Whole lotta chewin' going on for some

Tuesday, December 21, 2004

By Sarah N. Lynch

Journal staff writer

HOBOKEN - Many people this holiday season will be shoving Christmas cookies into their mouths without a second thought, but for Secaucus resident Dawn Rodriguez, every bite counts. Last January, Rodriguez, 40, had a gastric bypass - a surgical procedure to promote weight loss in which surgeons section off the top half of the stomach into a small pouch and bypass a portion of the small intestine to decrease calorie absorption. After the surgery, patients can eat only between two and four ounces per meal, said Hoboken bariatric surgeon Ajay Goyal, Rodriguez's doctor.

Patients are told to chew each piece of food about 20 times and to take breaks between bites, said nutritionist Karen Kelly, who works with Goyal's patients before and after surgery. This proves to be a difficult adjustment. "I was brought up in the clean plate club," said Rodriguez, who survived her first post-surgery Thanksgiving and now is gearing up for Christmas. "You had to clean your plate before you were allowed to leave the table."

Sitting in the lobby of the St. Mary Hospital Family Practice Center recently, Rodriguez held a plate with an egg-salad finger sandwich, three pieces of shrimp, a slice of watermelon and a piece of cantaloupe. She was one of about 75 of Goyal's patients to attend his first-ever bariatric holiday party - an event where everyone has something in common and where sugary snacks are out of sight.

Although the surgery comes with risks, people who choose not to have it have a much higher chance of mortality than people who do have the surgery, said Robert Brolin, a bariatric surgeon at the University Medical Center in Princeton. Brolin has conducted about 2,500 bariatric surgeries in the past 25 years.

"Recently there have been two major articles published in journals," he said. "(In a Canadian article), it said the surgical death rate is about one percent and the non-surgical death rate is six percent."

Dr. Mike Sarr, a professor of surgery at the Mayo Clinic in Minnesota, has conducted extensive studies on the outcomes of gastric bypass surgery. Complications after the operation can occur, including abscesses, the need for re-operation, wound infections and incisional hernia, he said. There is also a 30 percent chance that the operation will not work in the long run. Overall, however, weight loss operations have been found to reduce health problems associated with morbidly obese people - people who are at least 100 pounds over their ideal body weight - Sarr said.

"The reason we do these operations is to reverse the morbidity of it, so if one looks at diabetes, for instance, that is improved in 85 percent of people and cured in 70 percent," Sarr said. "If you look at high blood pressure, it's helped in 80 percent and cured in about 50 percent." Rodriguez, who once weighed 300 pounds, is now down to 180 pounds and fits into a size 12 - a size she hasn't worn since she was in eighth grade.

"I feel amazing," she said. "It's such a boost. It's an incredible feeling of power. I feel I took control. I made the decision and it's all about feeling healthy and looking good." Goyal requires his patients to continue seeing a nutritionist and a psychologist after surgery. Even before surgery, patients must start seeing a psychologist to change their eating habits and deal with their obesity problem, he said.

Like Rodriguez, Lisa Gebrail, 30, of Bayonne, is facing her first Christmas after surgery. An avid Twinkie fan, she said at first it was tough to stick to the four ounce limit. But exceeding the limit comes with consequences.

"It makes you violently ill," she said. "I'd have diarrhea and I'd throw up. Now, I judge (how much I can eat) by the saucer of a tea cup. If it don't fit on there, it don't fit in me," she said. Unlike Gebrail, some of Goyal's patients have not yet had their surgery. Elba Soberal, a 52-year-old resident of Jersey City, said that gastric bypass may save her life.

Soberal said she had two-thirds of one lung removed about two years ago when doctors erroneously thought she had cancer. Although she's been overweight her entire life, her one lung now makes it difficult to sustain her 295-pound frame, she said.

"My system is such that I can gain five pounds in a day," she said.

Soberal is hoping the weight-loss surgery will improve her quality of life.

"This is my one chance to live a regular, normal life," she said. "I want to dance at my grandson's wedding . It's all or nothing for me right now."

Sarah N. Lynch covers North Hudson. She can be reached at slynch@jjournal.com.