Patti Vasile was so desperate to lose weight she traveled to Pittsburgh in 2003 for gastric-bypass surgery.
Nine years later, the 43-year-old Erie woman was so thin and malnourished that she slept 20 hours a day and didn't have the strength to get out of bed.
"I couldn't walk," said Vasile, who is 4-foot-11. "My son had to carry me around, which wasn't hard because I weighed just 62 pounds."
Gastric bypass is a type of weight-loss, or bariatric, surgery performed on people who are obese and can't lose weight any other way.
More than 113,000 bariatric surgeries are performed each year in the United States. They have saved countless lives by helping people shed significant amounts of weight and avoid life-threatening illnesses like heart attacks, strokes and diabetes.
But they are complex surgeries that sometimes result in serious complications, said Dr. Muhammad Asad, a bariatric surgeon at Saint Vincent Health Center.
The complication rate for all types of bariatric surgery is about 7.5 percent, according to the National Institutes of Health.
"Complications happen. A bariatric surgeon or program is judged by how they handle these complications," Asad said.
Vasile was thrilled at first with the result of her surgery. Her weight dropped from 238 pounds to around 125 pounds in just eight months.
Her high blood pressure returned to normal, she felt energetic, and many of her aches and pains went away.
"I could go out to eat and not have people stare at me," Vasile told the Erie Times-News. "I was sick of being stared at when I went out."
Vasile felt great until 2008, when the first problems began to arise. She was shopping at the Walmart in Harborcreek Township when she fainted.
She was taken to Saint Vincent, where diagnostic tests were done, but doctors couldn't determine what caused her to pass out.
Later in the year she developed body tremors and couldn't move. An ambulance was called, and she was taken back to Saint Vincent.
"I was diagnosed with a tremor disorder and given anti-anxiety medicine," Vasile said. "Then I started having severe lower back pain."
Vasile was also given a blood transfusion, the first of 10 she would eventually receive, and later had her gallbladder removed. Her weight plummeted during one month of 2008 from around 125 pounds to 90.
"I was too small to wear adult clothes," Vasile said. "I was wearing a child's size 12."
By 2011, Vasile's body was breaking down. She developed aneurysms on her pancreas, and her hair began falling out.
"I was in bed all the time at that point," Vasile said. "Every other week I was at Saint Vincent. It was like a second home."
During a hospitalization in October, Vasile's doctors asked Asad to consult on the case. He determined that at least some of her problems were due to the bariatric surgery from 2003.
Vasile had undergone a Roux-en-Y gastric bypass, in which a small part of the stomach is used to create a new, smaller stomach, and the rest is bypassed. The small pouch is then attached to the middle of the small intestine.
"Her intestine was no longer long enough for her body to absorb all the nutrition she needed," Asad said. "If something wasn't done, she was going to die."
Asad wanted to operate and fix what was wrong with her stomach and intestines. But Vasile simply wasn't strong enough or healthy enough at that point to withstand surgery.
"She needed to gain some weight. She was skeletal," Asad said. "We started giving her nutrition through an IV."
Vasile was transferred to Select Specialty Hospital to gain weight and undergo occupational and physical therapy. She stayed a month and gained 10 pounds, then went home for two more months and gained an additional 30 pounds — enough weight for Asad to decide she could handle surgery.
On Jan. 29, Asad reversed part of the original gastric bypass, reattaching a section of her small intestine that was bypassed 10 years earlier.
"We lengthened her intestine so that her body could absorb nutrients better," said Asad, who estimated that about 5 percent of his surgeries are gastric-bypass reversals or partial reversals. "We also involved a nutritionist."
The surgery and follow-up care worked. Vasile now has the strength and stamina to go for short walks and cook meals.
She also has maintained her weight at around 100 pounds.
"It's the best I have felt in years," Vasile said. "I'm walking, I'm not sleeping all the time."
Vasile isn't symptom-free, though. She still battles bouts of vomiting and diarrhea.
She will see a gastrointestinal doctor later this month to see what is causing the problems. More surgery might be needed.
That's typical for someone who has gone through a lengthy illness and complex intestinal surgery, Asad said.
"Different patients have different problems," Asad said. "That's why it's so important that Patti comes back for follow-up visits, so we can identify these problems and treat them before they become more serious."
Vasile will probably see Asad on a regular basis for the foreseeable future.
"Once you do a bariatric surgery on a patient, you are making a lifelong commitment to that patient," Asad said. "The surgeon has an obligation."