Q&As

11:21

LG Health Admin:

Thank you for joining us at today's live online Q&A session on "Bariatric Surgery: Know Your Options" with Dr. James Ku. The session will begin at 12 noon. Please feel free to submit your questions for Dr. Ku at any time.

Monday November 14, 2011 11:21 LG Health Admin

11:23

LG Health Admin:

Did You Know?
There are three types of weight loss surgery procedures offered at Lancaster General Health: roux en y, adjustable gastric band, and vertical sleeve gastrectomy.

Monday November 14, 2011 11:23 LG Health Admin

12:00

LG Health Admin:

Thank you for joining us at today’s live online Q&A session on “Bariatric Surgery: Know Your Options.” Before we begin, let’s introduce you to our host.

Monday November 14, 2011 12:00 LG Health Admin

12:00

LG Health Admin:

James Ku, MD, is a board certified surgeon with over 10 years of experience in bariatric surgery. He has performed more than 2,000 bariatric surgeries, including 500 gastric banding procedures.

Monday November 14, 2011 12:00 LG Health Admin

12:00

LG Health Admin:

As medical director of Bariatric Surgery and the Healthy Weight Management programs, he oversees all of LG Health's weight loss programs and is supported by an experienced staff of registered dietitians, nurses, exercise physiologists and behavioral medicine specialists.

Monday November 14, 2011 12:00 LG Health Admin

12:01

LG Health Admin:

Dr. Ku earned his medical degree from Jefferson Medical College in Philadelphia. Dr. Ku served as Medical Director of bariatric surgery programs at both Reading Hospital and Penn State Hershey Medical Center. He was Founding Vice President of the Pennsylvania Society for Bariatric Surgery and has published numerous abstracts and articles in professional journals.

Monday November 14, 2011 12:01 LG Health Admin

12:02

James Ku, MD:

Thank you for joining me today. I look forward to answering your questions.

Monday November 14, 2011 12:02 James Ku, MD

12:04

[Comment From Elaine Elaine : ]

What if the surgery doesn’t work for me? Is it possible to have it reversed or is this something that cannot be changed?

Monday November 14, 2011 12:04 Elaine

12:05

James Ku, MD:

Successful bariatric surgery takes coordination and effort. Weight loss is hard work. My role is to give my patients the best possible surgical tool, and along with my team, we provide coaching and support.

Monday November 14, 2011 12:05 James Ku, MD

12:05

James Ku, MD:

The patient has the biggest role, which is to give 100% effort toward a lifetime of success. Even with our coordinated efforts, 20-30% of patients will not sustain long-term success. In those situations, additional procedures may help get back on track.

Monday November 14, 2011 12:05 James Ku, MD

12:07

[Comment From Hillary Hillary : ]

Dr. Ku when should you start to think about weight loss surgery?

Monday November 14, 2011 12:07 Hillary

12:08

James Ku, MD:

Wow, that’s a tough question. Ideally you want to consider aggressive weight management before severe health problems develop. That allows patients to do better long term.

Monday November 14, 2011 12:08 James Ku, MD

12:09

Have you had weight loss surgery?
Yes

( 0% )

No

( 100% )

Monday November 14, 2011 12:09

12:10

[Comment From Dana Dana : ]

What types of food can you eat after surgery?

Monday November 14, 2011 12:10 Dana

12:11

James Ku, MD:

Post-operative diet depends on the surgery type. Generally speaking, most types of healthy foods are acceptable after bariatric surgery. Different textures can influence food choices. For example, certain breads and starches are difficult to tolerate after restrictive procedures.

Monday November 14, 2011 12:11 James Ku, MD

12:13

[Comment From Mary Mary : ]

What do you think is the single most difficult thing someone must do to adjust to life after bariatric surgery?

Monday November 14, 2011 12:13 Mary

12:14

James Ku, MD:

I believe the most difficult adjustment after bariatric surgery is to maintain the healthy mindset after the weight has come off, the appetite has returned, and the honeymoon is over. There is no turning back to old ways after bariatric surgery.

Monday November 14, 2011 12:14 James Ku, MD

12:14

LG Health Admin:

Did You Know?
About 70% of patients who qualify for weight loss surgery have some form of sleep apnea.

Monday November 14, 2011 12:14 LG Health Admin

12:16

[Comment From Hillary Hillary : ]

What are the chances of having severe complications with any of the three procedures?

Monday November 14, 2011 12:16 Hillary

12:16

Have you attended a workshop or support group for weight loss surgery?
Yes

( 33% )

No

( 50% )

No, but I am considering it

( 17% )

Monday November 14, 2011 12:16

12:16

James Ku, MD:

Severe complications are rare, but with any surgery there will be some risks. Gastric Banding carries the least risk. The stapled procedures (Gastric Bypass & Sleeve Gastrectomy) have slightly greater risk.

Monday November 14, 2011 12:16 James Ku, MD

12:18

[Comment From Colleen Colleen : ]

Do the 3 types of surgeries provide the same outcome of weight loss? How do I choose which procedure to do?

Monday November 14, 2011 12:18 Colleen

12:19

James Ku, MD:

Great question! The rate of weight loss is different between the three surgeries. Gastric Bypass is the fastest, followed by the sleeve, and the band offers a slower & sustained weight loss. Long term data for all three looks very similar.

Monday November 14, 2011 12:19 James Ku, MD

12:19

James Ku, MD:

Choice of procedure is a complex decision process. My philosophy is to let the patient decide which procedure feels right; then I give my professional opinion.

Monday November 14, 2011 12:19 James Ku, MD

12:20

[Comment From Mandi Mandi : ]

What are the chances you have of dying during or after surgery?

Monday November 14, 2011 12:20 Mandi

12:21

James Ku, MD:

Risk of death during or after bariatric surgery is extremely unlikely. The mortality rate of bariatric surgery is below 0.1 percent, or one in a thousand.

Monday November 14, 2011 12:21 James Ku, MD

12:22

[Comment From sherrie sherrie : ]

When you know you are over weight and u have tried all kinds of things what is the next step?

Monday November 14, 2011 12:22 sherrie

12:24

James Ku, MD:

I would recommend to sign up for one of our FREE information seminars. I would love to talk to you in person! You can go here to register for a seminar.

Monday November 14, 2011 12:24 James Ku, MD

12:24

[Comment From Jill Jill : ]

How overweight do you have to be in order to be even considered for weight loss surgery?

Monday November 14, 2011 12:24 Jill

12:24

James Ku, MD:

A general rule of thumb is 100lbs over ideal body weight, but BMI is a better measure of candidacy for surgery. BMI 40 or greater is what we use. You can use our BMI Calculator online here.

Monday November 14, 2011 12:24 James Ku, MD

12:26

[Comment From Guest Guest : ]

My family and even some of my friends think I’m crazy for considering this. How should I respond when people I care about are critical of my decision to have weight loss surgery?

Monday November 14, 2011 12:26 Guest

12:26

James Ku, MD:

The decision to pursue bariatric surgery is a very personal one and should follow careful research into the risks and benefits. Many questions and concerns can be answered during the free informational session prior to surgery.

Monday November 14, 2011 12:26 James Ku, MD

12:27

James Ku, MD:

We invite interested surgical candidates to bring family and friends along with them to address these concerns.

Monday November 14, 2011 12:27 James Ku, MD

12:28

[Comment From Hillary Hillary : ]

How does someone know if they are a candidate?

Monday November 14, 2011 12:28 Hillary

12:29

James Ku, MD:

There is no simple answer to that. Your family doctor may be able to provide guidance. I will also take time to explain this question during my seminar. You can go here to register for a seminar.

Monday November 14, 2011 12:29 James Ku, MD

12:30

LG Health Admin:

Did You Know?
The first laparoscopic Roux en Y gastric bypass was performed in 1994.

Monday November 14, 2011 12:30 LG Health Admin

12:30

James Ku, MD:

Thank you for your great questions! We will be answering your questions as quickly as we can.

Monday November 14, 2011 12:30 James Ku, MD

12:31

[Comment From Sandy Sandy : ]

I heard that there is a special diet after the surgery. How long do patients have to follow the special diet before consuming regular foods.

Monday November 14, 2011 12:31 Sandy

12:32

James Ku, MD:

You’ve heard correctly. We do have a custom diet after each of the different surgeries. The time it takes to resume a regular diet depends on surgery type. Typically by 1 or 2 months patients are eating mostly normal foods.

Monday November 14, 2011 12:32 James Ku, MD

12:32

Are you considering weight loss surgery for yourself?
Yes

( 100% )

No

( 0% )

Monday November 14, 2011 12:32

12:33

[Comment From Guest Guest : ]

When choosing a doctor people have told me to look for a Center of Excellence. What is a Center of Excellence? Is LGH a Center of Excellence?

Monday November 14, 2011 12:33 Guest

12:33

James Ku, MD:

Bariatric Programs are credentialed as Centers of Excellence. The last 2 programs I directed both became Centers of Excellence. That is one of my short term goals for LGH.

Monday November 14, 2011 12:33 James Ku, MD

12:34

[Comment From Clarabell Clarabell : ]

Does American Health Mercy insurance cover this kind of procedures? My height is 5.4 and my weight is 256 pounds. Do I qualify for this surgery?

Monday November 14, 2011 12:34 Clarabell

12:34

James Ku, MD:

Amerihealth Mercy does cover bariatric surgery, including the gastric bypass, the Lap Band, and the sleeve gastrectomy. Based on your height of 5’4”, and weight of 256, your BMI is 43.9. This qualifies you for bariatric surgery.

Monday November 14, 2011 12:34 James Ku, MD

12:35

James Ku, MD:

I would urge any patient to ask their surgeon this question to make sure that their insurance covers the procedure.

Monday November 14, 2011 12:35 James Ku, MD

12:36

[Comment From Carl Carl : ]

How much weight can I expect to lose?

Monday November 14, 2011 12:36 Carl

12:36

James Ku, MD:

Of course that answer depends on the individual as well as the type of surgery. One realistic measure of weight loss outcome could be “lowest adult weight”. However I have had many patients lose more than that.

Monday November 14, 2011 12:36 James Ku, MD

12:37

[Comment From Tina Tina : ]

How long does the program take before I can get surgery?

Monday November 14, 2011 12:37 Tina

12:37

James Ku, MD:

We feel that we need at least 3 months to prepare patients for surgery. However, your insurance company may require additional time.

Monday November 14, 2011 12:37 James Ku, MD

12:38

[Comment From Guest Guest : ]

What would not qualify you for these procedures? Insurance not to coverage it?

Monday November 14, 2011 12:38 Guest

12:38

James Ku, MD:

Patients are occasionally turned down for bariatric surgery. The most common reasons are: insurance exclusions, poor psychological assessments, failures to lose weight during the preoperative program, and excess health risk.

Monday November 14, 2011 12:38 James Ku, MD

12:39

James Ku, MD:

I do my best to give every patient a chance to have this life-saving surgery.

Monday November 14, 2011 12:39 James Ku, MD

12:40

[Comment From amy amy : ]

When you are 315 pounds and need help at the age 29 who and where do you start?

Monday November 14, 2011 12:40 amy

12:41

James Ku, MD:

You start by attending a live Q&A with Dr. Jim Ku!

Monday November 14, 2011 12:41 James Ku, MD

12:42

[Comment From Tina Tina : ]

What is dumping syndrome?

Monday November 14, 2011 12:42 Tina

12:43

James Ku, MD:

Dumping syndrome is a known complication that may occur after Gastric Bypass. We don’t see it with the sleeve or the band. Dumping usually occurs after eating sweets or rich foods. Symptoms of dumping may include abdominal pain, nausea, vomiting, lightheadedness, or diarrhea. Some patients actually use dumping to stay away from certain foods.

Monday November 14, 2011 12:43 James Ku, MD

12:44

[Comment From Guest Guest : ]

If my BMI isn't quite 40 what other options do I have when I have tried diet and exercise and it isn't working.

Monday November 14, 2011 12:44 Guest

12:44

James Ku, MD:

Sometimes if your BMI is under 40, but you have severe medical problems, surgery is an option. That is something that I would be happy to discuss with you separately.

Monday November 14, 2011 12:44 James Ku, MD

12:45

James Ku, MD:

We are also developing a medical weight management arm of our Healthy Weight Management program. Exciting times ahead! Stay tuned for more information!

Monday November 14, 2011 12:45 James Ku, MD

12:46

LG Health Admin:

There are still about 15 minutes remaining in this session. Before you leave today's Q&A, please take a moment to let us know what you thought of it by answering a few questions on our brief Q&A survey. We appreciate your help...thanks! http://bit.ly/Survey_QA

Monday November 14, 2011 12:46 LG Health Admin

12:46

[Comment From Hillary Hillary : ]

If you have a food allergy is it harder to have the surgery done and still get proper nutrition afterwards?

Monday November 14, 2011 12:46 Hillary

12:46

James Ku, MD:

We have 2 full time dietitians on staff who are very comfortable customizing nutrition to fit your needs.

Monday November 14, 2011 12:46 James Ku, MD

12:48

LG Health Admin:

Did You Know?
It is estimated that only 1% of Americans who qualify for weight loss surgery actually pursue it and have the procedure performed.

Monday November 14, 2011 12:48 LG Health Admin

12:48

[Comment From Evelyn Evelyn : ]

Is it possible that surgery could cause someone to lose too much weight and risk health problems? If that could happen, is the surgery reversible?

Monday November 14, 2011 12:48 Evelyn

12:48

James Ku, MD:

Unless something is terribly wrong, it is near impossible to lose too much weight. However, if too much weight loss is a problem, most of the surgeries are reversible.

Monday November 14, 2011 12:48 James Ku, MD

12:49

[Comment From Fred Fred : ]

How much weight can I lose?

Monday November 14, 2011 12:49 Fred

12:50

James Ku, MD:

Please refer to my answer above about being able to be below your “lowest adult weight”.

Monday November 14, 2011 12:50 James Ku, MD

12:50

[Comment From Guest Guest : ]

What happens if I need my surgery redone? Can you have a revision done if it isn't working? I have a friend who this happened to which is why I ask.

Monday November 14, 2011 12:50 Guest

12:51

James Ku, MD:

That’s a complex question. We can perform re-operations if indicated, but weight-regain is not often handled through a second procedure.

Monday November 14, 2011 12:51 James Ku, MD

12:52

James Ku, MD:

I would recommend that your friend follow up with their bariatric surgeon to troubleshoot this.

Monday November 14, 2011 12:52 James Ku, MD

12:52

[Comment From dawn dawn : ]

How much weight would someone who has surgery and needs to lose around 100 pds lose in the first month

Monday November 14, 2011 12:52 dawn

12:52

James Ku, MD:

That’s a tough question. I’ve had some patients lose almost that amount in 1 month, or sometimes patients will lose only about 20 pounds. It really depends on the type of surgery. Different types of surgeries have different outcomes.

Monday November 14, 2011 12:52 James Ku, MD

12:53

[Comment From Guest Guest : ]

How long would it be before being able to go back to work after one of these surgeries?

Monday November 14, 2011 12:53 Guest

12:54

James Ku, MD:

Patients usually take 2 – 4 weeks off work, depending on the type of work.

Monday November 14, 2011 12:54 James Ku, MD

12:54

[Comment From dawn dawn : ]

My family is afraid I cannot eat with them the way they do, I said yes, but in smaller quantities. Is this realistic?"

Monday November 14, 2011 12:54 dawn

12:54

James Ku, MD:

I think it is very realistic to expect meals with your family. Eating is a very social thing, and I don’t want my patients to miss out on this.

Monday November 14, 2011 12:54 James Ku, MD

12:55

[Comment From Karen Karen : ]

I am 23 and considering weight loss surgery. I'm not sure if I should wait to have kids or have the surgery before I start a family. What are your thoughts?

Monday November 14, 2011 12:55 Karen

12:57

James Ku, MD:

Either way is fine. I’ve had many patients have kids after surgery. Just make sure you bring them during visits because my staff loves babies!!!

Monday November 14, 2011 12:57 James Ku, MD

12:57

[Comment From Dawn Dawn : ]

How long does the Roux-en Y surgery take to perform?

Monday November 14, 2011 12:57 Dawn

12:58

James Ku, MD:

It takes me a little over an hour to perform a Roux-en Y Gastric Bypass.

Monday November 14, 2011 12:58 James Ku, MD

12:58

[Comment From dawn dawn : ]

Does everyone get dumping syndrome?

Monday November 14, 2011 12:58 dawn

12:59

James Ku, MD:

It only occurs after gastric bypass and not every patient gets dumping syndrome.

Monday November 14, 2011 12:59 James Ku, MD

1:00

James Ku, MD:

Thank you for joining me today. I appreciate your thoughtful questions and hope that you found my answers to be satisfactory. If you could do me a favor, it would mean a great deal if you could please take a moment to fill out the bariatric surgery online survey to give us feedback so that Lancaster General Health can provide you with better quality educational sessions in the future. http://bit.ly/Survey_QA

For more information about Bariatric Physician Specialists and bariatric surgery, please visit us at www.lancastergeneralhealth.org/weightloss

Monday November 14, 2011 1:00 James Ku, MD

1:00

LG Health Admin:

If Dr. Ku did not get to answer your question, we will have him respond and add his answer to the archived version of this session.

Monday November 14, 2011 1:00 LG Health Admin

1:28

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