Physician Communication Packet June 2014
PHYSICIAN COMMUNICATION Packet
What’s Inside: 3 Physician Introduction 4 – 5
Jacksonville Orthopaedic Institute; Scott McGinley, MD
YMCA/Baptist Health
Youth nutrition counseling 6 – 8
Travel and Tropical Medicine Center
9 – 12
Baptist Center for Bariatrics
Baptist CareConnection
Link — June 2014
Baptist Briefs Link — June 2014
PHYSICIAN INTRODUCTION
Welcome Dr. McGinley Orthopaedic Surgeon, Jacksonville Orthopaedic Institute
Jacksonville Orthopaedic Institute is pleased to welcome Scott McGinley, MD, to their Fleming Island/Clay Division. Scott McGinley, MD, believes in caring for his patients by listening, engaging, and regarding everyone like family. He enjoys treating all injuries and orthopaedic conditions and is particularly interested in knees, hands, the spine and arthritis. His education and qualifications include: • M edical Degree from University of Medicine and Dentistry of New Jersey, Newark, NJ • R esidency in Orthopaedic Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ • F ellowship in Orthopaedic Sports Medicine, University of Florida College of Medicine, Gainesville, FL • B oard-certified in orthopaedic surgery
To make an appointment with Dr. McGinley, please call 904.276.5776 or visit joi.net. Jacksonville Orthopaedic Institute Fleming Island/Clay Division 1845 Town Center Blvd. Suite 405 Fleming Island, FL 32003
June 6, 2014 Dear Health Care Provider, It is shocking to learn that as of today 1 out of every 3 children in America is considered overweight or obese. Based on current trends, by the year 2030, 2 out of every 3 children born today will be obese by the time they graduate high school. Here at the YMCA of Florida’s First Coast, we believe that through knowledge, guidance and encouragement we can help our future leaders develop and realize their highest potential. This is why we invest in the education of our youth through all of the many camps and activities that the Y offers. And now for the first time, the Y is offering Youth Nutrition Consultations with our Registered Dietitians (RDN) who are highly experienced in youth nutrition education. During these consults, the RDN can estimate the child’s nutritional needs, suggest meal plans and discuss physical activity. The consult will be a personalized and interactive conversation between the child, caregiver (i.e. parent) and the RDN. Our goal is to help the child find a balance between home and school life to meet their health goals and set a foundation for future healthy living. For more information please call 904.854.2084 to get in touch with the First Coast YMCA’s Registered Dietitians. Please see the attached flyer for additional details.
Sincerely, Sue Dukes, DTR Director of Healthy Living Innovations: Nutrition & Obesity YMCA of Florida’s First Coast 12735 Gran Bay Parkway West, Suite 250 Jacksonville, FL 32258 sdukes@firstcoastymca.org
Youth Nutrition Counseling BROOKS YMCA
Private, one-hour individual consultations are available for children ages 2-17. COST Members - $45 Non-Members - $60
All children deserve to grow up carefree, but sometimes that can be difficult when health problems start to develop and get in the way of having fun. Many obesity issues can be curbed with the right diet and exercise, that’s why we’re making nutrition consultations available to our youth to help them start feeling like a kid again. Visit the Welcome Center for more information or call SUE DUKES, DTR Director of Healthy Living Innovations: Nutrition & Obesity 904.854.2083
Introducing Baptist Travel and Tropical Medicine Center James Allen, MD, PhD - Medical Director
A travel medicine and infectious diseases expert, James Allen, MD, PhD, consults with his patients to provide valuable information that is customized to their health needs and travel itinerary. James Allen, MD, PhD, is board-certified in Infectious Diseases and Internal Medicine, with a PhD in microbiology. He has earned a Certificate of Knowledge in Clinical Tropical Medicine and Travelers’ Health through the American Society of Tropical Medicine and Hygiene and a Certificate in Travel Health from the International Society of Travel Medicine. As an Infectious Diseases and Travel Medicine specialist, he is an active member in the following medical organizations: International Society of Travel Medicine International Society for Infectious Diseases International Society for Mountain Medicine Infectious Diseases Society of America Wilderness Medical Society The American Nepal Medical Association American Society of Tropical Medicine and Hygiene
As a highly sought-after speaker, Dr. Allen has given presentations internationally and domestically to corporations, physicians, nurses, students and travelers on the topics of travel medicine, hepatitis, malaria and other travel health issues. In addition to providing the appropriate immunizations to each traveler, Dr. Allen provides them with valuable information, about the following: Country specific health information Jet lag Country specific immunization recommendations World Disease Maps Malaria prevention - medicines and repellents Vaccine Information Statements (VIS) CDC Travel Notices U.S. Dept. of State Travel Warnings and Alerts Country specific diseases U.S. Consular information Food and water precautions Immunocompromised traveler Traveler’s diarrhea - prevention and treatment Deep vein thrombosis High altitude illness Health advice for women/child travelers
To schedule a Travel Consultation or to learn more, please contact Dr. Allen’s office at 904.396.3336. “ I have served as a medical missionary in Peru, Ecuador, Honduras, Costa Rica, Kenya and Nepal. As a result of my experiences, I gained extensive knowledge and a passion for tropical and travel medicine which I enjoy sharing with others.” - James E. Allen, MD, PhD
PHYSICIAN INTRODUCTION
Meet Dr. Allen
Physician, Baptist Infectious Diseases The physicians of Baptist Infectious Diseases are pleased to welcome James Allen, MD, PhD, to their Baptist Medical Center Jacksonville practice. Dr. Allen has extensive experience in all areas of infectious diseases. He has a special expertise in travel and tropical medicine and has served as a medical missionary in Peru, Ecuador, Honduras, Costa Rica, Kenya and Nepal. He is excited to bring his expertise to the Northeast Florida community. His education and qualifications include: • D octor of Medicine from the University of Miami, Miami,FL • R esidency in Internal Medicine, Loyola University Medical Center, Maywood, IL • F ellowship in Infectious Diseases, University of Colorado, Denver, CO • B oard-certified Internal Medicine • B oard-certified Internal Medicine sub-specialty Infectious Diseases • C ertificate in Knowledge in Tropical Medicine and Travelers Health • Certificate in Travel Medicine
To make an appointment with Dr. Allen, please call 904.396.4886. Baptist Infectious Diseases 820 Prudential Drive Suite 515 Jacksonville, FL 32207
B a p t i s t C e n t e r f o r B a r i at r i c s
Treating obesity. Transforming lives. Bariatric surgery is the most effective treatment for morbid obesity and can improve or resolve medical problems related to obesity. — National Institutes of Health
Quality • Recognized as an Accredited Bariatric Center of Excellence • B oard-certified, fellowship trained surgeons — more than 530 surgeries performed • Minimally invasive approaches result in fewer complications, faster recoveries • O utcomes for BMI reduction two years post surgery exceed the MBSAQIP benchmark • C reating a new wing of the hospital dedicated to bariatrics
M
Comprehensive • P erform the three most common types of bariatric surgery — tailor best option for each patient • M ulti-disciplinary team approach includes the primary care provider, bariatric surgeon, plastic surgeon, bariatric coordinator, clinical dietitians, psychologists, exercise specialists, dedicated nurses and trained hospital staff • C omprehensive program is structured for sustained weight loss and lifelong success — includes long-term follow up and ongoing free support groups
Affordable • U nlike other area programs, we do not charge a program fee — informational seminars, insurance assessment and support groups are free • L ow-interest financing options for hospital and surgery fees available for self-pay patients
Candidates for Bariatric Surgery
Referrals and Consultations
• BMI greater than 40 • B MI greater than 35 with associated medical problems (type 2 diabetes, hyperlipidemia, hypertension) • N ote: FDA approved use of Lap Band in patients with BMI over 30 with co-morbidities • P atient has attempted weight loss through behavioral modification or medical treatment • Patient is committed to long-term lifestyle changes
Fax: 904.391.5451 Phone: 904.202.SLIM (7546) Email: bariatrics@bmcjax.com Web: baptistbariatrics.com Thank you for allowing us to care for your patients’ weight loss and bariatric surgical needs.
Your Patient’s Journey Free informational seminar Insurance verification
Craig Morgenthal, MD, FACS Office: 904.398.0033
First consultation with surgeon
Psychological evaluation
Counseling with registered dietitian
Support group before surgery
Medical clearances
Steven Hodgett, MD, FACS Office: 904.398.0033
Second consultation with surgeon M
Surgery and recovery Monthly support groups post-op
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e
Baptist Center for Bariatrics
baptistbariatrics.com
Comparison of Baria Comparison of Bariatric Surgical Procedures Comparison of Bariatric Surgical Proced Comparison of Bariatric Surgical Procedures Comparison of Bariatric Surgical Procedures Comparison of Bariatric Surgical Procedures Comparison of Bariatric Surgical Procedures Comparison of Bariatric Surgical Procedures Comparison of Bariatric Surgical Procedures the Baptist Center for Bariatrics, or learn more about visit e-baptisthealth.com/bariatric To learn more about theTo Center forTo Bariatrics, visit e-baptisthealth.com/bariatrics call 904.202.SLIM learn more about the Center for Bariatrics, visit e-baptisthealth.com/bariatrics or(7546). call 904.202 Baptist Baptist 904.202.SLIM (7546) LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING SLEEVE GASTRECTOMY ADJUSTABLE GASTRIC BANDING ROUX‐EN‐Y GASTRIC BYPASS SLEEVE GASTRECTOMY ADJUSTABLE GASTRIC BANDING
LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC SLEEVE GASTRECTOMY ROUX‐EN‐Y GASTRIC BYPASS SLEEVE GASTRECTOMY ADJUSTABLE GASTRIC BANDING
LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING ROUX‐EN‐Y GASTRIC BYPASS ADJUSTABLE GASTRIC BANDING ROUX‐EN‐Y GASTRIC BYPASS SLEEVE GASTRECTOMY
LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC SLEEVE GASTRECTOMY ADJUSTABLE GASTRIC BANDING SLEEVE GASTRECTOMY ROUX‐EN‐Y GASTRIC BYPASS
LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING ROUX‐EN‐Y GASTRIC BYPASS SLEEVE GASTRECTOMY ROUX‐EN‐Y GASTRIC BYPASS
LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC Procedure Procedure Procedure Procedure Procedure Procedure Procedure Procedure LAPAROSCOPIC LAPAROSCOPIC LAPARO LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC LAPAROSCOPIC Procedure ADJUSTABLE SLEEVE ROUX-EN-Y Procedure Procedure ADJUSTABLE SLEEVE GASTRECTOMY ADJUSTABLE GASTRIC BANDING SLEEVEBANDING GASTRECTOMYSLEEVE ROUX-EN ADJUSTABLE GASTRIC BANDINGGASTRIC GASTRECTOMY GASTRIC BANDING GASTRECTOMY GASTRIC BYPASS
An adjustable silicone ring (band) is placed The procedure creates a small gastric The procedure works by removing 80 The procedure creates a small gastric An adjustable silicone ring (band) is placed The procedure works by removing 80 The procedure creates a small gastric An adjustable silicone ring (band) is placed The procedure works by removing 80 An adjustable silicone ring (band) is placed The procedure works by removing 80 The procedure creates a small gastric An adjustable silicone ring (band) is placed The procedure works by removing 80 The procedure creates a small gastric An adjustable silicone ring (band) is placed The procedure works by removing 80 The procedure creates a small gastric An adjustable silicone ring (band) is placed An adjustable silicone ring (band) is placed The procedure works by removing 80 The procedure creates a small gastric An adjustable silicone ring (band) is placed The procedure works by removing 80 Description around the top part of the stomach and percent of the stomach and reducing the pouch and also bypasses the stomach and around the top part of the stomach and pouch and also bypasses the stomach and Description percent of the stomach and reducing the around the top part of the stomach and percent of the stomach and reducing the pouch and also bypasses the stomach and Description around the top part of the stomach and percent of the stomach and reducing the pouch and also bypasses the stomach and Description around the top part of the stomach and percent of the stomach and reducing the pouch and also bypasses the stomach and Description around the top part of the stomach and percent of the stomach and reducing the pouch and also bypasses the stomach and Description around the top part of the stomach and Description around the top part of the stomach and percent of the stomach and reducing the pouch and also bypasses the stomach and around the top part of the stomach and percent of the stomach and reducing the creates a small pouch secretion of gastric hormones a portion of the small intestine Description creates a small pouch secretion of gastric hormones a portion of the small intestine creates a small pouch secretion of gastric hormones a portion of the small intestine creates a small pouch secretion of gastric hormones a portion of the small intestine creates a small pouch a portion of the small intestine creates a small pouch secretion of gastric hormones a portion of the small intestine creates a small pouch creates a small pouch secretion of gastric hormones a portion of the small intestine creates a small pouch secretion of gastric hormones Reduces amount of food that can be secretion of gastric hormones Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • •Reduces amount of food that can be • •Reduces amount of food that can be Reduces amount of food that can be • Reduces amount of food that can be Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • Reduces amount of food that can be • • Reduces amount of food that can be • • Reduces amount of food that can be •• Reduces amount of food that can be • Reduces amount of food that can be consumed consumed consumed • Reduces amount of food that can be Reduces amount of food that can be consumed consumed consumed consumed consumed consumed consumed consumed consumed consumed consumed consumed consumed consumed consumed consumed Adjustments (fills) are made through the • •Reduces the amount of calories and Reduces gastric hormones and sensation • consumed Reduces the amount of calories and consumed consumed • Adjustments (fills) are made through the • Reduces gastric hormones and sensation • Reduces the amount of calories and consumed consumed • Adjustments (fills) are made through the • •Reduces gastric hormones and sensation How does it work? • Adjustments (fills) are made through the es it work? • Reduces gastric hormones and sensation Adjustments (fills) are made through the • Reduces the amount of calories and Reduces gastric hormones and sensation • Reduces the amount of calories and How does it work? • Reduces gastric hormones and sensation • Reduces the amount of calories and • Adjustments (fills) are made through the • • access port by adding saline solution, of hunger in many patients How does it work? nutrients the body absorbs (controlled •• Adjustments (fills) are made through the access port by adding saline solution, of hunger in many patients nutrients the body absorbs (controlled • Adjustments (fills) are made through the • Reduces gastric hormones and sensation • Reduces the amount of calories and access port by adding saline solution, of hunger in many patients nutrients the body absorbs (controlled • Adjustments (fills) are made through the Reduces gastric hormones and sensation How does it work? How does it work? How does it work? st access port by adding saline solution, of hunger in many patients nutrients the body absorbs (controlled How does it work? How does it work? access port by adding saline solution, of hunger in many patients nutrients the body absorbs (controlled access port by adding saline solution, of hunger in many patients nutrients the body absorbs (controlled average 6 fills in the 1 year •malabsorption) No alteration to digestive tract malabsorption) average 6 fills in the 1st year • No alteration to digestive tract malabsorption) access port by adding saline solution, average 6 fills in the 1st year • No alteration to digestive tract access port by adding saline solution, of hunger in many patients access port by adding saline solution, nutrients the body absorbs (controlled of hunger in many patients st st average 6 fills in the 1 year • malabsorption) No alteration to digestive tract malabsorption) st average 6 fills in the 1 year • No alteration to digestive tract malabsorption) average 6 fills in the 1st year • No alteration to digestive tract st st • No alteration to digestive tract • No alteration to digestive tract • No alteration to digestive tract average 6 fills in the 1 year average 6 fills in the 1 year • No alteration to digestive tract malabsorption) average 6 fills in the 1 year • No alteration to digestive tract • No alteration to digestive tract • No alteration to digestive tract • No alteration to digestive tract • 50% of excess weight • 50‐70% of excess weight • 60‐70% of excess weight • 50% of excess weight • 50‐70% of excess weight • 60‐70% of excess weight • 50% of excess weight Average weight loss • 50‐70% of excess weight • 60‐70% of excess weight • No alteration to digestive tract • No alteration to digestive tract •50‐70% of excess weight No alteration to digestive tract weight loss stst st st Average weight loss st st st • 50% of excess weight • • 60‐70% of excess weight st st • 50% of excess weight • 50‐70% of excess weight • 60‐70% of excess weight • 50% of excess weight • 50‐70% of excess weight • 60‐70% of excess weight 1 pound/week in 1 year 1‐2 pounds/week in 1 year year Average weight loss 1‐2 pounds/week for 1 year st • 1 pound/week in 1 year • 1‐2 pounds/week in 1 year Average weight loss • 1‐2 pounds/week for 1 year st • 1 pound/week in 1 year • •1‐2 pounds/week in 1 year Average weight loss • •1‐2 pounds/week for 1 •• 50% of excess weight st st •• 50% of excess weight • 50‐70% of excess weight • 60‐70% of excess weight st st • 50% of excess weight 50‐70% of excess weight st st st • 1 pound/week in 1 year • 1‐2 pounds/week in 1 year • 1‐2 pounds/week for 1 year • 1 pound/week in 1 year • •1‐2 pounds/week in 1 year year • 1‐2 pounds/week for 1 Average weight loss • 1 pound/week in 1 • 1‐2 pounds/week in 1 year • 1‐2 pounds/week for 1 Average weight loss st Average weight loss Small portions of healthy food •Small portions of healthy food Small portions of healthy food • Small portions of healthy food st year st st • Small portions of healthy food • Small portions of healthy food st • Small portions of healthy food • Small portions of healthy food • •Small portions of healthy food •• 1 pound/week in 1 year • 1 pound/week in 1 year • 1‐2 pounds/week in 1 year st year • 1‐2 pounds/week for 1 year •Small portions of healthy food 1 pound/week in 1 1‐2 pounds/week in 1 year Small portions of healthy food • Small portions of healthy food • Small portions of healthy food • •Small portions of healthy food • Small portions of healthy food • Small portions of healthy food • • Small portions of healthy food • • Small portions of healthy food High protein, low carb •High protein, low carb High protein, low carb • High protein, low carb • High protein, low carb • High protein, low carb • High protein, low carb • High protein, low carb • •High protein, low carb •• Small portions of healthy food • Small portions of healthy food • Small portions of healthy food • Small portions of healthy food •High protein, low carb Small portions of healthy food Small portions of healthy food High protein, low carb • High protein, low carb • High protein, low carb • •High protein, low carb • High protein, low carb • High protein, low carb • • High protein, low carb • • High protein, low carb No drinking with meals •No drinking with meals No drinking with meals • No drinking with meals • No drinking with meals • No drinking with meals • No drinking with meals • No drinking with meals • •No drinking with meals Long‐term Nutrition •• High protein, low carb m Nutrition •• High protein, low carb • High protein, low carb • High protein, low carb Long‐term Nutrition •No drinking with meals High protein, low carb High protein, low carb • No drinking with meals • • No drinking with meals • No drinking with meals • No drinking with meals • No drinking with meals • No drinking with meals • No drinking with meals • No drinking with meals • Zero calorie liquids only • Zero calorie liquids only Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only Long‐term Nutrition Long‐term Nutrition Long‐term Nutrition •• No drinking with meals •• No drinking with meals • No drinking with meals • No drinking with meals No drinking with meals No drinking with meals Zero calorie liquids only • •Zero calorie liquids only • Zero calorie liquids only • •Zero calorie liquids only • Zero calorie liquids only • • Zero calorie liquids only Avoid sugar and fats to prevent • Avoid sugar and fats to prevent Long‐term Nutrition • Zero calorie liquids only Avoid sugar and fats to prevent Long‐term Nutrition • Zero calorie liquids only Long‐term Nutrition • Zero calorie liquids only •• Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only • Zero calorie liquids only Zero calorie liquids only • Avoid sugar and fats to prevent dumping* • Avoid sugar and fats to prevent dumping* • Avoid sugar and fats to prevent dumping* • Multivitamin • Avoid sugar and fats to prevent dumping* dumping* Multivitamin Multivitamin dumping* • Multivitamin • Multivitamin • Multivitamin • Multivitamin • •Multivitamin • •Multivitamin dumping* Multivitamin Multivitamin • Multivitamin No routine labs •Vitamin B12 Vitamin B12 • Vitamin B12 • Multivitamin • •Multivitamin • Multivitamin • Multivitamin • • Multivitamin • • Multivitamin • No routine labs • Vitamin B12 • Vitamin B12 • No routine labs • •Vitamin B12 • Multivitamin • No routine labs • Vitamin B12 • Vitamin B12 • Multivitamin • Multivitamin • Multivitamin Nutritional • Need routine labs at 3, 6 and 12 months • Calcium and iron (higher chance of • No routine labs • Vitamin B12 • Vitamin B12 • Multivitamin • Multivitamin nal • No routine labs • Vitamin B12 • Vitamin B12 • Calcium and iron (higher chance of Nutritional • Need routine labs at 3, 6 and 12 months • Need routine labs at 3, 6 and 12 months • Calcium and iron (higher chance of Nutritional • Calcium and iron (higher chance of •• No routine labs Supplements • Calcium and iron (higher chance of post‐op, then yearly thereafter nutritional deficiencies if don’t take) Nutritional • No routine labs • Vitamin B12 • Vitamin B12 ments nutritional deficiencies if don’t take) Nutritional • Need routine labs at 3, 6 and 12 months •Need routine labs at 3, 6 and 12 months No routine labs Vitamin B12 Supplements post‐op, then yearly thereafter • Need routine labs at 3, 6 and 12 months • • Calcium and iron (higher chance of post‐op, then yearly thereafter nutritional deficiencies if don’t take) Supplements nutritional deficiencies if don’t take) nutritional deficiencies if don’t take) Nutritional • Need routine labs at 3, 6 and 12 months Supplements • Need routine labs at 3, 6 and 12 months Supplements •post‐op, then yearly thereafter Nutritional • Need routine labs at 3, 6 and 12 months • Need routine labs at 3, 6 and 12 months • Calcium and iron (higher chance of Need routine labs at 3, 6 and 12 months post‐op, then yearly thereafter nutritional deficiencies if don’t take) Nutritional post‐op, then yearly thereafter post‐op, then yearly thereafter • Need routine labs at 3, 6 and 12 months post‐op, then yearly thereafter Supplements • Need routine labs at 3, 6 and 12 months post‐op, then yearly thereafter • Need routine labs at 3, 6 and 12 months Supplements post‐op, then yearly thereafter nutritional deficiencies if don’t take) Supplements post‐op, then yearly thereafter Lowest chance of operative Moderate chance of operative • Highest chance of operative post‐op, then yearly thereafter • Lowest chance of operative • Moderate chance of operative • Highest chance of operative post‐op, then yearly thereafter • Lowest chance of operative • •Moderate chance of operative • •Highest chance of operative post‐op, then yearly thereafter • Need routine labs at 3, 6 and 12 months complications complications including bleed or leak complications including bleed, leak or Lowest chance of operative Moderate chance of operative • Highest chance of operative complications complications including bleed or leak complications including bleed, leak or complications complications including bleed or leak complications including bleed, leak or • Lowest chance of operative • Moderate chance of operative • Highest chance of operative • Lowest chance of operative • • Moderate chance of operative •• Highest chance of operative post‐op, then yearly thereafter Possible complications include heart, •obstruction, less than 5% need Possible complications include heart, obstruction, less than 5% need • Possible complications include heart, • Possible complications include heart, obstruction, less than 5% need complications complications including bleed, leak or • Possible complications include heart, • •Possible complications include heart, complications complications including bleed or leak complications including bleed, leak or complications complications including bleed or leak complications including bleed, leak or •• Lowest chance of operative • Lowest chance of operative • Moderate chance of operative • Highest chance of operative •complications including bleed or leak Lowest chance of operative Moderate chance of operative lung, blood clots and infections lung, blood clots and infections reoperation lung, blood clots and infections lung, blood clots and infections Possible complications include heart, complications including bleed or leak • obstruction, less than 5% need Possible complications include heart, obstruction, less than 5% need lung, blood clots and infections reoperation lung, blood clots and infections reoperation • Possible complications include heart, • Possible complications include heart, obstruction, less than 5% need • Possible complications include heart, • • Possible complications include heart, complications complications complications including bleed, leak or complications complications including bleed or leak 10‐20% chance for reoperation by 10 •Possible complications include heart, Newer procedure with 3‐5 year • Possible complications include heart, • 10‐20% chance for reoperation by 10 • Newer procedure with 3‐5 year • Possible complications include heart, lung, blood clots and infections lung, blood clots and infections reoperation • 10‐20% chance for reoperation by 10 • •Newer procedure with 3‐5 year •lung, blood clots and infections lung, blood clots and infections reoperation lung, blood clots and infections lung, blood clots and infections reoperation •• Possible complications include heart, • Possible complications include heart, • Possible complications include heart, • Possible complications include heart, obstruction, less than 5% need Possible complications include heart, What are the risks? years due to band slip, erosion, leak or published outcomes lung, blood clots and infections e the risks? years due to band slip, erosion, leak or published outcomes lung, blood clots and infections What are the risks? years due to band slip, erosion, leak or • 10‐20% chance for reoperation by 10 published outcomes lung, blood clots and infections 10‐20% chance for reoperation by 10 Newer procedure with 3‐5 year • Possible complications include heart, • Newer procedure with 3‐5 year • Possible complications include heart, • 10‐20% chance for reoperation by 10 • • Newer procedure with 3‐5 year •• Possible complications include heart, lung, blood clots and infections lung, blood clots and infections reoperation lung, blood clots and infections lung, blood clots and infections port problem •Possible nutritional deficiencies Possible stomach enlargement and need • lung, blood clots and infections Possible nutritional deficiencies port problem • Possible stomach enlargement and need • Possible nutritional deficiencies port problem What are the risks? • Possible stomach enlargement and need •published outcomes What are the risks? years due to band slip, erosion, leak or published outcomes lung, blood clots and infections years due to band slip, erosion, leak or lung, blood clots and infections What are the risks? years due to band slip, erosion, leak or published outcomes lung, blood clots and infections • 10‐20% chance for reoperation by 10 • 10‐20% chance for reoperation by 10 • Newer procedure with 3‐5 year • Possible complications include heart, • 10‐20% chance for reoperation by 10 • Newer procedure with 3‐5 year •for re‐operation, 10% chance or higher Inadequate weight loss for re‐operation, 10% chance or higher • No aspirin, NSAIDs, or smoking due to • Inadequate weight loss for re‐operation, 10% chance or higher • No aspirin, NSAIDs, or smoking due to • Inadequate weight loss No aspirin, NSAIDs, or smoking due to port problem Possible stomach enlargement and need • Possible nutritional deficiencies port problem • •Possible stomach enlargement and need • Possible nutritional deficiencies port problem • Possible stomach enlargement and need •• Possible nutritional deficiencies What are the risks? lung, blood clots and infections years due to band slip, erosion, leak or What are the risks? years due to band slip, erosion, leak or published outcomes What are the risks? years due to band slip, erosion, leak or published outcomes • Easiest procedure to “cheat” risk of marginal ulcer or stricture • Easiest procedure to “cheat” risk of marginal ulcer or stricture • Easiest procedure to “cheat” risk of marginal ulcer or stricture • for re‐operation, 10% chance or higher Inadequate weight loss for re‐operation, 10% chance or higher • No aspirin, NSAIDs, or smoking due to • Inadequate weight loss for re‐operation, 10% chance or higher • No aspirin, NSAIDs, or smoking due to • Inadequate weight loss • No aspirin, NSAIDs, or smoking due to port problem • Possible stomach enlargement and need • Possible nutritional deficiencies port problem • port problem Possible stomach enlargement and need • Stomach pouch may stretch and lead to • Stomach pouch may stretch and lead to • Stomach pouch may stretch and lead to • Easiest procedure to “cheat” risk of marginal ulcer or stricture • Easiest procedure to “cheat” risk of marginal ulcer or stricture • Easiest procedure to “cheat” risk of marginal ulcer or stricture • Inadequate weight loss • Inadequate weight loss for re‐operation, 10% chance or higher • No aspirin, NSAIDs, or smoking due to • Inadequate weight loss for re‐operation, 10% chance or higher weight regain weight regain weight regain • Stomach pouch may stretch and lead to • Stomach pouch may stretch and lead to • Stomach pouch may stretch and lead to • Easiest procedure to “cheat” •2 nights Easiest procedure to “cheat” risk of marginal ulcer or stricture Hospital Stay Overnight (less than 1 day) 2 nights • Easiest procedure to “cheat” Stay Overnight (less than 1 day) 2 nights 2 nights Hospital Stay Overnight (less than 1 day) 2 nights 2 nights weight regain weight regain weight regain • Stomach pouch may stretch and lead to Time off Work 1‐2 weeks 1‐2 weeks 2‐3 weeks Overnight (less than 1 day) Work 1‐2 weeks 1‐2 weeks 1‐2 weeks 2‐3 weeks Overnight (less than 1 day) Time off Work 1‐2 weeks 2‐3 weeks Hospital Stay 2 nights 2 nights Hospital Stay 2 nights Hospital Stay 2 nights Overnight (less than 1 day) 2 nights 2 nights weight regain Operation Time 1 hour 1.5 hours 2 hours 1‐2 weeks on Time 1 hour 1.5 hours 1 hour Operation Time 1.5 hours 2 hours Time off Work 1‐2 weeks 2‐3 weeks Time off Work 2 hours 1‐2 weeks 1‐2 weeks 2‐3 weeks 1‐2 weeks Time off Work 1‐2 weeks 2‐3 weeks Hospital Stay 2 nights Overnight (less than 1 day) Better results if patients enjoy Good option for patients with type 2 • Most effective weight loss for patients Hospital Stay Overnight (less than 1 day) • Better results if patients enjoy • Good option for patients with type 2 Hospital Stay 2 nights Overnight (less than 1 day) 2 nights • Better results if patients enjoy • •Good option for patients with type 2 • •Most effective weight loss for patients Operation Time 1 hour 1.5 hours 2 hours Operation Time • Most effective weight loss for patients 1 hour 1.5 hours 2 hours 1.5 hours Operation Time 1 hour 2 hours participating in an exercise program and with a BMI of 35‐55 diabetes and patients whose medical with a BMI of 35‐55 Time off Work 2‐3 weeks 1‐2 weeks participating in an exercise program and diabetes and patients whose medical with a BMI of 35‐55 participating in an exercise program and diabetes and patients whose medical Time off Work 1‐2 weeks Time off Work 1‐2 weeks 1‐2 weeks 1‐2 weeks Better results if patients enjoy Good option for patients with type 2 • Most effective weight loss for patients • Better results if patients enjoy • Good option for patients with type 2 • Better results if patients enjoy • Most effective weight loss for patients • • Good option for patients with type 2 •• Most effective weight loss for patients are disciplined in following nutrition conditions preclude other procedures • Good option for patients with BMI over are disciplined in following nutrition conditions preclude other procedures • Good option for patients with BMI over are disciplined in following nutrition conditions preclude other procedures • Good option for patients with BMI over Operation Time 1 hour Operation Time 1 hour 1.5 hours 2 hours Operation Time 1 hour 1.5 hours participating in an exercise program and diabetes and patients whose medical with a BMI of 35‐55 participating in an exercise program and diabetes and patients whose medical with a BMI of 35‐55 participating in an exercise program and diabetes and patients whose medical with a BMI of 35‐55 guidelines such as anemia, Crohn's disease, 50, type 2 diabetes, severe heartburn, guidelines such as anemia, Crohn's disease, 50, type 2 diabetes, severe heartburn, guidelines such as anemia, Crohn's disease, 50, type 2 diabetes, severe heartburn, • • Better results if patients enjoy • Most effective weight loss for patients •conditions preclude other procedures Better results if patients enjoy • Better results if patients enjoy Good option for patients with type 2 are disciplined in following nutrition • Good option for patients with type 2 • Good option for patients with BMI over are disciplined in following nutrition conditions preclude other procedures • Good option for patients with BMI over are disciplined in following nutrition conditions preclude other procedures • Good option for patients with BMI over •extensive prior surgery or frequent Less effective for BMI over 50 extensive prior surgery or frequent joint problems or exercise limitations • Less effective for BMI over 50 extensive prior surgery or frequent joint problems or exercise limitations • Less effective for BMI over 50 joint problems or exercise limitations participating in an exercise program and Recommendations guidelines guidelines such as anemia, Crohn's disease, 50, type 2 diabetes, severe heartburn, participating in an exercise program and diabetes and patients whose medical with a BMI of 35‐55 mendations participating in an exercise program and diabetes and patients whose medical such as anemia, Crohn's disease, 50, type 2 diabetes, severe heartburn, Recommendations guidelines such as anemia, Crohn's disease, 50, type 2 diabetes, severe heartburn, • Safe for higher risk patients steroid use • Not recommended for higher risk and • Safe for higher risk patients steroid use • Not recommended for higher risk and • Safe for higher risk patients steroid use • Not recommended for higher risk and are disciplined in following nutrition • extensive prior surgery or frequent Less effective for BMI over 50 extensive prior surgery or frequent joint problems or exercise limitations are disciplined in following nutrition conditions preclude other procedures • Good option for patients with BMI over • Less effective for BMI over 50 extensive prior surgery or frequent joint problems or exercise limitations are disciplined in following nutrition conditions preclude other procedures • Less effective for BMI over 50 joint problems or exercise limitations Procedure is reversible Recommendations •elderly patients Safe for higher risk patients Recommendations elderly patients • Procedure is reversible • Safe for higher risk patients elderly patients Recommendations • Procedure is reversible • •Safe for higher risk patients guidelines • Safe for higher risk patients steroid use • Not recommended for higher risk and guidelines such as anemia, Crohn's disease, 50, type 2 diabetes, severe heartburn, • Safe for higher risk patients steroid use • Not recommended for higher risk and guidelines such as anemia, Crohn's disease, • Safe for higher risk patients steroid use • Not recommended for higher risk and Many insurance companies will Procedure is not reversible • Procedure is reversible • Many insurance companies will • Procedure is not reversible • Many insurance companies will • Procedure is reversible • •Procedure is not reversible • •Procedure is reversible Procedure is reversible • elderly patients elderly patients • Less effective for BMI over 50 • Procedure is reversible • Safe for higher risk patients elderly patients •• Less effective for BMI over 50 extensive prior surgery or frequent • Procedure is reversible • • Safe for higher risk patients •Safe for higher risk patients Less effective for BMI over 50 extensive prior surgery or frequent authorize this procedure Several insurance companies will Many insurance companies will authorize this procedure • Several insurance companies will • Many insurance companies will authorize this procedure • Several insurance companies will • •Many insurance companies will Recommendations joint problems or exercise limitations Recommendations Recommendations Many insurance companies will • Procedure is reversible • Many insurance companies will • Procedure is not reversible • Safe for higher risk patients • Many insurance companies will • Procedure is reversible • • Procedure is not reversible •• Procedure is reversible • Safe for higher risk patients steroid use • Not recommended for higher risk and •Procedure is not reversible Safe for higher risk patients steroid use authorize this procedure authorize this procedure authorize this procedure authorize this procedure authorize this procedure authorize this procedure authorize this procedure • Many insurance companies will authorize this procedure • Several insurance companies will • Many insurance companies will authorize this procedure • Several insurance companies will •• Many insurance companies will •• Procedure is reversible • Procedure is reversible • Safe for higher risk patients elderly patients •Several insurance companies will Procedure is reversible Safe for higher risk patients * Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small * Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small authorize this procedure authorize this procedure authorize this procedure authorize this procedure authorize this procedure authorize this procedure • Many insurance companies will • Many insurance companies will • Procedure is not reversible • Procedure is reversible • Many insurance companies will • Procedure is not reversible intestine too rapidly. Common symptoms include abdominal cramps and nausea. tine too rapidly. Common symptoms include abdominal cramps and nausea. intestine too rapidly. Common symptoms include abdominal cramps and nausea. authorize this procedure • Several insurance companies will • Many insurance companies will authorize this procedure • authorize this procedure Several insurance companies will * Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small * Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small * Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small authorize this procedure authorize this procedure authorize this procedure intestine too rapidly. Common symptoms include abdominal cramps and nausea. intestine too rapidly. Common symptoms include abdominal cramps and nausea. intestine too rapidly. Common symptoms include abdominal cramps and nausea.
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su 5 Nutritional • Multivitamin • Multivitamin • Multivitamin labs • Vitamin B12 • Vitamin B12 • exstejoN • Nutritional No routine labs • Vitamin B12 Nutritional • No routine labs • No routine • Vitamin B12 supplements • No routine labs • Vitamin B12 • Vitamin B12 • Sa e Supplements Supplements • atNeed routinemonths labs at 3, 6 and • Calcium and 12 iron • Need routine labs at 3, and 12 months • 6Need labspost‐op, 3, 6 and post‐op, ••m Pr P •N eed routine labs at 3, 6 and 12 routine •C alcium and iron 12 (higher chance •• Se M au then yearly a • Need thenpost-op, yearly then yearly then yearly of nutritional months deficiencies if routine labs * Also called rapid gastric emptying, dumping syndrome occurs when the u * Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or "dumped" into your small * Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transp don’t take)intestine too rapidly. Common symptoms include abdominal cramps and intestine too rapidly. Common symptoms include abdominal cramps and nausea. intestine too rapidly. Common symptoms include abdominal cramps and nausea. • ofModerate of operative com Lowest chance operativechance complications • Highest chance o • of Moderate of operative complications • Lowest chance of operative complications • Moderate chance operative chance complications • Lowest chance of• operative complications •N eed routine labs at 3, 6 and 12 including bleeding or leaking • blood Possible complications heart, blood bleeding leaking or obstru including bleeding or lung, leaking • Possible complications lung, including leakingthen • include Possibleheart, complications include heart, lung, include blood monthsor post-op, yearly
clots and infections
• Possible complications he • Possible complica • Possible complications lung, • include Possibleheart, complications include heart, lung, include clots and infections clots and infections
• Low risk of major complications such • Highest chance of operative What are • L owest chance of operative blood clots and• infections • re-operation 10-20% chance foryears re-operation by 10 years Possible nutrition blood clots • What 10-20% for What re-operation by 10 years due are blooddue clots and infections • 10-20% chance for 10 dueand infections arechancecomplications complications including asby bleeding, leakage or stricture the risks? the risks? the risks?slip, •erosion, • Newer procedure with 3‐5 year pu to band slip, erosion, leak or port problem • • Newer procedure with 3‐5 year published outcomes to band leak or port problem No aspirin, NSAI • Newer procedure with 3‐5 year published outcomes to band slip, erosion, leak or port problem bleeding, leaking or obstruction, • Possible complications include heart, P ossible complications include • enlargement Possible stomach enlargement and Inadequatelung, weight loss clots less than 5% need re-operation blood and infections heart,loss lung, blood clots and• loss • Possible stomach enlargement need for • Inadequate weight or stricture • Possibleand stomach and need for • Inadequate weight • Possible complications include • Possible and infections re‐operation, 10% chance or highe tostomach “cheat” enlargement re‐operation, 10% chance or higher • Easiest procedure to “cheat” re‐operation, 10% chance or higher • Easiest procedure• toEasiest “cheat”procedure heart, lung, blood clots and need for re-operation, 10% chance •2 5-40% chance for re-operation by infections or higher 10 years due to band slip, erosion, • Possible nutritional deficiencies leak 1Hospital orday) port problem Stay(less thanOvernight 1 day) 2 nights l Stay Overnight (less than nights 2 nights Hospital Stay Overnight 1 day) (less 2than 2 nights • No aspirin, NSAIDs or smoking • I nadequate weight loss Time off Workto “cheat” 1-2 weeks 1-2risk weeks Work due to of marginal2-3 ulcer asiest procedure 1-2 weeks 1-2 weeks weeks Time off Work• E 1-2 weeks 1-2 weeks or stricture Operation 1 hour 1.5 hours on Time 1 Operation hour 1.5 hours 2 hours Time 1 hour Time 1.5 hours Hospital stay Overnight 2 nights 2 nights
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suchsevere as anemia, Croh guidelines heartburn procedures, such as anemia, Crohn’s disease, procedures, such as procedures, anemia, Crohn’s disease, nutrition guidelinesnutrition 1.5 hours 2 hours extensive prior• surgery or frequen Less effective BMI overprior 50 surgery or Not recommende frequent steroid use • Less effective for BMI• over extensive prior surgery or frequent steroid use Less50effective for • BMI over 50 forextensive • Most effective weight loss for Recommendations • Better results if patients enjoy •G ood option for patients with type • Safe higher-risk patientsis reve Safe for higher-risk Procedure • Safepatients forand higher-risk patients Safe for higher-risk patients • Safe for higher-risk patients • Safeinfor patients Recommendations mendations • Recommendations patients withfor a BMI of • 35-55 2 diabetes patients whose participating anhigher-risk exercise• program • option Procedure is not reversible • Procedure ismedical reversible • Many • Procedure is not reversible • Procedure is reversible • Procedure Procedureinisfollowing reversible •is Gnot oodreversible for patients with insurance c conditions preclude other and are• disciplined BMI over 50, type diabetes, suchwill as anemia, Crohn’s nutrition • Several insurance companies will au • Many insurance companies authorize • Several insurance companies willinsurance authorize • Many insurance companies will authorize • Several companies will2 authorize • guidelines Many insurance companies willprocedures, authorize severe heartburn, joint problems disease, extensive prior surgery or • L ess effective for BMI over 50 this procedure this procedure this procedure this procedure this procedure this procedure nutrition Operation time guidelines 1 hour
• Safe for higher-risk patients • Procedure is reversible
frequent steroid use •S afe for higher-risk patients •P rocedure is not reversible
or exercise limitations • Not recommended for higherrisk and elderly patients • Procedure is reversible
* Also called rapid gastric emptying, dumping syndrome occursare when theofundigested contents of your small stomach are transported “du ed rapid gastric emptying, dumping syndrome occurs when the syndrome undigested contents your stomach transported “dumped” toointo rapidly. * Also called rapid gastric emptying, dumping occurs whenof the undigested contents yourorstomach are into transported or intestine “dumped” yourorCom sma
* Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or “dumped” into your small intestine too rapidly. Common symptoms include abdominal cramps and nausea.
B a p t i s t C e n t e r f o r B a r i at r i c s
Meet our bariatric surgeons Our goal is to provide your patients with safe, consistent, quality care that helps enhance and extend their lives. Craig Morgenthal, MD, FACS “ We guide our patients by encouraging a healthy lifestyle, providing a proven bariatric surgery tool and supporting them with a comprehensive program. Together, this is the framework for long-term success.” • Medical director of Baptist Center for Bariatrics • Board-certified general surgeon and fellow of the American College of Surgeons • A ttended medical school at Tel Aviv University, completed his general surgery residency at the State University of New York at Brooklyn, and did a research and clinical fellowship in minimally invasive and bariatric surgery at Emory University School of Medicine • Office: 904.398.0033
Steven Hodgett, MD, FACS “ What I appreciate most about being a bariatric physician is developing personal relationships with each patient.” • B oard-certified bariatric surgeon with advanced training in weight loss surgery and laparoscopic surgery • A ttended medical school at the Medical College of Wisconsin in Milwaukee, completed his residency in general surgery at the University of South Florida School of Medicine and completed a clinical fellowship in minimally invasive surgery at Washington University School of Medicine in St. Louis, Missouri • Office: 904.398.0033
Referrals and Consultations Fax: 904.391.5451 Phone: 904.202.SLIM (7546) Email: bariatrics@bmcjax.com Web: baptistbariatrics.com
Thank you for allowing us to care for your patients’ weight loss and bariatric surgical needs.