Dawn Burke before her gastric bypass surgery at approximately 360 lbs. Photo courtesy of Dawn Burke

Gastric bypass surgery gives many patients second chance

By Casey Clement
Naval Hospital Jacksonville Public Affairs

Dawn Burke once had painful arthritis that caused her to limp, chronic asthma and high blood pressure. She was uncomfortable sitting in booths at restaurants and had difficulty finding clothes.

But that was the old Dawn Burke. The new Dawn Burke is 180 pounds lighter and 73 inches smaller. Burke is literally half the person she used to be. After completing the necessary requirements, Burke had gastric bypass surgery at Naval Hospital Jacksonville in November 2000. Thanks to the procedure, Burke has been given her life back. Her blood pressure has returned to a normal safe level and her arthritis pain has lessened. Burke has not had an asthma attack since before her surgery in 2000.

Burke chose to have the procedure done at the Naval Hospital Jacksonville rather than being sent to a civilian hospital in Gainesville, Fla., a decision she does not regret. She is extremely satisfied with the care she received before, during, and after her surgery.

The results from her surgery and hard work are remarkable. ''I believe gastric bypass surgery is a tool that gives people the opportunity to get it right the second time around,'' Burke said.

Burke continues to participate in the gastric bypass program at the Naval Hospital Jacksonville through support group meetings and as a sponsor to new candidates for the surgery.

Naval Hospital Jacksonville was the first Navy hospital to have an organized gastric bypass program. The gastric bypass program at Naval Hospital Jacksonville has performed about 300 procedures, according to Dr. Miguel Cubano, director of Naval Hospital Jacksonville's Gastric Bypass Program. The only other Navy hospital performing this procedure is the Portsmouth Naval Hospital. The gastric bypass surgery program at the Naval Hospital Jacksonville has had remarkable results in the years it has been performed.

Gastric bypass surgery is a major procedure and must be taken seriously. There are strict requirements patients follow to even qualify for the surgery. There are several specific guidelines the patient must complete over a five-month minimum. First, the patient must consult with their general practitioner and receive a referral to Cubano. After meeting with the potential candidate, Cubano refers them to Noemi Massari, the case manager for the program.

To qualify for the surgery the patient must have a Body Mass Index (B.M.I.) of 40 for their height, age, and sex, which is roughly 100 pounds overweight. They also must provide documentation of failed attempts for other obesity treatments such as diet and exercise programs, or the Xenical program. Xenical is a Food and Drug Administration (F.D.A.) approved drug, which blocks the storage of fat in the small intestine.

Candidates for gastric bypass surgery must be less than 55 years of age. Having other medical conditions such as hypertension, diabetes, and chronic respiratory problems help to qualify a patient for the surgery.

Blood work is conducted to see if there are any conditions that could complicate the procedure. Some conditions that immediately disqualify potential candidates such as alcoholism, history of ulcers, and anemia.

After being accepted into the program, the gastric bypass candidate must complete the ShipShape program at the Wellness Center. The ShipShape program teaches candidates healthy food shopping and encourages activity. Lt. Cmdr. Tina Key of the Wellness Center said that long-term maintenance is crucial, and encourages making smaller more manageable changes in their lifestyle. The program stresses behavior modification. The Wellness Center also has patients complete a mandatory health fitness assessment. Surgery candidates must also complete a psychological evaluation.

Candidates must lose 10 percent of their total body weight before the procedure. This shows their ability to lose weight and their commitment to the program.

There are monthly group support meetings before and after surgery. The program teams up candidates for surgery with patients that have already had the procedure. Massarri said, ''These patients act as a sponsor and enhance group support. It gives the candidate someone they can call with questions and concerns.''

During the procedure the stomach is reduced to 50 ml. and then reattached to the small bowel. Gastric Bypass surgery usually lasts between three and five hours. Naval Hospital Jacksonville also offers a laproscopic gastric bypass surgery, which is less invasive and involves less scarring.

According to Cubano the most common complications from gastric bypass surgery are hernia and wound infection. A more serious complication is a leak from the anastomosis, the area where the stomach has been reconnected to the small bowel. The post operation follow-up care is done every few months for up to 18 months after the surgery, and the vitamin B12 must be taken for the rest of the patient's life.

Massari believes that gastric bypass surgery has more than just physical benefits. She has found that patients usually become more social, and many return to work or go back to school. Others choose to volunteer. Many patients feel as if they have a new lease on life.

In Burke's case it gave her the courage to make a career move after seven years with the same employer. She felt more confident and marketable in her field. She continues to be thankful for the opportunity the gastric bypass program at the Naval Hospital Jacksonville has given her.

For more information, call 542-7098.