Cardiomyopathy and Bariatric WL Surgery

I am 28 years old and was diagnosed with dialated cardiomyopathy after the birth of my second child last summer. I have been having a hard time getting the weight off and I am up to 236 pounds and I am 5'3 in height.
When I had an echo done my ejection fraction rate was below 30 about 6 months ago. I had a subsequent echo done and my EFR was between 40-45. I had a catherization and I don't have any blockages which they said was good. I had a stress test 2 weeks ago and I achieved up to 86%.
I am trying to have bariatric surgery and I have been up and down trying to obtain cardiac clearence. My cardiologist was giving me a hard time because he personally doesnt believe in weight loss surgery and told me weight loss should happen the "old fashion way" (diet and excersize)
I am taking Lisinopril and Co-reg which seems to be helping. Any advice? I really need the Weight Loss Surgery. I have borderline glucose levels, hypertension (slightly controlled with the meds), and arthritis.

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If you were 336, I might agree with the surgery, but you might try other avenues, first. Have you looked into Medifast or Optifast to jump start weight loss? They are not a long term solution, but you could lose 20 to 30 pounds the first month, then ease into a more realistic diet and exercise program. If you get the surgery, you'll be spending the first month or so on a liquid diet anyway. There's also a lot of throwing up involved after the surgery and it is not as easy as you might be led to believe.

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I have tried every diet.. you name it, I have tried it. Including different diet pills.. it doesn't work. Or.. I lose weight and then I gain it back or I gain more weight back. I am practically dead set at having surgery and I am aware of all the risks. 236 is obease and really unhealthy.. no need to be 336.. that would just be insane, but quite possible if I don't have this intervention soon. It's important to me that I lose the weight b/c my overall health will improve including the heart disease. My EFR will likely increase as well. I have small children and I want to be able to be the mother they deserve if I am able to.
Thanks for the feedback anyway.

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I don't think you would have to have your cardiologist approval..I think it mainly is your primary care doctor and the bariatric doctor getting the approval through your insurance (but of course your primary doctor my want you cardiologist to say yes also...You might have to get another opinion from a different heart doctor )....I think no one knows how it feels to be alot over weight unless they are or have been...It is so hard to lose sometimes on your own..and if you are to the point of not being able to do it on your own and you need help then only you and your dr. can decide what is the best route for you....I know I am there also...I am hoping to be able to get lap-band done...which my cardiologist is all for me doing it and has said it would be the best thing for my heart...I have cardiomyopathy and LBBB and MVD and congestive heart failure...I have a pace-maker and fibulator put in last year....If I can get my insurance to pre-approve it I will have it done...I wish only the best for you..and good luck in getting yours approved if that is what you feel it is the right thing for you.....P.S. call your bariatric doctor and talk with their office person that is in charge of what you need to do to get approved...Usually you have to attend a one time class to get all the ins and outs of what you need to do...to get approved...they are a great help in knowing every insurance company and knowing what yours expect of you to do...best wishes for you....Sharon

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Hi Guys,

Lap band surgery isn't a guaranteed permanent weight loss solution. You might loose a bit of weight initially, but unless you are really careful of what you eat/drink the weight can still come back. I agree with BeeBush, if you have the surgery, you will be on a liquid diet for a while anyway, so why not give Optifast or something similar a go first. You have nothing to loose....except some weight :-). I have struggled with my weight my whole life, so understand how hard it is. Be gentle with yourself, and don't look too far ahead. I can't stick to a diet, so what i do, is try to plan ONE days menu. Don't think about having to give up all the good things you like to have. Get up in the morning, have a small/ healthy breakfast, then last as long as you can, drink water, or hot drinks that are low calorie. Then have whatever you have planned for lunch, plan an afternoon snack, then have a small portion of meat/chicken/fish or whatever you like only keep it small, and pile heaps of steamed vegies on the plate to make it look like a big meal. I try to eat what i call a low human interference diet, so don't eat anything that is processed, or if i can't see what it used to be, i don't eat it :-) I fall off the plan, but don't beat myself up about it, just be careful not to think you have wrecked the diet, and start again from directly after the fall off. Don't think oh well i will start again tomorrow. I find i can loose a little bit at a time doing this. And believe me i totally understand how hard it is. I am absolutely not at an ideal weight, and won't be for a long time., but i am making an effort and after all the only person you have to have happy with you is YOU. Good luck, and be kind to yourself.......Hettie

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Another add, ask your primary for a referral to a nutritionist (registered dietitician), also, if your insurance allows. They are educated on the different disease processes and know which foods/calories to recommend.

Exercise is also so important because it will help strengthen your heart along

Be strong. Live strong. You can do it:)

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To address what Beebush said, DreamerGiftGirl's BMI is 41.8. That is morbidly obese. It becomes extremely difficult to achieve lasting weight loss at this level of obesity. Also there are many doctors who "just don't believe in WLS". Also true of many in the general population who call it an "easy way out" or view it as an act of laziness. If dealing with a doctor holding these attitudes, a frank appraisal of the ability to withstand surgery may be impossible to obtain.

Dreamer, you could discuss the issue with your bariatric surgeon and see what he/she recommends. A second opinion from a more open minded cardiologist might be helpful. I had WLS in 2006, before I had heart trouble. It has helped me keep my weight down. Though I am still overweight, I am 100 pounds lighter than my heaviest weight.

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I am skeptical about even entering this discussion because we overweight/obese folks have "no" as the first word on our lips. We are so resistant to defining a change and creating the climate for following that change. The phrase "I can't lose weight, nothing works for me" is the lie we tell ourselves. No one else really cares. This is an internal process. The motivation can be fear of living as a debilitated person.
When I had my SCAD and HA in Dec of 2011 it was not death that terrified me, but the living with a whole host of pains, doctors, hospitals, drugs and isolation.
I made a decision. It is the same decision that recovering addicts make about drugs and cigaretts.
I made the decision to quit eating sugar. Not the sugar that is in blueberries or apples or potatoes, but the sugar that we all know what I am talking about. I was pretty sick with the sugar withdrawl for a few days. The headache was worse than the HA.
After a month or so I ceased to be attracted to sugar. As time passed I ceased to be attracted to alot of foods that I had once consumed. I started liking foods that I did not like when I was eating sugar. My entire food ingestion has changed. I quit eating meat years ago and I never liked alcohol so that was not an issue.
Now I have evolved to juicing during the day and having a fish and vegetable dinner. I eat potatoes with a wonderful sour cream like dressing. I eat some raw foods like lettuce and salad stuff but not in large amounts. I make some geat soups in the winter months. I know it all sounds like "well, that's good for you, but I couldn't eat like that". Once you eat like that it becomes what satisfies you. It is not instantaneous.
I do exercise and have for many years, no matter what I weighed.

So now, 6 months after my HA, I am down 75 pounds with another 20 to go. I do not think that I will eat any differently when I am satisfied with my weight.
One thing I DO know is that if I eat sugar again I will get fat again. Sugar is poison for me. It is a drug for me. It will kill me because I am self destructive in it's world.
I can go out now and eat a big old plate of french fries, which I love, and not have any craving for more. I can eat things that I really love and not be triggered into self destructive behavior.

I am 63 and now have the blood profile of a youth. Cholesterol 122, BP 112/70, trigly60,glucose 82. I may die tomorrow but today I feel excellent and am no longer one of America's 69% of fat people. It was not a good group to belong to.

I do not believe that bariatric surgery will solve the issues that promote the weight. And it could really screw up your health in ways that you cannot imagine at this time.

If anyone wants to talk to me about this I am here. Laurie

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I am hopefully getting the sleeve. I considered lap band or the realize band, but I hear they are not always effective. The sleeve is supposed to be really effective.

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Thank you for the advice. I certainly appreciate it. I am going to seek a different cardiologist next week and keep my fingers crossed. I am hoping to get this done as quickly and as safely as possible.

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Gastric sleeve does preserve the pylorus which helps you avoid some of the complicating effects of gastric bypass, like dumping syndrome. Good luck.

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ok I can comment here with expierence. I was where you are now 1 1/2yrs ago, pushing for weight loss surgery. I jumped through all the hoops to meet cardiac clearence. I had a lap band placed. I DID NOT LOOSE ANY WEIGHT!! It was a failure for me. Now i have a possibility of band slippage and the port has a leak. Recently I was having pain at the port site and sought help with my surgeon. She sent me onto another surgeon who does conversion to the sleeve. I went to see him and had a consultation. After about 2 days, the doctor called me to advise I am too much of a cardiac risk and his anesthesiologist partner would not operate on me!! So they passed!! They recommended I see a bariatric surgeon at the University of Washington. (Dr #3 if your keeping track) The U of WA has 24/7 cardiac services and is a transplant center. Now I had planned to go see this doctor at the U, but I was having issues with missing work and could not go. So to summerize, I have a plastic band on my stomach that is not in the right place and a port that has occasional issues. I also have a ICD onboard. You should check out the "failed band" videos on U Tube. I did not do this until after I had this surgery and deeply regret not thinking this through. Consider the sleeve procedure carefully as well. Once they remove a part of your stomach, it's gone and you cannot go back to the way it was before surgery!!! I am on the same meds you take and have a simular EF (28 at last test).
Also my brother also has cardiomyopathy and had gastric bypass surgery. At first he lost a ton of weight. But now he has gained back alot of weight. So his stomach stretched. :/ It has not worked out well for him either.

Sorry it rain on your parade, but the suggestion to continue to work on your diet & excersize is the bast natural thing for the body. I wish I had NEVER had the band placed and worry what damage I am doing to my body. The band creates friction on your tissues and creates scar tissue. I cannot afford more medical bills to un do this band problem. So please re consider surgery.

Best of luck & huggs. Send me a message if you have more questions.
MC

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Hi,

I had a short period when weight was a problem but it had nothing to do with my diet. But I have a friend who was having a really hard time loosing weight . I would talk to her and talk to her but we all have our turning point. You are very young yet and have so much life ahead of you, I have a question for you. What is it worth to you to see your children grow up? Your cardiologist is right, there is an underlining reason why your weight is going the way it is. I smoked with asthma and looked at them telling me to quite as a joke. Dec. 2, 2010 I suffered an AMI, I've lost the lower chamber of my heart and am in stage III of CHF. The fastest way to stage IV or end stage is to light up another cigarette. My friend two months behind me suffered a massive stroke. We both almost didn't make it.

What your cardiologist is telling you is you most do a lifestyle change, it is what my friend and I had to do. If diets are keeping you on a see saw with weight the surgery is the last thing you want to do. I knew some one and I will stress the knew part so that you understand that it is in the past tense. She was doing all the things that you are doing to loose weight and finally she had a doctor agree to the surgery and she was not willing to do the lifestyle change. It was good, really great for about six months but she still failed to address what had caused the eating problem and she went right back to her old eating habits. Warning didn't help because she felt the surgery was going to stop her from gaining weight. But what she gained through surgery tore open and killed her.

Please, for me for your children do a lifestyle change, it will work. If you need some one to talk to I'm here and I believe in YOU.

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I am interested. I have 4 stents and need to take better care of myself. One of issues is family and attitudes. Where did you get your soup recipes. I joined Weight Watchers for the social aspect/support but have not been able to attend. I have pretty much tracked down the origins of my depression and go for therapy. I am raising my 10 year old granddaughter which I have had for 4 years. My husband's attitude is if I can walk I can work. Not much recovery time or rest time am I allowed. I am beginning to hate him. I used to drink a lot of wine at night just to numb myself from his continuing complaints about whatever, flip a coin and that could be the issue. Whine versus wine. Back to not doing that.

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Had to make a comment myself. I have considered doing this as well. I was recently told by a family member that if I wasn't fat I wouldn't be sick with DCM and CF. If I just loose weight I would instantly be better. Needless to say this family member doesn't get heart disease at all. My Dad's family had problems with their hearts. Mine is somewhat heredity. Tried to explain that the dilation of my heart is NOT going to decrease. I have cried a lot about his and I am trying to eat better. But because of a lot of my heart meds like COREG I am tired and the weight is there. It really just doesn't go up or down but I am obese for my height. A word I truly hate. I have gone to a nutritionist and gotten advice and I know the so called simple solution is eat less and move more. Well, I am fifty seven years old with lots of arthritis in my feet back, knees etc. I try to walk some but seems I hurt badly after doing so. Maybe this is an excuse but I also have had a knee replacement. I don't know what the solution to this is and yes I too have taken diet pills and lost twenty pounds. I have had many friends who tried the weight loss surgery and had all types of complications my niece almost died as they cut into her spleen.

I too would like to loose weight. There are my days I would like to throw out my heart meds. I will need a heart transplant if I am blessed enough to have one. I will have to follow and am following a very scary journey. It has been eleven years of being stable for that I am thankful.

Thanks for letting me vent and I hope some of what I said makes sense to my heart sisters.
Hugs.

Love,
Donna

I

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Donna, it is so frustrating not being able to exercise the way I'd like to. For me it's angina and fatigue that hold me back. I do not take a beta blocker. As far as I can tell my fatigue is not med related, but nobody has figured out what causes it. The last time I had this kind of flexibility with my time was in grad school. I walked all the time then, by choice. I walked 10 miles a day sometimes and walked a significant amount every day. I'd love to be able to do that now. My dog would love it too! There's a coffee shop about a mile and a half from here with a wonderful deck. If I could, I'd walk here there every day and sit on the deck to read or knit and enjoy a drink then walk back. There is also a network of nice trails in the park right next to my apartment. We walk some on that, but I can't really get out and explore it. Sigh.

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Weight Loss Surgery can be a solution especially when you are having heart problems with being tired and lethagric all the time. I read a study about 2 women who were extremly obese about 300 pounds +... so they both had significant issues with their heart and needed transplants, but it was too risky with their hearts being so bad and being so overweight. They had ejection fraction rates of below 20.. so the doctors figured they could successfully give them heart transplants after they got some weight off and they decided to give them weight loss surgery with a lot of supervision b.c of the heart conditions. Both of them did well and lost a significant amount of weight. Their injection fraction rates improved after about 3 months one to over 30 and the other to over 40 and they decided neither of them needed the heart transplant anymore.
I hear the horror stories of lap band and I understand that there are risks with weight loss surgery.. but there are risks with any surgery. There are risks with everything outside of surgery. I try to weigh the pros and cons and I think about my children 2 years old and 9 months old. They deserve to have a mother that is healthy and that can keep up with them. I want to run with my children and play with them. If I continue to live the way that I am living then its like Im not really living at all.
I keep God in my heart and I pray all the time. I ask him for a path.. I am hoping that since this is the path that I am on, maybe this is it. I hope all you ladies will pray for me that my weight loss surgery is a success and that I recover very well. I am so greatful to each of you for sharing your stories, concerns, worries, and encouragement.

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Yarnkitty,

I understand your frustration. I have many trails etc around me to walk at. I have a mall but I hate doing that. I have been overweight all my life and heart disease has made it worse for me. My fatigue level is high as I take 100 mg daily of Coreg. An amount my local heart dr. didn't think I could handle. My EF is 25. I tire easily I could cry most days. People look at me and wonder why I DON'T WORK EVEN THOUGH I DID FOR THIRTY YEARS.

It is not easy being disabled. I hate it and it has been five long years of SSD. I got sick at age 46 yrs. old from probably a virus, hereditary issues and stress. I was sick a lot longer than I let on. Short of breathe. I understand dreamergiftgirls need to be there for her kids. I don't have any. I am not certain I will ever have a heart transplant either though I pray I will. I promote organ donation to everyone. But many people don't get organ donation and they never think they are their family will need it. I am proud to say I am an ORGAN DONOR. They can have any organ that can help someone else after I am gone.

I too pray a lot for many things. I am trying to change my eating habits but I am a stress eater. I do some days push myself and pay for it for a couple of days. I try to live every day to the fullest because EVERYDAY IS A GIFT AND THAT IS WHY WE CALL IT THE PRESENT. I am thankful for the ones before me like Denise DeMarco who got the greatest gift a new heart and continues to do well with it.

I know they would never clear me for weight loss surgery and I have seen SO MANY BAD sides to it. The drs. make it seem like it is no big deal BUT YOU MIGHT NOT SURVIVE THE SURGERY. I have had many surgeries and survived them but the drs. have to take extreme caution when doing them. I have been removed from the OR because of my DCM and Blood pressure.

I have to weight the risks and for me now the answer is no. Any one who is thinking of having this type of surgery should research research research before doing ANYTHING. I understand the frustration.

Thanks again to all my heart sisters for letting me state my feelings. I know sometimes they are not always well received but please know that I do it with love in my HEART. HUGS TO ALL WHO CONTINUE TO FIGHT THIS HORRIBLE DISEASE.

Love,
Donna

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I too once spoke those exact same words as you my friend regarding not being able to lose weight. I convinced myself that it was impossible until I joined the Weight Watchers plan. It is the ONLY plan that my doctor would endorse and it is proven effective.

There is no magic pill to losing weight but rather it is as simple as burning more calories than you take in and you will lose the weight. If you take in more calories than you burn, then you will gain. Losing weight is not rocket science. There are very few peeps out there who cannot lose weight when sticking to a plan...and I mean really sticking to a plan!

Best wishes to you my dear no matter what path you choose.

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I wanted to make sure I came back here before this discussion closed to Thank all of you wonderful and kind ladies for your advice and input to my original post. I am happy to report that I am starting to feel tons better and I recently had the weight loss surgery sleeve on the 17th of July. I am hopeful that after I see some weight loss that I will be able to have a stronger and healthier heart.

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Congratulations! I hope your recovery goes smoothly. Walk a little each day and your endurance will improve. Take naps. That was a big surgery.

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