The Myth

The phoenix bird symbolizes immortality, resurrection and life after death. In ancient Greek and Egyptian mythology, it is associated with the sun god.

According to the Greeks, the bird lives in Arabia, near a cool well. Every morning at dawn, the sun god would stop his chariot to listen to the bird sing a beautiful song while it bathed in the well.

Only one phoenix exists at time. When the bird felt its death was near, every 500 to 1,461 years it would build a nest of aromatic wood and set it on fire. The bird then was consumed by the flames.

A new phoenix sprang forth from the pyre. It embalmed the ashes of its predecessor in an egg of myrrh and flew with it to Heliopolis, “city of the sun”, where the egg was deposited on the altar of the sun god. In Egypt, it was usually depicted as a heron, but in the classic literature as a peacock or an eagle.

The Phoenix Bird by Hans Chrisitan Anderson 1850

Bariatric Surgery is a branch of surgery that deals with the problem of severe (morbid) obesity. It is recognized by the American Medical Association and the American College of Surgeons as a safe and effective treatment of severe obesity. Its interests are promoted by the American Society for Bariatric Surgery

What is Severe Morbid Obesity?

Severe Morbid Obesity is a medical condition that is identifiable as a disease entity, described as a dangerous and chronic disease by Dr. C. Evertt Koop, former United States Surgeon General. The National Institutes of Health has identified a two to eight fold increase in mortality (death) associated with this illness. A Veterans Administration study found up to a twelve-fold increase in mortality in young men with an average weight of 316 pounds.

Numerous other medical conditions are frequently associated with sever obesity. These include high blood pressure, heart disease, diabetes, gall bladder stones, arthritis, breathing disorders, and psychological disorders to name a few. There are many social implications as well.

Nearly a third of Americans are afflicted with this serious health risk. Most of these have tried numerous diets and medications without success. The average length of a weight reduction trial is 10-12 weeks with an unimpressive weight loss of about 5.5 pounds. The addition of medication, exercise, and behavior modification for up to four years results in a similarly unimpressive loss of 3 pounds in those who continue with the program. It is very clear from these statistics that this is a tough disease to treat by non-surgical methods.

Who Qualifies for Surgery?

Patients with a serious weight problem, a body weight of twice ideal body weight, more than 100 pounds over ideal body weight or a body mass index of more than 40 (or 35 if other illnesses exist). Body mass index is obtained by dividing your weight in meters squared. Candidates must have also tried other serous methods of weight control without success.

Prospective candidates must be motivated and willing to commit to a life long policy of weight loss. Surgery alone is not going to achieve the desired results. There is a strict policy of diet and behavior modification that must be adhered to in order to achieve satisfactory results.

Surgery is an aid in achieving the desired results. By providing a sense of fullness with little food intake and by decreasing the amount of food absorbed, surgery makes it easier for patients to stay on the course of weight loss.

You must be willing to accept the anticipated risks of surgery. You must also be willing to participate in life long follow-up. You must also be willing to have your operation revised if necessary.

What is the Success Rate?

The success rate varies from patient to patient. The International Bariatric Surgery Register, and academic international register, has followed 14, 641 patients from 1987 thru 1997. The average weight loss was between 48% and 74% at five years after surgery. Other studies have reported similar results, some reporting sustained weight loss of 50% at fourteen years. Of course this does not happen overnight! Weight loss begins immediately, but continues for approximately 1-1/2 to 2 years before it levels off. Another benefit is that a lot of other associated illnesses (Diabetes, Hypertension, etc) will either resolve or decrease in severity after Bariatric Surgery.

What Does Surgery Involve?

Over the years, numerous types of operations have been designed. These operations have been modified and fine-tuned as we have learned more about their long-term success. Today, several different types of operations are available to treat morbid obesity. They consist of either a restrictive or mal absorption type of procedure or a combination of the two. Restrictive operations restrict the amount of food the stomach can hold, thereby producing a sense of fullness with little food intake. Mal absorptive procedures interfere with the normal digestion and absorption of food thereby limiting the amount of calories available from the ingested food.

It is the opinion of RGV Surgery that the combined procedure is the most likely to produce satisfactory and sustained weight loss. This procedure is known as gastric bypass. It results in a very small stomach, thus achieving a sense of fullness with very little food intake and it also produces a certain amount of mal absorption thus limiting the amount of food absorbed from the intestine.

What are the Drawbacks?

As with any surgery, there are risks and complications and even failures. Failure of sustained weight loss of at least 40% occurs in 10% of patients. Significant weight gain after initial weight loss occurs in less that 5%. Minor complications as well as major complications and even death can all happen. Fortunately these problems are relatively infrequent, minor complications in about 5%, major complications in about 1% and death in 0.17%. Some of these complications included:

• Inability to tolerate the effects of surgery on your eating and digestion.
• You may need to have more surgery to "undo" the operation which will result in weight gain.

Often, nutrition problems develop because of the altered anatomy and function after the operation. These include anemia and certain nutritional deficiencies. These can be remedied by observing a balanced diet and taking supplements as directed by your doctor.

As mentioned earlier, surgery alone will not achieve the desired weight loss. Patients must be willing to commit to a life long diet and behavior modification. There is no magic pill or operation that will cure you of this illness. You MUST be willing to participate in the process. You will have to change the way you eat, the way you think about food, and modify your behavior. Fortunately, surgery can help you achieve your goals.

How do I Pay for the Surgery?

Some insurance companies cover this surgery and unfortunately others do not. Overall, If you consider the health consequences (and financial consequences) of not having this surgery you will clearly see that the price of having the surgery is relatively small. Our business office will gladly assist you in find the best way to pay for your operation.

Your Diet After Surgery

Since you will have a tiny stomach capacity, your eating habits change drastically. The new sensation of fullness is usually felt as a tightness or feeling of discomfort behind the lower half of the brest bone, not in the "stomach area" at all! You must carefully watch out for this new sensation and learn to recognize this as your signal to stop eating! You must:

1. Remain on full liquids for about twelve days after surgery.
2. When the time comes to expand your diet, add one "new" food at a time making sure it agrees with you before adding another.
3. Eat slowly and allow half an hour between meals. If you feel full, stop eating.
4. Chew everything well. If you forge, the solid food will feel like a "lump of lead" in your stomach and may cause nausea and vomiting.
5. Reduce the amount you eat. If you feel full, stop. Do NOT take the next bite, do NOT try to wash it down with a drink. If you don't stop eating as soon as you notice the sensation of fullness, your distended stomach will hurt -cause physical pain in the upper abdomen and through to the back. If you persist, you will vomit.
6. Drink between meals. Remember there is not enough room in your new stomach for foods and liquids at the same time.
7. Eat only at meal times. NO SNACKS. Exception -beverages are to be taken between meals.
8. After surgery, you will soon learn how much you can take in and what foods you can tolerate. It is difficult to say what foods will agree with you and which foods won't since everyone is different. Fried foods, sweet foods and drinks and food with tough fiber such as orange pulp should be avoided.
9. Make a conscious effort to avoid high calorie foods. Regular Coke, Pepsi, 7Up and the like are OUT! Ice cream and ice milk are OUT! CAndy is OUT! Why? Because you can beat the system by taking in high calorie fluids which will pass on through the small stomach easily.
10. Avoid "red meat" for six months. Red meat such as beef, pork and venison requires acid for rapid digestion. Most stomach acid is formed in the lower part of the stomach, so it cannot help in digestion. Red meat therefore takes a long time to digest in the "new" stomach and results in the "lump of lead" sensation. Most patients find they can cope with small amounts of broiled or baked seafood at about six weeks after surgery and poultry at about eight weeks after surgery. The secret is to eat slowly and chew it really well.
11. Eat a variety of foods to get a balanced diet.
12. Take one multivitamin/mineral pill daily. DO NOT FORGET!
13. As time passes, you might find that weight loss slows down. If you want to lose more or your weight loss goals have not been achieved, further diet counseling may be required. Consult your doctor or dietitian about the best way to go about this.
14. This surgery does not cause diarrhea. If any bowel change occurs, it is more likely to be "constipation" because of reduced intake. If this occurs, it will be regulated by any laxative which works for you.
15. Avoid foods with high content of fiber residue such as coconut and citrus pulp unless you take care to chew them until the are essentially liquid. There is no room for chunks of fiber in your "new" mini stomach.