juices, is then reattached to the lower

segment.

> >

> > Patients then lose weight because the new pouch holds a few

ounces

> > of food at a time, and some calories and nutrients are not

> absorbed

> > because the food bypasses much of the stomach and small

intestine.

> > Patients must take protein and vitamin supplements to avoid

> > malnutrition.

> >

> > Since the start of 2003, three other Massachusetts patients have

> > died after gastric bypass, and the state is developing guidelines

> to

> > increase safety.

> >

> > The federal Medicare program has paid for stomach bypass

surgeries

> > for a few years, but only in people with related medical

> conditions

> > such as diabetes. It covered 7,801 operations in 2003, about

> double

> > the number in 2001.

> >

> > Dr. Steve Phurrough of the Centers for Medicare and Medicaid

> > Services said the agency recently ruled obesity can be considered

> an

> > illness on its own, so an advisory panel this fall is to

recommend

> > whether Medicare should cover the surgery in people without

> related

> > conditions. He expects the panel will urge waiting until there's

> > more research on the surgery on the elderly.

> >

> > " We have significant concerns about the risks, " Phurrough

> > said. " People die from this procedure. "

>

>

>

>

>

>

>

>

>

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P.S.

And I did a google search on it and it came up on a number of different paper's

websites. It was an article run by the Associated Press on August 11 of this

year.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

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I remember reading about it in the paper when it happened. I was

shocked at the time that a woman that big would think about

pregnancy but the paper made a big deal about failed by-pass

surgery. I think the last sentence said she was 18 months out. It

was a terrible shame but should not have been blamed on by-pass

surgery. Just my .02.

Pat in RI

> I went on truthorfiction.com and did not find anything when I

searched.

>

> Dora in Tennessee

> Lap/Open RNY 9/20/2004

> Vanderbilt Hospital

>

>

>

>

>

>

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Pat

was this women over 400lbs when she got pregnant? If so that is very

very dangerous I mean I almost lost my life having my daughter n I was 240

pre pregnancy that is. I know after I had her they told me it would be

life threatning for me to become pregnant again unless I lose alot of

weight wich will happen soon enough but even after I lose my weight I'm

not in a rush to have another child right away that is I do want more

children but not right away. n if i don't have anymore wich i'm sure i will

but if by chance i don't i'm lucky to have my beautiful healthy daughter she

is my heart my world and i tell you me going through all I did n almost

losing my life was all worth it for i have my little girl

Love Debbie

-------------- Original message --------------

I am not being mean or anything, but the woman weighted over 400

pounds, even without the surgery pregnancy at that weight seems like

suicide. The article doesn't tell us how much she lost or if there

where other complications.

Pat in RI

> I just copied it off a previous post so that you could read it too.

>

> Dora in Tennessee

> Lap/Open RNY 9/20/2004

> Vanderbilt Hospital

>

> ______________________________________________________________

> An obese Massachusetts woman and her 8-month-old fetus died of

> > complications 18 months after stomach-stapling surgery, an

> apparent

> > first that is leading to warnings about the risks of pregnancy

soon

> > after the surgery.

> >

> > The deaths raise concerns because most of the 110,000 people who

> > have gastric, or stomach, bypass surgery each year in this

country

> > are women in their child-bearing years, say doctors at Brigham

and

> > Women's Hospital in Boston who tried to save the mother and baby.

> > They reported on the case in a letter in Thursday's New England

> > Journal of Medicine.

> >

> > Brigham surgeon Dr. E. Whang cared for the 41-year-old

> woman

> > nearly two years ago, when she was brought to their emergency

> > department after two days at another hospital, where the cause of

> > sudden pain in her upper stomach was misdiagnosed.

> >

> > " She was nearly dead, " said Whang, who noted the woman had the

> > gastric bypass and prenatal care at other hospitals.

> >

> > After tests and symptoms indicated a massive infection, Whang did

> > emergency surgery. He found most of the woman's small intestine

> had

> > slid through a hernia, or tear, in an adjacent membrane, a defect

> > sometimes left after the intestines are rearranged in the bypass

> > operation. The hole choked off blood to the stretch of

intestines,

> > and the tissue turned gangrenous.

> >

> > By then the fetus had died. Whang repaired the intestine, but the

> > woman died within a few hours. She still weighed 440 pounds; her

> > original weight was not available.

> >

> > " This is a tragic case, but you need to look at the overall risk-

> > benefit of the surgery, " said Dr. Harvey Sugerman, president of

> the

> > American Society for Bariatric Surgery, an educational group for

> > obesity surgeons.

> >

> > Sugerman said three studies show extremely obese patients have

> death

> > rates as much as four or five times lower if they undergo gastric

> > bypass surgery, compared with those who don't, and other research

> > shows lower rates of pregnancy complications after the weight-

loss

> > surgery.

> >

> > Sugerman estimated more than 110,000 gastric bypasses will be

done

> > in the United States this year. Complications strike as many as 1

> in

> > 5 patients, and it is believed that for every 200 patients, 1 to

4

> > will die.

> >

> > Sugerman and other doctors said they know of no other mother-baby

> > deaths after the operation.

> >

> > But Whang said about 85 percent gastric bypasses are performed on

> > women, most of childbearing age. He advised any pregnant patients

> > with sudden pain to see a bypass expert quickly.

> >

> > " Most doctors recommend contraceptives for two years after the

> > surgery " to avoid pregnancy until the woman's weight stabilizes,

> > said Dr. Sattar Hadi, who runs the high-risk obesity clinic at

> > Vanderbilt University's Center for Human Nutrition.

> >

> >

> > Hadi said it's unclear whether the Massachusetts woman's hernia

> was

> > due solely to the surgery " or the fetus pushing onto the

> intestines. "

> >

> > Dr. Mark Tucker, director of bariatric surgery at the University

> of

> > Medicine and Dentistry of New Jersey in Stratford, said such

> hernias

> > are not uncommon and can happen up to five years after the

> surgery.

> > Because fertility increases with major weight loss, he said,

> reports

> > of pregnancies within a year of surgery are becoming more common.

> >

> > In the standard type of gastric bypass surgery performed on this

> > woman, a small pouch at the stomach's top is separated from the

> rest

> > using staples. Moving down the small intestine a few feet, the

> > surgeon then cuts it in two, pulls the bottom segment up and

> > attaches it to the new pouch. The dangling upper segment, which

> > carries digestive juices, is then reattached to the lower

segment.

> >

> > Patients then lose weight because the new pouch holds a few

ounces

> > of food at a time, and some calories and nutrients are not

> absorbed

> > because the food bypasses much of the stomach and small

intestine.

> > Patients must take protein and vitamin supplements to avoid

> > malnutrition.

> >

> > Since the start of 2003, three other Massachusetts patients have

> > died after gastric bypass, and the state is developing guidelines

> to

> > increase safety.

> >

> > The federal Medicare program has paid for stomach bypass

surgeries

> > for a few years, but only in people with related medical

> conditions

> > such as diabetes. It covered 7,801 operations in 2003, about

> double

> > the number in 2001.

> >

> > Dr. Steve Phurrough of the Centers for Medicare and Medicaid

> > Services said the agency recently ruled obesity can be considered

> an

> > illness on its own, so an advisory panel this fall is to

recommend

> > whether Medicare should cover the surgery in people without

> related

> > conditions. He expects the panel will urge waiting until there's

> > more research on the surgery on the elderly.

> >

> > " We have significant concerns about the risks, " Phurrough

> > said. " People die from this procedure. "

>

>

>

>

>

>

>

>

>

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Hey you guys I have 1 thing to say about this artical yes there are risk

with this surgery but there are risk with any surgery you get not just

this 1. There are in my opinion way way more risk to stay obese I don't know

about you all but I know the surgery is best for me I'm 25 yrs old I'm

alive but in my opinion not living it's hard to walk I can't walk or stand

long periods of time. I have sleep apnea and heart diesease. I had a heart

attack at age 21 and almost lost my life having my beautiful daughter. My

daughter had no complications at all it was me and in my opinion from

being way to over weight being pregnant ect.... I don't care what anyone

says there are more risk for obese and severly over weight womaen to

get pregnant and go through childbirth altho it is true noraml weght women

sometimes have complications with pregnancy as well. after I had my daughter

I was told it would be life threatning to get pregnant again UNLESS I

lose weight first at this point in time that I was told this I was 260

thats far off from over 400 and if it s life threatning for 260 imagin what

is it for 400 n over. Also my Dr 's family,Heart, n garstric bypass surgen

are telling me it is very low risk but they do tell u up front what

could possible happen but lookin at the statistics for where I'm getting it

done less then 1% die or have serious complication. However I'm gonna

end here but 1 last thing If you have not had the surgery yet you have to

look into yourself,,,, outway the risk of being obese to the risk of surgery

and think of the benefits this has to be a personal decision

Love Debbie

-------------- Original message --------------

I just copied it off a previous post so that you could read it too.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

______________________________________________________________

An obese Massachusetts woman and her 8-month-old fetus died of

> complications 18 months after stomach-stapling surgery, an

apparent

> first that is leading to warnings about the risks of pregnancy soon

> after the surgery.

>

> The deaths raise concerns because most of the 110,000 people who

> have gastric, or stomach, bypass surgery each year in this country

> are women in their child-bearing years, say doctors at Brigham and

> Women's Hospital in Boston who tried to save the mother and baby.

> They reported on the case in a letter in Thursday's New England

> Journal of Medicine.

>

> Brigham surgeon Dr. E. Whang cared for the 41-year-old

woman

> nearly two years ago, when she was brought to their emergency

> department after two days at another hospital, where the cause of

> sudden pain in her upper stomach was misdiagnosed.

>

> " She was nearly dead, " said Whang, who noted the woman had the

> gastric bypass and prenatal care at other hospitals.

>

> After tests and symptoms indicated a massive infection, Whang did

> emergency surgery. He found most of the woman's small intestine

had

> slid through a hernia, or tear, in an adjacent membrane, a defect

> sometimes left after the intestines are rearranged in the bypass

> operation. The hole choked off blood to the stretch of intestines,

> and the tissue turned gangrenous.

>

> By then the fetus had died. Whang repaired the intestine, but the

> woman died within a few hours. She still weighed 440 pounds; her

> original weight was not available.

>

> " This is a tragic case, but you need to look at the overall risk-

> benefit of the surgery, " said Dr. Harvey Sugerman, president of

the

> American Society for Bariatric Surgery, an educational group for

> obesity surgeons.

>

> Sugerman said three studies show extremely obese patients have

death

> rates as much as four or five times lower if they undergo gastric

> bypass surgery, compared with those who don't, and other research

> shows lower rates of pregnancy complications after the weight-loss

> surgery.

>

> Sugerman estimated more than 110,000 gastric bypasses will be done

> in the United States this year. Complications strike as many as 1

in

> 5 patients, and it is believed that for every 200 patients, 1 to 4

> will die.

>

> Sugerman and other doctors said they know of no other mother-baby

> deaths after the operation.

>

> But Whang said about 85 percent gastric bypasses are performed on

> women, most of childbearing age. He advised any pregnant patients

> with sudden pain to see a bypass expert quickly.

>

> " Most doctors recommend contraceptives for two years after the

> surgery " to avoid pregnancy until the woman's weight stabilizes,

> said Dr. Sattar Hadi, who runs the high-risk obesity clinic at

> Vanderbilt University's Center for Human Nutrition.

>

>

> Hadi said it's unclear whether the Massachusetts woman's hernia

was

> due solely to the surgery " or the fetus pushing onto the

intestines. "

>

> Dr. Mark Tucker, director of bariatric surgery at the University

of

> Medicine and Dentistry of New Jersey in Stratford, said such

hernias

> are not uncommon and can happen up to five years after the

surgery.

> Because fertility increases with major weight loss, he said,

reports

> of pregnancies within a year of surgery are becoming more common.

>

> In the standard type of gastric bypass surgery performed on this

> woman, a small pouch at the stomach's top is separated from the

rest

> using staples. Moving down the small intestine a few feet, the

> surgeon then cuts it in two, pulls the bottom segment up and

> attaches it to the new pouch. The dangling upper segment, which

> carries digestive juices, is then reattached to the lower segment.

>

> Patients then lose weight because the new pouch holds a few ounces

> of food at a time, and some calories and nutrients are not

absorbed

> because the food bypasses much of the stomach and small intestine.

> Patients must take protein and vitamin supplements to avoid

> malnutrition.

>

> Since the start of 2003, three other Massachusetts patients have

> died after gastric bypass, and the state is developing guidelines

to

> increase safety.

>

> The federal Medicare program has paid for stomach bypass surgeries

> for a few years, but only in people with related medical

conditions

> such as diabetes. It covered 7,801 operations in 2003, about

double

> the number in 2001.

>

> Dr. Steve Phurrough of the Centers for Medicare and Medicaid

> Services said the agency recently ruled obesity can be considered

an

> illness on its own, so an advisory panel this fall is to recommend

> whether Medicare should cover the surgery in people without

related

> conditions. He expects the panel will urge waiting until there's

> more research on the surgery on the elderly.

>

> " We have significant concerns about the risks, " Phurrough

> said. " People die from this procedure. "

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Share on other sites

I think she was, she must have disregarded doctor's advice or maybe

the pregnancy was an accident the newspaper article didn't say. I

weighted 168 when I delivered my son and I was miserable I also know

I was miserable at 250 I can not image being pregnant and over 400

pounds. It must have been really bad because 8 month premies

survive today. I just feel so bad for everyone involved.

Pat in RI

> > I just copied it off a previous post so that you could read it

too.

> >

> > Dora in Tennessee

> > Lap/Open RNY 9/20/2004

> > Vanderbilt Hospital

> >

> > ______________________________________________________________

> > An obese Massachusetts woman and her 8-month-old fetus died of

> > > complications 18 months after stomach-stapling surgery, an

> > apparent

> > > first that is leading to warnings about the risks of pregnancy

> soon

> > > after the surgery.

> > >

> > > The deaths raise concerns because most of the 110,000 people

who

> > > have gastric, or stomach, bypass surgery each year in this

> country

> > > are women in their child-bearing years, say doctors at Brigham

> and

> > > Women's Hospital in Boston who tried to save the mother and

baby.

> > > They reported on the case in a letter in Thursday's New England

> > > Journal of Medicine.

> > >

> > > Brigham surgeon Dr. E. Whang cared for the 41-year-old

> > woman

> > > nearly two years ago, when she was brought to their emergency

> > > department after two days at another hospital, where the cause

of

> > > sudden pain in her upper stomach was misdiagnosed.

> > >

> > > " She was nearly dead, " said Whang, who noted the woman had the

> > > gastric bypass and prenatal care at other hospitals.

> > >

> > > After tests and symptoms indicated a massive infection, Whang

did

> > > emergency surgery. He found most of the woman's small intestine

> > had

> > > slid through a hernia, or tear, in an adjacent membrane, a

defect

> > > sometimes left after the intestines are rearranged in the

bypass

> > > operation. The hole choked off blood to the stretch of

> intestines,

> > > and the tissue turned gangrenous.

> > >

> > > By then the fetus had died. Whang repaired the intestine, but

the

> > > woman died within a few hours. She still weighed 440 pounds;

her

> > > original weight was not available.

> > >

> > > " This is a tragic case, but you need to look at the overall

risk-

> > > benefit of the surgery, " said Dr. Harvey Sugerman, president of

> > the

> > > American Society for Bariatric Surgery, an educational group

for

> > > obesity surgeons.

> > >

> > > Sugerman said three studies show extremely obese patients have

> > death

> > > rates as much as four or five times lower if they undergo

gastric

> > > bypass surgery, compared with those who don't, and other

research

> > > shows lower rates of pregnancy complications after the weight-

> loss

> > > surgery.

> > >

> > > Sugerman estimated more than 110,000 gastric bypasses will be

> done

> > > in the United States this year. Complications strike as many

as 1

> > in

> > > 5 patients, and it is believed that for every 200 patients, 1

to

> 4

> > > will die.

> > >

> > > Sugerman and other doctors said they know of no other mother-

baby

> > > deaths after the operation.

> > >

> > > But Whang said about 85 percent gastric bypasses are performed

on

> > > women, most of childbearing age. He advised any pregnant

patients

> > > with sudden pain to see a bypass expert quickly.

> > >

> > > " Most doctors recommend contraceptives for two years after the

> > > surgery " to avoid pregnancy until the woman's weight

stabilizes,

> > > said Dr. Sattar Hadi, who runs the high-risk obesity clinic at

> > > Vanderbilt University's Center for Human Nutrition.

> > >

> > >

> > > Hadi said it's unclear whether the Massachusetts woman's hernia

> > was

> > > due solely to the surgery " or the fetus pushing onto the

> > intestines. "

> > >

> > > Dr. Mark Tucker, director of bariatric surgery at the

University

> > of

> > > Medicine and Dentistry of New Jersey in Stratford, said such

> > hernias

> > > are not uncommon and can happen up to five years after the

> > surgery.

> > > Because fertility increases with major weight loss, he said,

> > reports

> > > of pregnancies within a year of surgery are becoming more

common.

> > >

> > > In the standard type of gastric bypass surgery performed on

this

> > > woman, a small pouch at the stomach's top is separated from the

> > rest

> > > using staples. Moving down the small intestine a few feet, the

> > > surgeon then cuts it in two, pulls the bottom segment up and

> > > attaches it to the new pouch. The dangling upper segment, which

> > > carries digestive juices, is then reattached to the lower

> segment.

> > >

> > > Patients then lose weight because the new pouch holds a few

> ounces

> > > of food at a time, and some calories and nutrients are not

> > absorbed

> > > because the food bypasses much of the stomach and small

> intestine.

> > > Patients must take protein and vitamin supplements to avoid

> > > malnutrition.

> > >

> > > Since the start of 2003, three other Massachusetts patients

have

> > > died after gastric bypass, and the state is developing

guidelines

> > to

> > > increase safety.

> > >

> > > The federal Medicare program has paid for stomach bypass

> surgeries

> > > for a few years, but only in people with related medical

> > conditions

> > > such as diabetes. It covered 7,801 operations in 2003, about

> > double

> > > the number in 2001.

> > >

> > > Dr. Steve Phurrough of the Centers for Medicare and Medicaid

> > > Services said the agency recently ruled obesity can be

considered

> > an

> > > illness on its own, so an advisory panel this fall is to

> recommend

> > > whether Medicare should cover the surgery in people without

> > related

> > > conditions. He expects the panel will urge waiting until

there's

> > > more research on the surgery on the elderly.

> > >

> > > " We have significant concerns about the risks, " Phurrough

> > > said. " People die from this procedure. "

> >

> >

> >

> >

> >

> >

> >

> >

> >

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