Bariatric Surgery: Lindsey G's Story - CECity

Table. Prescription Medication RegimenMedication—albuterol sulfate—allopurinol sodium 300 mg—alprazolam 0.5 mg—citalopram hydrobromide—cyclobenzaprine hydrochloride—glyburide—insulin glargine—insulin lispro—lisinopril—metoprolol tartrate—oxycodone hydrochloride—pregabalin—simvastatinDosage/Administrationas necessaryorally once dailyorally twice daily as necessary20 mg orally once daily10 mg orally 3 times daily as necessary5 mg orally once daily40 U subcutaneously once daily at bedtime100 U/mL subcutaneously on sliding scale(used briefly postoperatively)10 mg orally once daily100 mg orally twice daily5 mg orally every 6 hours as necessary(used briefly postoperatively)50 mg orally once daily40 mg orally once daily at bedtimeLindsey’s goal was—and still is—todefeat her son at a game of 1-on-1 basketball.Bariatric surgery resultsBefore undergoing bariatric surgery,Lindsey required insulin to maintain herblood glucose level, and her glycosylatedhemoglobin (HbA1c) level was 6.4%. Afterthe surgery she was able to discontinueinsulin and maintain her blood glucose andHbA1c levels by taking only metformin500 mg orally twice daily. With further diet,exercise, and weight loss, no medicationswere needed for these purposes by November2011. At this time, her HbA1c level was5.7%, and her pre- and postprandialglucose levels stayed in the range of 86 to90 mg/dL with diet and exercise alone.Lindsey’s positive experience isconfirmed by the literature, which suggeststhat most patients have greatly improvedglucose control after bariatric surgery. Insome cases, patients may even experience,someone else, because it won’t work. I knewI needed to do it when I hit my top weightof 479 pounds a year before the surgery. Igot down to 417 pounds before the surgery.I took a year to improve myself and doexactly what I needed to do, eat the rightportion size. You have to be committed todo your part. You have to love yourself first.If you are not doing it to better yourself,then why do it?Lindsey summarized her no. 1 reasonfor undergoing the surgery: “My goal wasto get off the medications. I was tired of somany pills each day. The weight loss partwas important too, but not the biggestissue.”The process is easier if patients havesupport at home. For Lindsey, her family isher support system, as she explained:My husband told me that he would loveme no matter what size I am, but that hewould support me to lose weight becausethat is what I wanted to do. My husbandand son both support me so much. It is ahousehold effort. We eat at home insteadof going out, eat healthy portion sizes byusing saucers, and we exercise together.My son is like my coach. We are allgetting healthy together.22 AOA Health Watch DOs Against DIABETES May 2012