| 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 p |