 14-year-old Kayla Shoopman has braces. She’s had them for three years, but a lot of people didn’t know it. Before Kayla underwent bariatric surgery at Lucile Packard Children’s Hospital at Stanford, she didn’t do a lot of smiling.When Kayla’s weight had reached 305 pounds, feeling depressed and withdrawn were the least of her problems. Often she would stop breathing during sleep, a condition called sleep apnea, which went undiagnosed for a year. To treat her sleep apnea, Kayla had to sleep propped up and wear a mask and nose piece at night to regulate her breathing. Her lack of sleep led to fatigue and short term memory loss. She had high blood pressure and swollen legs that were hard to move. Sometimes she couldn’t feel her feet. Worst of all, she was borderline diabetic. Beginning her freshman year at a new high school also presented problems. Kayla needed her own table and chair because the normal chair with an attached desk unit could not accommodate her large frame. Her clothes for gym class had to be special ordered and her band uniform simply never fit. She needed a doctor’s note to exempt her from regular physical education activities. She couldn’t make it to her locker between classes because she couldn’t walk fast enough, so she started pulling a black wheeled suitcase around instead. All the things that made Kayla different also made her a target of ridicule. She had few close friends, and she’d had enough.  Kayla wanted the same bariatric surgery that had helped her mom, Marion, reduce from 260 lbs in 2001. The Roux-en-Y gastric bypass procedure reduces the patient’s stomach size, the connection between the stomach and small intestine, and the amount of food the patient can eat. But the evaluation process that qualifies an adolescent patient for bariatric surgery is rigorous.Only patients with a body mass index (BMI) of 40 or higher with severe obesity-related complications are considered for surgery. Those who meet such criteria must also prove that they have made medically-supervised efforts to reduce their weight by other means for at least six months. They must undergo extensive psychological evaluations before and after surgery. And most importantly, they must commit to long-term follow up care and lifelong dietary, exercise and medical guidelines. Finding a hospital that performs the surgery is another hurdle. Lucile Packard Children’s Hospital is one of the few children’s hospitals that offers bariatric surgery to adolescents, and the only one on the West Coast. Packard Children’s performs this procedure laproscopically, a less-invasive procedure that results in a faster recovery. Drs. Craig Albanese, Sanjeev Dutta and John Morton performed Kayla’s bariatric surgery in March 2006. Following a high protein, low carbohydrate diet, Kayla lost 70 pounds three months after her surgery. But she is clear that it’s not a walk in the park. “It takes a lot of determination and a lot of support. If you want to stay healthy, you have to work at it constantly,” she says. “You have to eat the right foods, take the right medicine and exercise.” She knows that without following strict guidelines, she can easily slip back to her previous weight, or more. Kayla understands that her bariatric surgery was only part of the solution. “What you choose to do – how you use the surgery – is how you fix the problem. You can’t just have the surgery and then do nothing.” Since surgery, Kayla’s sleep apnea and leg problems are gone and her blood pressure is normal. She’s happier, more talkative and feels less shame. “I’m not afraid to go outside and do stuff,” she says. “I look in the mirror and see that’s almost who I am. I’m on my way. I used to look in the mirror and say ‘that’s not me’.” Kayla’s bi-monthly support groups at Packard have put her in touch with other teens who have also had bariatric surgery, and they e-mail between meetings.
Kayla’s nurse practitioner and surgical coordinator, Susan Farrales-Nguyen, tells her, “You’re such a different person on the outside, but on the inside you’re the same wonderful person you’ve always been.” These days, Susan says, Kayla is “glowing. She smiles from ear to ear.” Kayla’s braces sparkle. She recently cut her waist-length hair into a bob. She’s lighter on the outside, and on the inside, too. Kayla says, “It was really worth it all.” View a Windows Media Player or QuickTime video of Kayla talking about her pre- and postsurgery life. Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.
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