Sun, Sea and Scalpels follows the experiences and pitfalls of tens of thousands of Irish people who travel abroad for cosmetic surgery each year.
Ahead of the first of a two-part program airing tonight, Wednesday 11 October, 9.35pm on RTÉ One, we sit down with Professor Helen Heneghan to discuss the many issues arising from ‘medical tourism’. We discussed the issue.
As well as working as a Bariatric Surgeon at the HSE and Head of Surgery at St Vincent’s Hospital, Professor Heneghan spends most of his week providing pre- and post-operative care at the Weight Management Clinic.
“Most of my work involves managing severely obese patients and administering surgical treatments to them,” she explains.
“About a quarter of the week I work in the clinic, where I see, consult, educate and consent patients for long periods of time before surgery.”
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As well as preparing patients for surgery, Professor Heneghan uses the clinic for follow-up care, many of which may last a lifetime.
She says the problem when Irish people go abroad for weight loss surgery is that these vital cares are simply not in place, and patients inevitably have to return home for additional care. That likely contributes to the waiting list. It was the first time she saw them go abroad.
“It’s a Catch-22,” she says. “It’s an added burden of unpredictable, unscheduled work. We don’t have time for it, but people come through the emergency department.”
“Their needs are often much greater than the patients we prepare for surgery and take good care of,” she continues. “If they require hospitalization, they are usually in critical condition and may stay there for several months. During that time, they end up occupying one of our bariatric beds. Masu.”
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There are two physical challenges that surgeons face when patients return from overseas surgery.
Firstly, many people are undergoing surgeries that are not available in Ireland.
“What I’m really trying to say is that people don’t weigh enough. They might lose a little weight, but they won’t get healthier. There’s no benefit and there’s no offsetting risk. It’s just a risk that the patient is taking. ”
Second, patients are not informed or educated about the critical procedures that are currently being performed.
“We see a lot of patients come in complaining of vomiting and pain for a period of time after surgery, and this is actually quite normal,” she explains. “But we have to assume there’s a problem unless we have evidence otherwise. So we’re going to have a lot of tests to prove it’s not a mechanical problem.”
“They don’t realize how slowly they have to eat or how little they have to eat,” she added. “Some people think they can act the same and the surgeries are done separately.
“We have to do that education after the fact, and that’s actually the most frustrating thing. We have to do a lot of the work that other providers would do.”
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In Ireland, there is a lengthy pre-selection process that checks potential patients’ mental health and whether they can adapt to the new eating habits they have to deal with.
Although time-consuming, this process is essential because obesity is often “linked to mental health issues,” Heneghan said.
“It’s very important to address this issue before surgery and to have the same person provide psychological support afterwards,” she explains. “For people with pre-existing mental health issues, this can be a very precarious surgery. We see people in dire straits when they return. I am.”
With names like “mummy makeover” and “tummy tuck,” Heneghan believes many serious procedures are perceived as quick fixes that require little thought.
“People don’t tolerate complications that can occur, even if it’s done very well. Any time you pick up a knife, there’s a risk of complications. It’s the same with any injectable. It is recognized that there are complications that can occur with the best of the best. “
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Despite the many risk factors involved, Ms Heneghan understands that being on a waiting list for years in Ireland can be incredibly taxing for people. However, he advises everyone to do their research before going abroad.
“At the end of the day, people join our program because they can benefit from weight loss and they don’t want to wait five years to join our program,” she says. “You can’t stop it, but I think they need to do their homework and understand that there needs to be multidisciplinary evaluation and follow-up.”
While some UK clinics offer virtual follow-up, many foreign clinics do not offer such services and require patients to contact their local healthcare provider if problems arise. Just instruct them to do so.
“They need to be financially prepared for what they’re going to do,” she argues. “We provide public care, but it is their responsibility if they need support and counseling or if they need specific follow-up care. You have to have a plan in case things go wrong.”
To find out more about medical tourism, tune into Sun, Sea and Scalpels tonight, Wednesday the 11th, at 9.35pm on RTÉ One.
If you have been affected by the issues raised in this article, please visit www.rte.ie/helplines.
