Complex stomach surgery renews life for Denton truck driver

By Debbie Bolles

Chuck Null

Chuck Null gingerly took bites of his favorite meal of steak and potatoes, anticipating the shooting stomach pains that once doubled him over.

But the pain never came, only memories of a near-lifetime spent dealing with abdominal distress, doctor visits, and surgeries that kept symptoms at bay for just awhile.

After undergoing rare and exceptionally complex abdominal reconstructive surgery at St. Paul University Hospital last year, Mr. Null, 47, now enjoys the simple pleasures of eating, and of living pain-free. The June 2011 operation represented the type of tough case that UT Southwestern Medical Center physicians take on without hesitation.

“I started to believe there wasn’t anybody who could fix me,” said Mr. Null, a humble and unpretentious truck driver, husband, and father who lives in Denton. “Now, I feel great and eat like a horse.”

Had he not met Dr. Edward Livingston, former Chief of GI/Endocrine Surgery at UT Southwestern, Mr. Null says there’s a good chance he might have died. Dr. Livingston offered hope when other doctors either stumbled or were at a loss regarding how to fix Mr. Null’s gastrointestinal problems.

“He had this big ulcer, couldn’t eat, and was extremely malnourished. We took everything that was left of his stomach out and then reconnected his small intestine to his esophagus,” said Dr. Livingston of the four-hour procedure. “Since there was a lot of scarring from past operations, his procedure was very difficult.”

The surgery, which Dr. Livingston characterized as high-risk, succeeded at rebuilding Mr. Null’s gastrointestinal system. After removing Mr. Null’s stomach and significant scar tissue, Dr. Livingston performed a Roux-en-Y esophagojejunostomy, which connects the esophagus to a piece of small intestine. Few surgeons today are trained in such complex procedures, which Dr. Livingston has perfected since his initial training at the University of California’s Center for Ulcer Research and Education.

“I learned from the masters of this how to operate on the stomach in difficult circumstances. These operations aren’t done very often, and there aren’t a lot of surgeons around who have that expertise,” said Dr. Livingston, recently named Deputy Editor at the Journal of the American Medical Association who will remain on the UTSW faculty and operate at the Dallas VA Medical Center as a part-time surgeon.

What came as second nature for Dr. Livingston had enormous significance for Mr. Null’s quality of life. Today, Chuck Null works full time as a truck driver, eats and puts on weight without difficulty, and enjoys family activities that include hunting with his 21-year-old son and 9-year-old daughter.

“I thought I’d end up spending the rest of my life dealing with pain,” said Mr. Null. “It’s a blessing to have met Dr. Livingston and for him to have done this surgery. It changed my life.”

Stomach pains started bothering Mr. Null when he was a teenager. They grew worse through the years, resulting in hospitalization numerous times for ulcers. At age 26, doctors at an area hospital removed parts of his stomach, small intestines, and pancreas affected by ulcers or pancreatitis. Two years ago, his stomach was rerouted with gastric bypass surgery in another attempt to repair ulcer damage. His stomach problems worsened. One day a nurse at an area medical center suggested Mr. Null contact UT Southwestern.

“She said: ‘Have you checked with UT Southwestern? I don’t think there are any doctors here who know how to treat you,’ ” Mr. Null recalled.

That’s when Mr. Null connected with Dr. Livingston, a decision he considers one of the best he’s ever made.

For Dr. Livingston, successful cases such as Mr. Null’s make the challenging job of a surgeon worthwhile.

“Learning how to be a surgeon is one of the hardest things there is,” Dr. Livingston said. “To be able to marshal all of those skills to do anything is good, but then to save somebody’s life and to transform them as occurred with Chuck is a remarkable feeling, and impossible to explain. I tell young people that there is no better occupation on the planet than being a surgeon.”