Friend's interesting gastric bypass experience

kteague · Post by **kteague** » Wed Dec 12, 2007 9:46 pm

Ran into an old friend from "back in the day" last weekend at a get-together. I'd heard he had a heart attack a while back. He has always struggled with his weight, had developed high blood pressure that didn't respond well to treatment, as well as diabetes. Was also diagnosed with OSA and he talked about how badly it affected him and how much cpap treatment helped.

He decided to have a gastric bypass, and they were able to do it with scopes so he had a smattering of punctures rather than a large surgical incision. What I'd not heard before is that he was not allowed to use his cpap machine for six weeks post op because of the concern that air in the stomach could cause it to expand before it was healed.

He has since lost 100 pounds and said he no longer has sleep apnea. Of course I was ready to jump in with advice to get tested to be sure, but he let me know he does everything by the book, and he had recently had an overnight study and was told he no longer needs cpap. Guess weight loss helps some.

Kathy

rested gal · Post by **rested gal** » Wed Dec 12, 2007 11:26 pm

Glad to hear the old friend is doing well. And that he did have a PSG sleep study to confirm he doesn't have OSA anymore after his gastric bypass.

I think weight loss can "cure" some people of OSA. There was a woman who posted several years ago on the TAS message board. She worked for a sleep doctor. He had written a paper, I think she said, about several of his patients who had been cured (confirmed by PSG) of sleep apnea after massive weight loss.

As best I can remember, their pressure requirements kept going down, and eventually they didn't need cpap at all.

On the other side of the coin, there are those who are not overweight at all, or are even too thin, but have OSA. There probably are a lot of etiologies for the disorder.

That's nice for your friend. Hope all continues to go well for him.

kteague · Post by **kteague** » Thu Dec 13, 2007 2:42 am

RG,
What was interesting to me was the post op instructions for no cpap for 6 weeks. Here all this time I thought aerophagia was just a discomfort some users deal with - didn't realize it is prevalent enough or severe enough for it to be a factor after gastric bypass surgery. (And I thought I was just one of the unlucky few!)
Kathy

differentdave · Post by **differentdave** » Thu Dec 13, 2007 5:41 am

I am 5’10” and way 187 lbs. At my highest I was around 200. I should weigh 170 so I am generally somewhere between 15 and 30 pounds overweight. I tacked them on during college and especially after trading in walking and biking for driving and commuting. Usually I am classified as ‘could use a few’. I have a bunch of friends who are doctors who laughed when I told them my ENT thought I might have osa. They said things like you have a neck, you don’t need to lose a 100, your not a size 17 are you (neck size), etc. And they all concurred I did not have sleep apnea. My mother was always anal about medical records, always asking for copies, etc when I was a kid, she kept insanely well kept records, etc. Well long story short when I was 12 I had two teeth removed before I had braces put on, I was given normal dose of sodium pentothal (sure I spelled it wrong) and had stopped breathing during recovery, etc. My mother insisted on going with me last time to ENT (embarrassing as I am 36) with all her records, my doctor loved her and the records. Since I went after work I was last patient of the night. They sat for an hour talking, reviewing, etc. and ENT is pretty sure I had it back when I was 12 as well. I just went undiagnosed (my mom sent me to shrinks, neurologists, etc when I was a kid for not sleeping, she had tons of notes about how I did not dream, (did not start dreaming again until my second night in sleep study when using xpap).
Lots of people have sleep apnea that are not overweight.

odawa · Post by **odawa** » Thu Dec 13, 2007 8:12 am

The sleep Dr. told me if I lost 25% of my weight I'd get rid of the OSA. Mine is weight related as I recently got diagnosed. I also have Diabetes which the Endo will start taking me off meds if I lose 20% of the weight.
I have been working on it, its so hard to lose weight when you are still tired.

tangents · Post by **tangents** » Thu Dec 13, 2007 8:53 am

Hmmm, Odawa, I am sitting here wondering how any doctor can know in advance that your OSA is weight related. Losing excess weight is always a positive thing, but I'd hate to see you brokenhearted if you still have apnea.

Take Care,
Cathy

odawa · Post by **odawa** » Thu Dec 13, 2007 9:46 am

I've always slept well before. Never had a problem with sleeping.
My problem with this is that I havent gained alot of weight recently. I had been exercising and working on weight loss when I got diagnosed.

kteague · Post by **kteague** » Thu Dec 13, 2007 10:00 am

Odawa,
If you were struggling with weight before being diagnosed it could have been due to sleep apnea, since it can affect the appetite hormones and contribute to weight gain. It's a vicious cycle - weight contributes to apnea, apnea contributes to weight. It's the old "which came first, the chicken or the egg" question. Guess the way to be sure is to lose the weight then get another sleep study. The way I'm going, it'll be a long time before it's even a consideration for me. Hope it's soon for you and you get the results your doctor predicts.

Kathy

odawa · Post by **odawa** » Thu Dec 13, 2007 10:35 am

I'll be really upset if I go through all of this and still have to use cpap. I am still not feeling rested with this therapy. For me, its not working. Well hopefully the iron tabs will help, maybe that will make the difference I need. The Dr did some blood work yest. & I have anemia.

ozij · Post by **ozij** » Thu Dec 13, 2007 10:42 am

People without sleep apnea, and with anemia can feel absolutely, thoroughly exhausted.

The iron tabs may take a while to work - and I hope that in about 3 weeks you'll feel the benefit of both the iron and the cpap.

O.

odawa · Post by **odawa** » Thu Dec 13, 2007 10:59 am

Hopefully that will explain why I dont feel better. This has been such an ordeal.

Country4ever · Post by **Country4ever** » Thu Dec 13, 2007 8:16 pm

Gas in the stomach can be really intense.
When I worked in open-heart recovery, I had a patient once who's monitor started looking like he was having a tamponade..........(Bleeding around the heart, so it presses on the heart and the heart can't beat properly). As I was troubleshooting what was going on, I figured out that he had a huge air bolus in his stomach. I think he had an NG tube but it wasn't working properly. As soon as we got that corrected, his heart calmed down. The air pressure in the stomach can press on the heart.
I personally have had this when I would get alot of upper GI gas, my heart would race and have irregular beats, until I could burp it out..........so the fact that they didn't want this guy to have any air in his stomach after his surgery makes alot of sense.

Also, when I worked in ICU, and there would be a morbidly obese patient who would have apnea at night.......they would call it "Pickwickian syndrome". I wonder if that's just apnea from being so overweight? I never hear it called that much anymore.

socknitster · Post by **socknitster** » Sat Dec 15, 2007 6:37 pm

From Wiki:

The Pickwickian syndrome, also known as obesity hypoventilation syndrome, is the combination of severe obesity, suffering from obstructive sleep apnea causing hypoxia and hypercapnia resulting in marked daytime somnolence and chronic respiratory acidosis. Although it is an eponym, it is not named after the doctor who first described it (as commonly happens), but after a literary character by Charles Dickens.

I wish it were as magic as that for me, is sure would be motivating to shed those extra lbs, but for me the apnea started before the weight piled on, I just didn't know it. Hindsight is 20/20.

Congrats for your friend!

I think aerophagia should be taken more seriously. I've suffered from it on and off. It went away when i took Prilosec, but came back with a vengeance when I went off. My OB recently ok'd me to use zantac, so I take it only at night. Pregnancy can be miserable enough. Add aerophagia, omgoodness!

Jen

Treesap · Post by **Treesap** » Sat Dec 15, 2007 7:08 pm

I think different people with OSA have different causes. I do believe weight can cause it. I believe that's why I have it. I have small facial features, especially a small mouth, which probably means I have small bronchial tubes, etc. Add weight to that mix, and OSA may be inevitable. I know I didn't have it prior to weight gain in the last 4 years. I sure hope if I lose weight, it will go away for me. If not, oh well. I will be a hose head the rest of my life. After over 6 months, I'm kinda getting used to it.

annie123 · Post by **annie123** » Sat Dec 15, 2007 7:27 pm

I have lost 100lbs in the last 11 months. I fully believe treatment (CPAP) helped me lose the weight. (I feel better, and as a result make better food choices and have enough energy to exercise.)
My pressure was too high after the weight loss, but the weight loss has not cured my OSA. I demanded an autoPAP rather than go through another sleep study, and the auto confirmed that my pressure should be lower than it was originally. As incompetent as I feel my doctor is at times, I'm glad that he didn't lead me to believe that I could be completely cured by weight loss. I would have been really disappointed if that had been my only goal for the weight loss.
I'm truly not trying to discourage anyone, and realize that everyone's apnea has different causes. ...Just sharing my experience.

Friend's interesting gastric bypass experience

Friend's interesting gastric bypass experience

Post Op Instructions

Weight and apnea

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