MDNews - San Antonio

S Y LV I A G R A DY: A H E A LI N G S U RG ERY SYLVIA GR ADY, 43, an Assistant Director at St. Mary's University business office, was watching her health problems mount. Despite exercising up to two hours a day, six days a week, she had been diagnosed with high blood pressure. "No matter how hard I worked out, when I looked at the scale, I was still obese," Grady says. "Finally, I learned I would have to take diabetes medication. At that point, I started looking to other paths besides diet and exercise to improve my health. I was blessed to find Dr. Peterson to perform my weight-loss surgery." Together with Dr. Peterson, she selected a gastric bypass procedure and had surgery in December. She is extremely satisfied with the results. Her diabetes, high blood pressure and other health issues have all resolved. Today, Grady is busy as a full-time employee and student. Her desire for life-long learning is aligned with the providers at CHRISTUS Weight Loss Institute – Westover Hills, who answer her questions and educate her about healthy food choices. "I underwent this procedure for health reasons," she says. "It has been great to accomplish my goals. I feel better, I sleep better at night and I wake up in a much better mood every morning." seminars. Then, they schedule a con- sultation with a physician to determine which procedure would best suit their goals and health needs. Finally, detailed pre-surgical education explains what to expect during and after the procedure. "O u r p at ient s h ave done t hei r research," Dr. Peterson says. "While the general public may regard bariatric surgery as a cosmetic procedure, for people who undergo or perform it, it's about health, not outward appearance. The outward changes patients undergo are simply visible indications of their greater well-being." Matching Patients and Procedures The physicia n consultation is a n essentia l first step in determining the appropriate surgical procedure. CHRISTUS Weight Loss Institute – Westover Hills offers gastric banding, sleeve ga strectomy a nd Rou x-en-Y by pass procedures. Each procedure meets specific patient needs, including weight-loss goals, health considerations or rev ision of a prev ious ba riatric surgery. Dr. Peterson discusses every ava ilable option w ith his patients, helping them make the best decision for their particular situation. For patients who are not extremely obese and have few hea lth compli- cations, gastric banding is a favored procedure. Banding is a highly safe sur- gery, resulting in the lowest mortality rates of any bariatric procedure — though, now that almost all bariatric surgeries are performed in a minimally invasive fashion, all options are quite safe, with mortality rates of less than 1 percent after three years. For other patients, a sleeve gastrec- tomy is the best choice. This procedure, a lso ef fe c t ive a nd sa fe, t y pic a l ly results in similar weight loss to bypass procedures and greater weight loss than adjustable banding procedures, according to a Cochra ne Database Systematic Review. Because the stom- ach is not bypassed, this surgery may be appropriate for patients who have very specific absorption needs, such as a highly nuanced medication regime, Dr. Peterson says. When patients have obesity-related health problems as well as significant weight-loss needs, Roux-en-Y gastric bypass may be the preferred option. In one study of more than 2,000 women undergoing banding or bypass proce- dures, bypass patients lost about a third of their body weight after three years, compared to banding patients, who lost about 15 percent of their body weight. Bypass surgeries also result in exten- sive metabolic benefits. More than 80 percent of patients who undergo g a st r ic by pa ss ex p er ience f u l l or partial resolution of their diabetes. Three-quarters of patients experience resolution or improvement of sleep apnea. High blood pressure and high cholesterol rates of ten improve or resolve, as well. Gastric bypass may also be used as a revision procedure for WO RT H IT A STUDY OF 3,651 patients who underwent laparoscopic bariatric surgery found the patients recouped their costs for the procedure, thanks to reduced medical expenses, within two years. 1 1 Crémieux, P. et al. (2008). A study on the economic impact of bariatric surgery. The American Journal of Managed Care, 14(9). previous surgeries that have resulted in complications or failure to lose weight. At CHRISTUS Weight Loss Institute – Westover Hills, many bariatric sur- geries are performed laparoscopically M D N E W S . CO M ■ MD NEWS San Antonio | 7

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