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Category: Obesity

Shared Success: Kriston & Shirden

August 27, 2015 5:27 am

My wife, Kriston, and I have struggled with our weights for most of our lives. Over the years we have tried dieting, exercise, medications, and so on….with no luck. A few years ago she started to bring up the idea of weight loss surgery as a possibility. This was an idea that I was dead set against partly for fear of having major surgery and partly because it felt like cheating to me. In my mind, I believed that I should have been able to lose the weight if I really wanted to do so. Kriston continued to bring up the subject. She talked about friends who had had the surgery and how well they were doing with their weight loss. I still resisted the idea until she made the argument that if we didn’t do something about our weight then we might not live to see our daughter grow up and have children of her own someday. That was when I realized that I had to investigate the surgery and what it entailed.

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Before Duodenal Switch
After1
After Duodenal Switch
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Sea Kayaking

We made an appointment to meet with Dr. Keshishian for an orientation and listened to him as he talked about the problems many people have with weight loss, obesity, genetics, metabolism, what surgeries were available, and the pros and cons of each of them. After meeting him and learning about the surgeries and obesity, I felt very confident that this was the man that could help us with our weight loss struggles. We decided to go with the Duodenal Switch and I scheduled my surgery for June of 2013 and Kriston scheduled hers for November of that same year. We felt this would allow me time to heal and then I would be able to help Kriston after her surgery. I won’t go in to all the details of the surgeries except to say that they both went very well. My recovery was a bit rocky, my wife will say that I was a big baby, but I did recover. I will admit that she was a much better patient than I. Fast forward two years and we are both doing very well. I have lost 180 lbs and Kriston has lost a little over 100 lbs. We look and feel great and we enjoy a much happier and active life style, we even went ocean kayaking last week which is something I could have never done at 370 lbs. This surgery has changed our lives and we could not be happier. We will be forever grateful to Dr. Keshishian, and his incredible staff, for all that they have done to help us become the healthy and happy people we are today.

Shared Success Story- Kylie

June 08, 2015 6:29 pm

I never knew how big and unhealthy I was until I decided I wanted a change. My experience with Dr. Keshishian and his staff was nothing less than amazing. He was very informative and made me feel comfortable and safe when undergoing the procedure. Not only did he operate on me, but also my brother, dad, and uncle as well. We are all so grateful for him and his knowledge as a surgeon. My mom had gastric bypass in 2005 by a different doctor and has numerous problems. We are all hopeful that eventually Dr. Keshishian will be able to help her also. Having my whole family’s support and understanding made the experience much easier for me. I am now happier and healthier than I’ve ever thought I’d be.

Before surgery, I weighed 250lbs, and my pant size was a 22. I now weigh 160lbs with a pant size of 8-10. I decided to have surgery because I wanted to be the confident girl who was trapped inside a 250-pound body to be able to shine. I wanted to be active and live a long and healthy life. I also wanted to start this lifestyle now so that when I have children one day, I can be a good example to them on how to be active. Most importantly, I wanted to be comfortable in my own skin. I wanted to feel beautiful. I was always “bigger.” I was a cheerleader from toddlerhood until high school and a swimmer for 12 years. I always stayed very active. Once I graduated high school, I moved out of state to attend cosmetology school and my active lifestyle completely stopped. I ate unhealthy and became very lazy. I wasn’t proud of the person I was becoming and struggled to change my bad habits. My brother had his surgery while I was in Idaho, and when I saw how great he was doing, I was inspired. I decided to fly home and meet these people and then it was my turn.

My Life has changed dramatically since I first met Dr. Keshishian. Working out and eating healthy have become habit. I ran in my first 5k, 10k, and half marathon. I continue to run every day in hopes of running in a full marathon. I LOVE to run, and have made it a way to relieve stress. Running has become good therapy for me. I love cooking and experimenting with foods I didn’t even know existed before I had surgery. It’s been 2 years, and I still haven’t bought or had a soda. I eventually gained what I call my “gym family.” I am there so often, that eventually, most of my friends were from the gym and people who have similar goals.

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This surgery affects everyone differently. For me, it was a game I had to play with my mind. Being big, I loved the satisfaction of feeling full after a meal. I would order food and try to decide if it was enough to make me full. After surgery, I would forget that I couldn’t eat that much. I would still want to order the item with the most food. It was almost like the “Old Kylie” was still sitting in the back of my mind telling me what I would have ordered before my surgery. I had to learn to be tough, and ignore her. That was (and sometimes still is) one of the hardest things I’ve had to do. I would look in the mirror and still see a 250 pound girl. I had to have a mental talk with myself, and look at old photos. It was a temporary issue I had with myself. I’ve learned so much about who I am since the surgery, and am so happy with the woman I have become. Having this surgery has made me feel like I can conquer anything I put my mind to. I had no idea how mentally strong I was until I made the choice to have this procedure. This will always be one of the best decisions I’ve ever made for myself, and I’ll always be supportive of others who are thinking of choosing the weight-loss surgery. I owe Dr. Keshishian so much for giving me my life back. Thank you!

Gastro-gastric fistula after gastric bypass operation

May 10, 2013 9:09 pm

One of the complications of gastric bypass is a gastro gastric fistula. This happens when a connection between the gastric bypass pouch develops to the remnant stomach. In a gastric bypass operation, a very small pouch is created from the stomach, and connected to a segment of the small bowel.

The purpose of this operation is to decrease over 95% of the volume of the stomach. In theory, the benefits of this is to reduce the volume of food that can be consumed. Over time, the size of the stomach pouch, and/or size of the gastro-jejunostomy anastomosis might stretch. This result in weight regain that is very commonly seen in about 3 years after a gastric bypass operation.

Gastro-gastric fistula after gastric bypass operation
alt="Gastro-gastric fistula after gastric bypass operation"
Gastro-gastric fistula after gastric bypass operation
Gastro-gastric fistula after gastric bypass operation

One of the complications of gastric bypass is a gastro gastric fistula. This happens when a connection between the gastric bypass pouch develops to the remnant stomach. In a gastric bypass operation, a very small pouch is created from the stomach, and connected to a segment of the small bowel.

The purpose of this operation is to decrease over 95% of the volume of the stomach. In theory, the benefits of this is to reduce the volume of food that can be consumed. Over time, the size of the stomach pouch, and/or size of the gastro-jejunostomy anastomosis might stretch. This result in weight regain that is very commonly seen in about 3 years after a gastric bypass operation.

Another possible explanation for weight regain may be an abnormal connection that may develop over time between the bypassed stomach and the small pouch that was created. This abnormal connection is known as a gastro-gastric fistula. In a patient who may have a gastro-gastric fistula, the food can travel down the gastric bypass path or enter the bypassed stomach and go down the path of a normal anatomy.
In these cases, the physiological effect of a gastric bypass procedure becomes ineffective.
The treatment that I favor most for correcting the complication of the gastro-gastric fistula is is to revise the gastric bypass to the duodenal switch operation.

Stages of Liver Failure

January 08, 2013 9:38 pm

The liver is probably one of the most forgiving organs when it comes to recovering from an injury. It can take a significant amount of “non structural” injuries and still be able to carry out its function. It is the only solid organ capable of regenerating its volume after a major resection. When a part of the liver is removed, it is within a matter of months that the size of the remaining liver increases to replace the removed portion.

A liver injury can be caused by a number of elements. In regards to weight loss surgery, these elements include alcohol consumption, high doses of Tylenol, excessive weight loss, and the most significant condition called steatohepatitis, also known as “fatty infiltration”. Steatohepatitis causes structural changes in the liver. Over time, the structural changes cause the liver to progress to an end-stage liver disease that requires a transplant. Structural changes to the liver injury are irreversible.

The healthy liver is normally soft and beefy-red with a very smooth and shiny outer layer.

How does steatohepatitis harm the liver? As the fat concentration of the liver increases, the liver loses its sharp edge and becomes distended with small pockets of fat that are visible as yellow satellite lesions.

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The healthy liver is normally soft and beefy-red with a very smooth and shiny outer layer.

How does steatohepatitis harm the liver? As the fat concentration of the liver increases, the liver loses its sharp edge and becomes distended with small pockets of fat that are visible as yellow satellite lesions.

This is gross evidence of steatohepatitis, which is commonly known as fatty infiltration of the liver. The most common cause of this is obesity, in addition to medications such as insulin that are used to treat diabetes. If the underlying cause of steatohepatitis is not addressed, then the liver damage will progressively continue to worsen and eventually be resolved in the structural changes to the liver.

If the physiologic injury to the liver continues unabated, it will develop irreversible cirrhosis. An increasingly continuous insult to the liver will result in sudden liver failure, which will require a liver transplant.

Weight loss information

September 22, 2009 4:22 am

I have posted a new newsletter to our web site. It is located here. I will continue to update the information both here and on our website.
I also read an interesting article in Newsweek Magazine dated September 21, 2009. While I know it is not a scientific journal, this particular article had medical sources quoted as the basis of the content. For anyone who believes obesity is just about overeating and lack of exercise, I encourage you to read it. Does overeating and lack of activity contribute to obesity? Yes, but there is much more to it than that. We should stop blaming the patients for a condition over which they may have little control.
Different weight loss surgical procedures have different outcomes, independent of the type of surgical procedure. The long term success and complications of these procedures is summarized on our website.