What will happen when we get older?

[Larra]

People considering bariatric surgery sometimes ask, what will happen when I get older? Will I lose too much weight, will I be able to keep up with the vitamins and protein requirements of my operation, what if I have to rely on others to help with this? These are legitimate considerations. Many Mo people will die before reaching that point from their obesity or comorbidities, but what happens to those who hang on?
Here is an article that details what can be the outcome for MO people who don't lose weight. My personal opinion is that the risks of dealing with the nutritional needs of a bariatric post-op are far outweighed by the risks of ending up as an elderly MO person, but each of us can form his or her own opinion.

http://news.yahoo.com/obesity-changing-care-elderly-190508397.html

 

[Clematis]

Thanks, Larra. I never realized that nursing homes refused patients for weight. My parents were in assisted livings and nursing homes. (My mother was obese, my father was very thin.) I saw how hard it was for the staff to manage the MO -- all of whom were in wheelchairs -- and even talked about this with one of the private nursing aides I hired for my father. She said there was a lot of things they would do for a thin person that they refuse to do for MO without a second aide -- and a second aide was rarely available. The MO have to wait to use the toilet, for example, until a second person was available and that could take more than an hour. I don't recall seeing any SMO in nursing home, but I did see a few in assisted living.

I told my husband that if I ever end up in a nursing home, I'll have to be bad enough off that I don;t want to live that way. Ergo, don;t even bother telling them about my diet and vitamin needs. A usual high carb, low protein, no supplement diet and I'll be dead all that much faster which will be OK by me.

 

[mike727]

In the back of my mind I've thought if I make it to a certain age I may just reverse the switch part. Not sure if anyone has ever suggested that or if it's crazy. I'm 34 now, so if I hit 64 maybe then I could reverse it? Who knows lol just thinking out loud. I'm sure I'll be afraid of weight regain if I did that.

 

[Clematis]

so if I hit 64 maybe then I could reverse i

Bwahaha you're so young. I'm turning 63 and am only 5 weeks out from the DS so with your strategy I'd be having it reversed in a year. Don;t stamp your expiration date just yet, Mike. I'm sure you'll feel differently as you get older.

 

[DianaCox]

Really!! I'm 62 and still just over the line of obese (BMI 31 or so). My mother was SMO most of her life, and as recently as a couple of years ago was still over 300 lbs. But in the last year or so, she has had a bowel obstruction and is really failing - including her appetite. She now weighs less than me (and she was about 6" taller than me in her prime). She looks so little and frail now at 83.

But yes, I think a quick little laparoscopic surgery to make a "kissing X" revision might be in order for some.

I WILL BE NORMAL SOMEDAY - if only for a few weeks.

 

[DSRIGGS]

I am not sure how much absorption one would gain back if the BPL was put back to use do atrophy from lack of use for say 20-30 years. Interesting thought.

 

[bearmom]

Medication management is usually an issue, and I'll have vitamins instead of some of the scripts for cholesterol, blood pressure, etc. And if I get an extra or miss one dose of vitamins, it's not nearly as big of a deal as missing or double dosing most medications.

It's funny, I once thought like Mike, and thought if I get to where I'm less efficient and need the intestinal part reversed, it may be possible. Judging by my 89yo mom, she is still verrry efficient and manages to stay fat on a few crackers a day, so I doubt it will ever be an issue I have to think about.

I help take care of her, and fortunately she is well under 5' tall, so even fat she is about 150lbs. If she were the same BMI and even a little taller, there is no way I'd be able to help her with all that I do.

 

[Razbry]

An excellent post. If I can't take care of my own vits, I'm pretty sure no one else can. I was just in the hospital, and they couldn't deal with it. I figure I'll just go out "naturally" from malnutrition. Hey, I'm 61 and I plan to make it up to at least my eighties! hahahahaha

 

[DSRIGGS]

An excellent post. If I can't take care of my own vits, I'm pretty sure no one else can. I was just in the hospital, and they couldn't deal with it. I figure I'll just go out "naturally" from malnutrition. Hey, I'm 61 and I plan to make it up to at least my eighties! hahahahaha

Such a good point. Hospitals are absolutely clueless and pathetic about our vitamin needs and how we don't absorb oil based vitamins. It pisses me off that when I am in the hospital where I am supposed to be getting improved health that I have to let my vitamin levels suffer because they are too lazy and ignorant to take care of my supplement needs. I bring my own vites but then they want to take the vitamins, have pharmacy look at them, label them with their BS hospital shit and then I have to fight with them to properly dispense....so if I remember to bring them (non emergency situation) I try to hide them and take on my own. Hospitals really suck when it comes to our nutritional and supplemental needs.

 

[Jo777]

Some interesting thoughts to consider.. who knows in the future what the state of WLS technology may be? As bariatric surgeries are going more towards malabsorptive procedures, and more of the population are requiring them to reach a ripe old age- perhaps there will be a more standard protocol for managing the "altered geriatric" population? I hope so.

I see issues with planning a revision at that late stage however- besides financial for some/many, by that point in life a good percentage may not be able to safely go under the knife to achieve the revision, for various reasons. I've seen death by malnutrition in the aged, it's really not something I'd wish on anyone, so here's to hoping the medical community will be proactive. It also means until then, some significant future planning will be needed (now, while healthy and making money) for those that will possibly, likely if they live long enough, require a lot more care than the typical assisted living/ drop-in nursing services may offer.

 

[Larra]

@Jo777 I think that's a very good point - do as much planning for possibly needing care while you are able.
The reason I posted the article is that I think, when we are younger and MO but still very functional, and managing our comorbidities if any, we forget that this becomes far more difficult when we get older. The damage of the obesity and the comorbidities is cumulative, and at some point, bariatric surgery becomes no longer an option due to failure health and excessive risk. Keep in mind also that many MO people are actually malnourished, it's just that no one thinks a fat person could be malnourished.
The other interesting thing in the article is that some of the MO, or more likely SSMO, people who are stuck in nursing homes are not elderly. They have become helpless and nonfunctional due to complications of their obesity - immobility, stroke, whatever. The specific people mentioned in the article sound as though they are also suffering from depression, IMHO, which isn't surprising given their (sometimes) distance from loved ones and poor quality of life. That's a pretty crappy way to spend the rest of your life.

 

[Jo777]

I agree, and I saw this first hand at the rehab center my mom was in for over a month. It is very sad to see patients in their 50's, with full mental capacity, living there long term because they have no mobility left (assuming from the extent of SMO)

Depression is also rampant. If you have a chronic illness, especially one that effects so many areas of life quality, from social, to physical comfort and autonomy- depression is almost a given. Bariatric surgery, regardless of future risks that frankly may or may not play out- is a risk that is almost a non-risk to take. You live long enough with obesity, and the suffering compounds. If my dad had lived long enough to need care, it would have been exceedingly difficult due to his size. Heck. His obesity was one major factor in why his tumor was inoperable- so there's that too. editing to add, unfortunately, he was never a candidate for WLS, even if he wanted it- due to his bowel disease.

You get surgery to help maintain a healthier size- at least you have a better opportunity to set some proactive plans into place in addition to getting to enjoy a normal life. I wonder about the future of many people who opt to never take the chance of WLS for whatever reason. I worry silently about some people in my life who are drifting towards the point of no return with excess weight stacking up.. I know at some point, the ability to pull it back without medical intervention becomes near impossible. Maybe if the reality of what lies ahead was more socially front and center it may help some to turn the tide before it's too late. But, it's an ugly picture.. and for that reason, stays pretty much under the covers.

editing to add: this article and discussion just kicked off a great convo on my end with Todd. The social aspects of obesity repercussion awareness is very, very tricky.

 

[Munchkin]

I am totally convinced we do continue to absorb more over time. Completely! Seriously, how can someone with a 75cm CC still be fat?

I am big on quality of life. If I end up in some kind of institutional setting, I would rather be dead. And I have done elder care and worked in nursing homes while I was in school. So it doesn't bother me in the least.

My motto for years has been the following: "I would rather die in a parachuting accident than in a nursing home!" And I mean it!

 

[robs477]

With ALL due respect, to anyone already “Old”…I agree with @Munchkin 10000%. I don’t want to live to be too old where I can’t take care of myself and am just clinging on to life barely living. This might sound weird to some of you, but dying does not bother me in the least, not one teeny, tiny bit, done it many times before…lol. I want to have a good quality of life while I am here and then check out. Least that’s the plan .

 

[robs477]

I WILL BE NORMAL SOMEDAY - if only for a few weeks.

......There is NOTHING that will ever be normal about you Lady Di.....and I mean that only in the best of way's of course .