| Stephanie:
What is the recovery time to resume normal
activites? |
| Kathryn L. Burg
MSN, CRNP:
Stephanie - Thank you for your question.
Patients are able to return to normal activities
within two to four weeks. |
| Sharon:
I need this, but my insurance won't pay
for this. Can you help me? |
| Noel N. Williams,
MD:
Sharon -- Thank you for your question. There
are advocacy groups that you can get in
touch with, from a legal standpoint, to
help persuade the insurance company to pay
for it. Please call 1-800-789-PENN for more
information.
|
| Stephanie:
I am a mother of 4 and when I had my first
child in 1989, I had blood clots fron the
c section. Am I considered high risk? |
| Noel N. Williams,
MD:
No, your risk would be moderate because
we are able to put a special filter in her
main vein so that the blood clots would
not get to your lungs. This would decrease
the risk of serious complication of pulmonary
embolus. |
| Naomi:
Isn't this surgery just a substitute for
willpower? I have thought of having the
surgery but I'm afraid that I still wouldn't
be able to change the real cause of my obesity
problems. |
| Rachel Griehs,
MS, RD, LDN:
Good question. Will power is also necessary
following surgery. However, long term success
of surgery is significantly better then
diet and exercise alone. |
| Theresa:
Is bariatric surgery covered by most medical
insurances? |
| Noel N. Williams,
MD:
Yes, bariatric surgery is covered by most
medical insurance. |
| Stephanie:
What is the average weight loss in the first
3-6 months after surgery? |
| Kathryn L. Burg
MSN, CRNP:
This varies significantly from patient to
patient. On average individuals lose between
40-75 pounds between 3-6 months following
surgery. |
| Stephanie:
I heard that having the method of surgery
that was shown on tv is higher risk than
the more invasive procedure. Can you please
comment on that? |
| Noel N. Williams,
MD:
Stephanie -- If you are going to have the
laparoscopic approach, it is important to
go to a bariatric program that has significant
experience with this approach. If you do
this, there is no difference in the risk. |
| Debbe:
If considering this type of surgery and
not sure of adherence to the diet restrictions,
would you give the patient a chance to follow
the diet beforehand? Does this surgery have
better success rate compared to Lap-Band?
|
| Rachel Griehs,
MS, RD, LDN:
Debbe - Thank you for your question. Yes,
sometimes we encourage patients to try eating
the types of foods on the post-op diet.
It would be difficult to eat the portion
size required after surgery. However, you
would want to start making behavioral and
diet changes. |
| Theresa:
After this type of surgery, is your diet
restricted to certain types of foods or
is the patient able to eat their usual diet
but in much smaller portions? Thank you!
|
| Rachel Griehs,
MS, RD, LDN:
There will be some foods that you will be
unable to tolerate after surgery. Sometimes
this is temporary and in other cases it
is permanent. Every person is different.
|
| Katie:
I have a consult date for early June with
Dr. Williams. The one thing concerning me
at this time is that I had 2 abdominal surgeries
in the past 2 years. Will the adhesions
and scar tissue hinder surgery, Open RNY
or Lap RNY? |
| Noel N. Williams,
MD:
It would depend on what your previous surgery
was, and where your incisions are, but we
often operate on patients who have had previous
abdominal surgeries. |
| Stephanie
What is the wait for the open surgery? Are
there meetings to attend before? |
| Rachel Griehs,
MS, RD, LDN:
Stephanie - Currently the wait period is
four to six months. We have monthly support
group meetings that you can attend before
and after your surgery. |
| John:
Hi Katie, it's JR. I thought I'd stop in
and say that the show is top-notch! |
| Kathryn L. Burg
MSN, CRNP:
Thanks JR!!! You are the best! |
| Dottie:
How much does it cost and will health insurence
pay for it? Is there a lot of pain after
the operation? |
| Noel N. Williams,
MD:
Most insurance companies will pay for it,
therefore there is no out of pocket cost
to the patient. There is some pain, but
it is well controlled by post operative
pain medication. |
| Linda:
Hello everyone! Guess what? I'm down 71
pounds since my surgery and I feel great.
Thank you for everything. |
| Rachel Griehs,
MS, RD, LDN:
Hi Linda - Thanks for your message. Dr.
Williams and Katie say hi. Great job on
your weight loss and the show. You are very
inspirational. |
| Linda:
I'm learning a lot from this program. I
had a VBG in 2000. I had none of the pre
or post op support that was discussed tonight.
Has this changed since my surgey? Or did
the VBG not warrant this type of support?
|
| Kathryn L. Burg
MSN, CRNP:
Linda, Yes, support groups are necessary
following VBG as well. It has been proven
that long term support increases success
longterm following any type of Bariatric
Surgery. |
| Jacquie:
I have 2 aunts that had the surgery with
your bariatric services, but when I met
with my primary doctor, he told my I am
not a candidate. I am 5'1" and 230
lbs. My weight is really causing alot of
health risk and I'm in the precusor stage
of type 2 diabetes. Why am I not a candidate?
I am at least 100lbs overweight. |
| Rachel Griehs,
MS, RD, LDN:
Hi Jacquie - If you are 100 lbs overweight,
you are a candidate for the operation. Please
call 1-800-789-PENN for an evaluation. |
| Christa:
How long of a wait is it to schedule surgery?
Here in NJ I have to wait until October. |
| Kathryn L. Burg
MSN, CRNP:
Christa, Currently the wait time for an
initial appointment is 4-8 months. Once
the initial appointment is complete, wait
time to surgery is approximately 2 months. |
| Greg:
I know this was extremely risky a few years
ago. What are the risks of complications
and chances of success on average today?
|
| Noel N. Williams,
MD:
The chances of success with this operation
are excellent. The complications are now
to a minimum in hospitals where signficant
numbers of these procedures are done. |
| Linda:
Do you also do the reversible technique?
Is it an easier procedure for the patient?
|
| Noel N. Williams,
MD:
At this point in time, some insurance companies
are beginning to cover the reversible technique.
Yes, it is easier on the patient. |
| Tom:
I notice you did not mention the LAP Band
as an option. Do you do that procedure?
If not why? |
| Kathryn L. Burg
MSN, CRNP:
Tom, Currently the insurance companies in
Pennsylvania have not covered the Lap Band.
Our surgeon is trained in the lap band and
you are welcome to have an initial consultation.
Due to the insurance issues, an appeal may
be necessary if the procedure is denied. |
| Peggy:
I'm about 175 lbs. overweight. I have shortness
of breath and edema in my feet and ankles.
I'm really worried about the risks of bariatric
surgery. What can you tell me? |
| Rachel Griehs,
MS, RD, LDN:
Hi Peggy - Thank you for your question.
It is important when considering the surgery
that you look at the number of operations
that the surgeon has performed. At the Hospital
of the University of Pennsylvania, we have
performed over 1,000 bariatric surgeries.
To schedule an evaluation, call 1-800-789-PENN.
|
| Greg:
As I am approaching 50, is there generally
a need for cosmetic surgery due to the skin
not being as elastic? |
| Noel N. Williams,
MD:
The chances are, if you have surgery for
morbid obesity at your age, you will need
to have cosmetic surgery. |
| Feng:
My son is 17 years old and he weighs about
240 lbs. His height is about 5 foot 10.
Do you think I should look into this procedure
for him? |
| Kathryn L. Burg
MSN, CRNP:
Feng, First of all it is necessary to look
at your child's overall health. Surgery
on Adolescents is a serious option. We take
it very seriously and make sure adolescents
need surgery. First of all you need to be
sure he has exhausted all other weight loss
options. |
| Dawn:
I got surgery at Pennsyvania Hospital back
in February and I lost 61 pounds. I did
hit a plateau for a month, though. I know
carbs are a big factor in the diet. However,
everything has carbs. Would it be wise to
take the carb blocking pills to help and
give an extra boost? |
| Rachel Griehs,
MS, RD, LDN:
Hi Dawn - Carb blocking pills may initially
help you lose weight. However, you will
not permanently keep the weight off. It
is important to adjust your diet. Protein
is the key to successful weight maintenance
and you should try to consume lean proteins
at each meal or snack. |
| Robin:
This has been a real eye opener. Thank you.
What's the most common side affect from
surgery? |
| Noel N. Williams,
MD:
The most common side effect after surgery
is dehydration, and for that reason, we
give our patients very clear guidelines
on nutrition after surgery. |
| Sheila:
I will be 62 in October. Is my age an impediment
to having the bariatric surgery? |
| Kathryn L. Burg
MSN, CRNP:
Sheila, Age alone is not a limitation to
surgery. We look at each individuals entire
health history and current health condition
prior to making a decision about proceeding
with surgery. |
| Beverly:
Thank you Dr. Williams, Katie, Rachel and
your entire team for what you did for my
husband, Ken. He is a completely different
person since surgery and a poster child
for your total lifestyle change program.
He is an inspiration to everyone, thanks
to you. |
| Rachel Griehs,
MS, RD, LDN:
Hi Beverly - Thank you for your message.
We are so happy that Ken is doing well.
He is a successful bariatric surgery patient
and we are happty to see that. |
| Pam:
I have type I diabetes, and I've had a cardiac
bypass. Could I be a candidate for bariatric
surgery? |
| Noel N. Williams,
MD:
Yes, you would be a candidate for surgery.
However, you would need to be fully evaluated
from a medical and cardiac standpoint prior
to surgery. |
| Denise:
After having such surgery, is one able to
be taken off of insulin and many medications
for things such as high blood pressure,
diabetes, cholesterol, etc? |
| Rachel Griehs,
MS, RD, LDN:
Hi Denise - Weight loss greatly contributes
to the improvement of many conditions. We
see patients discontinuing their medications
or greatly reducing the need for the medication.
|
| Karen:
Can you tell me more about the after-effects
of the surgery, namely the excess skin?
Is plastic surgery covered by insurance
down the road? |
| Kathryn L. Burg
MSN, CRNP:
Karen, Currently most insurance companies
cover excess skin surgery if it is medically
necessary. |
| Mary:
Hi Katie & Dr. Williams,
The show was great. I am so excited I am
having my surgery on May 20. See you all
soon. |
| Tracey:
What is required for your insurance company
to cover this surgery? What are the risk
for a 50ish asthmatic female? |
| Noel N. Williams,
MD:
Requirements vary with different insurance
companies. You will need to receive guidelines
from individual insurance companies. However,
the majority of insurance companies cover
the surgery. In relation to your second
question, you would need to be fully evaluated
by a pulmonary doctor, but your risk is
acceptable. |
| Rufus:
I have tried every diet and program you
can imagine and i still do not lose weight.
Is the surgery available for everyone and
what is the time frame before you get it?
|
| Rachel Griehs,
MS, RD, LDN:
Hi Rufus - The surgery is available to those
who meet the criteria of 100 lbs overweight.
Our timeframe for an appointment is four
to eight months. With surgery approximately
two months after that. We have support group
meetings you can attend before your appointment.
|
| Jackie:
I am very interested in the surgery, but
I don't have any insurance to pay for it.
I've tried everything imaginable to lose
weight, with no success. I am mordily obese
and need to lose the weight. Are there any
doctors out there who are willing to peform
this surgery for people in my situation.
Thanks. |
| Noel N. Williams,
MD:
Jackie -- Unfortunately, most institutions
will not allow their physicians to operate
on patients who do not have insurance. |
| Debbe:
Does this type of surgery have a better
success rate over LapBand surgery? |
| Kathryn L. Burg
MSN, CRNP:
Debbe, Yes it has a better success rate
then the Lap Band surgery. The estimate
for an excellent result from Gastric Bypass
is weight loss of 70% of excess body weight.
Estimates for the lap band vary from 40-60%. |
| Audrey:
Thank you so much for this program. This
has helped my family have a better understanding
of what I'm about to endure. How soon after
my evaluation will I be scheduled with the
psycologist and nutritionist. |
| Rachel Griehs,
MS, RD, LDN:
Hi Audrey - Thank you for your question.
At your initial consultation you will be
scheduled for an appointment with a nutritionist
and psychologist. These appointments are
typically scheduled three weeks after your
initial visit. |
| Peg:
Does the stomach grow depending on how much
one eats (before surgery)? This is a question
Weight Watchers would never answer and I
am just curious! |
| Noel N. Williams,
MD:
The stomach does not grow depending on how
much you eat. |
| Robin:
I am a breast cancer survivor diagnosed
in January of 2000. Since then, I have put
on around 80 punds due to inactivity, depression
and loss of thyroid function. I'm 4'11"
and weigh 228 pounds. Am I a good candidate. |
| Kathryn L. Burg
MSN, CRNP:
Robin, We would need to meet you and perform
a thourough history and physical examination
to determine if you are a good candidate
for surgery. |
| Lynne:
Are there any studies or do you have any
knowledge of people with Hepatitis C having
problems with fatty liver and cirrohsis
after bariatric surgery? |
| Noel N. Williams,
MD:
Weight loss will improve fatty liver associated
with this disease. |
| Dolores:
I was all set for this surgery, but the
day before (8-7-2002) the surgeon called
me to say another of his patients was having
trouble and he would not do me because he
did not want any more trouble. Since then
I have gained even more weight. I have Keystone
HPE. Could you help me. I am a teacher,
age 59, and NEED this surgery soon to recover
over the summer vacation from my job. Can
you please help? |
| Rachel Griehs,
MS, RD, LDN:
Hi Dolores - Thank you for your question.
Currently there is a four to eight month
wait period for an evaluation. Please call
us at 1-800-789-PENN for an evaluation.
Support group meetings are available prior
to your evaluation and surgery. |
| Pat:
I'm 60 years old and have diabetes and had
angioplasty in 1999. I don't take insulin,
but do take other medication. |
| Kathryn L. Burg
MSN, CRNP:
Pat, due to your significant health history,
it is difficult to say if you are a candidate
in this forum. We would need to perform
a complete history and physical examination
as well as obtain a cardiac evaluation in
order to decide if you are a candidate for
Bariatric Surgery. |
| Lona:
There is a procedure where a "band"
is placed that can be tighten in the office.
Is this procedure more risky than the procedure
showned on tv? Quite frankly, I truly need
the procedure for multiple health issues
but I'm scared of the risks. |
| Noel N. Williams,
MD:
No, this procedure is not more risky than
that shown on TV. If you truly need this
procedure, you should attend one of our
support groups for more information. Call
1-800-789-PENN. |
| Bonnie:
I have also had previous surguries. Last
year I was treated for stomach ulcers. I
have hypertension, diabetes (oral medication)
and colitis at times. I am 56 yrs old and
at 5'3" I weigh 270 lbs. With my past
medical issues would I even be considered.
I have tried every commercial diet and would
like to make a permanent change |
| Kathryn L. Burg
MSN, CRNP:
Bonnie, Since you have a complex medical
and surgical history, we would need to meet
you and perform a complete history and physical
examination, as well as pre operative tests
to determine if you are a surgical candidate. |
| Denise:
I am scheduled to met with Dr. Williams
in July. It is unclear to me if I am do
anything prior to that intial meeting, or
is my visit to establish a plan. I have
waited over one year for this appointment.
|
| Rachel Griehs,
MS, RD, LDN:
Hi Denise - Thank you for your question.
The initial visit is the first thing that
you need to do. If you need a referral from
your primary doctor, please bring that with
you to your appointment. You may attend
monthly support group meetings prior to
your appointment. To learn more about support
group meetings, please call 1-800-789-PENN.
|
| Gerry:
After meeting Doctors, going to appointments,
and meeting the staff team, how long will
it be before I can have the surgery? |
| Noel N. Williams,
MD:
Gerry -- Surgery will take place 6 to 8
weeks after meeting with doctors. |
| Emma:
Hello - If I move, is there support in other
States? |
| Kathryn L. Burg
MSN, CRNP:
We do not offer support group in other states,
however our patients who have moved have
joined support groups that are run by other
Bariatric Programs. |
| Annemarie:
Wanted to thank Penn and Dr. Kirkland for
giving my husband's his life back. He has
already lost about 60+ lbs since Jan 21,
2004. He is a new person. THANK YOU!!! |
| Rachel Griehs,
MS, RD, LDN:
Hi Annemarie - Thank you for your message.
Congratulations to your husband. |
| Tanya:
I have high blood pressure. Would this pose
an extra risk during the surgery? |
| Kathryn L. Burg
MSN, CRNP:
Tanya, When patients have high blood pressure,
we require cardiac clearance from a cardiologist
to determine if it is safe to proceed with
surgery. |
| James:
What factors determine whether the laproscopic
procedure is used in WLS insted of the open
procedure? |
| Noel N. Williams,
MD:
95% of patients who come to our practice
will get the laparoscopic approach. There
are certain situations where this is not
possible because of previous surgery. |
| Michelle:
I am 289 lbs and 5'9" is there a weight\height
requirement before qulifing for this surgery? |
| Rachel Griehs,
MS, RD, LDN:
Hi Michelle - Thank you for your question.
There is a weight criteria of 100 pounds
overweight or approximately 80 pounds with
obesity related problems (i.e. diabetes,
sleep apnea, or high blood pressure). |
| Patsy:
Hi, what is the BMI that justifies this
surgery? |
| Rachel Griehs,
MS, RD, LDN:
Hi Patsy - Thank you for your question.
A BMI of 40 or 35 with obesity-related complications
such as sleep apnea, high blood pressure
or diabetes. |
| Dawn:
My mother is going for surgery soon. She
had a screen put in for blood clots and
is on cumadin (blood thinners). Which is
a better option from your stand point for
surger? This or shots in the stomache for
a few days before called lomox. The heart
doctor said to be in the hospital for a
few days before and take heprin due to her
size. She is 460 and 5'5" |
| Kathryn L. Burg
MSN, CRNP:
Dawn, We also place IVC filters (screens)
in patients who are at high risk for blood
clots. Some physicians may also use blood
thinners such as Coumadin, Heparin, or Lovenox
as well. |
| Edna:
I have been interested in this surgery for
a couple years, I have already learned much
, but I was wondering how long does it take
to get an appointment for an evaluation,
then how long to the actual surgery? How
long will I be out of work? I sit at a desk
most of the day. |
| Noel N. Williams,
MD:
For initial evaluation appointment, it will
take 4 months from the first phone call.
After this visit, surgery will be 6 to 8
weeks later. You would be out of work for
approximately 3 weeks. |
| Michelle
I am 5'5 and weight about 250 lbs. I am
open to learn more, but I am not sure if
it's the right surgery for me. Are there
classes or someone I can talk to? |
| Rachel Griehs,
MS, RD, LDN:
Hi Michelle - We have monthly support group
meetings that you can attend prior to making
an appointment. This includes pre and post-operative
patients. The meeting is run by the bariatric
surgery team at Penn. Call 1-800-789-PENN
for more information. |
| Audrey
I am actually scheduled to meet with Dr.
Williams in July. My question is this: I
had a blood clot years ago after gallbladder
surgery. Does that make me less of a candidate
for this surgery since a side effect are
blood clots? |
| Kathryn L. Burg
MSN, CRNP:
Audrey, We do pay special attention to patients
with a history of blood clots. This does
not however preclude you from proceeding
with the operation. When we meet you we
will discuss this with you in detail. |
| Paula:
I had a hysteritomy in September 2002 with
complications due to extensive adhersions
from past abdominal surgeries. Will this
affect me qualifing for Bariatric surgery?
|
| Noel N. Williams,
MD:
Paula -- Each situation is individual and
you would need to be evaluated in the office
prior to making a decision on qualification
for surgery. |
| Chipper
I know about eating protein first, but I've
never heard you're to wait 30 minutes to
drink fluids after eating. |
| Rachel Griehs,
MS, RD, LDN:
Hi Chipper - Thank you for your question.
Initially, the pouch is not equipped to
handle foods and fluids at the same time.
If you eat and drink too close together
you likely will get sick. As you progress
through your recovery, the time between
eating and drinking will lessen. |
| Joan:
I am considering weight loss surgery and
have read that there is a less drastic option
called gastric banding. Do you offer this
option and if not, why not? |
| Kathryn L. Burg
MSN, CRNP:
Joan, Currently the gastric banding or Lap
band is not covered by Pennsylvania insurance
companies. We are trained in this procedure
and patients are able to be evaluated for
this procedure with the understanding that
it may be difficult to obtain insurance
coverage. |
| Peg:
I quit smoking one year ago and gained 50
pounds. I am now at 300 pounds (5'2").
I can't stand my weight. Do I need my family
doctor to refer me to you for insurance
purposes? |
| Noel N. Williams,
MD:
Yes, you would need your family doctor to
refer you. Please call 1-800-789-PENN to
schedule an appointment. |
| Bernie:
Dr. Williams, I just wish to say the surgery
you did for me 2 years ago has been excellent.
I have gone to doing major remodeling and
building re-construction for the Dragon
House rest. in Wildwood,N.J. and now work
full time. Please contact me at (609)425-2588.
Thank you again. Bernie |
| Rachel Griehs,
MS, RD, LDN:
Hi Bernie -- I am happy to know that you
are doing well. Dr. Williams says that he
will be there this summer! |
| Kathleen:
I had open bariatric surgery 2 and 1/2 years
ago. It is unsuccessful in that I can (and
do) eat just as much now as before the surgery
and have had none of the behavior mod changes
that I was told to expect. Could I be evaluated?
|
| Kathryn L. Burg
MSN, CRNP:
Kathleen Yes, you could be evaluated for
surgery. We would have you meet with our
entire team including the Psychologists
to assist you with the behavior modification
piece. |
| Jamey
I have a large surgial hernia. When i lay
down it stick outs. Will Ibe a candiate
for the surgery? Thank you. |
| Noel N. Williams,
MD:
Jamey, we would need to see you in the office
for an evaluation, but a hernia does not
preclude you from surgery. |
| Lisa:
Are there procedures for someone who is
overweight but not quite 100 lbs? I was
told that I am not a good canidate because
I'm about 80 lbs overweight . |
| Rachel Griehs,
MS, RD, LDN:
Hi Lisa - Thank you for your question. At
this time, surgery has only been approved
for those are 100 pounds or more overweight.
If you are 80 pounds overweight and have
obesity related problems such as sleep apnea,
high blood pressure, or diabetes you may
be a candidate. To learn more about the
program at Penn, call 1-800-789-PENN. |
| Michele:
I have Hepatitis C. Would I still be able
to get this done? |
| Noel N. Williams,
MD:
Michele - You will be able to have surgery,
but would have to be fully evaluated from
a liver function standpoint, prior to surgery. |
| Dave:
I am 400 lbs and have tried everything.
I would like to attend the support meetings.
Can you give me more information -- times,
dates. Are there any meetings at night ?
|
| Kathryn L. Burg
MSN, CRNP:
Dave, The support group meeting meets the
second saturday of each month. We meet at
the Hospital of the University of Pennyslvania
(34th and Spruce ) in the admissions center
on Silverstein 1 from 10am to 12pm. The
only exeption to this schedule is june.
WE meet on June 5th instead. |
| Sandie:
Do you have to be 100 pounds are more before
you are considered? I am 5 feet tall and
weigh 198, and have sleep apnea which was
determined from Penn. I have tried diets
and have lost about 50 pounds in the last
9 years but can't get the rest off and now
due to knee problems, I can't exercise. |
| Kathryn L. Burg
MSN, CRNP:
Sandie, We actually look at patient BMI
to determine if they are surgical candidates.
You can find a BMI calculator online to
determine what your BMI is. The criteria
for surgery are a BMI of 40 or greater,
or 35 or greater with obesity related health
problems (such as sleep apnea). |
| Joanne:
Dr. Williams, I am one of your miracle patients.
You did my surgery last March 5, 2003 and
so far I have lost 100 pounds. My sister,
Diane, had the surgery 3 months later and
she has lost even more. I am jealous of
her but thrilled for both of us! Anyone
who asks me if I would do it again, I give
them your number and say I wish I had known
you 20 years ago. To you and your entire
team, I want to say "Thank You"
for your gifts, caring and for giving me
the confidence to live my life again! I
really enjoyed your show tonite and know
that it took time and energy to put it together.
It was fabulous and again, a gift to those
who need this surgery to live. Hugs, Joanne
Fay |
| Noel N. Williams,
MD:
Joanne -- Many thanks. |
| Ange:
Congrats team, awesome show. |
| Rachel Griehs,
MS, RD, LDN:
Hi Ange - Thanks for your message. You are
an important part of the team! |
| Helen:
What is the leading cause of death after
the surgery? |
| Noel N. Williams,
MD:
Pulmonary embolism, or blood clots to the
lungs, are the leading cause of death after
the surgery. |
| Robin:
Since I have been cancer free for almost
5 years, would I be at any additional risk? |
| Kathryn L. Burg
MSN, CRNP:
Robin, This depends on a variety of factors.
We would need to perform a thourough history
and physical exam as well as pre operative
testing to determine the answer to this
question. |
| Susan:
How are family members involved in the process?
|
| Kathryn L. Burg
MSN, CRNP:
Susan, Family members are encouraged to
attend all aspects of the program. This
includes the initial evaluation, nutrition
class, psychology evaluation and support
group meetings. |
| Lorraine:
With the laporoscopic surgery like Linda
had, how soon could I go back to work? Also,
what happens when you get to your goal weight
with the extra skin, is there cosmetic reconstruction
surgery too? |
| Noel N. Williams,
MD:
Lorraine -- You could return to work in
approximately 3 weeks. We work closely with
the plastic surgeons at PENN, and refer
patients to them who require cosmetic reconstruction. |
| Tanya:
I am 5'8" tall, and currently weigh
260 lbs. Would I be eligible for this surgery?
|
| Kathryn L. Burg
MSN, CRNP:
Tanya, Yes, by your BMI you are a candidate. |
| Sarah:
Do you have a special ward for bariatric
patients? Also, how many doctors at HUP
are performing this surgery? |
| Noel N. Williams,
MD:
Sarah - yes, we do have a special ward for
bariatric patients. In addition to myself,
Dr. Steven Raper performs bariatric surgery
at HUP. |
| Jeff:
I am from the Lehigh Valley. Do you get
many patients from here and does Blue Cross
from here cover the procedure if you are
obese? |
| Kathryn L. Burg
MSN, CRNP:
Jeff, We actually get patients from all
over the Delaware Valley. You should contact
Blue Cross to make sure that your plan covers
the procedure (however, blue cross usually
does). |
| Barbara:
Hi, I had my surgery 7/02 and I'm down 100
lbs and I feel great. I still want to lose
at least 30 more. I go to a gym and I'm
real anxious to lose this weight. Does it
go slower now? Next, my doctor moved his
practice up to the Newark area. Is there
a support mtg in South Jersey or Philadelphia?
Thanks the show was super and right on target!
|
| Rachel Griehs,
MS, RD, LDN:
Hi Barbara - The typical weight loss period
is 12 to 18 months. At this point, the weight
loss will be up to you by exercising and
eating healthy. Support groups are for patients
coming to Penn or who had their surgery
at Penn. However, if you are unable to attend
meetings where you had your surgery, please
feel free to attend our meetings. Call 1-800-789-PENN
for a schedule. |
| Linda:
If you are considering bariatric surgery,
the most important thing you can do for
yourself is to weigh all the factors and
go to the best team, including the surgeon,
nutritionist, program supervisor, surgical
team and hospital. After considerable research
I found the whole package at the University
of Pennsylvania Health System. |
| Carol:
What are the financial costs to patients
(initial consultation fees, etc). Also,
how can interested people get information
on the nutrition classes and support groups
befor the surgery? |
| Kathryn L. Burg
MSN, CRNP:
Carol, Some insurance companies do not cover
the initial consultation (which costs about
$200). You need to check with your insurance
regarding this cost. Patients must also
pay $200 for the nutrition class/counseling
and $200 for the psychology evaluation.
You can get information on the support group
by calling the 1800789 PENN phone number. |
| Audrey:
Thank you for the program this evening.
It has enabled my family to have a better
understanding of what I am about to endure.
How soon after my inital consult will I
see the Psycologist and nutritionist.? |
| Rachel Griehs,
MS, RD, LDN:
Hi Audrey - After the initial visit, you
will see the psychologist and nutrionist
within three weeks. |
| Pam:
Does insurance cover cosmetic surgery if
needed after the weight loss to reduce excess
skin? |
| Noel N. Williams,
MD:
Pam -- It will only cover cosmetic surgery
if it is deemed to be medically necessary.
Otherwise, it will have to be paid by the
patient. |
| Dianne:
My husband had the Lap Band surgery done
I belive 4 years ago by Dr. Nole Williams
and had 2 follow up visits with him. He
was 320 lbs. The first year he lost 100
lbs. then he started gaining weight back.
He is now back up to to 290. Is it possible
the bands streched or broke? And it possible
to have surgery re-done? |
| Noel N. Williams,
MD:
Dianne -- It is possible that the pouch
has expanded, which would explain his weight
regain. Yes, it is possible to have this
converted to a gastric bypass. |
| Sandie:
If you have had laproscopic surgery previously
can you still be a candidate? |
| Kathryn L. Burg
MSN, CRNP:
Sandie, We would need to meet you and perform
a complete history and physical exam as
well as pre operative testing to ensure
that you would be a candidate. Usually previous
laproscopic surgery does not cause a problem
with this operation. |
| Audrey:
Once you have the surgery is there any chance
to actually gain back all of the weight
you may lose? |
| Rachel Griehs,
MS, RD, LDN:
Hi Audrey - Yes it is possible. It is very
important that you make behavioral and diet
modifications to permanently maintain your
weight loss. |
| Mary:
I had intestinal bypass surgery in 1976.
It didn't work. I weight presently 378lbs.
I am 57 can I get WLS. |
| Noel N. Williams,
MD:
Mary -- You would have to be carefully evaluated
prior to making this decision. |
| Mary:
I was glued to the t.v. during your show.
In 1990 (February) I was diagnosed with
endometrial cancer. I had radiation therapy
and finished my last treatment in June 1990.
I am 14 years out and have annual check
ups. Am I a candidate for this type of surgery
? |
| Kathryn L. Burg
MSN, CRNP:
Mary, This is difficult to answer without
meeting you and reviewing your entire health
history in detail. Cancer is not a contraindication
to surgery if it has resolved. |
| Cathy:
I have had a double hernia repair as well
as a total abdominal hysterectomy. Will
this hinder WLS? |
| Noel N. Williams,
MD:
Cathy - No, this will not hinder weight
loss surgery. |
| Pauline:
My son tips the scale at 500 lbs. He's 6'5"
tall. Ten yrs ago he was approx 250. He's
not yet developed high blood pressure or
diabetes, however, both run in our family.
Might he be a candidate for bypass surgery?
|
| Rachel Griehs,
MS, RD, LDN:
Hi Pauline - Thank you for your question.
Your son is 100 pounds overweight making
him a candidate for obesity surgery. If
you would like to schedule an evaluation
at PENN, please call 1-800-789-PENN. |
| James Preston
Dr. Williams: I just receved a surgery date
of 6-22-04. Please don't retire until seeing
me. Thanks. |
| Rachel Griehs,
MS, RD, LDN:
Hi James - Thanks for your message. We will
see you in June. |
| Robin:
Is there any insight to any compications
that may surface 15-20 years down the road?
|
| Noel N. Williams,
MD:
Robin -- Very good question. It is for this
reason that careful post operative follow
up is mandatory for patients who undergo
this surgery. |
| Chipper:
I noticed in a question above for surgery
the waiting period is 4-6 months. You said,
had an appointment for mid december 2003.
After waiting many months for it, it was
cancelled 3 weeks before my appointment
date. When they called they tried to reschedule
it and I said no. I waited long enough to
be evaluated. If I call and make another
appointment, will it be within 6 months
to surgery as stated in questions above
from another person? Thanks. |
| Kathryn L. Burg
MSN, CRNP:
Chipper, We have recently changed our clinic
times to decrease the wait for an appointment.
You are welcome to call and we will do our
best to accommodate you sooner. |
| Karen:
I generally always vomit after anesthesia.
Would this risk the newly stapled stomach?
|
| Noel N. Williams,
MD:
Karen -- Our anesthesiogists will make sure
you do not vomit after surgery. |
| Pam:
What are the dietary resrictions after the
procedure? |
| Rachel Griehs,
MS, RD, LDN:
Hi Pam - Thank you for your question. There
are several restrictions. There will be
foods that you can no longer tolerate. You
will also have to make changes in your eating
behaviors. |
| Marie:
I'm going to have the surgery in June and
am worried about blood clots. What cause's
them and is there any thing I can do to
help not get them? |
| Kathryn L. Burg
MSN, CRNP:
Marie, Blood clots are a risk from surgery.
They are caused by the fact that you are
in bed during the operation and for a period
of time afterwards. Obesity also increases
the risk of blood clots. We use many modalities
to prevent this risk in our patients. |
| Peg:
How long is the hospital stay for bariatric
surgery? |
| Kathryn L. Burg
MSN, CRNP:
Peg, The hospital stay is on average 4 days. |
| Helen:
What is the leading cause of death after
the surery? |
| Lou:
Great show, You all did a great job. |
| Saunsiree:
I have hypothyroidism and I had the rt thyroid
lobe removed. Since then my doctors are
having a hard time regulating my medicine
and I keep gaining weight. My primary suggested
I look into this. My main question is will
this help someone fighting with hypothyroidism? |
| Kathryn L. Burg
MSN, CRNP:
Saunsiree, Hypothyroidism is not a contraindication
to surgey. |
| Roe:
I have been dieting since I have been in
grade school. I am 55 years old and definitely
need to lose 150 lbs. When I do diet, I
am focused, but once I slip, look out. It
is great that there is a support group,
but best of all the option that if you don't
follow what you need to do, you will become
ill. How long is recovery time? I have signed
up to set up a date for an evaluation. |
| Noel N. Williams,
MD:
Roe -- Recovery time after surgery is 3-4
weeks. |
| Dave:
I am a 67 year old type 2 diabetic male
weighing 285 lbs and am 6'1" tall.
Am I eligible for Bariatric Surgery? |
| Kathryn L. Burg
MSN, CRNP:
Dave, Due to your variety of health problems
you most likely are a candidate for surgery.
Since you are 67 years old, we would need
to evaluate you carefully to determine if
this is a safe option for you. |
| Theresa:
Are there any guidelines regarding age in
having this surgery? Should it not be performed
after a certain age? Thank you! |
| Noel N. Williams,
MD:
Theresa - Generally, the age range is 20-65,
however, we have operated on patients 16-19
in certain situations. |
| Gerry:
If you are over 65 will there be a lot of
lose skin from the weight lost? If so, can
it be tighten through surgey? |
| Noel N. Williams,
MD:
Hi Gerry - Thank you for your message. This
will depend on your initial size, however
if there is loose skin it can be tightened
with surgery. |
| Bonnie:
I inquired about Bariatric surgery 2 years
ago and at the time Aetna said that I would
have to be on a doctor supervised diet for
at least 6 months. Does that still hold
true. Over the course of my last 20 years
I have been on many diets with doctors and
commercial brand diets. Does none of that
count? I lost but always put back on the
weight. |
| Kathryn L. Burg
MSN, CRNP:
Bonnie, Yes, Aetna does require at least
6 months of supervised dieting in order
to approve the surgery. Your previous dieting
attempts count if you have documentation
of physician supervision. |
| Barbara:
Way to go, team!!!! I enjoyed every minute.
|
| Kathryn L. Burg
MSN, CRNP:
Barbara, THANKS!! |
| Theresa:
Hello, I am super morbidly obese. My BMI
is around 70. I currently weigh 480lbs.
Am I too high risk to have the surgery or
if I am a candidate are there more risks
involved? |
| Kathryn L. Burg
MSN, CRNP:
Theresa, We would need to meet you in person
and perform a thourough pre operative evaluation
to determine the severity of risk for the
operation. |
| Lyn:
My medical doctor is too concerned about
the 5% death rate that has been reported
with this surgery. What are the adverse
event statistics at Penn? |
| Noel N. Williams,
MD:
Lyn -- the 5% death rate statistic is a
nationally published figure based on all
comers. We stratify risk based on the patient's
medical complications prior to surgery.
Patients are carefully evaluated to decrease
the risk. Our mortality rates are well below
the national average. |
| Toni:
I am over 90 lbs over weight I am not able
to loss the weight. Would I be a canadate
for this. Age 60 5'5" 225. |
| Kathryn L. Burg
MSN, CRNP:
Toni, Criteria for surgery are a BMI of
40 or greater, or a BMI of 35 or greater
with obesity related health problems. As
for your age, we evaluate each patient on
an individual basis to determine if it is
safe to proceed with surgery. |
| Peg:
I noticed you congratulating some patients
on their success....what happens to one's
stomach and body if they are not "successful"
after the surgery? Can they still gain weight
with such a small stomach? Thanks for this
forum. I am just full of questions! |
| Noel N. Williams,
MD:
Peg - As long as patients follow the instructions
post operatively, they will lose weight
and the operation will be successful. |
| Audrey:
Is there anything that can be done after
surgery to reduce the amount of excess skin.
In other words will exercise take care of
this or will there be some sort of excess
skin if you are severely overweight. |
| Kathryn L. Burg
MSN, CRNP:
Audrey, Exercise does help tone muscles
and to some extent excess skin. In some
individuals the elasticity of the skin does
not improve with exercise. |
| Paula:
What is concern to be a normal amount of
time after surgery that you can return to
work? |
| Noel N. Williams,
MD:
Paula -- You should be able to return to
work in 3 weeks. |
| Toni:
I am over 90 lbs over weight I am not able
to loss the weight. Would I be a canadate
for this. Age 60 5'5" 225. |
| Noel N. Williams,
MD:
Hi Toni - At 90 pounds overweight with obesity-related
medical problems including sleep apnea,
high blood pressure or diabetes, you would
be a candidate for the surgery. If you have
no medical problems, the criteria is 100
pounds overweight. |
| Molly:
Dr Williams,
I have already had a consult with you. My
inusurance was willing to cover in network
costs, however because you are out of network,
they only will pay me if I was willing to
have an affadavit drawn up to insure the
hospital receive their money. Not good enough
with the pre-admission certification. Seems
to me this is all about money. I am not
a charity case, nor do I have $6,000. to
put out up front. Am willing to pay, however
no provisions or considerations are made.
This for the good of the patient? Or is
the really about money as I stated above.
|
| Noel N. Williams,
MD:
Molly -- Please call my office on Monday
to discuss. Thank you. |
| Annmarie:
Don't know if my first message got through,
it said it did not. I had surgery on March
31. I had complications and was in the hospital
for 7 days and was given 6 pints of blood.
My incision was infected and is still draining,
and on top of that I am sick as a dog. I
am ,very, very nauseous. They tell me to
drink iospure, that would make me sick to
my stomach if I wasn't already, just about
keep water down. Any ideas on what to do?
I also tried suppositorys and they don't
help. It's been 18 days. Am I ever going
to feel better? |
| Noel N. Williams,
MD:
Annmarie -- Please call 1-800-789-PENN for
advice. |
| Kathy:
I've lost 75 lbs in 6 months since surgery
(thanks to the HUP team). I'm getting discouraged
though, that the weight loss is so much
slower then many other people at the support
groups. I exercise every day, and stick
to the program, but I'm stuck on 75...any
suggestions? |
| Noel N. Williams,
MD:
Hi Kathy - Thank you for your message. Weight
loss varies for each patient. People do
hit plateaus. At this point, your weight
loss will be much slower - likely one to
two pounds per week. Continue your healthy
eating habits and remember to consume protein
at each meal. Also remember to exercise.
Doing this will help you break the plateau.
|
| Sandy:
Hi, I'm 48yrs old about 300lbs, 5'4".
Previous surgery lap/gall bladder and total
abdominal hystercomy, then radiation therapy.
Am I a high risk for surgery? |
| Kathryn L. Burg
MSN, CRNP:
Sandy, We would need to evaluate you in
person and perform a thorough history &
physical examination as well as pre operative
testing. The variety of your health history
does not usually preclude surgery. |
| Harriet:
Would a chronic condition like Interstitial
Cystitis preclude me from Bariatric Surgery.
I am in pain alot of the time. |
| Noel N. Williams,
MD:
Harriet -- This does not preclude you from
bariatric surgery. |
| Colleen:
I had a gastric bypass about 25 yrs ago.
I am anemic and struggling to lose weight.
I have gone to Weight Watchers with no big
results, because it is more calories than
I have been eatting.
Where do I turn? |
| Rachel Griehs,
MS, RD, LDN:
Hi Colleen - Thank you for your question.
It is important to take supplements and
if you have been diagnosed as anemic by
your primary care physician, you may need
iron supplements. If you do not consume
enough calories as suggested by Weight Watchers,
you may not lose weight. |
| Alice:
I am 65 years old, have Type II diabetes,
controlled high blood pressure and had a
mild heart attack in December. I have been
going to cardiac rehab and am making progress
but it is very difficult at a weight of
289 lbs. Would these ailments rule me out?
|
| Kathryn L. Burg
MSN, CRNP:
Alice, Due to the severity of your health
problems and your age, we would need to
evaluate you and have you undergo a thourough
cardiac evaluation to determine if the surgery
is safe for you. |
| I heard there is a geater chance of
the staple gun miss firing in the lap procedure.
I would prefer this procedure, but this
problem does scare me. What do you think
about this? |
| Noel N. Williams,
MD:
Christa -- This information is false. There
is no difference in the two procedures.
However, it is important for the surgeon
to use the proper sized stapler for each
person's stomach. |
| Pat:
I am 280 lbs. and type 2 diabetic, also
have been bulemic in years past. Would I
be considered for this surgery? |
| Kathryn L. Burg
MSN, CRNP:
Pat, Due to your history of Bulemia we would
have you undergo a psychology evaluation
to determine if this type of surgery is
a safe option for you. |
| Cris:
I eat much of the time even after i am full-if
it's there i'll eat it even if i'm to the
point of feeling sick. What about that in
regards to the lap surg? |
| Noel N. Williams,
MD:
Cris - You will need to be evaluated prior
to surgery to see if you are a candidate
for surgery. |
| Dave:
Your show was great!! Thanks for all the
information. It gives a person a lot to
think about, especially knowing I am overweight
and diabetic myself as I stated on an earlier
message. I am sure there are side affects
to the surgery which you did not bother
talking about. What are the draw backs for
someone my age, 67. Thanks again and God
Bless. Keep up the great work. |
| Rachel Griehs,
MS, RD, LDN:
Hi Dave - Thank you for your question. You
should schedule an individual consultation
to evaluate your health history to see if
you are a candidate for surgery. Please
call 1-800-789-PENN for additional information.
|
| Richard:
Is age a determining factor? |
| Noel N. Williams,
MD:
Richard -- Generally speaking, the age range
is 20-65. |
| Anita:
Hello I'm Anita and I'm 308 lbs. and 5`2
I have high blood pressure and asthma and
I may need a knee replacement very soon.
I would like to have the Laparoscopic gastric
bypass surgery but I don't think my Insurance
will cover it and I don't know what to do
can you help me. PLEASE. I'm 43 and want
to be around to see Grandchildren. |
| Kathryn L. Burg
MSN, CRNP:
Anita, Most insurance companies cover the
procedure. If yours does not, there are
patient advocacy groups that can help. Please
call 1-800-789-PENN for more information
on this topic. |
| Patty:
What types of health problems would disqualify
one for the surgery? I had v-tac, no blockages,
ablation to repair, but no problems since.
Would this be a concern ? |
| Noel N. Williams,
MD:
Patty -- This would not necessarily be a
problem, but you would need to be carefully
evaluated by a cardiologist prior to surgery. |
| Catherine:
My daughter's been advised to have a hernia
removed. Would that make her a poor candidate
for bypass surgery? |
| Kathryn L. Burg
MSN, CRNP:
Catherine, It depends on the type of hernia.
Rarely hernia's preclude a patient from
undergoing Bariatric Surgery. |
| Sarah:
Is it possible to "stretch" the
pouch after surgery and regain the weight? |
| Rachel Griehs,
MS, RD, LDN:
Hi Sarah - Thank you for your question.
The pouch is difficult to stretch, however
it adapts. Therefore, you can consume more
calories than necessary without eating large
portions. This could cause you to gain weight.
|
| Elissa:
I had RNY WLS in Delaware on January 26th.
The surgery is performed by a similar team.
I did have a stricture and had and EGD and
my stomach needed to be strecthed about
6 weeks out. How common is this and I'm
told it might happen again? Thanks for the
informative program. |
| Noel N. Williams,
MD:
Elissa -- This happens in approximately
3% of patients. Usually, one stretch is
sufficient but some patients require two. |
| Fran:
How many of these surgerys do you do a day?
|
| Kathryn L. Burg
MSN, CRNP:
Fran, The surgeons perform between 2-4 surgical
procedures daily. |
| Sue:
How do I figure out my BMI? |
| Rachel Griehs,
MS, RD, LDN:
Hi Sue - Thank you for your question. There
are many BMI calculators online. If you
"google" BMI online you would
be able to calculate your individual BMI.
|
| Sam:
What evaluations are done besides the nutrition
and psychological? |
| Kathryn L. Burg
MSN, CRNP:
Sam, Patients undergo a thourough history
and physical examination by a nurse practioner
and surgeon. Some patients also require
a physical therapy evaluation as well. |
| Roberta:
I am 38 year black female and have been
morbidly obese most of my life. At last
weight I was 385lbs and am only 4'11"
tall. I have been seriously considering
being evaluated. I have one drawback, I
am uninsured and my family's income is too
great for medicaid. Would you and the university
consider taking on a paitent who has no
insurance? |
| Noel N. Williams,
MD:
Roberta -- Thank you for your question.
Unfortunately, the hospital cannot admit
a patient without insurance for this procedure. |
| Pat:
Once you reach your target goal how do you
slow/stop the weight loss? |
| Rachel Griehs,
MS, RD, LDN:
Hi Pat - Your body knows when to stop losing
weight. It is important to make dietary
and behavior changes. Regular exercise is
important too. |
| Jim:
You answered a question earlier about the
wait time to resume normal activities. You
said 2-4 weeks. Was that for laparoscopic
or invasive, and does normal activities
include work? Thanks. |
| Noel N. Williams,
MD:
Jim -- This is for the laparoscopic approach.
Normal activities would include work. |
| Linda:
I am diabetic and have had two upen heart
sugeries. I am presently 160 pounds over
weight on medicare , disablity - I need
help please? |
| Kathryn L. Burg
MSN, CRNP:
Linda, We would need to meet you and perform
a thourough history and physical examination,
and undergo a cardiac evaluation. This would
determine if Bariatric Surgery is a safe
option for you. Medicare is not a problem
with coverage (in most patients). |
| Jacob:
I'm 52 yrs.old 200lbs. over weight. I had
back surgery in 2001 twice which went south
and that's how I gained the weight. Will
this surgery help me lose the weight so
I can get back to a normal life an maybe
back to work? |
| Noel N. Williams,
MD:
Jacob -- THis surgery will help you to lose
weight and return to a normal life. |
| Terri:
What are some of the foods that you may
not eat after the procedure? My Husband
just had it this week and I want to make
sure I have the proper food for him? I know
he needs protein - I have bought ensure
High Protein and all the required items
on the list. But I am worried about the
next phrase. Thank you so much. Penn was
wonderful to me and my husband. |
| Rachel Griehs,
MS, RD, LDN:
Hi Terri - Thank you for your question.
Following surgery there is a progression
from liquids to solid foods. If you have
specific questions, please feel free to
give us a call at 1-800-789-PENN. |
| Sharon:
I am 5'4 and 195 lbs. Would someone my size
be considered for this type of surgery.
|
| Kathryn L. Burg
MSN, CRNP:
Sharon, To determine your BMI you can go
to the University of Pennsylvania department
of surgery website (look under laproscopic
surgery then obesity surgery), or just Google
BMI calculator. Once you have determined
your BMI, the criteria is a BMI of 40 or
greater, or 35 or greater with obesity related
health problems. |
| V. Benson:
I smoked for 10 years, stopped a year and
a half ago and have gained over 70lbs. I
have breathing problems and I can not walk
more than a block without feeling exhausted.
Because I smoked for many years is this
surgery an option for me? |
| Noel N. Williams,
MD:
You would have to be evaluated from a pulmonary
stand point to determine whether you are
a candidate for surgery. |
| Robert Merrigan:
As a comment to the show.... I loved the
show, very informative. I went through a
dramatic weight loss back in '96 and '97,
but gained the weight back and more. I started
at 185lbs. in '96 and at the time off my
layoff in '97, I was 145lbs.
The weight loss came from poor nutrietion,
smoking, and running around a warehouse
all day. The weight gain came from going
through a bad period of my life.
I have quit smoking (smoke free for close
to two years), got a better job and taking
control of my life... Just would like info
for weight loss support groups.
|
| Sandie:
Are there any support groups availabe in
New Jersey (South Jersey) |
| Rachel Griehs,
MS, RD, LDN:
Hi Sandie - Thank you for your question.
Please call 1-800-789-PENN for more information
regarding support group information. |
| Anita:
What can be done with the excess skin, if
its removed is that in included in the cost
of the surgery. |
| Kathryn L. Burg
MSN, CRNP:
Anita, Plastic surgery is an option to remove
excess skin. Insurance will cover the procedure
if it is medically necessary. Unfornately
plastic surgery is not covered as part of
Bariatric Surgery. |
| Linda:
I am 160 pounds over weight. I have had
2 heart surgeries, I am diabetic, high blood
pressure all the ills that go with obesity.
Medicare/disablity can I get help? |
| Noel N. Williams,
MD:
Linda -- You are a potential candidate for
surgery, but would have to have full medical
and cardiac evaluation. |
| Jim:
I have COPD and had emergency AAA surgery
two years ago. Will this prevent me from
having this procedure? |
| Noel N. Williams,
MD:
Jim -- This would make you a poor candidate
for surgery.
|
| Audrey:
Thank goodness I currently do not have any
health issues except I am over 100 pounds
overweight. Since I do not have any issues
would my insurance be less likely to pay?
I have Keystone East. |
| Rachel Griehs,
MS, RD, LDN:
Hi Audrey - If you 100 pounds overweight,
your medical insurance should cover this,
regardless if you currently do not have
any medical problem |
| Grace:
How long after the surgery will I be able
to drive and return to work? |
| Kathryn L. Burg
MSN, CRNP:
Grace, You need to wait 2 weeks following
surgery to drive. Most patients wait at
least 4 weeks to return to work (however,
this varies depending on the type of job). |
| Dee:
I am interested in the surgery and know
several people who have had it. My fear
is being put to sleep. Can this surgery
be done by not being put to sleep? |
| Noel N. Williams,
MD:
Dee -- Unfortunately, you do need general
anesthesia for this procedure and therefore
cannot be done without putting you to sleep |
| Megan:
i am 5'8 300lbs i was wondering if i was
eligable for the surgery |
| Kathryn L. Burg
MSN, CRNP:
Megan, You would need to determine your
BMI. BMI calculators can be found by simply
googling BMI calculator. The criteria for
surgery are a BMI of 40 or greater, or a
BMI of 35 or greater with obesity related
health problems. |
| Jackie O:
I had my gastric bypass performed elsewhere
exactly 2 years ago this week. I lost over
100 lbs, but still cannot seem to take off
another 40 to 50 lbs. Do I increase exercise
and can you recommend some lean protein
foods you advise your patients to eat? Thank
you. |
| Rachel Griehs,
MS, RD, LDN:
Hi Jackie - Thank you for your question.
Exercise is key to weight loss. We recommend
lean proteins such as skinless chicken,
turkey, lean ground beef and low-fat dairy
products. |
| Carol:
Do you remove the gall bladder during surgery?
|
| Noel N. Williams,
MD:
Carol -- If you have gall stones in your
gall bladder and have symptoms attributable
to this, your gall bladder should be removed. |
| Michele:
Are the support meetings held during the
day or are they different times of the day?
|
| Kathryn L. Burg
MSN, CRNP:
Michele, Our support group meeting is held
on the 2nd saturday of each month from 10am
to 12pm at the Hospital of the University
of Pennsylvania. You can obtain more information
by calling 1-800-789-PENN. |
| Lisa:
What is the minimum weight requirement for
this type of surgery? |
| Rachel Griehs,
MS, RD, LDN:
Hi Lisa - To qualify as a candidate, you
must be 100 pounds overweight or approximately
80 pounds overweight with medical problems.
|
| Kathie & Cliff:
To everyone on the team....just a note to
say your unending support and true caring
is so appreciated. Between the 2 of us,
we are 309 lbs lighter! Thanks |
| Rachel Griehs,
MS, RD, LDN:
Hi Kathie and Cliff - Thank you for your
message. You both are great success stories.
|
| Theresa:
If a patient is severely obese, which I
am, is the procedure different in any way?
I have read a lot about the surgery and
I was wondering if you perform the distal
RNY on super morbidly obese people? |
| Noel N. Williams,
MD:
Theresa -- If you are a super obese patient,
you will have a long RNY. |
| Greg:
How long does the actual procedure tend
to take? |
| Kathryn L. Burg
MSN, CRNP:
Greg, The operation on average takes 2 hours
to perform. |
| Elissa:
What is the hospital stay after the surgery?
|
| Rachel Griehs,
MS, RD, LDN:
Hi Elissa - The hospital stay is approximately
four days. |
| Kate:
Dr Williams, you've created a monster! My
husband has lost 75 lbs so far, and now
he won't leave me alone. He's acting like
a teenager instead of a 53 year old man.
(thanks) |
| Barbara:
In general, what is the most important factor
when you are evaluating a person for this
operation? I have a very bad back with herniations
at every level of my lumbar spine. I have
had three back operations and all failed.
I now weigh 222lbs.I have been able to take
of about 70lb over the last nine years but
cannot get under 200 no matter what I do.
I also am diabetic and take the oral medication.
I am 5'4''tall. and 60 years old. I was
an LPN and got hurt lifting a patient. This
happened nine years ago. I am very unhappy
because of my weight and the chronic pain
I live with. I believe if I could lose the
weight the pain would not be so difficult
to live with. Can you help me? |
| Noel N. Williams,
MD:
Barbara -- we would need to see you in the
office for an evaluation to see if you are
a candidate for surgery. |
| Kat:
I had v-tac and it was corrected with ablation.
No problems since. I am 5'6 and 230. My
belly is a sagging disgusting sight. My
husband wants the woman he married back.
Is this surgery available near Lancaster,
PA ? |
| Kathryn L. Burg
MSN, CRNP:
Kat, Our health system does not have a hospital
in Lancaster. You are welcome to come to
Philadelphia if you are interested in having
surgery performed by our team. |
| Chris:
I eat much of the time even after I am full.
Sometimes to the point of getting sick.
If its there i will eat it. Is there help
for me with the lap surgery? |
| Rachel Griehs,
MS, RD, LDN:
Hi Chris - Thank you for your question.
The surgery prevents you from being able
to eat large portions of food. However,
if you do not change your eating behaviors,
you will have a difficult time being successful.
Many patients seek the assistance of a psychologist
to help them with their behavioral issues.
|
| Kumar
I heard that it takes about a year of research
and treatment before surgery is this true
and what kind of treatments do you do? |
| Noel N. Williams,
MD:
Kumar -- It takes 4-6 months to get an appointment
for an evaluation. |
| Susan:
Is there a charge or requirement to go to
the support meetings? |
| Kathryn L. Burg
MSN, CRNP:
Susan, There is no charge for the support
group for pre operative patients. Post operative
patients are charged $5 per session. |
| Gerry:
Where are the support groups and when do
they meet? Does it cost anything to attend
the meetings? |
| Rachel Griehs,
MS, RD, LDN:
Hi Gerry - Thank you for your question.
We do have support groups available at Penn.
After surgery, there is a nominal fee of
$5 to attend the meetings. Please call 1-800-789-PENN
for more information on our support group
meetings. |
| Karen:
I am currently weighing in quite over the
100 lbs to be considered. I have a few other
health issues of high blood pressure, and
a very bad case of cellulitis in my legs.
Would either of those take me off othe list
of being considered? And what is the number
to call for an evaluation. Thank you for
presenting the program and helping so many
so far, I hope to one on the road to a normal
life again with your help. |
| Kathryn L. Burg
MSN, CRNP:
Karen, Your health problems are common in
obesity. We would need to meet you and perform
a complete history and physical examination
as well as cardiac evaluation do determine
if Bariatric Surgery is safe for you. To
make an appoinment please call 1-800-789-PENN.
I'm glad the show was helpful! |
| Elese:
I have try a lot of diets and fail. I have
fatty breast under my arms and my arms are
large. Can you assist me in this situation? |
| Noel N. Williams,
MD:
Elese -- You could attend one of our support
group meetings to find out more information.
Please call 1-800-789-PENN. |
| Roberta:
Do you have any memorable patients? Folks
who just excelled beyond expectaions? |
| Rachel Griehs,
MS, RD, LDN:
Hi Roberta - We have very successful patients,
in fact last year one of our patients competed
in her first triatholon. If you would like
more information, contact 1-800-789-PENN
to attend one of our support group meetings.
|
| Jo Anne:
After I have lost the weight, what happens
to my skin tone? Also, I was told that if
you are unable to connect my intestins to
the new stomach (Gastic Bypass), then Lap
Band surgery is performed. Is this true?
|
| Noel N. Williams,
MD:
Jo Anne -- 95% of patients are able to have
their intestines connected. In situations
where this is not safe, a band is placed
for the vertical banded gastroplasty operation.
Many people require plastic surgery for
their skin tone. |
| Jeanne:
Does anyone of you do the gastric band and
if so how safe and is it? I hope not a material
of latex is used as I am highly allergic. |
| Kathryn L. Burg
MSN, CRNP:
Jeanne, Currently we have not performed
the LAP BAND. THis has been due to lack
of insurance coverage in pennsylvania. Our
team is however trained in this procedure
and are willing to evaluate patients for
this operation. We are unsure if the band
is safe with a latex allergy. Please call
our office to discuss this further 1800
789 PENN. |
| Diana:
Hi, I am very much over weight, over220
lbs. I have diabetes, high blood pressure,
brachial plaxis. I have tried to lose weight
on my own, and I can't seem to want to do
anything. I need help |
| Rachel Griehs,
MS, RD, LDN:
Hi Diana - Thank you for your question.
If you are approximately 80 pounds overweight,
because of your medical conditions, you
would meet the criteria. To schedule an
evaluation, call 1-800-789-PENN. |
| Pat:
Dr. Williams, I am considering the surgery
- I had a VBG 20 yrs. ago. Can you address
the added risks for a VBG patient, if any,
and have you performed the RNY on someone
who has had a VBG? What is success rate?
Thank you. |
| Noel N. Williams,
MD:
Pat -- You will have to be fully evaluated
before a decision can be made to do the
conversion. Please call 1-800-789-PENN to
schedule an evaluation. |
| Lona:
Is the surgery performed at both Penn hospitals?
Does Dr. Kirkland still operate at 8th &
Spruce? How long are you usually an inpatient?
How long before you have a follow-up visit
with the doctor? |
| Kathryn L. Burg
MSN, CRNP:
Lona, Yes, Dr. Kirkland does Bariatric surgery
at Pennsylvania Hospital (8th & Spruce).
The inpatient stay is on average 4 days.
The initial follow up visit occurs at 10
days post operatively. |
| Chester:
I am concerned about my sister-in-law. She
is between 350-400lbs. She does not want
any help from us, nor does she want to help
herself! how do we get her off the couch
and in to treament? We did order your info,
and when we told her that she got very upset.
|
| Rachel Griehs,
MS, RD, LDN:
Hi Chester - The decision to have surgery
is an individual decision. The person needs
to be 100% sure that this is best option.
To learn more about the bariatric surgery
programs at PENN, call 1-800-789-PENN. |
| Benson:
I weigh 190lbs, 4'11", could I be considered
for this surgery? |
| Noel N. Williams,
MD:
Benson -- Yes, you would be a candidate.
Please call 1-800-789-PENN to schedule an
evaluation. |
| Payton:
Hi Dr. Williams - Great show tonight! Is
there any health risks 15 years from now?
Has any studies been shown? |
| Noel N. Williams,
MD:
Payton -- Thanks for your question. Studies
have shown that if patients are followed
carefully, there will not be any long term
health risks. |
| Plummer:
I am on a blood thinner. Does taht matter?
The test for pulmonary embolism and clots
in the lungs were inconclusive.
|
| Kathryn L. Burg
MSN, CRNP:
Blood thinners are not a contraindication
for surgery. We would need to meet you for
an initial consultation and discuss your
current health status & health history
to determine if Surgery is safe for you. |
| Susan:
What is "dumping?" And can you
ever eat normal proportions again? What
is the death rate for this procedure? Thank
you. |
| Rachel Griehs,
MS, RD, LDN:
Hi Susan - Dumping is a side effect of eating
simple sugars. Some symptoms are abdominal
pain, diarrhea, fatigue, headache and light-headedness.
Following the surgery, you will need to
consume small portions of food. Mortality
rate for this surgery is .5%. |
| Colleen:
I had gastric bypass surgery. If you are
depressed and really tried every diet without
lasting results it is worth the couple weeks
of recovery. |
|
Roberta:
Is there pain postoperatively?
|
| Kathryn L. Burg
MSN, CRNP:
Roberta, Yes there is pain following surgery.
We manage the pain with medications. The
pain resolves on average about 1-2 weeks
following surgery. |
| Dave:
Is it true that you can not drink carbonated
beverages after the surgery ? |
| Rachel Griehs,
MS, RD, LDN:
Hi Dave - Carbonated beverages are not encouraged
for the first couple of months following
surgery. Some people are not able to tolerate
theses types of beverages again after surgery.
Every individual is different. |
| Gabrielle:
I had the surgery on July 16,2002. It was
a success with no complications. However,
I AM CONCERNED because I WENT FROM 312 lbs
to 109. I am 5'4 inches is this a healthy
weight for me? I was featured in health
system news & also on maury povich show
because of this weight loss. |
| Noel N. Williams,
MD:
Gabrielle - Please call my office to discuss
your question. |
| Barbara:
Can you get pregnant after the procedure?
I am a 25 years old I have no children and
I am about 125 over weight and I am thinking
about getting the procedure, But I am wondering
if I can have kids after the surgery |
| Kathryn L. Burg
MSN, CRNP:
Barbara, Yes, you can have children following
surgery. It is necessary to wait at least
18 months until the rapid weight loss has
ceased. During pregnancy close attention
to nutrition must be observed. |
| Nancy:
I have heard that alot of people that have
this stomach bypass...have gas and burp
alot. Is that true? We never hear the bad
things about surgeries, and I would love
to know. I'm wheelchair bound now because
of my weight which is a long story, but
need to know as much as possible and doctors
in my area really could care less. They
just say go on a diet. Thanks for any info
you can give. |
| Rachel Griehs,
MS, RD, LDN:
Hi Nancy - To qualify for this procedure
you would need to be 100 pounds overweight
or approximately 80 pounds overweight with
medical problems. To learn more about the
bariatric program at PENN, please call 1-800-789-PENN.
|
| Diana:
Hi, I am very much overweight, over 220
lbs. I have diabetes, high blood pressure
and a lot of other ailments. I've tried
to lose weight own my own but I have no
will power and no energy. My son has just
joined the Army and left in March for boot
camp, and since he left, all my motivation
is gone. I also have brachial plexus on
in my right arm, shoulder, shoulder blade
and hand. I've had this for over 1 year
and I am not active at all from this. Can
someone please help me? I really need to
lose weight so I can see my children get
married. Thank you very much! |
| Noel N. Williams,
MD:
Diana - Please call 1-800-789-PENN to schedule
an evaluation. |
| Ricky:
Do you recommand this if you want to have
children in a couple of years? |
| Kathryn L. Burg
MSN, CRNP:
Ricky, It is possible to become pregant
safely at about 18 months following surgery.
You must wait until the rapid weight loss
period has ceased. It is imperative to pay
close attention to nutrition throughout
the pregnancy. |
| Sandie:
I have Keystone Health Plan East. Could
you advise me, besides a referral, what
out of pocket cost would I be required to
pay? |
| Noel N. Williams,
MD:
Sandie -- Contact Keystone Health directly
for this information. |
| Ag:
I drink approx.1 gallon of water daily.
How will this be modified after surgery
and what are your recommendations to prevent
dehydration? |
| Rachel Griehs,
MS, RD, LDN:
Hi Ag - After surgery, you must drink slowly.
To prevent dehydration, we recommend 48
to 64 ounces of fluids per day. |
| Roberta:
Is this the only GI surgery you do? |
| Kathryn L. Burg
MSN, CRNP:
Roberta, Dr. Williams, & Dr. Kirkland
perform a variety of Gastrointestinal surgical
procedures. |
| Meagan:
Shoud I go to my primary care physician,
or go directly to you? I currently have
CIGNA HMO. Is this usually covered by my
program? I really enjoyed your TV program
which aired this evening. |
| Noel N. Williams,
MD:
Meagan -- Contact your primary care physician
and your Cigna HMO to find out more information.
Generally, we do accept Cigna. |
| Joanne:
Do you accept Mid-Atlantic insurance? |
| Kathryn L. Burg
MSN, CRNP:
Joanne, You would need to contact your insurance
company and ask if they cover the procedure.
I am not familiar with this insurance company. |
| Denise:
To attend a support group meeting, do you
need to register for the group or can you
just attend. |
| Kathryn L. Burg
MSN, CRNP:
Denise, You may attend a support group meeting
without registering.
|
| Debbe:
During the initial consultation and your
experience with HMO insurance coverage for
previous patients would you have an idea
if my insurance will pay for the surgery?
|
| Noel N. Williams,
MD:
Debbe -- Contact your insurance company
to find out if this surgery would be covered.
|
| Gabrielle:
Dr. Williams, please keep me in mind for
any kind of media stories such as this.
I had made remarkable results. I was in
health system news, The Daily News &
Maury Show, praising you for changing my
life dramatically. People don't even notice
me any more. I have gone from 312 to 109
with hardly any extra skin. I will be seeing
you in July for my annual check up. Thank
you! |
Jeanne:
I work for virtua and the make up pay and
out of network copay is $500.00. Do you
or would you do the surgery in a new jersey
hospital ? |
| Kathryn L. Burg
MSN, CRNP:
Jeanne, We do not have a hospital in
New Jersey.
|
| Roberta:
Why does the weight loss vary so much from
person to person? |
| Rachel Griehs,
MS, RD, LDN:
Hi Roberta - Weight loss depends on the
size of the patient as well as the individual's
eating and behavior modification.
|
| Debbe:
Are support groups only in "the city"?
|
| Kathryn L. Burg
MSN, CRNP:
Debbe, Yes, our support group meetings take
place only at the Hospital of the University
of Pennsylvania.
|
| Theresa:
Do you know what percentage of people are
unsuccessful after having the surgery? And
what is the most common case of their lack
of success? |
| Noel N. Williams,
MD:
Theresa -- Approximately 95% of patients
are successful. This can be as much as 100%
as long as proper directions are followed
after surgery.
|
| Rose:
I am a patient of Dr. Kirkland and I had
my surgery on January 26th of 2004. I have
lost 53 pounds so far, but I feel I should
have lost more by now. Also, I am having
trouble drinking water since after the surgery.
It makes me very nauseous. I know I am not
drinking as much as I should. Is is normal
to get sick from water after surgery? Great
info show tonight. |
| Rachel Griehs,
MS, RD, LDN:
Hi Rose - Every individual is different.
If you are having difficulty drinking liquids,
you should contact your physician.
|
| Phil:
I just got approved for gastric bypass by
my insurance provider. How long will it
take to have surgery with Dr. Kirkland?
I had my first visit in February 4 and was
set for surgery in March 16, 2004 but put
off by denied claim. I am approved to get
operation, but a 6 month time limit is all
they gave me. |
| Rachel Griehs,
MS, RD, LDN:
Hi Phil - Thank you for your question. It
would be best for you to contact your physician
directly with this question.
|
| Faith:
I've had this surgery suggested to me by
two doctors. I believe I fit the criteria
as far as weight but there are medical conditions
that I have that I wonder about, specifically
Crohns-Crohns/colitis, which is in remission.
However other conditions seem to be mounting
up each year and quite frankly I'm terrified.
The weight, the meds, or the surgery all
seem deadly, but I'm getting serious for
something. |
| Noel N. Williams,
MD:
Faith -- You would need to be evaluated
by one of our GI physicians before making
a decision for surgery. Call 1-800-789-PENN
to make an appointment.
|
| Audrey:
How does this procedure differ from the
stomach stapling that use to take place
years ago. I remember many people had problems
with the stapling afterwards. |
| Kathryn L. Burg
MSN, CRNP:
Audrey, We would need to see a copy of the
Operative report. There have been a variety
of weight loss surgical procedures performed
and we would need to see specifically what
procedure you are referring to. Please feel
free to contact our office to discuss further
1800 789 PENN.
|
| Mary:
Thank You to Dr. Williams, Katie and Rachel
for spending your Saturday night answering
all the questions. It was great and informative.
I am so looking forward to my in life that
is coming in May. |
| Jeff:
I am considering the surgery. I tend to
get uric acid kidney stones from too much
protein. Will it be worse after the procedure? |
| Noel N. Williams,
MD:
Jeff -- You would have to be very well hydrated
after the surgery to decrease the incidence
of kidney stones.
|
| Sandy:
What condition would preculde you from surgery
|
| Kathryn L. Burg
MSN, CRNP:
Sandy, Each patient is evaluated on an individual
basis to determine if their health conditions
create a contraindication to surgery. There
is not a list of health problems. It truly
depends on the patient and the severity
of the health problems.
|
| Michele:
I don't know if my message went through...I
am 57 years old and
I had a open RNY on August 30, 2002. I was
357 lbs. I have lost 100 lbs since my surgery
date. I don't feel that my surgery was successful.
I have consulted with my surgeons, dietitians,
PCP and no one can tell me why I am not
losing weight. I go to the gym 3-4 days
a week and work out 1-1.5 hours. My daily
calorie count is between 800-1300 daily
with at least 100 grams of protein. I don't
feel that my surgery was a success because
I have stopped losing weight. I have not
lost any weight since June 2003. Could there
be a reason why I haven't lost any more
weight. I read how so many people lose their
weight, get off their meds, I still take
all the same medications and my weight loss
has stopped.
Any answers???? PLEASE HELP!!
|
| Rachel Griehs,
MS, RD, LDN:
Hi Michele - Thank you for your question.
The typical weight loss period is between
12 and 18 months following surgery. After
that, it depends on the individual. If you
have specific questions regarding your situation,
we advise you to speak with your physician.
|
| Jennell:
How long does this surgical procedure usually
require a patient to be under anesthesia?
|
| Noel N. Williams,
MD:
Jennell - The surgery lasts about two and
half hours.
|
| Debbe:
Does this surgery increase symptoms of IBS?
|
| Kathryn L. Burg
MSN, CRNP:
Debbe, No the procedure does not increase
these symptoms.
|
| cv:
I am about 95 lbs overweight, am I a likely
candidate for this? |
| Rachel Griehs,
MS, RD, LDN:
Hi CV - Candidates for this surger are 100
pounds overweight or approximately 80 pounds
with obesity-related complications. For
more information, call 1-800-789-PENN.
|
| Theresa:
Is the laproscopic procedure impossible
to perform on someone who is over 400lbs.?
|
| Noel N. Williams,
MD:
Theresa -- In general, the procedure is
not done laparoscopically in patients over
450 lbs.
|
| Carol:
Are the doctors and the team only affliated
with the University of Penn? Or do they
have other hospital affliations where they
perform the surgery? |
| Kathryn L. Burg
MSN, CRNP:
Carol, Our health system currently has Bariatric
Teams at The Hospital of the University
of Pennsylvania and Pennsylvania Hospital.
|
| Mae
How common is leaking? My friend was very
sick with this after her surgery. |
| Noel N. Williams,
MD:
Mae -- Leaks take place in 1% of patients
|
| Audrey:
As I stated in an earlier post I am scheduled
to meet with Dr. Williams in July. What
should I do in the meantime? Should I try
to be more careful about what I am eating
and/or exercise so that I am as healthy
as can be for surgery? |
| Kathryn L. Burg
MSN, CRNP:
Audrey, It is always helpful to be losing
weight prior to your office visit. It is
also helpful to get whatever health problems
you have tuned up and under as best control
as possible prior to your visit.
|
| Eileen:
So much of what I've heard tonight is that
this surgery is a piece of cake, every one
comes out fit as a fiddle. I'd appreciate
knowing the down sides and just what exactly
can and has gone wrong after surgery. This
way we can made an informed decision as
to whether we do want this operation. |
| Rachel Griehs,
MS, RD, LDN:
The population getting bariatric surgery
is high risk to begin with. There are many
complications that can occur, however, choosing
the appropriate facility is important. The
risks of the surgery decrease with the expertise
of the surgeon. At Penn, we have done over
1000 operations. Log on to the Bariatric
Surgery Program at Penn website to learn
more about the surgery. To schedule an evaluation
please contact 1-800-789-PENN
|
| LB:
I am 235lbs 5'3 I suffer from Hepatitis
C, diabetes 2, high blood pressure and acid
reflux. I currently am covered by mercy
keystone. Would they cover the surgery?
I'm waiting on a hearing for disability. |
| Rachel Griehs,
MS, RD, LDN:
If medically necessary, Keystone Mercy will
cover the surgery. To qualify for surgery,
you need to be approximately 100 pounds
overweight (BMI of 40) or a BMI of 35 with
obesity related health problems, such as
diabetes and high blood pressure. To determine
your BMI, body mass index, please log on
to the Penn Bariatric Surgery Program website.
|
| Dee:
I've just read some previous questions and
would like to know what is considered super
obese and what is rny? I will be calling
next your office to begin the surgery process.
Thanks for the info. |
| Rachel Griehs,
MS, RD, LDN:
Super obesity is anyone with a BMI of 50
or greater. To determine your BMI, please
log on to the PENN Bariatric Surgery Program
website. Roux-en-Y is the name of the gastric
bypass that is performed, which involves
creating a smaller stomach for food to enter
and bypassing a portion of your intesting.
You can also find this information on the
Bariatric Surgery Program website.
|
| Olive:
I am currently 360lbs. I had 2 c-sections
in 2001 and 2003. Currently I am diagnosed
with sleep apnea and high blood pressure.
I have aetna as my insurance. Am i a candidate?
|
| Rachel Griehs,
MS, RD, LDN:
If you are 100 pounds overweight, [Jones,
Veronica] most insurance companies will
cover the surgery. Having a c-section will
not prevent you from getting surgery.
|
| Debbe:
Do I need my primary care physician's approval?
|
| Rachel Griehs,
MS, RD, LDN:
If you have an HMO, you need a referral
from your primary care physician. It is
recommended that you follow up with your
primary doctor for bloodwork and other health
problems that may improve following surgery.
|
| Elizabeth:
I have an initial appt. with Dr. Williams
in August. I want to know what I need to
bring to the appt. Should I have had a psych
evaluation before I come in? Should I be
attending any meetings before the appt?
Thanks in advance! |
| Rachel Griehs,
MS, RD, LDN:
If required, you need to bring in a referral
from your primary care physician on the
day of your appointment. The psychological
evaluation will be scheduled on the day
of your initial visit. Support groups are
availiable prior to the initial visit with
the surgeon. To learn more about support
group meetings, please call 1-800-789-PENN.
|
| Lisa:
I have lost about 209lbs.I have a little
skin sagging in between my legs and on my
tummy. Sometimes it rubs & gets sore.
Can you recommend a plastic surgeon that
will help my health insurance cover this?
I heard if it is medically neccessary that
it is covered. My doctors told me with the
soreness it possibly is medically neccessary. |
| Kathryn L. Burg
MSN, CRNP:
There is an excellent group of plastic surgeons
at the University of Pennsylvania. They
recommend that you go to your Bariatric
Surgeon first and obtain a letter that states
you are an appropriate candidate for surgery.
Once you have that letter you can call the
Plastic surgery office to make an appointment.
If you had your Bariatric Surgery performed
at HUP, we would be happy to evaluate you
for this procedure.
|
| Lona:
I've seen several questions relating to
insurance coverage. As a medical collection
specialist, I highly recommend they speak
directly to their insurance carrier before
their initial consultation. If possible,
their PCP (primary care physician)could
help them explain to the carrier their medical
issues and why the surgery would be beneficial
for them. I would think it would be hard
to wait for the initial consult only to
find out it may not be a covered benefit.
|
| Kathryn L. Burg
MSN, CRNP:
We agree. Prior to making an initial appointment,
we send patients a letter stating they need
to contact their insurance carrier to ensure
the procedure is covered.
|
| Ricky:
How likely is it that after having a baby
that you gain most of your weight back? |
| Kathryn L. Burg
MSN, CRNP:
This is unlikely. So far our patients who
have given birth following Bariatric Surgery
have been able to keep their weight off
by exercising and consuming a healthy diet.
|
| John:
I just want to say to all of the pre-ops
out there and those considering the surgery
- come to one of our support group meetings
and learn about what life is all about post-WLS.
You'll find a great outpouring of love and
friendship. If you are like I was (and many
others) as a pre-op, you didn't want to
spend a lot of time in public due to self-consciousness
about your size. Well, at the HUP support
group, there are lots of people that are
either like you or were like you once. There
are so many successful post-ops at HUP that
if you met them on the street and didn't
know they had the surgery, you never would
have guessed it. Thanks to Drs. Williams
and Raper, Rachel, Katie and the rest of
the staff from my wife and I - both WLS
post-ops. |
| Kathryn L. Burg
MSN, CRNP:
I agree. The Support Group meetings are
the best way to understand life after surgery
from people who have lived it!
|
| Roberta:
Do the psycological appts. continue after
surgery?? |
| Kathryn L. Burg
MSN, CRNP:
The psychology appointments with our team
do not continue after surgery. Many of our
patients do however continue counseling
by an outside psychiatric provider following
surgery. Our psychologists are available
if needed when a patient needs guidance,
however this occurs on an individual patient
basis.
|
| Mo:
W as my question about being a teacher and
not being able to go the bathroom when needed
ever answered? |
| Kathryn L. Burg
MSN, CRNP:
Many of our patients are teachers and have
been fine returning to work. This has not
presented a problem if patients take enough
time off from work to recover from the operation
(4-6 weeks).
|
| Diane:
I take alot of medications daily for depression,back
pain,and to sleep. In DE they said because
I craved suger and was so depressed they
denied me. Would you also deny me? |
| Kathryn L. Burg
MSN, CRNP:
This is hard to say. We would have to evaluate
you both from a medical standpoint and psychologic
standpoint to make that type of decision.
|
| Jennell:
How long does it take to compplete this
surgical procedure? |
| Kathryn L. Burg
MSN, CRNP:
The actual operation takes about 2 hours.
|
| Edaa:
Would like to know how much work time has
been lost after surgery |
| Kathryn L. Burg
MSN, CRNP:
Most patients take 4-6 weeks off of work.
This varies on the type of work patients
do.
|
Kathryn
L. Burg MSN, CRNP, Nurse Practitioner
Rachel
Griehs, MS, RD, LDN, Bariatric Clinical Specialist
