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Surgery offers mixed blessings

She wears denim and a smile as she does a model's half-twirl.

"I don't look like I ever weighed 335 pounds, do I?" Jackie Boiman says, holding her denim jacket away from her waist. "I feel great. I'm about 188 now, and 30 pounds of that is excess flesh."

Two students crouched over laptops nearby lift their heads to listen. In the quiet, nearly deserted snack bar at the Touro University School of Osteopathic Medicine in Henderson, Jackie's pronouncements might as well have been made with a bullhorn.

I visited Touro the other day because Dr. Weldon Don Havins, a professor there and a former president of the Clark County Medical Society, told me Jackie had a compelling story to share. Havins and I had been talking about the challenges American society has in dealing with obesity, a contributing factor in as many as 400,000 deaths per year.

"She'll really make people think," he says.

The more she shares, the more uneasy you become.

Now 65 with a short salt-and-pepper do, the 5-foot-3-inch administrator recalls that she was about the same weight she's at now when she met her future husband in her 20s.

When she became pregnant about seven years later, she ballooned to more than 240 pounds.

Her way of dealing with anxiety, she says, has been to eat. A divorce and becoming a single mom stressed her so that food became her only comfort. By 2006, at the age of 60, she was more than 330 pounds and headed for 400. She had diabetes and cardiovascular problems.

Weight-loss surgery seemed the way to go if she wanted to live. Doctors saw no way for her to take off more than 150 pounds on a diet. And she had heard good things about the surgery.

I had, too, and wrote about it. Last year I told of how teenager Cody Weiss shed 160 pounds and medical problems with a gastric bypass, where staples are used to make the stomach smaller. I did stress that the procedure isn't something to take lightly: About one in 300 patients dies, and complications that can arise include ulcers, bowel obstructions, and protein, vitamin and mineral deficiency.

"Every complication from a gastric bypass you can get, I got," Jackie says, a grin turning into a grimace.

She ended up in emergency rooms a half-dozen times with dry heaves. Her stomach went into spasms and she needed medication to settle it down.

Ulcers developed and she needed two operations to remove them. Two bowel obstructions also required surgery.

And she needed to go under the knife to overcome superior mesenteric artery syndrome, a condition in which a person vomits after meals because of a blockage of the blood supply to the intestine. About one in three people die from the syndrome.

When her teeth felt "strange," she went to the dentist. A calcium deficiency resulting from the surgery caused her teeth to die. Her teeth had to be pulled and replaced with dentures.

She has no intention of suing her surgeon because she says she was warned about all the complications.

Her health complications haven't been her only concern. Her insurance paid just $5,000 of the $16,000 cost of the bypass and only $5,000 for the additional surgeries. Her medical bills totaled $61,000 and she had to declare bankruptcy.

The more than $20,000 she needs for plastic surgery to get rid of excess skin isn't covered by her insurance. "Skin from my thighs covers my kneecaps," she says. "Hanging skin isn't a pretty sight. I don't know if I'll ever have the money for it."

Jackie still sees her weight loss surgery as largely positive. Her diabetes, she notes, is gone.

"Without the surgery, I probably wouldn't be alive to talk with you right now."

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908.

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