Three weeks ago, 34-year-old Helen Finger stepped on the bathroom scale, watching as the digital readout flashed its frightening message: 268 pounds. For her height--5 feet, 6 inches--that put her about 140 pounds over her ideal weight. And those extra pounds were threatening Finger's life, causing problems ranging from hypertension to arthritis.
Finger, a Santa Ana resident who works as a health-care coordinator for a group of doctors, says she had "tried everything" when she read in a medical journal about something called a gastric bubble, a small plastic balloon that is inserted through the mouth and inflated in the stomach, causing the patient to feel full and decreasing the desire to eat.
So, on Nov. 6, Helen Finger became one of the first patients in the U.S. to have the new device, approved by the FDA on Sept. 17, inserted in her stomach. In the first two weeks, Finger lost 20 pounds and went shopping for new clothes. "I feel great. I just can't eat as much," she said. "You actually can't hold as much food."
The bubble, designed by two Delaware doctors and manufactured by an Irvine laboratory, is currently available through only 16 specially trained physicians in the United States. Of those 16, six are in California--two in Orange County and four in Northern California.
The physicians received their training in Delaware from Drs. Lloyd and Mary Garren, the husband-and-wife gastroenterologists who designed the bubble. (He is an instructor of medicine at Jefferson Medical College in Philadelphia; she is chief of gastroenterology at Union Hospital of Cecil County in Elkton, Md.)
Within weeks, American Edwards Laboratory of Irvine, which makes and markets the product for the Garrens, expects the bubble to be available nationwide through hundreds of doctors, mostly gastroenterologists (physicians who specialize in diseases of the stomach and intestines), according to Mark Cole, a representative of American Edwards.
Until then, the only two Southern California doctors trained to prescribe the device are Drs. David J. Chapman in Placentia and Davinder Singh in Santa Ana, according to American Edwards Laboratory. Both Chapman and Singh, board certified gastroenterologists who do not specialize in treating obese patients, became interested in the bubble and joined the first group of physicians to be trained to use it.
So far Singh's only patient has been Helen Finger. Singh, who has a private practice in Santa Ana, says that "a couple of other obese patients" are interested in the bubble, but says he is "keeping a low profile. I have other patients who want it," said Singh, who teaches at Martin Luther King County Hospital. "But I want to wait and see how this patient does first."
Singh adds, however, that he does feel the bubble is "safe and simple . . . a safer procedure than gastric surgery."
Chapman, on the staff at Placentia-Linda Community Hospital, expects to insert his first gastric bubble this week in 31-year-old Jim Switzer, a Placentia engineer, who is 120 pounds overweight. Switzer found out about the bubble through his wife, a registered nurse at the Placentia-Linda hospital.
Chapman, an associate clinical professor at USC, has been following the bubble's development for more than two years.
"To me it (the bubble) seemed like an exciting advancement in an interesting field," he said. Chapman describes the bubble as a "less invasive, less serious" method of treating obese patients than such radical procedures as stomach reduction, intestinal bypass surgery or gastric stapling, all of which require extended hospital stays. "All the other procedures are major surgery in people who are not good surgery candidates to begin with," he said.
Enthusiastic About Bubble
Dr. Daniel Hollander, chief of gastroenterology at UC Irvine Medical Center, is also enthusiastic about the development of the bubble. Although Hollander has not used the bubble, he has read about its development in medical literature since 1982 and says: "Basically the problem we are dealing with is a selective group of patients having morbid obesity; that means most of these people are in the 300 to 400 pound range and unable to control their weight. And they are experiencing health problems because of this."
Such people have had "no medical means of controlling their weight," he said until the development of intestinal bypass surgery or stomach stapling. "But the problem with surgery," Hollander said, "is the high rate of mortality (associated with it) and we have stopped recommending bypass surgery altogether because we are dealing with a 20 to 30% mortality rate. There is good weight loss, but the risk is quite high."
Stapling or suturing the stomach--making the stomach smaller and reducing the amount of food it can hold--"seems to be working better," Hollander said, "and is the method of choice until recently."
However, Hollander views the gastric bubble as a "promising new approach."