2. STEPHANIE DRUZIAKO Bariatric Surgery: Gastric Bypass Kennedy Health Bariatric Surgery Information Session

3. Just Imagine… Being able to play with the grandkids Fitting comfortably in an airplane seat No longer needing to take medicine for Diabetes Boosting up your confidence

4. When to Consider Surgery Have you been trying unsuccessfully to lose weight for years? Do diets, exercise, or medicine fail every time? Is it difficult to do every day activities due to your size? Are you at a loss for what to do next?

5. Surgery Myths Surgery is a cure for obesity Surgery is an easy way to lose weight I do not have to prep much for surgery It will be easy to avoid overeating post- surgery False Surgery is merely a tool when other options have failed. Weight loss is not guaranteed and takes a lot of commitment. There are 6 months of prep work.6 months You can only fit in 1 oz. of food at a time, but you can still eat too often.

6. Initial Criteria Between the ages 18 and 60 Void of serious medical conditions that might complicate surgery Psychologically stable Has not smoked or abused drugs within past year  Does not abuse alcohol Is prepared to make a permanent change in his or her lifestyle and diet Do You Qualify?

7. Weight Criteria Weigh 100 pounds overweight BMI of 40 and up BMI BMI of 35 and up if you have…  Type II Diabetes  Heart disease  Other obesity related disorders Weight makes you medically disabled Weight keeps you from completing daily tasks Do You Qualify?

8. So you qualify. Now What?

9. So you qualify. Now what? 1. Initial visit 2. Prepare your body 3. Pre-tests and screening

10. Initial Visit Meet with Kennedy Bariatric Surgery Team Last 1-2 hours Will discuss…  Medical history  Surgery procedure, benefits, and risks  Insurance qualifications

11. Prepare Your Body Quit smoking Lose weight  Any amount helps Increase activity level of any kind  Park further away  Walk around the block Takes roughly 6 months to best prepare your body for surgery

12. Pre-tests and Screening Primary care examination Age-Related Screenings Cardiac Evaluation Pulmonary Evaluation Sleep Study Evaluation Chest X-ray Upper Gastrointestinal X-ray Upper Endoscopy

13. Verify coverage with insurance company Gain approval for procedure Specify exclusions Ensure procedure and hospital are both covered Make sure you specify obesity versus morbid obesity Document dieting and exercise Undergo psychological evaluation Submit medical records and letter of medical necessity Insurance Coverage

14. Support Pre-Operative education class  Understanding the process and answering questions Nutrition counseling  Pre and postoperative nutritional guidance Support group  Support available for patient and family pre and post operation

15. Procedure Minimally invasive Overall Result: Allows food to bypass part of stomach and small intestine so fewer calories are absorbed 1. Small pouch is created at top of stomach to hold only 1 ounce of food 2. Pouch is connected at a later point on small intestine to skip over lower stomach and upper small intestine

16. Gastric Bypass Procedure

17. What can I eat after surgery? Stage 1  2 weeks of clear, sugar-free, caffeine-free, and uncarbonated liquids Stage 2  2 weeks of low-fat, low-sugar pureed foods Stage 3  2 weeks of soft, cooked foods Stage 4  Lifetime of low-fat, high-protein, high-fiber solid foods

18. Risks Injury to intestines, stomach, organs Leaking from stomach Malabsorption of nutrients Negative reaction to simple carbs, high-fat foods, and refined sugars Breakdown of the stomach pouch or opening

19. Life After Surgery Feel more full with less food at a time Patients lose up to 80% of excess body weight if plan is followed Patients are often shown to maintain weight loss for 15 years Minimally invasive means shorter recovery time

20. It’s about more than just appearances!

21. Testimonials "Bariatric surgery changed my life completely. I can do things I haven't been able to do in years, including hiking up a hill." Eileen Grabosky of Washington Township, NJ Age 52, from 286 lb to 153 lb Harry Soards of West Berlin, NJ Age 47, from 338 lb to 238 lb "I was hardly in any pain at all after the surgery. Everyone at the hospital – from Dr. Neff to the nurses to the nursing assistants and even the people who cleaned my room – treated me like a king."

22. References Kennedy Health System - Bariatric Surgery | What to Expect. (n.d.). Retrieved September 26, 2015, from http://www.kennedybariatric.org/are-you-a-candidate/what-to-expect.html Calculate Your Body Mass Index. (n.d.). Retrieved September 26, 2015, from http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm Myths and Misconceptions about Bariatric Surgery | Grand Rapids | Mercy Health Saint Mary's Campus. (2013, May 16). Retrieved September 28, 2015, from http://www.mercyhealthweightmanagement.com/saintmarys/myths-and-misconceptions/