New Haven Register (Sunday) (New Haven, CT)
Sleeve Gastrectomy Popular Alternative to Gastric Bypass, Dr. Craig Floch Says
In 2021, for the first time in her life, Linda Gilbert felt full. The 62-year-old Milford resident had been on yo-yo diets since she was 10 years old.
“I’m only 5 feet tall, and I’ve battled weight all my life. I was a chubby kid, and I’d go home for lunch, and my mom would give me one hot dog no bread and a cup of cottage cheese,” she said. “I’ve dieted all my life.”
At her highest weight, 185 pounds, Gilbert just barely met the qualifications for bariatric surgery. In order for most insurances to cover the procedure, the patient’s BMI must be 35 or higher, a requirement her surgeon, Dr. Craig Floch, says shouldn’t be the only metric used in coverage. Dr. Floch is the Director of Metabolic and Bariatric Surgery at Hartford HealthCare’s St. Vincent’s Medical Center.
“You have people whose BMI is just a little lower who don’t qualify, but that doesn’t mean they wouldn’t benefit,” he said. “Things like diabetes sometimes completely go away. It’s not that you are curing it, but you are decreasing the body fat, so you don’t need the insulin as much. Sleep apnea and high blood pressure are often resolved so that patients no longer need those medications.”
Indeed, Gilbert’s blood pressure has gone down along with her weight. She’s also been able to stop her cholesterol medication.
“I feel great; I’m 105 pounds now. I run a daycare, and it had been getting harder to get on the ground with the kids. I’m glad I did it. I really am.”
Gilbert underwent a laparoscopic sleeve gastrectomy, a surgery that reduces the stomach from about the size of a football to the size of a banana. This means she has to eat more slowly, and less food, otherwise her stomach will fill up completely, hence her feeling full.
“We make small incisions and go in laparoscopically and staple through the stomach and remove that portion of stomach,” Dr. Floch said. “The piece that we remove is gone permanently. The stomach does not grow back to its full size. It can’t.”
The sleeve is a popular alternative to its older counterpart: gastric bypass surgery. It is far less invasive and has a quicker recovery time. In fact, Gilbert was only in the hospital for one night, and her recovery took just weeks to get over the major hurdles.
“I was in bed the first week,” she said. “The biggest thing was walking. You have a lot of gas after the surgery, a lot of discomfort, and walking helps that. I would do laps around my living room.”
Gilbert’s husband also had the sleeve surgery, six years ago, also through Dr. Floch. He lost 130 pounds and kept off the weight, but that’s not why Gilbert took the plunge. For her, the decision to go for it came while she was on vacation.
“We went to Barbados in March of 2020, and we walked everywhere, and it was so uncomfortable. I hurt everywhere,” she said. “We came back, and I wanted to see if I was a candidate.”
“Excess weight puts wear and tear on your joints,” Dr. Floch said.
“Even if you are not exercising, you’re putting strain on your hips and knees just by walking. By losing the weight, some people who are close to needing knee or hip replacements no longer need the operation,” he said.
Bariatric surgery, however, is not a one-anddone solution. It is an entire lifestyle change that lasts a lifetime.
“You have to develop good habits. It’s not magic,” Dr. Floch said. “If you drink high calorie liquids or snack on high calorie items throughout the day, if you are drinking sugary sodas or eating candy bars and potato chips, you’ll tend not to be successful.”
He says the surgery prohibits people from eating large portions, but some people simply switch
to eating many small meals throughout the day, keeping their calorie intake the same. This, he says, doesn’t work.
“I could put away food. I could always come back for seconds,” Gilbert said. “Now I’m finding that I’m looking for the best because I’m only going to have a couple of bites. Each bite you take, you can feel yourself getting fuller.”
Because the surgery goes hand-in-hand with permanent lifestyle changes, most patients, including Gilbert, must go through a rigorous screening process beforehand where they see nutritionists, dieticians, cardiologists, pulmonologists, and psychologists over a period of months leading up to the surgery. This ensures the patient is being treated
holistically with all their medical information at hand, and is very important in determining success.
“These things help make people aware of what their issues are and recognize them in real time. They guide them through what they should eat, when they should eat, and what some of their triggers are. Most people have some type of trigger that will make them want to eat,” Dr. Floch said.
He says he went into this line of work from general surgery because the techniques became so good that successful outcomes are common, and he likes providing people with that happiness and stability in their lives.
“I see a real need for people struggling, and I know there is a big satisfaction for people who lose and maintain the weight with this surgery,” he said.
As far as Gilbert is concerned, there is no going back.
“Having a smaller stomach permanently was a big push,” she said. “I wanted it done; I wasn’t playing. I love to tell people what I’ve been through, because it’s not easy, but I just passed my one-year anniversary, and they are so pleased with me.”
This is just one example of Hartford HealthCare St. Vincent’s Medical Center bringing more specialists and providers to the community. Tune into the Connecticut Post’s Facebook Live discussion, where you can ask your questions, January 27 at noon. And for more information, log onto WhatWillYouGain.org or call 855.792.6258.