PWS AND GASTRECTOMY EXPLAINED
It was at this time that we met a relative at a family function, who told us about bariatric surgery. We had not heard of any child who had undergone this surgery, but we were desperate to save our son’s life and were willing to consider any option. We also realised that we had no other way of saving Rishi. He was slowly dying and we had tried diets and failed.
In July last year we made an appointment at the Asian Bariatrics hospital in Ahmedabad, western India, where doctors conducted a detailed check-up and concluded that Rishi’s condition was serious and required surgery. I had to dip into my savings to pay for the surgery, which cost Rs300,000 (about Dh18,220).
“I do not suggest putting Rishi on a diet because you have already tried it, and it has not worked,” Dr Mahendra Narwaria, the surgeon, told us.
“Rishi is dying because he is putting on weight so drastically. He is suffering from sleep apnoea and also experiencing severe problems related to breathing because of his weight. There are risks involved when going ahead with surgery, but he is in a serious condition, so we have to take this extreme measure.”
We were in a dilemma after we heard the doctor’s prognosis. We were terrified that we would make a wrong decision. At the back of my mind we were scared that the surgery might go wrong. We discussed it with our friends and family, who were very supportive. They knew how much we’d tried to control his eating and to help him lose weight and that we had failed. They too agreed that we should go ahead with it.
Finally, in August last year, we agreed to the surgery.
Rishi had no idea what was going on. “Doctors are going to drill two holes in your stomach and check where you are hiding all the jalebis,’’ we told him, so that he wouldn’t be worried. But we were really scared. We had to force ourselves to smile as Rishi was wheeled into the theatre for surgery at the Asian Bariatrics hospital last September.
Dr Mahendra performed a twohour operation, where he removed Prader-Willi syndrome (PWS) is a genetic disorder that can result in a number of physical and behavioural problems. A key feature of the condition is a constant sense of hunger that the patient feels.
A gastrectomy is done under general anesthesia. A cut is made in the abdomen and part of the intestine removed. By making the stomach smaller, it fills more quickly. This may help the patient eat less. However, gastrectomy is only an appropriate obesity treatment when other options have failed, say experts.
Sources: www.mayoclinic.org, www.healthline.com 70 per cent of Rishi’s stomach. Those two hours dragged on. We tried to be strong and prayed that our little boy would survive. “We’re doing the right thing,” I told Henna, who was in bits.
While the gastrectomy would not cure his condition, it would help control it to a certain extent, because he would eat less and thereby lose weight. This would improve his life because he would be able to exercise, play games and do all the things children his age do.
Finally the operation ended. “He’s in recovery,” the surgeon told us. “You can see him soon because the operation went well.”
Rishi was in intensive care for three days. He was fine but sedated.
On the fourth day, he was put on a liquid diet of fruit juices and nutritious smoothies. A week later he was back home and within the first month he lost 3kg.
Importantly, he did not complain of hunger and did not seem to be missing his regular large meals. There
Initially we were terrified that we’d made the wrong decision by going ahead with the surgery, but now we know it was the right choice. I see my son swimming, cycling and running and enjoying life again. That is a wonderful feeling.
Rishi no longer tires easily. However, there are days when his craving for his favourite jalebis kicks in. Whenever he sees other children eating, he wants the same. We indulge him, but with very small portions.
Rishi has to lose at least 6kg before he’s classed a normal weight for a child his age.
Dr Mahendra admits he believes gastrectomy is not always the right option for children so young, even though he encouraged us to go ahead with the surgery. “Rishi suffered severe difficulty in breathing while sleeping where his oxygen saturation levels dropped below 60 per cent leaving him gasping for breath. Generally, we would avoid bariatric surgery in such a young child, but his problem could have been fatal,” he told us.
“I would say it’s better for such young children to be put on a strict diet and learn a healthy lifestyle. But in the case of Rishi, surgery was the only option left.”
Doctors are also monitoring Rishi’s PWS and have told us that it is under control.
We are so glad that everything has turned out well. We just hope that Rishi’s appetite doesn’t grow again as he grows older. We hope he won’t have to have any more surgery.