MDNews - Cleveland-Akron-Canton

Patient Success Stories A 70ŠY E A RŠOLD FEM A LE weighing 193 pounds with a BMI of 40 was referred by her gastroenterologist for evaluation for para - esophageal hernia. She also suffered from morbid obesity, hypertension and hypercholesterolemia. For the previous several years, she had increasing subxiphoid burning despite being on bid proton-pump inhibitors and taking over-the-counter antacids. She resorted to sleeping upright, with at least once daily meal regurgitation. She complained of a hoarse voice. She had a laparo - scopic paraesophageal hernia repair with a Roux- en-Y gastric bypass eight months ago. Since then, she has lost 100 percent of her excess weight, has no reflux symptoms and is able to eat and drink without difficulty. A second patient, a 67-year-old female, had a Roux-en-Y gastric bypass with hiatal hernia repair. At the time of her surgery, she weighed 249 pounds with a BMI of 41 and suffered from hypertension, hypercholes- terolemia, asthma, urinary stress incontinence, GERD and had been getting surveillance esophago- gastroduodenoscopies (EGDs) for biopsy-proven Barrett's. Eighteen months after her operation, she weighed 149 pounds and had an EGD by her gastroenterologist with no evidence of Barrett's or hiatal hernia. She has no GERD symptoms, and her other comorbidities have resolved, as well. patients with Barrett's esophagus. According to Dr. Ben-Meir, "In addition to decreasing abdominal pressure from weight loss, gastric bypass likely functions as an anatomic defense against gastro- esophageal reflux by diverting gastric and duodenal contents from the esophagus. This combination of benefits from Roux-en-Y gastric bypass has proven quite eŸective in improving symptoms and reducing irritation of the esophagus." For those patients who choose weight loss surgery, Dr. Ben-Meir emphasizes the need for them to understand that bariatric surgery is a tool, not a solution on its own. "Patients need to be fully committed to the process and undergo a lifestyle change after surgery to stay healthy and have long-term success," he says. "Our program's holistic approach to weight loss provides everything patients need to achieve and maintain their weight-loss goals." THE RECIPE FOR SUCCESS Through Lake Health's Bariatric Surgery Center, patients receive a vast array of services, including physical and psychological pre-operative evaluation, pre- and post-operative education, ongoing counseling in nutrition and exercise, free patient support groups, and a lifelong follow-up plan. "There are two very important and distinct things that are necessary for patients to have success with bariatric surgery: surgical excellence and lifelong support," says Dr. Ben-Meir, "and we created a program that has both." It starts with Dr. Ben-Meir and his surgical team. All are dedicated to, and have undergone special training in, bariatric surgery. They assist in each bariatric operation. The same is true of the nurses in the bariatric unit. All have additional training and are dedicated to taking care of bariatric surgery patients. A medical team, headed by a specially trained internist, evaluates all weight-loss patients before they come to the hospital for surgery and manages any medical problems they may have while in the hospital recovering from surgery. In addition, psychologists, dietitians, and exercise physiologists provide ongoing education and support to prepare patients for success and keep them on track. Candidates for weight-loss surgery are those over the age of 21 who are approximately 50 pounds or more overweight and have not had success with traditional weight-loss strategies such as diet modification, exercise or medication. Patients with hiatal or paraesophageal hernias who opt for weight loss surgery as part of the hernia repair must meet the same National Institute of Health criteria and insurance requirements as those who are pursuing bariatric surgery solely for weight loss. There is no upper age limit. In fact, in a retrospective review of his own bariatric surgery patients, Dr. Ben-Meir found no diŸerence in length of stay or complication rate of the 175 patients over age 60 as compared to a younger cohort of patients. He concluded that bariatric surgery is safe in older patients who are screened and selected appropriately. CO-MORBIDITIES RESOLVED Three surgical approaches for qualified candidates are oŸered at the Lake Health Bariatric Surgery Center: laparoscopic Roux-en-Y gastric bypass, laparoscopic vertical sleeve gastrectomy and laparoscopic adjustable gastric banding. Dr. Ben-Meir views these operations as powerful tools which resolve medical problems associated with being overweight, including sleep apnea (80 percent remission rate), high blood pressure (about 80 percent remission rate), high cholesterol (more than 80 percent remission rate) and type 2 diabetes (65–85 percent remission rate). Because the eŸect of weight-loss surgery on diabetes is so great, many patients have normal blood sugar levels within hours after surgery. Roux-en-Y gastric bypass combined with paraesophageal hernia or hiatal hernia repair can also resolve GERD symptoms and Barrett's esophagus. Free educational seminars led by Dr. Ben-Meir are oŸered Monday evenings at various loca- tions throughout northeast Ohio. A modified version of the seminar is also available online at lakehealth.org/bariatric. Physicians with patients who prefer to receive information and have their questions answered one-on-one can also arrange an o«ce visit with Dr. Ben-Meir. "Weight-loss surgery is life-changing and potentially lifesaving. It restores patients' health and quality of life in such a dramatic way," Dr. Ben-Meir says. "That's why I became a doctor. That's why I became a bariatric surgeon." To learn more about bariatric services at Lake Health and their upcoming educational seminars, visit lakehealth.org/bariatric or call the Best of Health Line at 800-454-9800. To refer a patient to Dr. Aviv Ben-Meir, call 440-602-6737. ■ M D N E W S . C O M /// M D N E W S C L E V E L A N D /A K R O N / C A N T O N ■ M A R /A P R 2 016 1 9

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