CityView Magazine

50 | January/February 2019 By 2017, fewer than 3 percent of bariatric surgeries involved lap bands. Classen said that's because the procedure was more problematic and produced more complications than other procedures. ese days, most bariatric patients choose to have either a Roux-en-Y gastric bypass, which Classen and Ejeh both described as "the gold standard" of bariatric surgery, or the gastric sleeve, which is slightly less complex because it involves only the upper half of the abdomen. e gastric sleeve has become the most popular weight-loss surgery nationally, chosen by nearly 60 percent of bariatric patients in 2017, according to ASMBS. Both procedures are excellent, Classen and Ejeh said. Classen said the Roux-en-Y – the procedure done on Carter – typically produces more weight loss than the sleeve. In the first year or two aer surgery, the average Roux-en-Y patient loses 70 percent of her excess weight while the average sleeve patient loses 60 percent of her excess weight. More hunger-affecting hormonal changes are associated with the Roux-en-Y procedure. e Roux-en-Y is a better option than the sleeve for some patients, including diabeetics and those who suffer from acid reflux, Classen said. e hormonal changes that occur because of the procedure can decrease or end a diabetic's insulin problems and many "walk out of the hospital never again taking shots or pills," he said. Diabetics who undergo a sleeve procedure should also see their diabetes improve. But because the sleeve causes fewer hormonal changes, their improvement is proportional with their weight loss, Classen said. And if the weight comes back, the diabetes comes back, he said. Classen said weight-loss surgery can also produce significant improvement in other health issues. Once painfully aching hip and knee joints can become livable aer excess pounds melt away. Sleep apnea improves about 75 percent of the time and urinary stress incontinence about 90 percent of the time. Hypertension improves about 75 percent of the time. Many bariatric patients eventually regain a little weight but oen not enough to rekindle other diseases or disorders. "You only have to lose 40 to 50 percent of your weight to have improvement in your comorbidities," Classen said. e best part may be the improvement in the way a patient experiences life. Rebecca Morris, Classen's nurse, weighed 255 pounds in 2004. She was 31 then and had been heavy since childhood. "I tried my whole life to diet," she said, but it never worked for long. She'd lose 40 pounds, then regain 60. Morris said she was always out of breath, she sweated too much and she struggled to bend over. en she had weight-loss surgery and, like Carter, her co-worker, her life changed for the better. Smiling, she recalled the day her 9-year-old son told her, "Wow, Mom, I can put my arms all the way around you!" Morris said five of her cousins were so impressed, they also had weight-loss surgery. All had great results, she said. Classen and Ejeh don't do weight- loss surgery on anyone under 18. But there's no age limit as long as a patient Ijeoma Ejeh, M.D. of Ferncreek General Surgery does many types of surgery but says she finds bariatric surgery the most fascinating.

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