Penn State Surgical Weight Loss Information Seminar

Penn State Surgical Weight Loss Information Seminar


>>So, I’m Ann Rogers, I’m the Director of
the Penn State Surgical Weight Loss Program. You have come to our information seminar. We’re going to talk about how the program
works and the different operations that we do and then I’ll show you some images of some
of our prior patients. And then we’ll open it up for questions and
answers. So, we’re going to talk about who’s a candidate,
why come here, what we offer, how the program works. Do I qualify? Bariatric surgery is offered to patients at
a certain body mass index. And the way you calculate body mass index
is using a combination of height and weight. And if you fall into the red zone you qualify
for weightless surgery. So, you notice it’s a big part of a square. It’s a lot of people who qualify. If you have any concerns about where you are,
you can come up and we can plug it into a BMI calculator and find out exactly where
you are. Why come here? We are a nationally accredited bariatric center. It’s very difficult to achieve this accreditation
and to keep it. Not all programs in Central PA have this accreditation,
so we’re very proud of it. It took a lot of work and it means that our
complication rate is very low compared to national averages. We do not out source, everything that happens
in this program is contained within this program. You go to our dieticians you don’t go to general
nutritionists, we have our own psychologist and our own exercise physiologist, so everything
is contained within our program. We offer the typical kinds of surgery that
are offered at most programs. Everybody’s heard of the gastric bypass, sleeve
gastrectomy is now most of what we do. This is the most common operation for weight
in the world. And I also perform the duodenal switch procedure
which is not offered at most programs. Duodenal switch accounts for about 4% of all
bariatric operations, but it’s something that we’re capable of doing here for patients who
need it. Everything that we do can be done laparoscopically,
meaning through small incisions. If you want a great big long incision, I guess
we could do it, but you’d have to talk me into it, not, I can’t think of many reasons
why you would want to do that. Some of my partners do their laparoscopic
operations with the assistance of a robot. I choose not to use the robot for reasons,
but some of my partners like to use it, so we have it. The first thing I’ll talk about is the gastric
bypass since everybody’s heard of it and we have a little movie here that shows how this
operation works. So, there’s your stomach and the first thing
that happens is we make a little pouch here that separated from the whole rest of the
stomach. And then we hook up some intestines to the
pouch so that the blue food that you eat takes a detour it’s not going through the big part
of the stomach anymore and that’s why this is called a bypass. And it is that detour that accounts for why
this operation works. This is the sleeve gastrectomy, as I said
it’s the most common operation for weight. And in this operation, we make a narrow tube
out of the stomach and a great big outer stretchy part of the stomach is completely removed
from the body. There is not rearrangement of the intestines. I had a patient in my clinic yesterday saying
“Well, I don’t want the sleeve because I don’t want a foreign body put inside me.”. We do not put something in you, there is not
sleeve that’s wrapped around you, it’s your own normal tissues. When they say sleeve they’re just talking
about the tubular shape of the stomach that you have left. But it’s all your normal tissue. And I think we have another video that shows
how this works. This guy comes in for surgery and looks like
he’s standing up, you actually get to lie down and be asleep for our operations. So, we use some small ports, these are tubes
through which we can insert instruments and the camera so that they’re inside the body. And there’s your stomach again, so for some
reason this guy just really likes blue food, I don’t know why. Alright, but you know, it can really fill
‘er up and some of our patients have very large expanded stomachs. Some of my patients have a stomach about the
size of a football, so it will hold a lot of food. And then once you have the sleeve, you’re
left with this narrow tube and it just simply doesn’t hold as much food and it is not stretchy
at all. So, once you take that one bit too much, it’s
going to bounce back up. So, it learns you very quickly to not overeat. To preselect a portion size and not take that
extra bite so that when the blue food comes down you’re not getting as much in. What’s great about the bypass and the sleeve
along with weight loss is the fact that frequently you see improvement of the medical problems
that go along with weight. And a lot of our patients are more concerned
about getting rid of their diabetes or their sleep apnea than they are about losing enough
weight to look like Twiggy. So, these operations are great at helping
you improve or eliminate certain medical problems. On average with these operations you can expect
to lose approximately 1/3 of your weight and some people lose more, some people lose less,
it depends on a lot of factors. When we do these operations most people come
in on the morning of surgery, have their operation, stay through the night, start drinking liquids
and protein shakes the next day, and usually are able to go home by the afternoon of the
day after surgery. I recommend for patients who are doing desk
jobs, computer work, things like that, to take about 3 weeks off after surgery. If you’re doing something that’s very physical
like operating a jackhammer, or moving patients as a nurse, you might want to take six weeks,
so we sort that out with our patients when we’re filling out their FMLA paperwork. So, the way our program works is driven by
insurance. So, most insurances in Central Pennsylvania
require that you attend a six-month, multidisciplinary program of education. Some insurances only require three months. We make it so that you get the exact same
information no matter what kind of insurance you have. If you have a six-month insurance, you’re
essentially going to come once a month for six visits, if you have a three monther, you’ll
come twice a month, so that you get the same exact information. And the main point of the program is for you
to learn the skills of how it, to be a successful bariatric patient. This is not general nutritional education. It’s education to make it safe for you to
be a bariatric patient while you’re losing weight. So, we do like patients to lose weight while
they’re in the program. If you’re gaining weight in the program we
feel guilty, we don’t want this to be the Penn State Surgical Weight GAIN program, and
in fact some insurances require that you lose a certain amount of weight. Many of them require that you be below your
starting weight, so that’s only a pound, there have been some insurances in the past that
required a 5% weight loss, whatever, Dawn is our insurance guru and she will let you
know what exactly your particular insurance requires. It’s very important to attend regularly because
some insurances, if you miss a month, they make you start all over again. So, if for some reason you need to cancel,
because of some family emergency, do try to get scheduled back in within the same month
so that you don’t have to start all over again. You’re going to learn how to do a diary or
a food journal of every single thing that you eat or drink and that’s an important thing
to work with and to bring to every visit, because the dieticians can look that over
and maybe look at one thing you’ve been choosing that’s higher in calories and come up with
something that’s similar but has fewer calories to help you make adjustments to what you’re
eating. Every patient in this program must be nicotine
free. That’s not required in all programs, it should
be. We test for it, we even test for it on the
day of surgery, if you have quit smoking during our program and if you have resumed smoking
again, your surgery will be canceled. So, we will help you with that, we do have
smoking cessation people here in the medical center who can help with that, but it’s best
to start as soon as possible. Because if you quit smoking a week before
surgery, you’re actually at risk for even more complications than if you hadn’t even
quit at all. So, it’s best to do it at least six weeks
before the surgery. And everybody has to be able to exercise,
now most people hate exercise they can’t stand it, they don’t have time for it, it hurts. We have an exercise physiologist; his name
is Mike and he is happy to work with our patients and find a special exercise plan just for
you to help you get moving but in a way that doesn’t hurt. So, there’s paperwork in the back if you haven’t
gotten it already, there’s an application that we ask people to fill out that gives
us a history of the kind of weight loss attempts that you’ve tried in the past and what your
medical problems are. There’s a simple one-page checkoff sheet for
your family doctor. If your doctors are in the Hershey System,
we don’t need any additional records we can get that all off the computer. And once we’ve received that information and
review it you will be called by our beloved Allison to schedule your first visit. Once in a blue moon we find information on
your screening information that makes us think this might not be a good time. So, not a good time is you’ve just lost your
house and you’re living in a cardboard box, or you have a parent who’s about to die, you
know, if you have big social things going on that are going to be a distraction, this
is not a good time to pursue weight loss surgery. Wait until you’ve cleared up what’s going
on in your family before you start. So, we have permission from some, these are
my patients, and they’ve given permission for their images to be used and their stories
to be told. This is Jason who used to work in a bar and
he would get free food and drink and he made use of that [chuckles]. He came to me wanting to have a Lap Band and
we talked about it and I did not think that that would serve him well and by the end of
our conversation, he had agreed to have a gastric bypass and he’s down to about 180
pounds, he’s a semi-professional rugby player. He’s a competitive rugby player. Very active. And he’s been keeping his weight off. I think he had his surgery probably six or
seven years ago and he was profiled a year or two ago on our ABC27 news show as one of
our success stories. And he’s a great guy. This is Gina and you might think looking at
her “How could she possibly qualify for weight loss surgery?” Well weight loss surgery patients come in
all shapes and sizes and you may not be an enormous person, but you might have severe
medical problems that make you qualify. So, this is a pretty typical result after
weight loss surgery. This is my patient Janice and she’s wearing
her daughter’s cheerleading outfit at the office Halloween party. [ Laughter ] And she had a magnificent result and what’s
most amazing about her, she did have a lot of excess skin but she did not end up needing
plastic surgery. She was young enough and resilient enough
that she was able to snap back. And this is not through plastic surgery, she
snapped back. You may be curious about body contouring and
plastic surgery and we can talk about that afterwards. This is Lisa and she HATED having her picture
taken when she was heavy, but she had this picture taken the day she was coming in for
surgery. And she’s sad, you can’t see it very well,
and here she is happy. So, this just brings to mind that there are
major quality of life improvements that usually go along with surgical weight loss and she’s
living the dream. So, now I’d like to open it up to questions,
this is the most important part of the seminar and there are no silly questions, do not be
shy.

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