Sometimes you have to lose a little to gain a lot.
The portion of small intestine and stomach that Randy Siford lost during a gastric bypass procedure he had April 18, 2006, was a small price to pay for the profound physical and emotional transformation he has experienced as a result.
"I feel great," said the 54-year-old North Tonawanda native, who has whittled down from a high of 462 pounds to a relatively svelte 290.
"I can go to any store and buy my clothes," says Siford, who manages Ava's Place, a North Tonawanda tavern owned by his mother, Ava.
Ava Siford, along with Randy's sister, Barbara Jean Harper, of Geneva, accompanied Randy to the hospital to lend support on the day of his operation.
Siford said he has much more energy since the procedure. He can bend over and tie his own shoes. He saves a lot on groceries.
"Before, I would eat a whole pizza and still be hungry," he said. He now considers two poached eggs with hot sauce and a cup of coffee a satisfying breakfast.
As the national epidemic of obesity continues to grow, so does the demand for gastric bypass surgery. Rates increased roughly tenfold over roughly the past decade, to more than 140,000 in 2005.
By utilizing the laparoscopic technique, which involves several small incisions and a camera, as opposed to more invasive traditional methods, the mortality rate has been drastically reduced, as well.
More health insurers are willing to cover the $25,000 average cost of the procedure, as it has shown long-term effectiveness in reducing obesity and related health conditions, such as diabetes and high blood pressure.
But far from being a cure-all for obese patients, the procedure, first performed in the 1960s, can also lead to gastrointestinal-tract disorders, anemia and vitamin deficiencies.
Patients considering the procedure as a last resort, after failed attempts at dieting and exercise, may feel that it is an acceptable risk in light of the gains to be made.
A 2004 article in the Journal of the American Medical Association revealed that 77 percent of obese patients in a study experienced a reversal of diabetes following surgery to lessen the size of the digestive tract, 62 percent had their high blood pressure eliminated and 70 percent experienced lower cholesterol levels.
Siford's high blood pressure and constantly swollen ankles have disappeared since his operation two years ago. He also takes vitamin and calcium supplements to stave off potential complications.
Dr. Venkat Kolli performed Siford's operation in Niagara Falls Memorial Medical Center.
Beforehand, Siford had to meet with a psychologist, a nutritionist, a physical therapist and the surgeon, as well as tahe a battery of physical and psychological tests.
He showed good motivation by losing 40 pounds prior to the surgery, to get down to 422 pounds.
His procedure was done under general anesthesia and took roughly two hours to complete.
Dr. Kolli's partner, nurse practitioner Karmell Macoretta, assisted him during the procedure. Although the operation is no longer being offerred at Niagara Falls Memorial Medical Center, it is currently being offered at Buffalo General Hospital, which has been doing the Rouex-en-Y procedure, as the surgery is known, as well as laparoscopic adjustable banding, since 2003.
Dr. Alan Posner, said the Buffalo General program has performed more than 500 bypass surgeries and more than 200 banding surgeries. Gastric bypass procedures also are offered at Sisters Hospital.
Niagara Falls Memorial stopped offering the operation for the foreseeable future due to the lack of a second qualified surgeon on staff.
"Surgery is only a tool," Kolli said. "It's not just an operation, it's a lifelong commitment to a change in eating habits."
Siford, whose stomach is now roughly the size of an egg, could not gorge himself as he once did, even if he wanted to. Due to the operation, which allows food to bypass part of the small intestine, allowing fewer calories to be absorbed, thus resulting in weight loss, Siford feels full after having a very small amount of food.
"I try foods. If it agrees with you, OK," he said. "Now a bowl of soup would make me much more happy that a piece of steak."
Those interested in the procedure can call Buffalo General at 859-3196, and Sisters Hospital at 565-3990. Successful candidates will need a referral from their primary care physician.
Aside from the increased energy he now has, Siford feels many other benefits after having the operation.
"People stop and talk to you more," says Siford, "Best thing I ever did. I wish I had it done sooner."
Charles Lewis is a Buffalo News staff photographer.