SDH Bariatric Online Seminar

SDH Bariatric Online Seminar


(inspirational music) – Hi, I’m Amy Johnston. Thanks for joining me as we learn more about weight loss surgery, and your options for
a healthier lifestyle. Located in Austin, Texas
the Bariatric Center at St. David’s Medical
Center has been named a comprehensive center by the Metabolic and Bariatric
Surgery Accreditation and Quality Improvement Program. This designation supported by both the American College of Surgeons and the American Society For Metabolic and Bariatric Surgery works to advance a safe, high-quality care for bariatric surgical patients. During this online
seminar you’ll learn about different weight loss
procedures and how to determine which might be the best for you. You’ll also hear from
nurses and a dietician about the support you
can expect to receive before and after surgery. And finally you’ll hear
from real life patients who are sharing their
personal journeys with us. And if you should decide
that weight loss surgery is for you, we’ll walk you
through the next steps. First, lets discuss who
qualifies for bariatric surgery. Who is the best fit for
this kind of surgery? Allow me to introduce
Dr. Tim Faulkenberry. He is the Medical Director
of the Bariatric Center here at St. David’s Medical Center. Thank you for joining us.
– My pleasure. – Let’s start right with defining obesity. What is obesity? – Obesity is the carrying of fat, adipose tissue on the body
that is in an excess amount. People who have morbid obesity, really the people that
should consider surgery, are folks that have obesity
that is now reached a level to where it’s actually contributing to, or really outright
causing medical illness. – Well let’s talk about BMI. What is BMI specifically? – BMI is body mass index. It’s a calculation of
height compared to weight. It’s a very common measurement
that’s used nowadays. We know that a BMI of 25 or less is in an ideal weight category. A BMI of 25 to 30 is now overweight. 30 to 35 BMI gets into the obese category. And then a BMI of 35-40 is going to be in a morbidly obese category. A condition where those
medical issues such as diabetes, or high blood
pressure, or joint pain are actually being made
worse by the level of fat that the person is carrying on their body. – So who is this type of
weight loss treatment for? – A person who is
significantly over weight almost always has made
efforts to try to lose weight. They’ve done adaptations
to their lifestyle. They may have been able
to make effective changes in their diet, and excessive
more, and yet in spite of those efforts still have
been unable to lose weight. The body actually gets to
where it gets used to being significantly overweight and it becomes very difficult for them to
lose weight successfully. And for those people,
surgery may be an option. – Well lets talk about
some of those implications, the health implications with
being obese, what are they? – We know that obesity
causes many medical problems, metabolic type problems, in the body. The most common ones probably
are high blood pressure, and Type 2 diabetes. Those conditions become
very difficult to treat as there’s more excess fat on the body. There are actually chemical
processes that go on from being significantly overweight that make it very difficult to
control some of those issues, and then in addition there
may be risk of stroke, risk of heart failure,
certainly joint pain. You can imagine the people
that carry around a lot of excess weight are going
to have knee pain, hip pain. Back pain is so common. Those conditions, there
is no treatment for it that’s going to be
significant except getting rid of some of that weight. – Now what are some of
the trends with obesity that you’ve seen through the years? – We have seen an alarming increase in the amount of obesity in our country over the last two decades. An increase in obesity in the adolescence. We now know that a third
of adolescent teenagers are obese. One third. It’s a very alarming statistic
and so what we need to do is to make as much effort
as we can to try to correct that problem or
else once they have gotten into that condition and they become adults we wanna try to do something to help them to control their weight, to lose weight so that they can go on
and live a healthy life. – Now there are a couple
of procedures out there. Can you walk us through them,
each one of them, thoroughly? – The most common procedure
nowadays is sleeve gastrectomy, vertical sleeve gastrectomy. It’s an operation that’s
done laparoscopically. Most all the operations done nowadays are done laparoscopically. The sleeve gastrectomy
removes a substantial portion of the stomach, leaving a
long skinny tube of stomach, the sleeve of the stomach. This operation is very good
at controlling appetite and the amount of food that
it takes to satisfy appetite and as a result the weight
loss with this operation has been so good that
it is climbed to the top of popularity in just a
matter of a few years. It’s very successful. – And another option
would be a gastric bypass. – Correct. Gastric bypass is still
considered the gold standard operation. It is an operation that combined
both bypassing a portion of the stomach as well as a
portion of the small intestine. It is the most powerful
operation that we have for difficult controlled metabolic issues such as diabetes and high blood pressure, and it’s still the best
choice for some patients. Both the sleeve gastrectomy
and the gastric bypass operation are very
effective at weight loss. – Are there any other options? – Yes, the adjustable gastric
band is a procedure that is designed to control
appetite and control the amount that a person eats. The success of that
procedure is pretty good for some patients, select patients. It is a procedure where an
adjustable Silastic device is put around the upper
portion of the stomach, and a port is placed under
the skin on the abdominal wall to make adjustments in
how tight that band is around the stomach. – And what can successful
weight loss achieve? – Well we know that weight loss, of course everybody wants
to focus on how many pounds their going to lose. That’s not the only thing
that is a measure of success. The measure of success
that we emphasize is that if you take less medicine,
your medical conditions come under control, your joints hurt less, you’re there to be with your
children or your grandchildren. You can count on that,
you’re not so worried about are you going to be
continuing on the path of immobility, which many patients are. They get to where they have
difficulty to get around. Lose some of that weight,
you maintain weight loss, your lifestyle improves. That’s really the measurement of success. – You know, for people watching at home, statistics show they are not alone in this weight loss battle. Can you give us a glimpse at some of those patient statistics? – Well, we know that,
just mentioning earlier, that the trend in the last 20
years has been really alarming and the amount of obesity
that has been recorded by the CDC, the Center
for Disease Control, showed that in 1990 we had a moderate amount of
obesity in the United States. Within the next 20 years
we have more than doubled the number of obese folks
in the United States and in the South, where
we’re included of course, the amount of obesity is astounding. We have more than a third
of the adult population is morbidly obese. – That’s stunning numbers. Well thank you very much for joining us. We appreciate it. Well as Dr. Faulkenberry
said you are not alone in your journey to a healthy weight. An estimated 18 million
plus adults could qualify for weight loss surgery each year. Which option is best for you? Hilary underwent surgery at
St. David’s Medical Center in 2011. It was a decision that continues
to have a lasting impact on her health and overall well being. Take a look. (light piano music)
[Hilary’s Story] [Losing 120 pounds]
[With the St. David’s Bariatric Center] – [Hilary] I think being
active’s really important for fitness and mental health, so I do walk my dog
fairly often when I’m not traveling for work, and
I also swim and do yoga fairly often as well. Being at a normal-ish weight
is just really helpful from a lack of pain standpoint. I mean my knees and
feet used to hurt a lot when just walking, and
that’s not the case anymore, so I think having less
weight makes being active actually easier. My name is Hilary and I had
the vertical sleeve surgery in 2011 with Dr. Faulkenberry. So I’ve always been a pretty big person, both tall and not particularly
thin from an early age. And through junior high
and high school I played volleyball and basketball and
was never thin, but was fit. And then moving in to
college I played horse polo which kept me fit as well. But then when I moved
in to graduate school it was just so much focus on the work that I became fairly
sedentary and got married and sort of blissful in that period and put on 100 pounds
over three or four years, which just wasn’t very
comfortable physically. That’s how I sort of came to the weight loss surgery decision. (inspirational piano music) [Hilary turned to the Bariatric Center at
St. David’s Medical Center.] – Folks that are considering
weight loss surgery have several different options
that are available today. Surgically we are very
commonly recommending sleeve gastrectomy which
is now the most popular operation in the United States. The adjustable bands are not
as popular as they once were. They are certainly okay for
a select number of patients, but still I think the gold
standard for maximum control of metabolic issues as
well as weight loss is still gastric bypass. Once a patient has decided that surgery is maybe the thing for them,
what they need to do is to call the Bariatric Center or email them and they will then begin the
process of getting the patient lined up with the surgeon, giving them opportunities for choices, and move them along the
path that’s ultimately going to get them to the operating room and to a life that’s
going to be different. – [Hilary] I lost maybe
10 pounds the first week, after the water weight
of surgery came off. And then after that
it’s a few pounds a week for as long as you are
strictly following the diet, and the longer you can
strictly follow the diet the better I think your
long term success will be. – [Faulkenberry] Everyone is
really anxious for the results to show, and for most
people it is very important. It’s imperative to follow
their instructions about diet, about portion sizes,
about drinking and eating, separating those. Very important to follow
all of those directions. It’s been designed, it’s
been proven to work, that if folks will be very
compliant and very attentive, they’re opportunity to
maximize their weight loss is very real. – I think it can enable
other people, really, to have whole lifestyle makeovers
who maybe felt held back by their weight, and when
they shed that weight then they feel empowered
to be more confident, both in their personal and
professional relationships. (light piano music) – Wow. So amazing to see the change. She looks great, and feels even better. Joining me now is Carrie
Lin, the Nurse Manager here at the Bariatric
Center at St. David’s. You’re gonna walk us through
the surgery process, right? What can people expect in the beginning? – The very first thing
that somebody needs to do when they decide to
have weight loss surgery is choose a surgeon, and they can go about that process many ways. Some people know a family or a friend who’s had surgery with somebody. There’s a few places you
can look online to look up surgeons and see who
you’re comfortable with. Sometimes it’s as easy
as who’s office is close to where you live or to where you work. Once you’ve established
who your surgeon’s gonna be they have a really great
system set up where there’s gonna be somebody
who helps you with the insurance process. We could have the same insurance, we could both have the same
company covering our insurance, but we could have vastly
different policies. So it’s really a good thing
that somebody can look up and tell you ‘this is what
your insurance covers, this is what you can expect
for out of pocket expenses, and these are the things
you need to do to qualify through your insurance.’ It’s also important if you’re
gonna be a self-pay patient, that you know what to
expect as far as pricing and there’s gonna be
people who can walk you through that as well. – What kind of support can
people get before the surgery? – We don’t expect our
patients to be experts on figuring out how to
maneuver the medical system, so there’s gonna be
somebody who’s telling you ‘this is what you do next’, they’re gonna be checking
in on the paperwork that you’ve gotten finished, they’re gonna be making
sure that everything is meeting the requirements
you needed to meet for your insurance or for your surgeon, and they’re gonna be
making sure that you get from point A, which is
that very first appointment with your surgeon, to point B, which is leaving
the hospital healthy. We’re gonna be there
every step of the way. – If someone’s watching
today, what are the next steps that they need to be taking? – Finishing this seminar is
absolutely the first thing they need to do, and after
this seminar is finished one of our staff members
at the Bariatric Center at St. David’s, we’re
gonna reach out by phone and talk you through the next steps, make sure you know what to do next. – Make sure they have all of the answers. – Absolutely. – All right, thank you Carrie. Appreciate it.
– Thank you. – That is just what our
next patient, Gary did. Gary reached out to St.
David’s Bariatric Center. Just over a year later he’s
achieved life changing results and continues to turn to
St. David’s for support. Here’s his story. (light piano music)
[Gary’s Story] [Losing 140 pounds
with the St. David’s Bariatric Center] – [Gary] I think the thing
that I would emphasize is how much additional stamina that I have. How much I have a love
of life where in the past it was sometimes a dreaded
thing, to get out of bed or to walk up a flight of stairs, or to go out for a simple
walk in the neighborhood. My name’s Gary, I had
gastric bypass surgery on August 11 of 2014. I had the surgery on a Monday
and I was out of the hospital within about three or four days. There was some pain associated with it. Not as much as I thought there would be. They had me up and walking rather quickly. The nurses and the doctors
at St. David’s were great. – Every patient who has
surgery of course is going to expect that there will be some discomfort associated with it. However, since all of the
operations that are done nowadays, for the most part, are
laparoscopic, the recovery is fairly rapid and the
discomfort associated with it is modest in comparison
to many other operations. – After that I was able to come
home and recuperate at home, and within probably two weeks
all the pain had pretty much gone away and then it was
just a matter of following the routine that they give you
as far as diet and exercise. – Once a patient has
had weight loss surgery there is a lot that’s going
on that’s gonna be different. Their diet is of course going
to be monitored and regulated for the first several
weeks as they go through the recovery process and
moving from liquids to soft to regular solid foods. The diet for the most
part is not special foods, just quality food, and
they’ll be instructed about eating much smaller
portions, eating more slowly, chewing very carefully. – Here we go, all right. – [Faulkenberry] There’s going
to be collaboration between the Bariatric Center here at
St. David’s Medical Center and the surgeons office. There’ll be dietitians, nurses,
folks who will be able to answer questions and direct patients into the right direction, perhaps
to suggest support groups. Support groups are very
helpful to many patients. – [Gary] It made me feel
much better about everything. So by the time it was
time to do the surgery, I was feeling comfortable
with the whole situation and I didn’t have the nerves
that I think I would’ve had had I not had the education
that came out of the support group, and the
support group was great for doing that and I commend them
and St. David’s for putting together the support groups and I still continue to go
to them from time to time. – [Faulkner] As the
weight begins to come off, the patient who may previously
have been limited in exercise will be able to do much more exercise, and it’s important to
take advantage of that. – I try to walk at least a
mile, sometime two miles a day at a reasonably fast pace. Not tremendously fast, but reasonably fast to burn the calories. – [Faulkner] It helps the
joints, it helps the heart, it helps their back, and
in general as patients feel better, they oughta do better. (light piano music) [Gary reached his weight loss
goal in less than a year.] [He continues to work to maintain
his goal weight. He enjoys other sucesses
that come with weight loss.] Many patients go into
weight loss surgery thinking that their only measurement
of success is going to be the amount of weight that they lose, but we encourage people
to do their absolute best to maximize whatever they
can do and to really look at how much their life changes
in other ways as well. – [Gary] I feel great. I have stamina that I never had before. Prior to surgery I had diabetes that I was taking insulin for, I had high blood pressure. I have neither of those now. Life changing event, that’s for sure. (light piano music) – Now Gary talked about
the importance of support. Joining me now is Valerie
Castro, registered dietitian and Merritt Manuel, a registered nurse at the Bariatric Center. Thank you for being here. First lets talk about why
it’s so crucial to have a support system throughout this journey. – This is a life altering surgery. A lot of big changes have to be made, and it’s really important for
patients to have that support. We start the support process off with us at the Bariatric Center. Then it kind of follows
to the primary caregivers at the hospital, and then we
definitely like to extend it into the patients family and friends. In order to be successful in their goals, they need to have that support. We also do support groups
here at St. David’s, which are great for patients
to come and meet each other and kind of talk about the
challenges, the pitfalls, the achievements that
each other have made. We’re also at each support
group and so it’s a great way for us to see the patients face to face and to help them along
the journey as well. – And Gary talked about the
responsibility that he takes. Can you kind of walk us through
some of the dietary changes that will happen? – Yes, after surgery
patients are going to be first placed on a liquid
diet for a few weeks. After that we’ll progress
them to a puree diet which consists of food of
applesauce or baby food consistency. Followed by that are going
to be our soft foods, and eventually they will get
to regular consistency foods. – And this is where
portion control comes in. – Yes. – All right, you’ve brought some examples. Can you show them to us? – [Valerie] Yes, this
plate over here represents the recommended servings
of someone preoperatively, or you and I. And this plate represents
portions that are recommended post surgery once patients
are on the regular consistency phase. – [Amy] You know I look at that and it’s a pretty radical difference. How do they do? – Well the appetite is so
well controlled after surgery that patients are satisfied
with these portions. – So, have you seen cases
where a patient may plateau or even fall behind on their goals? – Plateaus and weight
goals regain can happen. Initially patients are
really excited to see the results on the scale,
but then sometimes they forget to continue the recommendations set for by their surgeons, such
as appropriate calorie intake, protein intake, their
vitamins and supplements. – So Valerie, when that
happens how do you get them back on track? – First of all we want them
to start food journaling. We want them to ensure
they’re taking in the appropriate recommended calories, protein, and vitamin mineral supplements
recommended by their surgeons office, because a
lot of times out of sight, out of mind. If you’re not documenting,
you’re not exactly sure what you’re actually ingesting. – So true. Now Merritt, it hasn’t been too long since Gary had his surgery. Are the staff at the Bariatric
Center available long term? – Definitely. We give all our patients phone
numbers, contact information, so at any point along their
journey they need anything, we’re here for them, because
their questions are going to be different at two weeks
post op, two months post op, two years, so we’re always available. I think that’s what makes St.
David’s a really great program is because we’re here with
you every step of the journey. – All right, thank you
ladies for being here. For more frequently asked questions like will insurance help pay for this procedure and will I be able to get
pregnant after weight loss surgery please click on our FAQ page
at StDavidsweightloss.com Once you’ve completed
watching this seminar, please provide your
information and a member of the Bariatric Center will
be happy to contact you. As we learned today the staff
here is eager to help you navigate your journey to healthy and long lasting weight loss. Thank you for joining us today. We look forward to helping
your weight loss journey here at Bariatric Center at
St. David’s Medical Center. (upbeat music) [Your next step: Call the Bariatric
Center at St. David’s Medical Center
to choose the surgeon that’s right for you.] [To start your Bariatric Surgery Journey, please visit:
www.stdavidsweightloss.com, or call
(512) 476-7111] [The Bariatric Center
St. David’s Medical Center
www.stdavidsweightloss.com]

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