>> 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.