The Free Press, Mankato, MN

September 20, 2012

Gastric bypass surgery gives Mankato man new take on life

By Robb Murray
Free Press Staff Writer

— Every once in a while Howard Rosten winds up on the business end of a television camera. He heads up the electronics recycling program for SMILES in Mankato, and their annual collection drives have occasionally been considered “news.”

But, prior to 2010, the arrival of a camera crew didn’t exactly make Rosten’s day.

“I used to hate doing TV because I looked like Godzilla,” Rosten jokes.

To see a photo of him from before August 2010 is to see a photo of a plump man. To see his before-and-after picks side by side is to see a dramatic transformation. And he says he owes his weight loss to the gastric bypass surgery he underwent at Abbott Northwestern in Minneapolis.

Rosten went from 300 pounds to about 170 in roughly nine months. And he’s kept it off.

“There are things I want to do now that I never would have thought of before,” he said.

Gastric bypass and other bariatric surgeries are becoming more common as the nation deals with what some doctors are calling epidemic rates of obesity.

Until recently, most people had to travel to the Twin Cities to have weight-loss surgery. But now there are several options to have the procedures done closer to home for south-central Minnesota residents.

Mayo Clinic Health System in Mankato recently added a physician, Megan Gilmore, who will specialize in bariatric surgery. And a new clinic in lower North Mankato, run by James Lee, is offering the treatments as well while performing surgeries in St. Peter.

Gilmore said Mayo’s process for people wanting the surgery will always begin with a consultation. Rosten said that was the case for him at Abbott Northwestern. Mayo just had their initial one with Gilmore at the helm and 12 prospective patients showed up.

At the informational session, Gilmore collects insurance information. This is a major part of the process. If a patient’s insurance doesn’t cover it, it can be cost-prohibitive.

Once the consultation is over and insurance questions are answered, Gilmore sets up an appointment for patients to meet individually with her to talk about the three different types of weight-loss surgery available through Mayo Clinic Health System in Mankato.

“Generally they come in with a pretty good idea of what they want done,” Gilmore said.

The three available are: Laproscopic gastric banding, vertical sleeve gastrectomy, and Roux-en-Y gastric bypass.

Gilmore says lap band surgery, which once held a lot of promise as a less-invasive way to achieve results similar to gastric bypass, is seeing a decrease in the number of patients choosing it. It works by placing an inflatable band around the upper portion of the stomach to restrict consumption. It is minimally invasive, adjustable and reversible.

But results are proving on average to not be as strong as other types of surgery. While some people do indeed lose large amounts of weight with lap band, in general individual weight loss is less. Also, Gilmore said roughly 45 percent of patients who undergo lap band surgery require additional surgeries to remove the band or repair port that are sometimes installed to maintain the band.

The vertical sleeve method is the newest form of weight-loss surgery, and is being recommended more and more for patients for whom it is unsafe to do a gastric bypass. A sleeve gastrectomy reduces the stomach to about the size and shape of a banana.

Initially, Gilmore said the sleeve was designed as a step in the process for patients who would ultimately be candidates for gastric bypass. But the results from the sleeve alone have been so great that it is commonly being offered as an option on its own. The only problem with the sleeve, Gilmore says, is that they only have five years of results to gauge.

Beyond the surgery, going through a weight-loss surgery process means getting involved with a comprehensive plan to arrive at a healthy weight. And that means lots of counseling and lots of follow up.

Rosten said he’d gone through several meetings with doctors and other medical professionals — he even had to take a psychological exam — before he got the green light from Abbott Northwestern. Afterward, he was scheduled for monthly visits, then more visits even more spaced out. In August, he had his two-year, follow-up visit.

He says his life changed dramatically when he had surgery.

“People would say to me, ‘You can’t eat the way you used to,’” he said. “And I’d say, ‘Yeah. But look at where I was. I like where I am now.’”

There have been sacrifices, of course. Rosten loves pizza, and he used to make a weekly stop at Papa Murphy’s for a large pizza where he’d eat half and put the other half in the fridge for the next day. Now he stops at Papa Murphy’s maybe three or four times a year. Instead of half a pie, though, he cuts it up into little squares and eats just a few pieces. The rest goes into the fridge and gives him a dozen more meals.

He eats a lot less. Right after his surgery, he was consuming maybe 500 calories a day. Now he’s up to about 1,200.

His attitude from the beginning, when he decided to do the surgery and take on the challenge that would come with it, was this: “It’s not ‘Can I do this?’ It’s ‘I can do this.’”

Gilmore says any weight-loss surgery is just another tool. But if used properly — by understanding how difficult the road can be, and by truly committing to lifestyle changes in diet and exercise — it can be life changing.

In the early days of weight-loss surgery, Gilmore said, it was common for patients to gain their weight back. Today, though, she says the long-term success rate is about 75-80 percent (which is judged by the percentage of people who lose more than 50 percent of their body weight and keep it off.)

“I can’t think of anyone who has said they’d wished they’d never done it. It’s quick. It happens fast. They lose the weight,” Gilmore said.

She said she worked with a patient who, after having weigh-loss surgery and losing weight, ended up running in and finishing the Boston Marathon.

“They’re happy, their family members are happy, especially the kids,” Gilmore said. “When their parents are able to go outside and play football and ride bikes ... It’s the little things that we often take for granted.”