After being diagnosed with diabetes and putting on many kilos, Dan Konu went through an overly aggressive surgery in Turkey and a complication that put his life in danger. After two years of suffering, the rescue was a corrective intervention carried out in Romania. “I made a mistake because I did not complete the documents, did not check the clinic, did not read about the operation. Now I advise everyone who is thinking about bariatric surgery to first check the clinic and doctors,” says the man.

Former athlete, long-time vice-champion in boxing, Dan Konu (40 years old), after tests, discovered that he has type 2 diabetes in the initial stage. After leaving his sports career, he gained weight up to 127 kilograms. He did not think long before deciding to undergo bariatric surgery.

“I had a friend who underwent tummy tuck surgery at a clinic in Turkey. He had an operation, he got rid of diabetes, and I thought that this was the way out: I would reduce my stomach, lose weight and also get rid of diabetes,” says Dan. He arrived at a clinic in Turkey recommended by his friend, went to a consultation where he underwent a series of tests and said he was ready for surgery. “I returned to Romania, gathered my affairs and underwent surgery a month later, on July 8, 2020,” he recalls.

Turkey’s intervention

At the Turkish clinic, Dan spoke to the doctor through an interpreter, but says the doctor didn’t explain in detail what the surgery would entail, how long it would take, and what recovery would entail. “I didn’t ask for details, and that was my mistake. I just went by what my friend told me. I thought it was a normal gastric bypass operation, but it’s not,” says Dan.

The bariatric intervention lasted almost 8 hours, and problems appeared immediately when the liquid treatment, which is recommended after such operations, began. “We had a lot of chairs after every meal. There, I told the doctors that something was wrong, but they assured me that it was nothing, that it was because of the operation, that it was sensitivity,” he recalls.

After a week in the hospital, Dan was discharged from the clinic, although the incisions were infected. He was supposed to return for a post-operative check-up in two weeks, but decided to stay at a hotel near the hospital because he was not feeling well. “I had anemia and I was afraid that something would happen. You see, I was a 127-pound, athletic man who could barely stand on his feet. I couldn’t walk. Where should I go immediately?”, says the man.

“My friends didn’t recognize me”

He went home to Bucharest with still open wounds from the operation. After a month and a half of treatment, the wounds closed, but the indigestion continued. 3 months after the intervention, he returned to Turkey for examination. He told the doctors again about his problem, but they again assured him that the recovery was going well.

No food remained in the digestive tract for more than 20 minutes. Extremely rapid intestinal transit, constant abdominal pain, flatulence, malaise, dizziness and nausea made his life impossible.

In 3 months, he lost 20 kilograms – more than what usually happens after the removal of the stomach. A year and a half after the operation, Dan weighed only 71 kilograms, less than he weighed as an adult. The percentage of fat in the body decreased to 11%, while the optimal value for a man is 15-20%.

The diabetes he suffered from disappeared after the intervention, but when he repeated the tests, other problems began to appear: a lack of iron, vitamin D and other deficiencies. “I was so anemic that I looked like I was dead: my face was black, the muscles “fell off” from my legs and everywhere else. I was depressed, I couldn’t sleep. My friends stopped recognizing me when I met them. After 9 months, I again went for an examination and argued with the doctor. I was very upset that I couldn’t find out what happened. With the tests in front of me, the doctor was telling me I was fine, even though the tests said otherwise, and I looked devastated. For a while, they gave me liquids to drink, but I continued to exclude everything I ate, except for rice,” says the man. In Romania, he underwent a course of treatment with injectable vitamins, which, according to him, put him back on his feet.

“I didn’t think I’d ever get back to normal”

A year and a half after the operation, Dan went to the clinic in Turkey again, determined not to leave until he knew what he had. “The doctor who operated on me gave me several sachets of cholestyramine and promised that I would get rid of this problem. I actually took the medicine right after eating there in Turkey and I had no more stool problems. My wife looked up the indications on the Internet and found that the drug is used for short bowel syndrome or diverticular bowel. When I heard that, I looked up the information about the surgery to see what was done to me,” says Dan.

The operational protocol he received was in Turkish, so he called a translation agency. Although the summary of the surgery report indicated that he had a simple stomach reduction operation, the contents also indicated a small bowel operation called an ileal interposition.

“My stomach shrunk and my intestines moved away, which caused loose stools. I learned this only a year and a half after the operation, sometime in March 2022,” the man recalls.

This is exactly what intervention on the small intestine means: the lower part of it, called the ileum, is “cut out” and inserted into the upper part, which is located immediately after the stomach. In the normal process of digestion, a food lump is processed by the stomach, then the jejunum (the upper part of the small intestine), then the ileum (the lower part of the small intestine), and finally the colon, followed by evacuation. . After the operation, there was a “short circuit” of a large part of the small intestine. The bowl of food leaving the stomach was immediately processed in the ileum, which now went directly into the dilatation of the stomach to be evacuated. Digestion was superficial and very rapid, nutrients were not properly absorbed by the body, and evacuation was rapid and caused much discomfort. Fortunately, however, no part of the bowel was removed, making correction possible.

Operation in Romania

The treatment that Dan received for his intestinal disorders was only a temporary solution, it could not solve the cause of the chronic diarrhea and it could not be prescribed indefinitely. Through bariatric reconstructive surgery, the bowel can be repaired to restore normal intestinal transit. Dan Kon no longer had the courage to go to Turkey and decided to be treated by a professor, Dr. Catalin Kopaescu, at the Ponderas Academic Hospital.

“Mr. Dr. Copescu told me that I will recover from this operation, that in 6 months I will reach a normal weight for my bones and muscle mass, my anemia will disappear and I will go to the toilet once a day like a normal person, in I will no longer have chronic diarrhea. I didn’t think I would ever get back to normal,” says Dan.

The reparative intervention, performed on September 5, 2022 at Ponderas Academic Hospital, was anything but simple: the anatomy and physiology of the small intestine was restored by reassembling it. Dan was subsequently monitored post-surgery in hospital until he fully recovered, rather than at home or in a hotel, where an authorized team could not monitor his physical parameters.

“Right after the operation, I felt much better. I was discharged from the hospital a week later. 6 months after the intervention, I am already a different person. I have fully recovered. I gained 12 kilograms, as the doctor said. I look different, I feel different, I am active, I work. At 6 months, I had all the tests done, and I had absolutely nothing left. September 5 was a day of rebirth for me, which I will remember for the rest of my life,” says the man.

Too aggressive an intervention

At Ponderas, Dan Conu discovered that he was not the only patient who had been operated on at other centers and needed a repeat operation due to complications. “There were 4-5 other people in the hospital with me who were operated on with the same problem as me. They all underwent the same operation. I don’t know if it was in the same clinic, but we all had the same experience,” he recalls.

Every week, more than two patients come to the doctors of Ponderas Academic Hospital due to postoperative complications arising from bariatric surgery performed in Turkey. Professor Dr. Cătălin Copăescu, coordinator of the only Center of Excellence in Bariatric Surgery in Romania, advises patients to be careful before buying “bargain” offers that offer, as a package, quick operations, impressive results, possibly including in the price a few days of rest at by the sea

In Dan’s case, to achieve the desired effect, it would be enough to shrink his stomach. According to Dr. Kopescu, in Turkey, bariatric surgery has been unnecessarily duplicated with ileal interposition surgery. At the time of the decision to go to Turkey, Dan Konu had the initial stage of diabetes, which did not justify such an aggressive surgical intervention.

“His diabetes could be controlled if he lost a significant amount of pounds or took medication. There are many very effective medical solutions in the treatment of diabetes at the beginning, and this is before the insulin is reached,” emphasized Dr. Kopaescu. Bariatric surgery is a treatment option for patients who cannot control their diabetes even with insulin.

Bariatric interventions must be tailored to the patient

Before any operation of this type, it is necessary to conduct a thorough examination. They should guide the surgeon in choosing the right type of intervention for each individual patient. “In Turkey, I was operated on on a conveyor belt, like other diabetics or who knows what other problems. They didn’t ask if the operation was suitable for me or if it was too much for me,” says the man.

There are more than 20 types of bariatric interventions that are recommended according to the anatomical and metabolic characteristics of each patient. “Some interventions have a limited effect on the digestive tract, while others have a large effect on body functions. Among the latter was the intervention that Dan underwent in Turkey, which was too aggressive for his body, which is usually recommended only in the case of old, severe diabetes and not controlled by other methods,” explains Dr. Catalin Kopaescu.

“In any case, it is necessary to avoid hasty decisions, no matter how attractive the solutions may seem, because the consequences can be irreversible.”

Prof. Dr. Catalin Copaescu, Coordinator of the Center of Excellence in Bariatric Surgery at the Ponderas Academic Hospital

Before any intervention, the patient must understand what is recommended and ask for an explanation.

“I made a mistake because I did not complete the documents, did not check the clinic, did not read about the operation. I now advise all people considering bariatric surgery to triple check the clinic and the doctors. Another thing that I advise, and which unfortunately I did not do, is to always see another doctor. I wanted to tell my story because I don’t want anyone else to go through what I went through. I was able to overcome this experience well thanks to the Romanian doctors,” concludes Dan Konu.

The article was approved by Queen Mary