Lost Lives Through Weight Loss

 Thousands of patient records had been reviewed and yielded an alarming discovery about a previously unknown risk associated with a popular weight loss operation: Suicide in bariatric surgery. Bariatric surgery is a complex surgical procedure concerned with causes, prevention and treatment of severe overweight known as obesity. Bariatric operations are major gastrointestinal procedures which alter the capacity and/or the anatomy of the digestive system.  In simple terms, the stomach is made smaller so as to speed up weight loss. Some bariatric procedures are performed using general anesthesia via a midline abdominal incision. Another method is to use laparoscopic surgical techniques, involving smaller instruments connected to cameras through which they view the operational site. 

There are two types of bariatric surgeries:

1.Restrictive -  This type of surgical procedure simply reduces the size of the stomach, using staples and/or a band, resulting in a drastic reduction in the quantity of food it can ingest.

2.Combined Restrictive and Malabsorptive – This type of surgical procedure reduces stomach capacity and bypassing the upper part of the small intestine, causing a reduction in the number of calories and nutrients which the body absorbs. 

In bariatric surgery, most studies show that the risk of dying is about 1%, and complications strike up to 40 % of obese patients. Aside from being overweight, these patients usually have health problems, such as diabetes and heart disease, that's why it's no wonder they also have higher death rates from natural causes.

However, nearly 17,000 weight-loss surgeries performed in Pennsylvania from 1995 to 2004 had been reviewed and the findings were startling.  Out of the 440 deaths in the group, 16 were due to suicide or drug overdose, according to the University of Pittsburgh researchers who reviewed the data. About three cases of suicides should have occurred in the group based on the suicide rate in the general population, the study authors say. Even more disturbing is the fact that another 14 of the drug overdose cases that were reported are likely to include some suicides, suggesting that the real suicide rate was even higher. “There is a substantial excess of suicide deaths, even excluding those listed only as drug overdose,'’ the researchers noted.

The New England Journal of Medicine reported last August 2007 about a review of nearly 10,000 bariatric surgery patients by Utah researchers, who compared them to a control group of obese people who had applied for a state driver’s license. Although these surgery patients had a 50% lower risk of dying from disease compared to obese people who hadn’t undergone surgery, their risk of dying in an accident or suicide was 11.1 per 10,000 people.  That statistics is 58% higher than the 6.4 per 10,000 rate in the obese group. The study revealed that the suicide risk was twice as high for surgery patients than for those who had not had surgery, though the finding wasn’t statistically meaningful.

Experts are clueless as to why bariatric surgery patients seem to be at higher risk for killing themselves. Some research suggests a connection between obesity and depression, that is why the typical surgery patient may already be at higher risk for depression and suicide even before the operation. There is a great possibility that depressive symptoms may worsen in patients who have unrealistic expectations about the results of surgery, or who struggle not to regain weight after the procedure. 

The Pennsylvania case review reveals that there is already a 7 percent death rate from suicide and drug overdose signals the need for better mental health follow-up for patients who have undergone weight-loss surgery. Although many weight-loss surgery programs require psychological evaluation prior to the procedure, most doctors seem lenient about making follow-ups after the surgery, as well as patients who prefer to disregard follow-up counseling.

Managing Those After- Birth Woes

 All expecting mothers are scared stiff by the thought of giving birth, even those who don´t admit it, During the nine months of waiting, expectant mothers have their regular check ups, and their physicians  really do their best to calm and motivate the mothers-to-be. Expectant mothers usually buy tons of books and magazines about childbirth, pregnancy and health in preparation for their upcoming baby. They read every detail about pregnancy and child care. 

Giving birth is a magical moment in most mothers' lives, yet many fear it the first time it happens to them. Questions run through their minds like what will happen to them, what should they prepare for, is the baby going to be fine, and a long list of other nagging questions about pregnancy and childbirth. Every woman will experience something different and unique during birth. In the United States and other western countries, the risk of complications is low. But after giving birth, there are changes, both expected and unexpected, such as postpartum depression.

After childbirth, a dramatic drop in estrogen and progesterone may trigger depression. The hormones produced by the thyroid gland may also drop sharply and leave the woman who recently gave birth feeling tired, sluggish, and depressed. Changes in a woman's blood volume, blood pressure, immune system, and metabolism can lead to fatigue and mood swings.  However, some women may experience a deep and ongoing depression which lasts much longer. This is called postpartum depression. Researchers have identified three types of postpartum depression: baby blues, postpartum depression and postpartum psychosis.

The “baby blues” is the most minor form of postpartum depression, Several major rapid changes are brought about by this form of depression including a drop in hormone levels, breast engorgement, and reluctance to return home from the hospital after the delivery. “Baby Blues” usually start one to three days after delivery. It is characterized by weeping, irritability, lack of sleep, mood changes, and a feeling of vulnerability. The baby blues are not an illness, as they will go away on their own. There is no treatment necessary other than sufficient rest, reassurance, and support from family and friends. 

People often confuse the baby blues with postpartum depression because they have common symptoms. Postpartum depression may appear to be the baby blues at first, but the signs and symptoms are more intense and longer lasting, eventually interfering with a woman's ability to function as a mother. Moreover, some women do not tell anyone about their symptoms because they feel embarrassed, ashamed or guilty about being depressed when they're supposed to be happy about having given birth to a healthy baby.

Postpartum depression is more debilitating than the baby blues. Women with this condition suffer from melancholy, feelings of inadequacy, guilt, anxiety, irritability, and fatigue. Physical symptoms include headaches, numbness, chest pain and hyperventilation. A woman with postpartum depression may regard her child with negativity or disinterest. An adverse effect on the bonding between mother and child may result because of this particular pregnancy and childbirth-related mental and emotional distress. Because this syndrome is still poorly defined and under studied, it tends to be under reported. Estimates of its occurrence range from 3% to 20% of births. The depression can begin at any time between delivery and 6 months post-birth, and may last up to several months or even a year.

Postpartum psychosis is a relatively rare disorder. The symptoms include extreme confusion, fatigue, agitation, alterations in mood, feelings of hopelessness and shame, hallucinations, and rapid speech or mania. Studies indicate that it affects only one in 1,000 births. Postpartum psychosis requires immediate treatment, often in the hospital. When a woman's safety is assured, treatment may begin with antidepressant medications or hormone therapy. 

Experiencing depression after childbirth isn't a character flaw or a weakness. Sometimes it's simply part of giving birth. If a woman is depressed, prompt treatment can help manage her symptoms and enjoy the baby and the rest of her new life as a mother.