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Providers Help to Remove Barriers for Obese Patients

Menorah Medical Center June 10, 2013

Dr. Nicole Fearing, MD, at Menorah Medical Center has specialized in bariatrics since 2004.

by Linda Friedel | Reprinted courtesy of KC Nursing News

Andrew Oyelere transitioned to a specialty with happy endings.

Oyelere, RN, was recently promoted to bariatric nurse coordinator at Menorah Medical Center. Oyelere says surgical weight loss is a new beginning for many patients.

“This is something I am really excited about,” Oyelere said. “There are a lot of people with this medical problem. After surgery almost all their medical problems are gone.”

Oyelere will launch a support group for patients who have had bariatric surgery. The support group is a way for patients to share their successes, tips and momentum, he said.

“People who are like-minded can share their stories,” he said. “They can share their success stories.”

To date, patients have pursued support groups beyond the hospital campus, he said. The new support group will help to provide the continuum of care, he said. Oyelere will launch the support group and moderate the gatherings. He has a passion for education, he said, and has served as preceptor for many nurses. He sees the program as a way to follow up with patients who have undergone weight-loss surgery by watching their progress. After surgery, patients experience a new beginning, he said.

“Follow with people after surgery. Share with others,” Oyelere said. “Now this is what I have achieved with the surgery. After surgery you need people to support them.”

Oyelere meets with patients to let them know what they can expect before, during and after the surgery. Bariatric surgery is not the first option for most people who have struggled with obesity, Oyelere said. Instead, patients seek surgery when they feel they have exhausted all other options to lose the weight, he said.

“This is not their first approach to solve their problem,” Oyelere said. “This option is the last resort that can totally change their life. This is their last resort. I am at a point where I can be helpful and help in this transition.”

With obesity on the rise, people are experiencing more health problems associated with obesity, Oyelere said. Patients who pursue bariatric surgery meet with a multi-professional team, Oyelere said. Oyelere connects his patients to specialties from psychiatry, nutrition, radiology, surgery and psychology.

“I have a respect for them,” Oyelere said. “They are going through a path. They are making a big decision. This job is multidimensional.”

Heather Turner of Leavenworth, Kan., lost 65 pounds as a result of bariatric surgery at Menorah six months ago. She opted for the gastric sleeve procedure.

“I want to lose 40 more pounds,” Turner said.

Turner, 48 years old, said her weight had gone up and down for the past two decades. Turner weighed 248 pounds before her surgery. She was inspired to pursue the surgery after watching her co-worker succeed.

“I saw how fast she lost the weight,” she said. “I wanted to do the same thing.”

Prior to bariatric surgery, Turner had undergone surgery for a herniated disc. To keep the health momentum, Turner opted to have the gastric sleeve procedure as soon as she could after the herniated disc surgery. The excess weight has added to issues with her knee, she said. Because weight was associated with her knee, Turner said her insurance company paid for the surgery. It took one year to receive their approval, she said.

“I need a knee replacement. I cannot exercise right now,” Turner said.

After surgery, Turner lost weight immediately, she said. She does not have any food restrictions but eats a low-carbohydrate diet. She consumes 1,200 calories on a daily basis and walks for 20 minutes most days.

“I move a lot better and I’ve got more energy,” Turner said. “My ability to get up and move around is a lot better.”

Turner said she sailed through surgery and has embraced her new diet and lifestyle. She eats healthy foods and has energy to play basketball with her children. She moves better than ever, she said. Turner said the toughest part was two weeks prior to the surgery, when she was restricted to a liquid diet.

“I lost weight,” Turner said. “It helps your liver for the surgery. That was tough.”

Turner took one month off from work to recover, though she was ready to go back sooner. Without insurance, Turner said she would not have been able to afford the procedure. Turner said she is grateful for the procedure. She sees an active future.

“I am going to do more with my kids,” Turner said. “My youngest has already seen the difference with surgery. I play basketball with her. Before, I was home a lot and tired, and now I’m not.”

Nicole Fearing, MD at Menorah Medical Center has specialized in bariatrics since 2004. Fearing said many of her patients decide on weight loss surgery because they cannot keep up with activities in their lives. There is pain associated with obesity, she said. Being 150 pounds overweight is like carrying three bags of 40-pound dog food and exercising.

“You would never exercise like that,” she said. “Their quality of life has decreased. For a lot of people once they get the weight off, they can go back to exercising and moving again.”

Health problems associated with obesity include high cholesterol, acid reflux, joint pain, lower back pain, heart disease and infertility. Some kinds of cancer are associated with obesity, she said.

“There are a myriad of health problems associated with obesity,” Fearing said.

Some insurance plans cover the procedure and some do not, Fearing said. Requirements vary with insurance plans, she said. Requirements for insurance plans range from weight loss before the procedure, psychological testing, a dietary evaluation and a cardiac evaluation. Fearing specializes in the gastric sleeve procedure. Patients like the gastric sleeve procedure because there is less follow-up necessary compared to the lap band procedure which requires monthly visits after surgery. Fearing sees her patients four times in the first year. Patients lose 50 to 85 percent of the excess body weight within 12 to 18 months, she said.

“You really help people make a huge change in their lives,” she said.

People feel shame if they cannot lose weight on their own, Fearing said. It is not easy to lose weight if you are that overweight, she said. Obesity is one of the leading causes of deaths in the United States, she said.

“We’re not getting smaller as a country,” Fearing said. “We’re getting larger as a county.”

Health care professionals do not do a good enough job about being sensitive to people who are obese, she said. Obese people need to be understood and not shamed.

“We need to be more sensitive to them,” she said. “Understand it’s a health problem.

That’s what those people need. They don’t need to be shamed.”

If patients feel shame about seeing their providers, they will stop seeking medical help and their problems become worse, Fearing said. Right-sizing furniture and wheelchairs in health care settings helps to take away their shame, she said.

“You’ve given them their dignity back,” she said. “It’s just being sensitive. It’s there already. They feel like you care.”

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