DECEMBER 15, 2000
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Courageous Tribal members tell their
story of struggle, pain and change.
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For those reasons, the process of actually get
ting approval for gastric bypass surgery is
a lengthy one. Clients undergo consulta
tions, which includes them proving that
they have exhausted all other options, seeking insur
ance approval (a very touchy subject) and undergo
ing analysis to determine whether their condition is
actually life threatening. The last two parts are of
ten intertwined.
Insurance, in fact, remains a sore issue for
Flannagan.
"Insurance companies always turn it down," he said
rather angrily.
When an insurance company does not approve a
patient, Flannagan said, they could appeal it. Un
fortunately, as no federal regulations exist concern
ing how insurance companies can regard obesity, that
appeal process is often through the company again,
resulting usually in another rejection. In addition,
many insurance companies specifically exclude
weight-loss surgery from their coverage plans.
Flannagan suspects that medical insurance is pro
pelled often by the financial interest of the company.
The one time cost of $15,000 plus that the surgery
usually costs is vastly outweighed by the fact that
many obese people are paying up to $500 per month
in insurance premiums just to cover the cost of their
medications. The demands that companies set in
order to cover bariatric surgery are what Flannagan
calls "a high-jump bar."
"It's a pathetic situation," he said disgustedly.
But it is a situation that Flannagan is crusading
to change. Every year he and other fellow bariatric
surgeons travel to Washington, D.C., "politicking,"
as he says, to get legislature passed that will put an
end to insurance self-regulation. Their trips are
funded out of their own pockets.
Flannagan sees bariatric surgery, especially
gastric bypass, not solely as a remedy for
weight-loss, but as a cure for obesity re
lated diseases and a preventive measure.
"We've been tracking our results for more than 15
years, since June of 1982," he said. "Our records show
the surgery holds up."
Not only do most patients maintain their weight
loss, he said, many of the related illnesses disappear.
"In our diabetic patients, diabetes goes away 95
percent of the time," he said. "Hypertension goes away
80 percent of the time."
"We return people to good health," he said. "They
are reborn."
Shelley Hanson would agree.
"I'm definitely more confident now," she said.
And that confidence shows. Although the finan
cial burden of undergoing the surgery forced her to
close down her plus-size clothing store in Salem,
Hanson regrets little, and embraces a lot of the new
changes.
"I have a new boyfriend," she said, smiling. "Dat
ing is certainly not something I ever imagined I'd be
doing again.
"I just feel great!"
But to be fair, Hanson said, it wasn't easy. As she
nears the one-year mark of the newest chapter in her
life, in hindsight she can say it was anything but easy.
"The first year has been a real roller-coaster ride,"
she said.
Actually, two years if you count the year she spent
on Dr. Flannagan's waiting list and getting screened.
But life following the operation, she said, is a virtual
shock.
"The physical change," she paused. "It triggers so
much mental and social anxiety."
Hanson struggled with depression, no longer able
to turn to food for emotional support. But she found
solace in the monthly gastric bypass support group
offered by Dr. Flannagan.
"It was hard emotionally," Hanson said. "This is a
major life change."
Dr. Flannagan contends that
there are many "individual varia
tions of attitude" following the
surgery. Post-op life will be
vastly different for everybody.
Complications from the sur
gery are minimal, five per
cent of the time. And Dr.
Flannagan is fast approach
ing the 1,000 patient mark,
with a waiting list six
months long.
"We definitely need
more bariatric sur- (
geons, he said, observ
ing that he only performs
maybe four operations per
week.
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The Tribe's own Dr. James Molloy offers his
endorsement of the surgery.
"I'm a proponent of any therapy that is
proven to work," he said. "And this sur
gery seems to work extremely well."
He adds that Native Americans are at a particular
risk for obesity, often having rates from two to ten
times that of other races. But even though he de
fines gastric bypass as "phenomenal" for weight-loss,
Molloy still offers a word of caution.
"People should exhaust all avenues before attempt
ing GBS (gastric bypass surgery)," he said.
Tribal member Marilyn Porter offers testament to
that. .
"If there is any other way to lose weight," she said.
"Go that direction. This is a simply drastic change."
Like Hanson, Porter has struggled with her weight
for the greater part of her existence. She was teased
as a child, a regularity she said that has made her
very shy and introverted.
"I've had to force myself to be normal," she said.
Porter attributes her low self-esteem to obesity. And
throughout her life she has found salvation in eating.
"Food was my lover, my friend, my companion,"
she said. "It fulfilled every emotional need I couldn't
get anywhere else."
Strangely enough though, Porter is also one of the
few people who is simply obese. In other words, she
hasn't gained any of the other undesirable conditions
of obesity, like diabetes or heart disease.
"I am completely healthy," she said. "And for that
reason I had to switch insurance companies to pay
for the surgery."
Porter sought the surgery because she had reached
the landmark age of 40, the year she claims "things
start to break down." The disintegrated cartilage in
her knee is a good example, and has also posed a
major complication since her surgery on August 16.
Having to take up an exercise regimen has been
"painful," yet Porter recognizes the necessity. But
recognizing and accepting the new lifestyle are two
different species.
"They do the surgery on your body," she said. "But
they don't do it on your brain. "The first three months
my head was just screaming 'you need to eat! You
need to eat!'"
Porter not only attends the support group, but she
is undergoing therapy as well. And it almost isn't
enough, she said. Yet like Hanson, Porter has no
regrets about gastric bypass.
"I can't say I'd do it again... at this point," she
said. "But I'm glad I did it."
Porter has dropped 67 pounds since the surgery.
Not bad, really, and interesting considering Porter
confesses she hasn't stuck to the post-op regimen that
well.
"I know I can do it," she said. "Some people breeze
through it, some don't."
Evidently, Tribal member Janell Haller is one of
those people who did.
"Well, some days I felt like crap," said Haller, who
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PERSONAL MIRACLE - Shelley Hanson and other
Grand Ronde Tribal members have found hope in
a relatively unknown surgery that may have
saved their lives. "It's a miracle," said Hanson
of her new body and healthy lifestyle. The sur
geon who performed the surgery on Hanson and
others will be in Grand Ronde in early January
for an open forum and discussion of the risks
and benefits of gastric bypass surgery.
had gastric bypass surgery May 17. "But over all,
I've haven't had all that tough a time with it."
The surgery was more of a must for Haller, who at
the same time had surgery for chronic gall bladder
problems. She had gone up and down for most of her
life, but sailed through some particularly rough wa
ters when her father, Pete Grout, died in February of
1998. He died from diabetes at 67 years old.
"After my dad died, I gained 80 pounds," she said.
"Food filled a void for me."
She also realized that at the age of 45, some changes
were in order, for the sake of her daughter.
"I did it for Cody," Haller says. "I want to see my
grandkids."
Her weight has gone down and she feels great.
"To know this is final is wonderful," she said. "I
don't have to live with the fear of putting it (weight)
back on."
Haller believes that Native Americans have been
hit the hardest by obesity compared to other ethnic
groups. And she despises the stigma that invariably
falls upon them.
"The perception that fat people are heavy because
they're lazy. ..." she shakes her head in contempt. "It
pushes people into the wrong environment, it lowers
their self-esteem."
And Haller has little doubts that obese people are
discriminated against. But she, like others, is con
vinced that redemption is on its way, and that a new
day is dawning.
"At our support group, we had Marilyn Porter," she
said. "And to be honest, that was the first time I'd ever
seen her smile. . .and she has smiled a lot since then."
Haller grinned, and nodded her head.
"You could see hope in her eyes."
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For more information on Gastric Bypass Surgery:
Shelley Hanson
503 879-3737 or e-mail: shansonwvi.com
Oregon Center for Bariatric Surgery
655 E. Eleventh Ave., Eugene, Oregon 97401
541-687-1445 or www.oregoncenter.com
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