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Healthy You

Bariatric Surgery, The Latest Advancements at NorthShore

September 12, 2019 1:00 PM with Liz Farwell

Bariatric Surgery is being used more and more to help people regain control over their weight issues.  While you may not have been a candidate in the past for these procedures more doctors are using these techniques for a wider array of patients.

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Join Liz Farwell, Bariatric Coordinator for the NorthShore Bariatric Services as she answers your questions on all aspects of the surgery process. From if you should consider getting the surgery, to what type of surgery might work for your condition.  She will also be answering questions on what new technologies we use and which new surgeries are being used more frequently.

Ben (Evaston) - 12:45 PM:
We are going to get started in about 15 minutes. Feel free to submit your questions no, so we have them ready for our expert.

Ben (Evaston) - 1:00 PM:
Welcome to the Bariatric Surgery chat. The chat is now open and you can submit your questions anytime.

  Karen (Vernon hills Illinois) - 1:05 PM:
I'm considering doing the surgery. What's the best way to start?
Liz Farwell
Hi. This is Liz Farwell. I am the Bariatric Coordinator at NorthShore and the APN for Bariatric Surgery. I am happy to be answering questions about bariatric surgery at NorthShore. Hi Karen. the best way to get started is to attend one of our Free Bariatric Surgery Information Sessions. We hold these the 3rd Tuesday of every month at 6:00 pm at 501 Skokie Blvd, Northbrook. First floor. Or you can call 847-570-1700 and schedule an appointment with one of our 4 Bariatric Surgeons. At the initial appointment, you will meet with the surgeon and one of our bariatric nurses who will discuss the process in detail with you.

  Betsy (Wilmette, IL) - 1:10 PM:
How long are people typically off work after the surgery? How soon do people get back to their normal routine?
Liz Farwell
We encourage you to take 2 weeks off of work. We want you up walking every 2 hours that you are awake. You may not have your usual energy, for about the first 4 - 6 weeks after surgery, but you can live your normal life. You will have a 20-pound lifting restriction for the first 2 weeks. otherwise, there are no restrictions.

  Felix (Vernon Hills, IL) - 1:14 PM:
What's the price for the balloon procedure?
Liz Farwell
The gastric balloon is not currently covered by insurance. So it is a pay-out-of-pocket procedure. It is currently $8000. which includes the insertion and removal of the gastric balloon, as it needs to removed in 6 months.

  Stephanie (Rogers Park) - 1:16 PM:
I am thinking about seeing if I'm a candidate for bariatric surgery, but I'm unsure if I am going to be able to adjust to a new eating lifestyle afterward. My question is, is it reversible if it doesn't work out? Thanks!
Liz Farwell
I think that by the end of the pre-operative process, you will be prepared for bariatric surgery. Success after bariatric surgery requires lifestyle changes. We start working on those changes, during the pre-op process. You will have an opportunity to work with our health psychologists about your fears, and about adjustments post-op, you will be able to work with me, on learning new lifestyle changes that will aid in your success, you will have a bariatric dietitian working with you and you will be invited to bariatric support group to help in adjusting to your new life and aid in your success. I have been here 11 years, and we have not had to "reverse" a bariatric surgery.

  Sara (Glenview, il) - 1:21 PM:
I know there is a 2-3 hour psych eval before the procedure. What should I expect during that evaluation?
Liz Farwell
The psych eval time length varies. Usually, there is a 1-hour interview, followed by various questionaries. Please know, we rarely "deny" anyone for surgery. Sometimes, a "brief hold" is advised, to give the patient additional time to work on things prior to surgery. For instance, if someone has depression, we want to make sure their depression is optimally controlled prior to surgery. Or if someone is smoking, they will need time to stop smoking, prior to bariatric surgery. Please keep in mind, we are trying to address things pre-op, to give you the best chance at success post-op.

  Tonya (Blue Island, Il) - 1:26 PM:
I have struggled with my weight but I don't qualify for Bariatric. Is there something else I could possibly do or try to help me with my weight loss?
Liz Farwell
Absolutely, there are many options at NorthShore. There is a class that our health psychologists lead that is called JumpStart. you can register for JumpStart at 847.425.6400. We have a Weight Loss Nurse Practitioner, named Cassie Snitowsky, who will see patients for supervised medical weight loss and you can discuss with her if weight loss medications are an option for you. You can schedule appointments with Cassie by calling 847.570.1700.

  Pam (Highland Park) - 1:30 PM:
How much weight will I lose with gastric bypass surgery?
Liz Farwell
On average people usually lose about 70 - 80 % of their excess weight after a gastric bypass. Keep in mind, that is an "average" so if you are a rock star with following all the post-op instructions, especially with increasing your exercise post-op, you may lose all of your excess weight post-op.

  Dominique (Palatine) - 1:35 PM:
Does binge eating disqualify one from surgery? Also, do you do endoscopic surgeries if a patient doesn’t want laparoscopic procedure?
Liz Farwell
Binge eating does not disqualify you. In order to be successful after Bariatric Surgery, you will want to have that under control. In other words, being more mindful of the situations that lead to binge eating - work stressors, or family stressors, or boredom, etc. Whatever the initiator is, it is important to learn other ways of coping with those various things. That is one of the things our health psychologists are great at. They help patients identify stressors and establish other coping mechanisms. Binge eating after bariatric surgery will not help you get to your weight loss goals. We do offer endoscopic bariatric surgeries. Unfortunately, those are not covered by insurance at this time. So they would be self-pay surgeries. The Endoscopic Sleeve or the Endoscopic Gastric Balloon are two endoscopic surgeries we provide.

  Deb (Wadsworth, IL) - 1:41 PM:
Is a gastric balloon the same as a lap band and why is it removed after 6 months?
Liz Farwell
The gastric balloon is a balloon that is filled with saline. This is supposed to give the patient a feeling of fullness as it takes up space in the stomach. Unfortunately, it can lead to a lot of nausea. It needs to be removed in 6 months, or it can lead to an obstruction if it pops or migrates out of the stomach. The Lap band is like a seatbelt that is put around the outside of the stomach. The Lap Band also has a port, that can be filled with saline to make the band tighter, or the port can be used to remove fluid, to make the band looser.

  Lexi (Chicago) - 1:45 PM:
I'm 64 years old, 5 feet 5 inches tall and struggle to keep my weight under 190 pounds. My blood pressure and lipids are controlled on medication. I have battled weight increase for many years, with a net gain after each cycle of loss/gain. Without any known contraindications, would I be a possible candidate for bariatric surgery, and if so, which surgery might be best suited? Under those circumstances, would such a procedure be considered medical or cosmetic? Thank you for your help!
Liz Farwell
That gives you a BMI of 32. At that BMI you would not qualify for bariatric surgery. The basic qualifications for bariatric surgery include: A Body Mass Index (BMI) of 35 - 40 AND a diagnosis of diabetes, hypertension, or sleep apnea. If you do not have any of those illnesses, you need a BMI of 40 or more in order to qualify. BMI is a calculation of your height in centimeters and your weight in kilograms. There are many BMI calculators are online.

  Karen (Skokie, Il) - 1:48 PM:
What are the best options when you have about 100 or 125 to lose?
Liz Farwell
Gastric bypass patients can expect to lose about 70 - 80% of their excess weight. So if someone is 100 pounds overweight, the average gastric bypass patient will lose 70 - 80 pounds. Sleeve gastrectomy patients can expect to lose about 60 % of their excess weight. Loop Duodenal Switch patients can expect 80-85% of their excess weight. Lap Bands are not being done very much, anymore, as we have other more effective bariatric surgeries

  Deb (Wadsworth, IL) - 1:51 PM:
If the gastric balloon is not covered by insurance, is there a procedure that is?
Liz Farwell
Gastric bypass, sleeve gastrectomy, and Lap Band are covered by many insurances. the Loop DS is a newer surgery and some insurances are not covering that one as much yet. After your initial Bariatric Consultation, we will reach out to your insurance, to verify if they cover bariatric surgery for your policy. And we find out if they have any additional specifications that they require, other than the "usual" list of pre-op things - like dietitian consultation, psych eval, support group, etc.

  Emily (Lincolnwood, IL) - 1:55 PM:
What are my options if a surgery doesn't work?
Liz Farwell
Working with our health psychologists on lifestyle changes has proven to be very helpful for many patients. Working with our bariatric dietitians to ensure you are meeting all of your protein needs, taking the proper post-op vitamins and ensuring your exercise and your intake are appropriately aligned, is also important. Participating in the Bariatric Support Group has shown to help people post-op. Following up with the bariatric surgery team, if you gain 8 or 10 pounds is also important. And lastly, there are revisions that can be discussed, if one is on point, with all the post-op lifestyle components. Keep in mind, bariatric surgery is not a magic bullet. It will only work if you work at it.

Ben (Evaston) - 2:00 PM:
That's all the time we have today for questions. Thank you, Liz, for your time and expertise!
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