Mumbai Mirror

• The Qatari national is possibly the biggest patient the country has seen; but with help from doctors at Jaslok, he wants to change that soon

A19-year-old Qatari national is causing quite a stir in Jaslok Hospital. At 284 kg, he is possibly the heaviest patient the country has seen.

The teenager is a student of Mohhabib Abdullah Waha School in Doha. Six years ago, he started putting on weight.

On August 14, he visited Jaslok Hospital for limb lipoma surgery on his left leg. Seeing his size, doctors warned that any further increase could pose a threat to his life. They suggested that he undergo surgery to cut down his obesity.

The teenager’s father told doctors at Jaslok that he was unable to get suitable treatment in their native Qatar.

When both father and son gave their consent, physician Dr Nasir Fulara carried out some tests — complete body profile, hormone test, kidney and lung function test, ECG, echo test, sonography, x-ray, cholesterol. 

The results revealed that all parameters are normal. He is fine except for some problems breathing and walking.

Unlike normal obese patients, in this case, treatment will involve two surgeries — sleeve gastrectomy followed by gastric bypass surgery.

Doctors are ready to go ahead with the operation but for a CT scan. The problem is that they are unable to find a machine that can accommodate the patient.

Meanwhile, the hospital has had to make several special arrangements for this special patient.

•  To begin with, it arranged for a special stretcher and a special bed.

•  Doctors had to employ unconventional methods to check his blood pressure.

•  It came up with a special method to help him pass stool.

•  The pathology department arranged for a special needle since the regular ones would not penetrate the teenager’s body. Also, finding a vein is not easy.

•  Since he could not be accommodated in the x-ray machine, the machine had to be brought to his bed. Carrying out a sonography was also not an easy task.

•  For the operation, two tables will be used

•  Special laparoscope

•  SLEEVE GASTRECTOMY

It is a new procedure that induces weight loss by restricting food intake. The surgeon removes approximately 60 per cent of the stomach using a laparoscope so that it takes the shape of a tube or sleeve. This procedure is usually carried out on super-obese or high-risk patients. A gastric bypass or duodenal switch is essential at a later date.

•  GASTRIC BYPASS

It is the most common form of weight loss surgery in the United States because of good results with acceptable risks and minimal side-effects. The surgeon staples a large section of the stomach. Patients simply can’t eat as much as they did before surgery because of the reduced size of the stomach and end up losing weight.

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*  I had operated on a 240 kilogram patient earlier but this youth is the heaviest  one in the India. The operation will be carried out by obesity surgeons. First step is sleeve gastrectomy. It will reduce his weight by around 70-80kg. After six months we will carry out a gastric bypass surgery. We can administer local anaesthesia, but not general anaesthesia to such a patient as it can prove fatal. So, the operation will be carried out in the presence of a team of anaesthetists. At present, we are facing a problem. We want to carry out a CT scan, but are not getting a machine that can accommodate him
— Dr Nasir Fulara

*  I need the surgery because my weight is increasing with each year. It is very painful for me. I feel shy and it denies me a normal social life. The Qatar consulate here accepted our plea for financial assistance for this surgery. I hope the doctors here will be able to treat this problem
— Patient

*  I think, this is the first case of its kind in India. It will be very difficult to operate. It requires meticulous planning. In a normal case, 120 to 170 kg, only one surgery is enough. In this case, two will be essential.First, he will have to undergo sleeve gastrectomy followed by gastric bypass.
— Obesity surgeon Dr Sanjay Borude, attached to Breach Candy Hospital, about the procedure