Patient's Query
Hello doctor,
I am considering metabolic surgery and need advice.
I am a 39-year-old male, with a height of 5'11" and 347 pounds, with a body mass index (BMI) of 48.4. My health has deteriorated rapidly over the past few years. I was diagnosed with type 2 diabetes four years ago, with HbA1c now at 9.7 despite taking maximum doses of Metformin and Glipizide plus 65 units of insulin daily.
My blood pressure stays around 168/98 mmHg even while taking three different medications. Sleep apnea is severe (Apnea-Hypopnea index (AHI) of 42), but I cannot tolerate continuous positive airway pressure (CPAP). I wake up, ripping the mask off every night.
Recently hospitalized with deep vein thrombosis (DVT) in my left leg and am now on blood thinners. My knees and back hurt constantly, making exercise nearly impossible. Liver enzymes are elevated (Alanine transaminase (ALT) 96, Aspartate Aminotransferase (AST) 84), and ultrasound confirmed fatty liver disease.
I tried losing weight through diet so many times and lost 40 pounds on keto but gained back 60 pounds when I could not maintain it. My cardiologist is concerned about my heart function and says I am at high risk for a heart attack if something does not change. My father died of a heart attack at 52 years, and I have two young children. I want to see them grow up.
My insurance will cover bariatric surgery, but I am terrified of complications. A friend had a gastric sleeve and developed serious vitamin deficiencies afterward. How effective is metabolic surgery for reversing diabetes? What is the mortality risk for someone with my health problems? Would gastric bypass or sleeve be better for my situation? I am desperate but scared.
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
Metabolic surgery is indicated in your case due to the following complications:
Diabetes mellitus (DM).
Hypertension.
Nonalcoholic fatty liver disease (NAFLD).
Deep vein thrombosis (DVT).
Joint dysfunction.
Metabolic surgery is an effective way of reversing DM. About 80-85% of patients benefited from DM reversal. Even if a complete reversal is not possible, less medication will be needed.
The best choice in your case will be gastric bypass surgery, given your DM, gastric, and cardiovascular complications.
These days, metabolic surgery is safe. The mortality rate is only 0.1 to 0.3 %. While the complication rate is 3 to 6 % which is quite manageable.
Lifelong vitamins will be needed. These include:
Vitamin B12.
Calcium.
vitamin D.
Iron.
Kindly consult a specialist doctor, talk with them, and take medications with their consent.
I hope this helps.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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