Bariatric Surgery Blog

Dr. Myers Signs Contract with The Reading Hospital and Medical Center

2012-01-22T17:59:00.000-08:00

I am now able to announce that I have agreed to become one of the bariatric surgeons at The Reading Hospital and Medical Center and the Medical Director of the Weight Management Center of the Reading Hospital beginning February 29, 2012. The Reading Hospital and Medical Center is a 650 bed hospital that serves a large area just west of Philadelphia. After much careful consideration I have selected this new location near Philadelphia, Pa for the following four reasons:

1). The Reading Hospital has had a decades long track record of deep commitment to persons of size with a large program performing over 400 bariatric operations per year.

2). The Weight Management Center is a comprehensive approach consistent with my core values for caring for persons of size

3). It will be my privilege to work along a bariatric surgeon, Fred Ceppa, MD, who demonstrates deep empathy for patients who are suffering with the medical, social and psychological difficulties brought on by obesity. Dr. Ceppa has excellent outcomes and a very low morbidity and mortality rate.

4). I will be able to continue perform surgery with a surgical robot, continue to do research to profect robotic bariatric surgery further and provide the highest quality of care for my patients.

Although it is difficult for my wife and I to leave our many friends in Ohio, I would be honored to care for patients from all over the United States or from around the world if they chose to travel to Reading Hospital and Medical Center.

I will continue to contribute to this blog as frequently as I can to help as many bariatric surgery patients as possible obtain their best possible results no matter where they chose to have their operation.

A Very Merry Christmas from Rev. Gary Rode

2011-12-16T19:53:00.000-08:00

Dr. Myers,

Just wanted to drop you a friendly hello and wish you a Merry Christmas.

I received the letter this fall announcing that your were making some changes in your professional life. Hope that is turning out well for you. I know that I really appreciate the care and skill that you and your staff demonstrated in my surgery and in our doctor/patient relationship.

I wanted to give you an update on how things are going for me. Last May when I came in for my one year check-up for my gastric by pass surgery, lab tests showed that my A1C was 7.3 At that time you recommended that I begin taking Metformin. I went home and thought about it. One of the reasons that I had the surgery was to get off of diabetes medication. So I decided to try an alternative treatment. Something really radical. I started to exercise. Yes, I know that everyone on your staff reminded me over and over again about the importance of exercise. But the weight was rolling off without the exercise, so I just ignored it.

Finally in mid-June I began a program of walking/running for 30 minutes per day. Eventually I arrived at the point where I could run the full 30 minutes. Finally in early September I ran in my first 5K, a fund raiser for a local ministry that provided housing and care for the Mentally Retarded ( I have two adult sons with Downs Syndrome). In mid-October I saw my local family doctor, and by adding "running" to my treatment regime, my A1C dropped from 7.3 down to 6.6. I am thrilled. He seems to think that if I continue this the A1C will drop even further. Since then I have ran in two more 5K races -- one to support Special Olympics, and another to support Hospice of Northwest Ohio (My mother died in March 2011 and received Hospice care.) Even though the temperatures are dropping, I have bought the necessary clothing and I am hitting the streets at about 6:15 am, 4-5 times per week running 3+ miles. I look at it as my diabetes medicine. Before having bariatric surgery, I sometimes thought about running. In fact during part of my pre-surgery goal setting, I had running as a potential future activity. I find that I am really enjoying doing it. My health is great, my weight is staying down, I have lots of energy, and my diabetes is under control.

Thanks again for your help and best wishes with your changes.

Gary Rode
United Methodist Pastor
Perrysburg, OH

Thank you Gary for allowing me to share this with everyone. This should be an encouragement to all of us to work hard at staying active. Great job and congratulations! Merry Christmas to you and yours as well.
God bless.
Dr. Myers

A Message of Thanksgiving from Joanna

2011-11-23T13:58:00.000-08:00

Dr. Myers—

I hope this finds you well and moving forward. I think of you often and wonder where you have decided to practice, but I am especially thinking of you this week as I am reminded by this season to ponder all the things for which I am grateful.

You and your work, Dr. Myers, are near the top of the list, behind only God’s gift of a relationship with Him and the gifts he’s given me in my family and friends. Because of your work, you have helped to give me a life I thought I would never have. I am still surprised when I walk by the mirror at my new body, and it’s been four-plus years since surgery!

I have no pain in my joints and back because I don’t carry the extra weight that was previously putting stress on them. I have more energy to keep up with my disabled daughter and my teenagers. I no longer fear the blood-pressure cuff, which previously revealed increasing numbers. I enjoy shopping, and rather than worry about finding something that I feel comfortable in, I have to worry about spending a little bit too much money!

My husband, who has always been a loving, generous man, and claims he always found me beautiful, can’t stop telling me what a beautiful woman I am. I am more comfortable moving toward people and getting to know them and allowing myself to be known. I can’t think of any aspect of my life that having this surgery hasn’t touched. I feel that I have freedom to be the woman that God created me to be—a freedom that I’m sure that I had as a larger woman, but didn’t realize, didn’t grasp hold of.

I continue to meet people who have had bariatric surgery, and I am always glad to meet them and eager to share my story. I am increasingly shocked when I find out that many of them had little or no preparation in changing their eating habits, dealing with their emotions, and increasing their activity prior to surgery. I am even more shocked when I learn that some of these people are chewing food at 6 weeks! So, I’m not surprised, but definitely saddened, when I find out that these same people are returning to some of their old habits—particularly eating sugar—just months after their surgery! It is so sad!

I am so, so grateful to you Dr. Myers that you have refused to water down your standards and that you’ve chosen to stand by what you know is true about what is best about your patients. I wish you and your family only the best as you move forward in your career. I hope that wherever you have chosen to practice, that you will invite me sometime to speak at one of your seminars. I love to share my story, love to travel, and welcome the chance when I am able to get coverage for my special needs daughter Jessica.

Wishing you all the best this Thanksgiving season and always,

Joanna

Thank you for such a special Thanksgiving message. I am so pleased you are doing so well four years after your operation. I am in discussion with a hospital in Reading, Pa and Grand Rapids, MI. I will certainly let you know when we have made a final decision.

Happy Thanksgiving to you and your family and to all of my patients.

Dr. Myers

More from James Bennett

2011-10-30T12:48:00.000-07:00

James Bennett recently sent me more information and postoperative pictures to add the story he recently shared on the blog. Here are his additional comments:

My total weight loss I measure from the night I went to your seminar. I weighed in that night at 406 lbs. I now weigh between 182 and 185! From size 56 jeans to 34 slims! From big and tall to the young mens dept! Instead of being parked on the couch I now re-enjoy camping, hiking, lifting weights, fishing, golfing, and so on! personal physician doesn't think my idea of skydiving is safe because of my artificial hip and spinal fusion, but he may okay zip lining, which I am looking forward to! Jen and I would still be more than willing to speak for you wherever you move your practice to!

Sincerely, James Bennett

James Bennett Tells His Story

2011-10-24T10:25:00.000-07:00

Having developed degenerative arthrits approximately fifteen years ago, I noticed severe pain and damage in my lower back and both hips. The more pain I was in, the less active I was, and kept gaining weight. In march of 2005, I had emergency abdominal surgery because of severe diverticulitis. I was off my feet for three months, and began gaining weight at a rapid pace.

In April of 2006, I had a full left hip replacement, followed by three months of physical therapy. Off my feet and work for another three months, gaining even more weight, but the pain was no better.

In March of 2007, I had a lumar spinal fusion because I had a disc basically disintegrate and had vertebrae grinding together. When the surgeon opened me up, he discovered one of the affected vertebrae was cracked, and also repaired that. This time, off my feet and work for four months, gaining even more weight. The pain was still severe

Then in January of 2008, I had read about Dr. Myers and bariatric surgery. After going to the seminar in Mansfield, I went home and weighed in at 406 pounds and knew this was the right decision for me. By this time, I was in so much pain I could not walk without a cane or walker, (That is me with the orage shirt sporting a cane in the third picture), and my wife had to push me in a wheelchair when we would go shopping. September 25, 2009 I had a gastric bypass procedure done by Dr. Myers. That day I weighed in at 376, having lost some weight by following the Fresh Start nutrionist diet and changing my eating habits.

The first three months were a little tough, going through the different stages of liquids and soft foods before getting back to a normal diet. The rapid weight loss kept me motivated, losing 80 pounds in the first 90 days. Slowly the pain FINALLY began to wane. Now I was really motivated.

Some things were difficult to adjust to, physically and psychologically, but the fresh start team was right beside me through it all. To date I have gone from a whopping 406 pounds (54 on the BMI chart) to 185 pounds (26 on the BMI chart)! Now instead of buying my clothes at big and tall, I shop in the young mens dept! Instead of laying on the couch in agonizing pain, I am golfing, hiking, camping, canoeing and all the other funs things I used to enjoy doing.My pain and stress level are way down and my attitude and self esteem are way up!

For me, sacrificing 3-4 helpings at dinner, bags of chips and cookies was a miniscule price to pay for the health and happiness I am enjoying everyday. Dr. Myers and the entire Freash Start team are definately the most caring and professional group I have ever met! I owe him my life.

James Bennett

8 Tips for Fuller, Thicker Appearing Hair

2011-10-08T18:34:00.000-07:00

Often my patients ask how they can avoid hair loss and improve the appearance of their hair.

You can read further about my recommendations regarding preserving as much hair as possible during the time of temorary hair loss between the fourth and sixth months after bariatric surgery by choosing the subject "Hair" in the index of this blog. However here are important cosmetic tips from Jake Miller, an experienced hair stylist at Rafeal's studio in Clintinville, Ohio. Jake has been my personal hair stylist for the last several years and I recently asked him to share some tips for making our patient's hair look as thick as possible even during the "thin" times.

Here are Jakes 8 tips to make hair look thicker:

Talk to your hair stylist about working with your fine hair.

1. Create blunt lines to make your hair style look and feel thicker keeping tapering to a minimum.

2. Cut bangs deep toward the top of the head for an even thicker look in front bringing more hair forward.

3. Shorten fine hair to create fullness.

4. Expand the hair shaft with thickening shampoos, conditioners and volumizing tonics.

5. Blow dry hair forward and against the usual direction your hair is combed with a flat paddle brush.

6. Part hair on the opposite side you usually part to create fullness. This will lift the hair up further from the scalp giving the apearance of more hair.

7. Curl with hot rollers or a round brush and blow dryer to create more lift and the apearance of volume.

8. Color hair lighter shades to blend with your natural scalp color so the scalp is not so obvious.

Jake is even willing to do free consultations for our patients.

Jake Miller, Hair Stylist
Rafiel's Studio
Aveda Lifestyle Salon

2927 N. High St.
Columbus, Ohio 43202
(614) 784-1177
www.rafielsstudio.com

Dr Myers Leaves Fresh Start and Riverside Methodist Hospital

2011-09-30T15:37:00.000-07:00

It is with sadness that I share the letter I am sending to many of my patients with my readers:

From the Desk of

Stephan R. Myers, MD, FACS

September 30, 2011

Dear Patient and Friend:

I am writing this letter to you with mixed emotions. I have decided to end my relationship with Riverside Methodist Hospital and the Fresh Start Bariatric Program effective as of September 30, 2011. This has not been an easy decision for me to make. Caring for my patients in the Central Ohio area has been a great source of satisfaction and pleasure for many years. Since it is likely that I will be taking my practice out of state, our physician-patient relationship must sadly come to an end. I will continue to provide emergency treatment and access to services with me for a period of thirty (30) days from the date of this letter to allow you to transition to a new physician. If you need to make an appointment to see me within the next 30 days please call Annie McQuate at 419-571-6054 to make that appointment.

Several of my current patients have asked whom I would recommend as a bariatric surgeon in the Central Ohio area. I have given this significant thought, as I continue to be concerned for the health and well being of my patients, and would recommend Dr. Bradley J. Needleman at Ohio State University. Dr. Needleman is a highly experienced and well regarded surgeon and an overall good individual. If you need to schedule an appointment with him, please contact his office at (888) 366-8907.

Of course, you are free to seek care elsewhere if you wish. If you do not know where to begin, I suggest you contact the Ohio State Medical Board who can give you names of doctors in the area that are accepting new patients. In any event, be sure to check with your insurer or managed care organization to verify that the services of the physician or physicians you are considering are covered by your health plan. In the event a medical emergency arises in the interim, please remember that assistance is always available from the Emergency Department of Riverside Methodist Hospital.

The contents of your medical records are confidential and can be transferred to another doctor only with your permission. If you would like us to transfer your medical records to a designated physician, including Dr. Needleman, please sign the enclosed authorization form and return it to the Fresh Start office as soon as possible. Your records will continue to be on file in my former office at Fresh Start which may be contacted by calling 614-566-3946.

I have valued my relationship with my patients more than I can express in words. I thank you for your loyalty and friendship and extend my best wishes for your future health and happiness. You are welcome to follow me on my blog: BariatricSurgeryBlog.blogspot.com for further bariatric surgery information.

May God greatly bless you as you continue your journey toward better health.

Sincerely,

Stephan Myers, M.D.

Gastric Sleeve Success Story - Jaime Manley

2011-08-04T19:28:00.000-07:00

Bowel Issues Following Bariatric Surgery

2011-07-31T17:46:00.000-07:00

Diarrhea, or loose stools, is rarely an issue after patients have a standard gastric bypass, a gastric sleeve or a gastric band. Occasionally they will experience a few days of loose stools while they recover from surgery but this improves without any therapy.

Diarrea is a side effect of some bariatric operations such as the duodenal switch, biliopancreatic diversion or a gastric bypass that creates a short common channel for absorption of food.

However, if you have several high volume explosive stools a day associated with fever and crampy abdominal pain you should contact your bariatric surgeon’s office since antibiotic use during your hospitalization can change the bacteria in your stool leaving only the C. Diff bacteria to grow and cause these symptoms. A stool test can determine if C. Diff is the cause and treatment with an antibiotic called Flagyl can solve the problem.

Constipation

Constipation is a more frequent complaint from bariatric surgery patients.

1). During the first week after surgery the use of pain medicines such as Percocet or Vicodin that contain narcotics will slow bowel function causing constipation. The solution is straight forward. Stop the narcotic pain medicine and use Tylenol or Tramadol. In a day or two bowel function will return.

2). After the first week or so following surgery constipation is usually the result of inadequate fiber intake. Very little fiber is consumed early after a bariatric operation. Adding 25 grams of fiber each daywill usually correct the problem in a week or so. Many fiber products are difficult for bariatric surgery patients to consume since they often form into a gel after being swallowed. I recommend Benefiber since it is tasteless and dissolves in liquids. Benefiber should be added to nearly all fluids consumed for a total of 25 grams each day.

3) For more immediate relief as the fiber is doing its work you can use the following three over-the-counter preparations:

A). Miralax - You can repeat this several times as necessary until constipation is relieved.

B). Milk of Magnesia

C). Colase stool softener

As you return to more normal foods three to six months after surgery you will be able to decrease the amount of supplemental fiber as long as your stools stay soft.

Laparoscopic Gastric Sleeve Operation - Questions Answered

2011-07-27T18:34:00.000-07:00

In response to a recent posting on laparoscopic gastric sleeve operations I did in June 2011 I received several questions.

Pete S. from Columbus, Ohio asked about outcomes and frequency of the gastric sleeve operation nationally.

Pete, I returned from the American Society for Metabolic and Bariatric Surgery in June 2011 and I can tell you that the changes I am seeing in my practice is happening all over the USA and around the world. The frequency of gastric banding has dropped off rapidly and the frequency of the gastric sleeve is increasing rapidly as well. My practice is probably out ahead of the curve somewhat because I have been performing the laparoscopic gastric sleeve longer than many. My first gastric sleeve operation was performed nearly 4 years ago and I have probably performed about 250 of these operations to date.

My practice is now about 50% gastric bypass and 50% gastric sleeve with only one or two gastric bands a month. The gastric sleeve may even be more frequent than the gastric bypass although it may be too early to know for sure. I doubt that this would be the case across the country but the trend is clear.

In regard to outcomes, Across the country there is a range of weight loss from 50% of excess weight lost at 1 year to 80% of excess weight lost at 1 year. As I mentioned in the earlier blog posting I refer to above our average person who has a gastric sleeve loses 78% of their excess weight at 1 year after surgery for those who are at a BMI of 55 or less at the time of surgery. There are several likely reasons for this discrepancy.

1). Technical – Obviously the operation must be performed correctly. The sleeve should be narrow. However, it cannot be so narrow it causes an obstruction along the sleeve. I use a 32 French gastroscope for a sizer and make sure it is not too tight. This allows me to look at the size of the sleeve from the inside of the sleeve before completing the operation to make sure I am happy with the diameter.

One of the most frequent errors that probably contributes to inadequate weight loss is to leave too much room in the top of the stomach called the fundus. When this occurs the fundus is likely to dilate over time making the stomach too large and allowing too much food to be consumed at each meal. This can be corrected but will require an additional operation to remove the excess fundus.

2). Patient must be well prepared – The patient must be ready to make the necessary dietary and behavioral changes to get their best result. This includes being psychologically ready as well. Only participating in a bariatric surgery comprehensive program is likely to do this for most people.

3). Great long term care – It is important to see your bariatric surgeon often after surgery to make sure you are on track. I see my patients at 1, 3, 6 weeks and at 3, 6and 12 months. This allows for mid course corrections if you are not meeting expectations. Ask your surgeon how frequently you will be seen after the operation.

So Pete, hopefully this helps you to understand what is happening on the national scene.

Five More Apps for your Smart Phone

2011-07-23T11:26:00.000-07:00

In addition to the free and paid apps introduced on my last blog posting, here are five more paid apps for your smart phone:

1). MyFitnessPal
This is a calorie counter, as well as a diet and exercise.

2). DailyBurn
This is a calorie counter as well as a workout and weight tracker.

3). Ihourglass
Virtual hour glass which allows you to choose multiple time intervals to help you eat slower and clock times between bites.

4). Fooducate
This application allows you to take a photo of a bar code while shopping to help you make better, healthier choices.

5). Meal snap
This app lets you take a picture of your meal and "magically tell you what foods it detects and calculates the estimated calories in each item and meal! How crazy is that?

Nutrition and Exercise Apps for Your SmartPhone

2011-07-22T19:03:00.000-07:00

In this era of smart phones there are many apps that can help you on your Journey to better health through the help of bariatric surgery.
Kristi, one of the Fresh Start Bariatrics dieticians, gave me this list and made the following comments on each.

Free Apps:

1). Fresh Fruit
This application contains a description of various fruit, nutritional info. It also explains the country of origin and when they are in season.

2). Nutrition Tips
This contains a collection of 500+ interesting and useful nutrition tips and health facts.

3). Lose It!
You can use your iphone camera to scan barcodes on food packages and track your calories.

4). FoodScanner
This also allows you to scan the barcodes on food packages and track your calories.

Paid Apps:

1). Tap and Track
This is a user friendly calorie/ nutrient, weight and exercise tracker with a built in USDA data base of 7000+ food items.

2). Restaurant Calorie Count for Dummies
This provides nutritional information including calories from restaurant menus.

3). Eight Glasses a Day
This application helps ensure you meet your fluid requirements. The new1.3 version allows you to track from 1 to 12 glasses of water daily. Touch the virtual water glass after drinking an 8 oz. and watch it disappear.

4). Livestrong.com
This is a comprehensive nutrient analysis and exercise tracker.

5). Mealboard
This is a recipe storage app that lets you plan your meals for the week and generates a grocery list.

Hope this is helpful. Thanks to Keisti for reviewing these apps.

Skin Fold Irritation is Worse in Hot Weather

2011-07-21T18:46:00.000-07:00

With the heat wave spreading over the United States this summer many of my patients are struggling with the effect of heat and moisture in skin folds such as:

1). Abdominal skin fold

2). Skin folds under breasts

3). Groins

4). In skin folds in the inner thighs

5). Other skin folds

The best treatment for this problem I have ever found is a product you can find at nearly any pharmacy. It is called ZeaSorb-AF. This is a nearly odorless, white powder seaweed product with an added anti-fungal agent.

I think this product is much better than corn starch or baby powder.

After showering, dry the areas well with a dry towel and apply this powder liberally in the skin folds to keep the areas dry and treat any fungal infection that may be starting in these locations.

I hope this helps you stay more comfortable during hot humid days and nights of summer.

Increasing Your Activity of Daily Living to Improve Your Weight

2011-07-14T17:28:00.000-07:00

In June I was at the American Society for Metabolic and Bariatric Surgery in Orlando, Florida and had the privilege of hearing Dr. James Levine speak of his research.

Most of the calories we expend are the result of activities of daily living, not from exercise. Exercise is important but we use allot more calories in our activity of daily living.

He explained that people that are lean "automatically" increase their activity of daily living after a time of consuming more than needed. Some of his suggestions include:

1). Walk more and faster all day long.

2). Walk, don't sit, in any meeting of two people.

3). Swear off elevators and escalators.

4). Do not sit while speaking on your cell phone, always walk up and down the hall.

5). Park as far as possible when you drive to work or the store.

6). Move your legs up and down while sitting at your desk at work.

7). Move your chair out of your cubicle and use a fitness ball to sit on.

Even more aggressive options are sometimes suggested including increasing the height of your desk and standing during much of the day, using a stair stepper at your desk during part of the day and even designing a tread mill at your desk!

You may have even better suggestions but each person must design more activity into our daily lives to maintain our weight at a healthy level.

Laparoscopic Gastric Sleeve Operation is Becoming Much More Frequently Performed

2011-06-06T19:55:00.000-07:00

An important shift is occurring in our practice. Patients appear to be requesting the gastric sleeve operation more frequently than any other operation. We are much less likely to be requested to perform an adjustable gastric band than a coup;e of years ago.

In my opinion a gastric sleeve is a great operation for many patients. However, a gastric bypass is usually the best operation if you have significant type 2 diabetes or severe gastroesophageal reflux.

A gastric sleeve operation does not change the small intestine and therefore supplemental vitamins and calcium may not be medically necessary.

Also the circular muscle at the outlet of the stomach functions somewhat as the gastric band. In a way this operation is the best a gastric bypass and a band without some of the potential problems of either.

I have now had the privilege of performing over 200 laparoscopic gastric sleeve operations and I have found patients are generally very pleased with their results. In our practice our patients lose about 20 lbs. a month for about three months and they lose an average of 78% of their excess weight at one year after surgery. This is similar to the 80% excess weight loss a year after a gastric bypass in our practice.

One Week Before Dr. Myers's Special Informational Seminar Explaining How Type 2 Diabetics Can Be Free From Diabetes

2011-05-31T13:03:00.000-07:00

Please consider this your invitation to a special seminar I am giving on Thursday June 9th at 7-8:30 PM at the McConnell Heart Health Center 3773 Olentangy River Road.

"Freedom From Diabetes
How Surgery is Helping to Resolbe Type 2 Diabetes"

The purpose of this seminar is to inform the public of how bariatric operations are are now being used specifically to resolve or improve type 2 diabetes. In fact these operations are beginning to be called "Diabetic Surgery" by some.

Bring your freinds or relatives with diabetes to hear Dr. Myers explain how they can be free from diabetes. Surgery is not just treating but reversing diabetes!

Who would have ever thought it? Surgery is now able to reverse type 2 diabetes.

This is not an introduction to our program but an educational seminar. Feel free to bring interested friends and family.

The seminar is free and Hors d'oeuveres will be served but seating is limited so R.S.V.P to 800-837-7555.

I look forward to meeting you there!

Last Week Before Dr. Myers' s Seminar on Reversing Type 2 Diabetes

2011-05-31T12:59:00.000-07:00

Please consider this your invitation to a special seminar I am giving on Thursday June 9th at 7-8:30 PM at the McConnell Heart Health Center 3773 Olentangy River Road.

"Freedom From Diabetes
How Surgery is Helping to Resolbe Type 2 Diabetes"

The purpose of this seminar is to inform the public of how bariatric operations are are now being used specifically to resolve or improve type 2 diabetes. In fact these operations are beginning to be called "Diabetic Surgery" by some.

Who would have ever thought it? Surgery is now able to reverse type 2 diabetes.

This is not an introduction to our program but an educational seminar. Feel free to bring interested friends and family.

The seminar is free and Hors d'oeuveres will be served but seating is limited so R.S.V.P to 800-837-7555.

I look forward to meeting you there!

Chaka, The African Boy with Amputations Recieves His New Legs

2011-05-30T19:55:00.000-07:00

As many of you will recall I had to perform a difficult and emotional operation when I was in Mali, West Africa in January of this year, having to amputate both legs of a 13 month old baby below the knees because the baby's lower legs were dying.n(You Can read the original posting called "The most difficult operation I have ever done" from January 2001.)

The little boy's name is Chaka and he recently received his prosthetic legs. Here is a report from Rosanna Hess who was recently at the hospital in Mali.

"Hi

While I was in Mali in early May I took some photos of Chaka with his new prosthetic legs!!! I have attached them. It was his first week with them attached and he's gotten spoiled being carried everywhere for several months. So besides the pain Chaka might have been feeling, Dr Brett noted that Chaka didn't like to be put down and made to get around on his own. That's why he's crying in the photos. But it was neat to see him moving around despite the tears.

Rosanna"

I am delighted Chaka is doing well and in time I am sure he will be able to walk with his new legs!
Dr Myers

Things Randal Hall Learned Before and After Bariatric Surgery

2011-05-25T19:15:00.000-07:00

Randal Hall is an engineer who spoke at a recent seminar. He had a gastric bypass operation 10 months ago has lost a total of 200 lbs so far. He did a terrific job sharing many things he learned while proceeding through the process of bariatric surgery and printed his thoughts for us. I think you will enjoy reading them:

Things I Regret:
a.) Nothing!

Three things I wish I would have done differently:
I wish I would have taken more and better pictures and monitored my weight/size loss better.
I wish I would/could have done it sooner
I wish I would have started exercising sooner and stuck with the program better.

Things I didn't expect:
a.) I could have comprehended just how different my life could have been.
b.) My weight loss was very rapid.
c.) My size loss was not as rapid but much more steady than the weight loss.
d.) “Plateaus” are very frustrating but when they end the changes are dramatic.
e.) I became lactose intolerant, no big deal, I hate milk anyway.
f.) Reaction to the new “Me” varies greatly from awkward avoidance to wanting to know every detail.
g.) Size loss does not equal weight loss.

Things I am still learning:
a.) When I look in the mirror, sometimes I still see the “Old Me”, it is kind of weird.
b.) My eyes have not adjusted to my new reality. I see myself as the old size/lifestyle.
c.) Portion selection is still very difficult. I look at a very small portion and think that will never be enough and then I can only eat less than half of that.
d.) Buying clothes is difficult for a few reasons, self awareness of actual size and what fits today may not fit tomorrow.
e.) Chewing is critical, seriously! Few things are worse than getting food backed up, I learned fast to avoid this.

Things that worked out fantastic:
a.) Total lack of hunger (good and bad but the bad is manageable)
b.) Very small portions of food satisfy.
c.) Fluid consumption is not a problem, I can drink water/sports drinks normally as I use to.
d.) I don't notice increased energy levels, just increased endurance.

Things that disappointed me about the process:
a.) Sugar doesn't give me symptoms.
b.) Fats seem to cause mild dumping.
c.) High protein intake means you need to consume some sort of fiber trust me...
d.) While I don't get hungry, I get a feeling like low blood sugar when I need to eat, I try to avoid that.

Things I do different now:
a.) When I eat, I eat quality not quantity.
b.) I don't worry about a clean plate anymore, as a matter of fact, I don't know the last time I cleaned a plate. Wasting food is not good but it doesn't end up on my waist.
c.) I don't take elevators anymore; I don't get winded on the stairs now.
d.) I don't park close to the doors; I walk from the back of the lot now.
e.) I run, I just ran the Komen 5K in 41:00 and I run 4 miles 3-4 times a week.
f.) I can fly coach comfortably now. (This was a primary goal)
g.) I can buy clothes at department stores, non-Big & Tall stores. (This was a primary goal)
h.) I eat slowly, it is not a race and it makes me sick to eat fast now.

Things I recommend doing prior to surgery:
a.) Exercise
b.) Reduce portions
c.) Get use to eating small portions 6-8 times a day, this is critical practice.
d.) Do research. Research your surgeon, hospital, surgery method and every aspect of what you are about to do. I particularly recommend Dr. Myers and Fresh Start, they were absolutely fantastic to me.
e.) Once you start the program take pictures, weighing yourself can cause frustrations but pictures really lets you see your progress.
f.) Develop your story, you will be asked a lot of questions, if there are things you do not want to disclose, formulate your avoidance answers, you will be asked a lot of questions. Prepare for people to say rude things and ask inappropriate questions.
g.) Realize that this is not the easy way out, this is not easy at all. Your life will not be the same after the surgery.
h.) Prepare for post surgery. Have your foods ready and test them prior to make sure what you like, experimenting post surgery can be quite interesting.

Warnings From My Personal Experience:
a.) DO NOT proceed with the program unless you are 100% ready and confident with your choice!
b.) DO NOT think that the surgery is MAGIC!
c.) DO NOT think that you will be happier post surgery!
d.) DO NOT think people will stop judging you post surgery!
e.) DO NOT think that all of your eating troubles will go away post surgery!
f.) DO NOT think that this is the easy way out, while I didn’t find this to be difficult, if this is the easy way the hard way is to do nothing!
g.) DO NOT think the Fresh Start Staff is kidding when they tell you that you have to meet your weight goals before being released for surgery, they are not kidding!
h.) DO NOT think that if you really want to do this, that you CAN’T, you most certainly can!
i.) DO NOT think that my experience will be the same as yours!

Questions you may not be comfortable to ask me:
How much did I weigh before the program?
464lbs was my max weight.
424lbs was my surgery weight.
268 is my weight today.
200-225 is my goal weight.
Max Waist Pant Size: 52” current Pant Size: 38” and shrinking.

Do I have trouble eating anything?
Breads and stringy meats (chicken breast and roast beef) cause me the most issues but if you chew properly and eat slowly they are quite manageable.

Is sex better?
Yes! Very much so.

Do I consider what I did hard?
No, I think in the grand scheme it was pretty easy but there were points where I did ask myself what the heck I had done to myself. If I can do it anyone can do it.

What was the worst part of the whole surgery?
There were two particularly bad points. The first period was the three week period post-op. I was very sore and then one day I woke up and it was totally gone, like magic.
The second period was about 6 weeks out, I had to go back to thin liquids because I couldn't get or keep much down, that lasted for about 2-3 weeks and Dr. Meyers refers to this as the "Misery Window" and he is not joking. Since that period, I have felt fantastic. Other than being sore, I have never felt bad.

Do people treat me different now?
Some do, some don't. I don't let what people think of me effect how I think of me.

Do I tell everyone what I did?
No, not at first, not anymore. I did for a while and the reactions were mixed. I have adopted the "Less History More Mystery" model and it really reduces the drama. It is not that I am ashamed, it is that I prefer people get to know me now before I tell them about my history to avoid the prejudice.

What am I the most proud of?
I started running on October 1st of 2010 at 320lbs. I had not voluntarily run more than a few steps in 20 years. I started a Couch-to-5K program and by March 30th I had ran my first continuous 5 kilometers. I was able to run the Komen race without stopping in 41:00. I am very proud of this.

Can I go out to eat at restaruants?
Of course I do, I just choose much better than I use to but I still enjoy the experience just as much.

Thanks so much for sharing so much of your life with us. I know everyone will really appreciate this.I am also very proud of you. Not only for completing the 5K run but for all the work you are putting into getting your best result!

Best wishes for your ongoing sucess,

Dr. Myers

Dr. Myers Gives Informational Seminar on Type 2 Diabetes

2011-05-19T17:06:00.000-07:00

Please consider this your invitation to a special seminar I am giving on Thursday June 9th at 7-8:30 PM at the McConnell Heart Health Center 3773 Olentangy River Road.

"Freedom From Diabetes
How Surgery is Helping to Resolbe Type 2 Diabetes"

The purpose of this seminar is to inform the public of how bariatric operations are are now being used specifically to resolve or improve type 2 diabetes. In fact these operations are beginning to be called "Diabetic Surgery" by some.

Who would have ever thought it? Surgery is now able to reverse type 2 diabetes.

This is not an introduction to our program but an educational seminar. Feel free to bring interested friends and family.

The seminar is free and Hors d'oeuveres will be served but seating is limited so R.S.V.P to 800-837-7555.

I look forward to meeting you there!

Blood Clot Prevention before Bariatric Surgery

2011-05-13T19:23:00.000-07:00

Martha Pettit explains how the preoperative placement of an Inferior Vena Cava Filter the day before her bariatric operation prevented the development of a pulmonary embolus. Martha was determined to have a high risk of developing deep vein thrombosis and/or pulmonary embolus. She was advised to have the filter placed before surgery and now she is glad she did.

Bowel Habits After Bariatric Surgery

2011-05-08T15:52:00.000-07:00

While seeing patients in my office I often hear concerns about constipation. This is a frequent complaint in the early days or weeks after the three most frequently performed bariatric operations; gastric bypass, gastric sleeve, and adjustable gastric band.

Although after surgery patients may be using narcotic pain medicines that slow the intestine that may result in constipation, usually the problem is the lack of fiber in the diet. Since patients are only taking liquids for a time after the operation it is very difficult to consume adequate fiber.

I make the following 4 suggestions to my patients:

1). Stop the use of narcotic pain medicines.

2). Add 25 grams of Benefiber everyday to your drinks or meals. Most fiber products become thick and are difficult for bariatric surgery patients to tolerate. Benefiber disolves in liquids, is tasteless, colorless and is not gritty.

3). Use Miralax as necessary if you have not had a bowel movement for several days.

4). Censider using Colase twice daily until the fiber therapy results in soft bowel movements.

Fiber therapy is not an instant cure for constipation but over a week or so bowel movements will become softer and should stay that way as long a the patient is taking enough fiber. As fiber is added to the diet in other ways the amount of supplemental fiber can be reduced.

2011-05-02T18:05:00.000-07:00

Recently I saw Angela McCaulley in my office. When I sat down across from Angella I first told Her,"I might see your name on this chart but I really do not know who you are!" Angela had her laparoscopic Roux en-Y gastric bypass performed by me nearly 18 months ago. She has had an amazing result as you can see.

She now walks or runs everywhere.

To remove some of the extra skin she had a "belt lipectomy" romoving skin from all around her waist about 6 months ago.

I did not feel so badly for not recognizing her after Angela told me even her grandmother did not recognize her!

Congradulations Angela, the great result you have obtained is the result of your exceptional efforts over the last 18 months.

Testimonial Robotic Gastric Bypass

2011-04-16T11:51:00.000-07:00

Tom Cocran had a robotic gastric bypass operation 4 months ago. He is 6 ft 4 inches tall and weighed 356 lbs. He lost 60 lbs in the Fresh Start Bariatrics program prior to surgery. He has now lost a total of 114 lbs. He no longer has type 2 diabetes with a normal HbA1c. He is no longer on diabetic or blood pressure medicine. He also no longer is on his CPAP machine for sleep apnea.

Tom shared this at the Fresh Start Seminar on April 16, 2011.

Testimonial Robotic Gastric Bypass

2011-04-15T18:58:00.000-07:00

Chest Pain after Gastric Sleeve Operations

2011-04-14T17:42:00.001-07:00

Heather explains symptoms of chest pressure just 6 weeks after her gastric sleeve operation.

Testimonial After Gastric Bypass

2011-04-11T15:16:00.001-07:00

Jennifer Albalakousy has lost 96 lbs just 8 months after her laparoscopic gastric bypass operation and now wieghs just 175 lbs!

She has two children, Zahn who is two years old and Mazin who is five. "I can now keep up with them and play outside with them. We recently went ot Disney World and I had no feelings that I am too large to ride the rides. I would not have been able to do this before because I was too embarassed.

Congradulations! You should be very pleased with what you have accomplished and it has been great to see how supportive your husband has been throughout this process.

Bariatric Surgery and Kidney Stones

2011-04-10T11:33:00.000-07:00

Stephen Vijan, MD, Urologist

I was sitting at the nursing station at Riverside Methodist Hospital today after making rounds on my patients and noticed Stephen Vijan, MD, a urologist, sitting next to me writing a progress note on one of his patients who was on the same nursing floor. I told him I had noticed that not infrequently my bariatric surgery patients have kidney stones in the first year after their operation but I rarely heard about kidney stones thereafter. He thought it was probably because of 2 reasons:

1). They may have more difficulty drinking as much as they should for a few weeks or months after a bariatric operation.

2). They are probably breaking down muscle as well as fat as they lose weight rapidly. Breaking down muscle increases the amount of uric acid in there blood steam and in the urine as it is cleared from their system. Increased uric acid in the urine is known to increase both uric acid stones and more importantly it increases the development of calcium oxalate stones which are the more frequent type of kidney stones.

Dr. Vijan went on to give 5 suggestions for my patients to help prevent kidney stones:

1). Drink as much as possible up to 2 to 2.5 liters. (I am fully aware that this is not possible early after bariatric surgery but do your best.)

2). Take the recommended calcium citrate with meals. This way the calcium will bind the oxalate keeping it in the intestine and away from the urine. Also, the citrate in the calcium citrate will be excreted in the urine and will decrease the acid milieu in the urine making it more difficult for kidney stones to form.

3). When possible avoid oxalate rich foods. This includes cranberry juice, nuts, chocolate, and colas.

4). Be careful not to take too many dairy products such as milk and cheese as they can contain too much protein. (Of course we wnat you to take 60 grams of protein a day for women and 75 grams of protein daily for men. Early on this is challenging and your first priority after keeping hydrated.)

5). Finally, taking other citrate products can help. He suggested that Theralith pills. This is medicine you can order over the internet from Therologics.

A water pill like hydrochlorothiazide can help but since it is likely to cause dehydration in our bariatric patients I would not advise this medicine for most patients.

Dr. Vijan agrees that this problem is likely to be temporary and will not continue to be at risk for kidney stones after they are able to drink 2 to 2.5 liters of liquid a day and after they have lost most of their weight.

Many thanks to Dr. Vijan for taking the time to explain this to me. I am sure it will help many bariatric surgery patients from all over the world.

Testimonial after gastric bypass-Christina Dillman

2011-04-04T15:21:00.000-07:00

Before her laparoscopic gastric bypass Chistina Dillman She felt out of control and had difficulty taking nature walks with her students. Now since she has lost 128 lbs she feels much better about herself and she is the one that starts the day by exercising for 10 minutes with her preschoolers!
Shopping is fun again since she has dropped from a 5X to sizes 18 or 20.

She is much happier and her children have lost weight too since mom is making healthier choices.

Great job Christina. You deserve many fun days shopping!

The 7 Steps that Stop Us from Keeping Our Weight Off after a Diet

2011-03-31T18:29:00.000-07:00

Why do we seem to always return to our previous body weight no matter how many weight loss programs we try?

The hormone called leptin is the key to this dilemma. At the recent world congress on interventional therapies for type 2 diabetes Dr. Leibel from the Columbia University Medical Center explained that our bodies are programmed to protect themselves from starvation not obesity. The challenge humans have faced throughout history is to survive despite times of famine.

Food being too easily available has not been our problem until the last few decades.
The body is tuned to defend our body weight and preserve our stored calories so we do not run out of energy in times of famine.

Here are 7 steps that keep us returning back to our previous weight each time we diet.

1). The more calories we store as fat in our fat cells the larger the fat cells become. As the fat cells become larger they put out more and more of the hormone leptin.

2). Each time we gain weight the leptin level increases and our brains are reset so our weight setting goes up to a new level.

4). This means our weight settings will go up and up each time we gain weight.

5). Unfortunately, weight setting in the brain only resets upward and does not reset downward!

6). Any fall in the level of fat we have decreases the amount of leptin and our brains will trigger mechanisms such as hunger, delay in satiation of food and decreased muscle activity to preserve our stored calories and restore our weight to the previously set level.

7). When we start to lose weight our metabolism slows down and we use 10-15% less energy so we do not use the stored calories any faster than absolutely necessary.

All of these steps serve to maintain our body fat so we have the energy we need to stay alive as long as possible during times of famine.

Unfortunately, when food is too plentiful such as we see in our time these steps work against us as we lose weight and try to keep it off.

If you have struggled to lose weight and keep it off you now understand why it is so difficult to maintain the lower weight. Fortunately, the surgical procedures we use in bariatric surgery counteracts many of these mechanisms and at least 80% of our patients keep their weight off long term.

Testimonial: Kyle Harrington Shares His Gastric Bypass Results

2011-03-29T17:06:00.000-07:00

Kyle Harrington is 34 and a science teacher of 4th, 5th, and 6th graders. He is also a father of twins, Jacob and Lilly, but he weighed 415 lbs and was struggling to do the things he needed to do. Fortunately, his wife and family were very supportive when he decided to have a Roux en-Y gastric bypass by Dr. Myers at Fresh Start Bariatrics at Riverside Methodist Hospital.

He did a great job before his bariatric operation losing 30 lbs so he could have his operation more safely. He weighed 385 lbs. at the time of his operation in December, 2009. He says having his operation was a “God send”. Kyle now weighs only 190 lbs!

He says he had a couple of “bumps” in the road including severe gout as he was losing his weight requiring prednisone and other anti-gout medicines. Also as he lost his weight it became clear he had a deformed coccyx that made it impossible to sit down. This was so difficult he had to have it removed by Dr. Myers surgically.

Now he is off several medicines including Benicar, Allopurinal, Cholchicine, Midrin, and the gabapentin he had been taking for fibromyalgia. He no longer has high blood pressure and is no longer having migraine headaches he no longer needs his CPAP machine for sleep apnea.

Now he is active in Scout’s and can even sit down in a normal position at the campsites!

Congratulations, Kyle, you have worked hard to get your best result from your operation and may God bless you and your family as you enjoy your fresh start life with your wife and twins.

Introduction to The 2nd World Congress on Interventional Therapies for Type 2 Diabetes

2011-03-28T15:19:00.000-07:00

It is really great to be part of The 2nd World Congress on Interventional Therapies for Type 2 Diabetes in New York City and hear so many doctors and researchers from different specialties become so excited about the changes that happen patients with type 2 diabetes after having bariatric operations. In fact, I several of these doctors and researchers are viewing a Roux en-Y gastric bypass as diabetic therapy. Some are even using the words "Diabetic Surgery for procedures such as gastric sleeve, gastric bypass and even adjustable gastric band in selected circumstances.

We even heard from the International Diabetes Federation review their recent position statement encouraging their members to explain to diabetic patients that these operations should be considered as options for diabetic therapy. You could review the position statement by going to www.idf.org and scroll down to select "position statement on bariatric surgery". I would suggest you select the 2 page version by selecting "Executive Summary".

There are 300 million diabetics in the world today and there will be 450 Million by 2030. Since a gastric bypass and similar operations can result in patients resolving their diabetes 80% of the time, this type of surgery is needed now more than ever. With conferences like this attended by over 1,000 medical specialists including so many diabetic specialists the word is getting out and these operations are becoming an acceptable alternative to insulin treatments and other medications. In time I believe we will be able to develop a cooperative relationship between surgeons and diabetic specialists that will bring improved health to diabetics and a decrease in the terrible complications of type 2 diabetes.

Bariatric or "Diabetic Surgery" should be seen as a compliment to medical therapy with the goal of remision of type 2 diabetes or at least the optimal control of type 2 diabetes.

Patient Testimonial Sleeve Gastrectomy

2011-03-24T16:46:00.000-07:00

Cheryl Dalton had a laparoscopic gastric sleeve operation only 7 days ago by Dr Myers at Fresh Start Bariatrics at Riverside Methodist Hospital in Columbus, Ohio. She now explains how her postoperative pain has been managed.

Patient Testimonial after Robotic Gastric Bypass on How Her Pain is Controlled

2011-03-23T19:34:00.000-07:00

Jill Ehrhart had a robotic Roux en-Y gastric bypass just 9 days ago by Dr Myers at Fresh Start Bariatrics at Riverside Methodist Hospital in Columbus, Ohio. She explains what she experienced and how her pain is controlled after her operation.

Many Paths Before Meeting Criteria for Bariatric Surgery

2011-03-22T19:05:00.000-07:00

I have to admit I am somewhat absent minded. On occasion I will be driving along thinking about something else and miss my exit. Before I realize it I have gone quite a distance and when I finally become aware of my surroundings I ask myself, “How did I get here?” I think some of my patients are like that. They are amazed that they have arrived at a weight that is starting to harm their health.
There are many reasons people become over weight. Sometimes I hear someone explain that they had to be on steroids for their asthma and gained a lot of weight. Occasionally I hear the person had a car accident and was immobile for months and gained allot of weight at that time. Others tell of a traumatic episode in their life such as the loss of a child, a parent or even a divorce that led to depression and they started to gain weight while depressed and on antidepressants.

Dr. Tell, the psychologist that works with our program tells me that over 60% of the women in a bariatric surgery practice have been sexually abused as a child or young adult. Sometimes obesity is a way of keeping themselves at a distance from men and keeping themselves felling safe. However by the time they seek help from a bariatric surgeon they have often dealt with the trauma and are married and have healthy marriages and families but they feel trapped in their own body.

Often men tell me they were very active in sports during their teens and or while they were in the military but became much less active as the entered into the work force, found a sedentary job and have gained some weight nearly every year since then.

Women explain they gained weight with each child and now after their last child the weight seems to just keep coming. Or they gained weight during a depression following a miscarriage or stillbirth.

Still others have told me they were always heavier than their peers and cannot remember a time when they were not heavy or that food was used to manipulate them as a child and they just feel driven to eat to prove they are in control of this area of their lives.

Regardless of how a person of size arrived at their weight they usually seek help when their activity level and health are deteriorating. They often feel trapped and desperate and feel their life is slipping away from them.
What is important is that there is hope because with bariatric surgery obesity and related medical problems such as type 2 diabetes can be reversed.

I see it happen every day and I love to hear the stories of how lives are changed and how fun life is again. They tell me of new jobs, having children and having more energy to do the very things they thought they would never be able to do again. I remember John who had not been able to go on the yearly golf trip with his brother for years and the year after surgery he had lost so much weight he was able to take his brother golfing again and oh by the way he is getting married! I remember Molly who was so depressed with her life that she spent most of her time at home in bed but now she has lost all of her excess weight and is salsa dancing again and Sandy who after getting rid of most of her diabetic medicines and losing most of her extra weight took ball room dancing lessons and was recently a champion at a regional competition!

Some of my patients do crazy things like jumping out of perfectly good airplanes, run marathons or going across valleys on zip lines. There are so many stories and so many changed lives. Life can be great again and you can begin to live again. Bariatric surgery can be your fresh start to life. I see it happen every day.

Patient Testimonial / Gastric Bypass / Betty McCauley

2011-03-18T19:46:00.000-07:00

See other testimonials on my YouTube channel. Go to Google and enter "DrSteveMyers YouTube".

Obesity Causes Diabetes / Diabetes Causes Obesity

2011-03-17T15:01:00.000-07:00

Although Type I diabetes, previously called juvenile diabetes, is a serious problem of inadequate production of insulin, in this posting we will primarily be speaking about type II which is 90-95% of all diabetes. Whereas most Type I diabetics are not obese, Type II diabetes is frequently associated with obesity. In fact, the curve associated with the increase in frequency of obesity parallels the increase in type II diabetes. That makes perfect sense since patients who suffer from obesity develop resistance to insulin resulting in increasing blood sugar levels. Most people understand that they increase their risk of developing Type II diabetes as they increase their weight and the longer they are heavy the more likely they will develop Type II diabetes.

What is surprising to people is that the reverse is also true; the treatment of Type II diabetes causes obesity. When your blood sugar is high we try to lower the blood sugar by taking diabetic pills or insulin to lower the blood sugar. However, the glucose does not just disappear. Many of the medicines drive the glucose into the cells of the diabetic so the glucose can be used for fuel. Unfortunately, many medicines including Insulin, Glyburide, Glucotrol, Amaryl, Pranlin as well as Starlix, Actose and Avandia drive glucose into fat cells increasing the amount of calories stored as fat. As a result the person becomes heavier. This in turn causes more insulin resistance requiring more diabetic medicine to keep the blood glucose down! How frustrating is that; obesity causes type II diabetes and type II diabetes make the obesity worse.

Patient Testimonial Reversing Diabetes with Gastric Bypass

2011-03-16T15:02:00.000-07:00

Christopher Anderson had a robotic gastric bypass by Dr Myers just one week ago and now is off of all of his diabetic medicines. Chis shares his story.

Patient Testimonial after lap gastric bypass

2011-03-15T13:49:00.000-07:00

John Lyle has lost 143 lbs just 1 year following lap RNY gastric bypass. His knees are much better and he is having a positive effect on his daughter.

Tree Reasons Type II Diabetes is Often Reversed by Gastric Bypass

2011-03-14T15:16:00.000-07:00

How a gastric bypass can reverse diabetes Here are thee reasons

1). Early after the operation carbohydrate intake is minimal so the glucose level remains low. In fact in our practice I have patients on a very low carbohydrate diet, (650-800 calories per day), for 1 to 2 weeks before surgery primarily so they have an opportunity to use up the stored calories in there liver, (glycogen), which results in loss of water stored in the liver and the reduction of the size of the liver. This allows me to work more easily under the left side of the liver where the upper part of the stomach lives. This makes the operation easier for me and safer for my patients. What I have observed is that frequently many of my patients no longer need their diabetic medicines even before surgery as long as they continue to consume very few carbohydrates. The reduction in the amount of carbohydrates consumed is clearly an important component in this process that continues even after their operation since it takes several weeks or a few months for the amount of carbohydrate a person consumes increases and stabilizes at a new lower amount.

2). Second, since obesity is the most important reason most of our patients
develop diabetes, losing weight and keeping it off decreases the obesity and the patients lose their resistance to insulin which was caused by their obesity in the first place. Therefore the amount of insulin they are able to make is frequently enough to keep their glucose in the right range. Unlike the previous two components that decrease the blood sugar right after surgery this component takes time to show the beneficial effect of weight loss but by the time the patient is able to consume a more normal amount of starch and sugar he or she has lost enough weight to no longer need their diabetic medicines because of the loss of insulin resistance from the resolution of their obesity. This is why with some patients we need to slowly decrease the amount of diabetic medicine they are on over several weeks or even a few months.
It is important to understand that not everyone will have resolution from their diabetes. About 15 to 20 percent will still need to be on some diabetic medicines after a gastric bypass operation. The longer a person has type II diabetes the less likely it is that they will resolve their disease. However I have seen some patients resolve their diabetes after a gastric bypass operation even after 10 or 15 years of diabetes. Nevertheless even if the diabetes is not completely resolved it is much easier to manage and usually a person needs to be only on a pill they can take by mouth and they will not need to take insulin shots.

3). Finally, of these three most common operations, (gastric bypass, gastric sleeve, adjustable gastric band), the gastric bypass has an additional component that helps the diabetic. It is the hormone change that occurs after a gastric bypass. Probably the most important of these changes is the increase in a hormone like substance from the last part of the small intestine and the first part of the large intestine called GPL-1 (Glucagon Like Polypeptide-1) which increases the amount of insulin a gastric bypass patient sends into the blood stream after consuming carbohydrates.
Instead of giving yourself an injection of Byetta or Symulin, which is the injectable form of GLP-1, after a gastric bypass operation your body produces more GLP-1 on its own in response to ingesting carbohydrates resulting in better production of insulin and improved use of insulin where the insulin does it’s work.
This begins immediately after the operation and is part of the reason that many diabetics that still needed some diabetic medicines before surgery even while they were on a very low carbohydrate diet will leave the hospital after their gastric bypass operation on no diabetic medicines at all and have normal blood glucose.

If a person of size has had diabetes for 10 or 20 years, sometimes the insulin producing cells of the pancreas have been so severely damaged that they are no longer able to produce enough insulin to meet their needs even if they lose their excess weight and therefore lose the insulin resistance that comes along with obesity. Nevertheless I have observed amazing results even when I did not expect them. Even if all the patient who has had diabetes for many years are not able to stop all of their diabetic medicines, generally they are on alot less medicines and their diabetes is much easier to manage. They still should be able to maintain a HbA1c
of 6 or less.

The gastric bypass operation is a wonderful tool for persons of size who want to improve or reverse their Type II diabetes.

Diabetes Reversed by Bariatric Surgery as Viewed by Dr. Myers, Assistant Mike Palasek, RN, CRNFA

2011-03-13T13:22:00.000-07:00

Mike Palasek. RN has been working with me as the surgical assistant for over 10 years. He is great help and has helped me with every bariatric operation that I have performed and that is over 1,000 operations. Mike has a “bird’s eye view” of how our diabetic patients do after surgery. He sees each patient after surgery in the office shortly before I see them and records their medicines and how they are doing with their weight and glucose readings. He often speaks to prospective patients who attend our Fresh Start Educational Seminars before I start my part of the presentation. I have heard him say, “I have been a nurse for over thirty years. When I first started nursing I had no idea we would be operating on people to improve their medical problems such as diabetes and high blood pressure. When I was first a nurse I gave insulin for diabetes but no one ever got better and off the insulin injections. We gave pills for high blood pressure but no one ever got off of their blood pressure pills. For me, as a nurse, it is very satisfying because instead of just managing these and other medical problems in our patients we are actually seeing these problems resolve. Now I see people getting off insulin and other diabetic medicines and it is not uncommon for patients to no longer need any medicines for diabetes. Patients who needed 3 or 4 diabetic medicines or are on an insulin pump before surgery are no longer on any of these medicines and they are no longer taking any insulin. It is surprising but we often see patients that are taking 70 or 100 or even more units of insulin every day prior to surgery taking no diabetic medicine or insulin at all with normal blood sugars. As a nurse, that is really rewarding.”

Dr Myers On TV4 - Robotic Gastric Bypass

2011-03-09T18:55:00.000-08:00

Gastric Bypass Testimonial Deb Hoffman

2011-03-09T15:02:00.000-08:00

Debbie Hoffman explains the results she has experienced 2 1/2 years after her Lap RNT gastric bypass operation. She has lost 131 lbs and kept it off.

For more patient stories from our practice by googling DrSteveMyers and selecting my YouTube channel.

Medical Establishment Too Slow to Accept Bariatric Surgery for Diabetics

2011-03-08T17:59:00.000-08:00

There have been many instances in history where the medical establishment has been only too slow in incorporating important new medical information into the practice of medicine.

A fairly recent example is the finding that most ulcers are not related to excess acid produced by stress but ulcers are actually caused the individual having a bacterial infection in their stomach that can be cured with antibiotics instead of surgery! That is an example where the treatment of ulcers changed from surgery to being treated primarily with medicine. Unfortunately, it took the Australian doctor that made this discovery drinking a glass of water filled with the ulcer causing bacteria making himself ill before the new finding was accepted by the medical establishment.

And yet here we are again. The medical establishment is not accepting new medical information. In this case the change goes the other way. In many cases the treatment of diabetes will need to change from being treated with only medicines to incorporating bariatric surgery for the treatment of diabetics that weigh enough to meet criteria for bariatric surgery.

The evidence is overwhelming that bariatric surgery can often resolve type II diabetes and we are still not hearing about it from “experts” in the field of diabetes. It is especially difficult when changing the treatment of a medical disease form only medications to incorporating surgery as a treatment for what has previously been thought to be a disease that is only treated with medicines.
Nevertheless, slowly things are changing. I have witnessed a real change over the last 7 years. When I began to perform bariatric surgery very few primary care doctors and diabetic specialists considered bariatric surgery to be a legitimate treatment for obese patients with diabetes.

However, younger doctors seem to be much more receptive of bariatric surgery especially for their diabetic patients. Not long ago I heard a diabetic specialist say, “Bariatric surgery is the only cure for diabetes.” He was probably overstating the situation to make point. I suspect he fully understands that diabetes could return in the diabetic patient that goes into remission and has no further evidence of diabetes following bariatric surgery. Their diabetes could recur if they do not make the necessary long term lifestyle and dietary changes that are necessary for them to keep the excess weight off and instead they regain their weight so I believe the word “cure” is too strong a word.

I also recently heard one of my patients say that their diabetic specialist now has a discussion about bariatric surgery with each patient who is heavy and has a new diagnosis of type II diabetes.

Things are changing but it may be too late for many diabetic patients. All diabetic and even pre-diabetic people of size should be aware that if they are treated with bariatric surgery early enough they can reverse type II diabetes. As a bariatric surgeon it is a great privilege to help conquer obesity every day and care for so many with diabetes whose lives are changed in so many ways including resolving or improving their diabetes.

Things do change, evem if too slowly.

Find diabetic patient success stories on YouTube by googling DrSteveMyers and selecting my TouTube channel.

Dr Myers's Patients on YouTube

2011-03-05T15:51:00.001-08:00

It is easy to find Dr. Myers's YouTubre Channel!

To see Dr Myers's patients on YouTube

1). Go to Google.com

2). Type in drstevemyers

3). Select DrSteveMyers's Channel

4). Enjoy.

App for a Smart Phone Can Help Bariatric Patients

2011-03-05T14:40:00.000-08:00

Jennifer Kanagy was seen in my office this week and explained that she had found a new App that had been helpful to her. It has a name that could insult anyone!

FatSecret.com alows you to manage your calories, protien, fat, calories and exercise.

Download app
Bring up daily food guide
click scan
scan bar graph
Obtain nutrition info
change size of portion
collect info about food consumed
etc.

Jennifer hopes this is helpful for others on their bariatric surgery journey.

Kathy Tells How Her Type II Diabetes was Resolved with a Robotic Gastric Bypass

2011-03-03T17:43:00.000-08:00

Diabetes Improvement Barely Mentioned

2011-03-01T14:40:00.000-08:00

Recently on a Sunday in late winter I stepped off the escalator on the second level of our local Barnes and Nobles book store at Easton in Columbus, Ohio and my eye caught a large group of books on the medical self just in front of me. I counted 23 books about diabetes and as I looked further no other medical subject devoted so many books to one disease. Not heart disease, not high blood pressure, not even cancer. As a busy bariatric surgeon caring for diabetic patients nearly every day, I was intrigued.

After bariatric surgery amazing things happen to improve the lives of diabetic patients. Usually I see patients with type II diabetes discontinue all of their diabetic medicines soon after bariatric surgery. Less frequently patients who have had diabetes for many many years see improvement in their diabetes, discontinue insulin but still need some diabetic medicines that they take by mouth. In fact, it is extremely rare for a patient NOT to either resolve or improve their diabetes after bariatric surgery.

Filling my arms with a copy of each of these books, I headed for the store’s coffee shop and began to read. I tuned the pages of these books for references to the amazing things I was seeing following bariatric surgery. Surprisingly, I found very little. In fact I found only three books that even mentioned bariatric surgery and only one mentioned bariatric surgery could improve diabetes.

Why is there so little information in most books about diabetes about the amazing improvement for diabetics after bariatric surgery?

I will share more thoughts about this dilemma in postings over the next week.

See patients telling their stories on YouTube by googling DrSteveMyers and selecting my channel.

Follow Up on Chaka, the African Child Who Required Amputations

2011-02-25T15:59:00.000-08:00

As some of you will recall, while recently in Africa I had to perform a very sad operation on a one year old baby. The baby had severe malaria and because it took so long for him to recieve adequate care his fingers and feet died and I had to amputate many of his fingers and do amputations of his lower legs. (See postings under African Hospital in the index to the left of this posting and find "The Saddest Operation I Have Ever Performed")

Chaka felt much better a few days after his operation and now has gained weight and will soon recieve the artificial lower legs from a doctor in the USA.

If you look closely at the photo you will note the partial absence of several of his fingers but each is well healed.

I am so pleased he is alive and doing so well. I will be excited to see him next year and see how he is walking with his articicial legs.

Gastric Bypass - Jennifer Pierce Reports 3 Years Later

2011-02-24T16:58:00.000-08:00

-----------------JENNIFER NOW-----------------

"Best thing I have ever done for myself!" Jennifer exclaimed. It was my privilege to see Jennifer Pierce in the office three years after her laparoscopic Roux en-Y gastric bypass by me at Riverside Methodist Hospital in Columbus, Ohio.

She was very willing to share some of her journey.

She told me she weighed 267 lbs before surgery and now weighs only 155 lbs. She is near ideal weight and doesn't she look great?

"I now love to work out," Jennifer said when I asked if she is staying active.

She is much happier as you can see from her photos. She has more confidence in herself and is feeling much better than before her operation.

Jennifer's weight loss is a result of her strong effort to get her best result from her operation by staying active and making great choices. She lost nearly all of her excess weight in the first year after her gastric bypass but her weight has remained stable since then.

Great job Jennifer! I am delighted with your result and you should be very proud of yourself for what you have accomplished and how you have kept the weight off.Keep up the good work!

A Fashion Show to Help African Women

2011-02-19T18:05:00.000-08:00

Stephanie Myers, Dr. Myers' daughter, has helped many women from Fresh Start Bariatrics with their fashion needs after bariatric surgery. Stephanie also has been working with Amani Africa to help marginalized women in africa by training them to sew dresses for Amani Africa for sale in the USA.

Now Stephanie is bringing Korto Momolu, a Liberian fashion designer from New York who has been of "Project Runway" to Columbus for a fashion show at the Athletic Club NEXT SATURDAY, Feburuary, 26, 2011 to raise funds for the project in Africa. The cost is just $35 per ticket and can be purchased at peacethroughfashion@gmail.com.

This is a very exciting event. We would love to see many of you there showing support for Stephanie's project. Learn more by attending the fasion show or go to her blog at fortheloveofkunmabo.blogspot.com.

Robotic Bariatric Surgery and Improvement in Pain

2011-02-10T17:42:00.000-08:00

The results of our first 50 robotic gastric bypass operations have now been completed. The most dramatic difference we have noted is that our patients who have had robotic operations are much more comfortable following surgery and are leaving the hospital the day after surgery in the vast majority of cases.

At the live bariatric surgery seminar I gave last Saturday,as usual one of our patients volunteered to share her journey through our program. She had lost 135 lbs over the last year and is clearly doing very well. However, one thing she said took me by surprise. She explained that she experienced considerable pain at the one incision in the left side of the abdomen for several days after her operation. The reason this was surprising to me is that I remembered how much discomfort this particular incision caused many of our patients and that I have not heard this at all for the last several months since we have been using the da Vinci Robot.

This is a remarkable change. Previously we made an incision a little over an inch in size that allowed the passage of a fairly large circular stapler into the abdomen. This required the spreading of the muscles at this location which caused much more pain than the small incision we use with the robot.

Using the robot allows me to perform the connection between the gastric pouch and the Roux limb with two rows of stitches instead of using a circular stapling device. Of course the stitches, which we call sutures, are easily passed into the abdomen without any additional abdominal openings. In fact we have been able to decrease the number of incisions from five incisions we previously used and now use only four smaller incisions.

The result is much less pain and the ability to leave the hospital the day after surgery.

It is a privilege to be the only bariatric surgeon in central Ohio using the da Vinci Robot to perform the gastric bypass operation and to be one of the very few surgeons in the country to use the da Vinci Robot routinely to perform a Roux en-Y gastric bypass. It is wonderful to work Riverside Methodist and have the privilege to use today's most advanced technology to improve the lives of so many people.

Gastric Bypass and Smoking

2011-01-31T12:43:00.000-08:00

I saw a patient in the office today who was complaining of epigastric pain.

She had had a gastric bypass operation 6 months ago and had stopped smoking as we required prior to surgery. Unfortunately, she had restarted smoking and now presented to my office with worsening pain in her abdomen just below her breast bone which has continues for two days.

The pain is constant and sometimes is felt into her back. It feels worse when she eats or drinks.

This situation is most consistent with an ulcer that develops at the connection of the gastric pouch to the intestine. We refer to it as a marginal ulcer.
This problem is 40 times more frequent in people who smoke after a gastric bypass. That is why at Fresh Start Bariatrics we require that patients stop smoking prior to surgery and we strongly advise that patients refrain from smoking for the rest of their lives.

When necessary an ulcer is diagnosed with an Upper Endoscopy.
Other causes of a marginal ulcer could include:
• Use of alcohol
• Ingestion of non steroidal anti-inflammatory medications such as ibuprofen or naprosyn
• Infection in the stomach from Heliobactor Pylori

A marginal ulcer is treated for several months by:
• Stop smoking and other possible causes of the ulcer
• Start Sucrafate to bring relief from the pain by coating the ulcer
• Start Omeprazole or another proton pump inhibitor twice daily
• Pain medications as necessary
• Adequate protein in the diet

Potential complications could include:
• Bleeding from the ulcer
• Perforation with leakage of gastric contents into the abdomen requiring an emergency operation
• Scarring that will narrow the gastric outlet and require dilation of the narrowing with a dilation balloon or an operation to remove the ulcer and create a new connection between the gastric pouch and the intestine

The message is clear. Do not smoke if you ave a gastric bypass. If you do smoke you are likely to develop a marginal ulcer.

Jeff Howard runs at Walt Disney World Half Marathon!

2011-01-24T11:29:00.001-08:00

Dear Dr. Myers,

In January of 2010 my wife Kristie participated in the Walt Disney World Marathon. At that time I promised Kristie that I would participate in the Walt Disney World Half Marathon which would take place in January 2011. It was my hope that this goal would be the incentive I needed to once again try to lose the weight that for so long had been a health problem for me and was only getting worse with time. By May of last year not only had I not lost any weight, I had actually gained a few pounds. I was unable to walk a mile without becoming fatigued and out of breath. I felt that there was just no way I would be able to make good my promise to Kristie to participate in the half marathon or to get my weight under control

On June 12, with the encouragement of my family, friends and my physician I attended a Fresh Start seminar where I first met you and learned about gastric bypass surgery. After discussing the benefits and risks associated with the surgery with my family and personal physician I decided that it was time to get control of my life and my health. At the time of the June 12 seminar I weighed 305 pounds. My daily medications included Lantus insulin each night, Novolog insulin each morning, in addition to an oral diabetes medication. Also I was taking two different blood pressure medicines and two different medications for elevated cholesterol. My daily blood sugars ranged between 200 and 300 hundred each morning.

Only July 1 I completed my first round of testing at Fresh Start and met with the dietitians for the first time. After that first meeting I met with the Kristi Highly for monthly dietitian visits each month through August, September and October. Then on November 2 I had my gastric bypass surgery at Riverside Hospital and was discharged home on November 3. As of my discharge from the hospital I am no longer taking any medications for diabetes or high blood pressure. My daily blood sugars are now typically in the 90 to 100 range and my blood pressure at my last physician office visit was 128/78.

And today I am happy to share with you that on January 8, 2011 I participated with my wife, my daughter in law and her parents and 28,000 other runners and walkers in the Walt Disney World Half Marathon. I completed the 13.1 miles in 3 hours and 17 minutes and averaged a 15 minute mile pace throughout the race. And my weight as of the writing of this email is 215 pounds, a loss of 90 pounds since my first visit.

I cannot thank you and your entire staff for the wonderful care and support you have given Kristie and I throughout this continuing journey. You have given me my life back and I am sure you have added many years to my life with Kristie. I do not have the words to truly express my gratitude and can only say "Thank You and God Bless You" for using the gifts God has given you to help "people of size" like me.

Thanks again and I'll see you soon!

Jeff Howard

Jeff before his operation

Congratulations, Jeff, on a job well done and a promise kept! Thank you for alowing me to share your story on this blog. You are an inspiration to us all.
Dr. Myers

Adjusting Back to the USA

2011-01-21T17:56:00.000-08:00

Well, if it is true that it takes 1 day to recover for each time zone crossed I am well on my way to adjusting. It has been 5 days since my wife, Beth, and our team returned from Africa by way of Paris. Although we do well during the day, by early evening we are already getting sleepy. Fortunately we are doing much better now.

As I reflect on our time in Mali, West Africa at the Hospital for Women and Children, I am very pleased with results of performing 20 to 25 operations primarily on children.It is an unbelievable privilege to be able to do what I am trained to do in another country where there are so many that need surgery. Although I limit my practice to bariatric surgery in the US, many of you know I have been a general surgeon for many years and spent some time training in pediatric surgery as well.

But what I do there is only a small augmentation to what is going on at that hospital all the time. These are wonderful people that have left their homes in the USA, Canada and Holland to live in Koutiala, Mali so they can work with the Malian hospital staff to provide vital health care for those that come to this hospital. They do about 1,500 deliveries per year and care for all these babies and many more women and children in need. They demonstrate a tremendous amount of love and dedication.

I am so pleased to be associated with dedicated people such as Dr. Dan Nesselroade, Ob/Gyn and Marcy his wife, Dr. Brett McClean, Pediatrician,and Sherri his wife, Jake and Jessica, full time nurses, Ed Bonvillin, Medical lab technician and Andrea his wife, and Doug and Angela Wenger and all the excellent African staff. Job well done guys! Keep up the great work. They are saving the lives of many women and children. God less you all.

I am already looking forward to being with them again nest year and I know Brett is already seeing patients to add to my operating room schedule for next January.

Bon voyage for now but we hope to see you all again next year.

Finishing Our Work in Africa for theYear

2011-01-12T13:12:00.000-08:00

Wednesday, January 12, 2011, Koutiala, Mali, West Africa

Today was our last day at the Hospital for Women and Children in Koutiala, Mali, West Africa for this trip.

I was asked to present at the morning devotions for the hospital and spoke on the story Jesus told of the Good Samaritan. I asked two questions.

Who was the "neighbor" Jesus spoke of? Clearly Jesus speaks of our neighbor as someone in need that comes to our attention with a need we have the possibility of meeting. For the hospital staff their "neighbor" includes all of the many people who come to the hospital for care regardless of their religion, country of origin, ecomomic status or tribe.

For this hospital every staff member whether from Mali, the USA or another contry that loves God with his whole heart and provides for the needs of the person that come to the hospital with love and resect are "Good Samatitans". I explained to then that I saw many "Good Samaritans" in the African staff at this hospital and I was very proud to work along side them for this time. This is my forth time to this hospital and I look forward to returning again nest January.

Today after seeing many patients on rounds we completde a skin graft to the shoulder of a young girl that had been burned. A 2 month old baby boy came to the hospital from a far away village with a very large hernia on each side. His mother was very conserned. We added him on to the operating room schedule and did his operation today. I also took a 8 year old male child with a year long history of a severe bone infection that had eaten away much of the left side of his jaw bone to the operationg room to explore the infection to remove any extra pieces of bone before begining the boy on long term antibiotics to treat his infection. We then did a partial amputation of a foot on an elderly woman recovering from a severe foot infection. Finally,a woman who is a refugee from the Ivory Coast presented with an infection in her left chest and I plaved a tube into her chest to drain the pus.

Tomorrow we leave Koutiala to travel to Bamako. In the evening we will fly overnight from Bomako to Paris where we will spend a couple of days befor returning to Columbus, Ohio.

Progress at the Hospital for Women and Children in Koutiala, Mali, West Africa

2011-01-11T09:49:00.000-08:00

January 11, 2011, Koutiala, Mali

The Hospital for Women and Children in Koutiala, Mali has had ultrasound machines to diagnose gynecologic and obstetrical problems since the hospital opened in 2006. However, over the last year the hospital purchased a $35,000 X-ray machine. It is a beautiful machine in an equally beautiful new room. This has been very helpful especially in diagnosing pediatric problems such as pneumonia, tuberculosis and abdominal pain.

With contrast I brought form the USA we were able to do the first contrast study ever done at this hospital. I infused contrast in the colostomy of the baby with the imperforate anus. This showed a greatly distended colon from the colostomy to the vagina with the rest of the colon now decompressed from the colostomy. This will be helpful as we prepare to repair this problem next year.

The lab is becoming more sophisticated each year as well. Although they have been able to do transfusions since the beginning of the hospital, but the hospital now has a blood bank. In fact, I was able to give a unit of my blood when a twin was born with a very low blood count. The baby had my blood type, B+, and received two transfusions to bring the blood count up to normal.

It is a exciting to see improvement each year. By next year they should be in a new building with 3 new operating rooms.

The Saddest Operation I Have Ever Performed

2011-01-10T13:38:00.000-08:00

January 10, 2011, Kautiala, Mali, West Africa

We completed all three scheduled operations today.

The tonsillectomy was performed on a 5 year old boy with recurrent, chronic tonsillitis. This went well but I did not have some of the tools I have had in the past when I have performed tonsillectomies in the USA. I did bring a disposable suction cautery device but I did not have a standard mouth/tongue retractor nor did I have a headlight. Last week David Stryka, another of our team members, and I found a more basic mouth retractor that we were able to use but, Shannon, one of our team members kept the tongue out of the way with a standard wooden tongue blade. The anesthesiologists are always anxious over a tonsillectomy and for good reason. I am working around the endotracheal tube they place to control the childs's airway and bleeding can be a big problem after surgery. Fortunately we did not have bleeding and all went quite well. This is another first for this hospital and both the boy and the anesthesia personel survived the operation!

I was then able to teach Dr. Nesselroade how to do a mastectomy as he had an older woman that had a severe chronic breast abscess requiring a mastectomy.

Finally, I returned the 13 month old child who had the terrible dead finger tips and mummified feet from severe malaria to the operating room and again examined what was left of both feet. Unfortunately there was not enough of either foot to save so I had to perform a below the knee amputation on both legs of this unfortunate little guy. Before I started I prayed for the little one with the rest of the operating room staff as we often do. This time I got so choked up I could not finish the prayer. I guess the Lord knows what was so heavy on our hearts. Techniqucally both amputations went very well. Nelson Hess, Rosanna’s husband, prepared plastic splints for this patient and he will soon receive prosthetics for each leg.

The hospital staff and our team have all been very depressed over what had to be done for this little one. Of course the child’s family is distraught as well.

Although this may be the emotionally stressful operation I have ever done I am very pleased to have taken this awful burden off of the shoulders of the hospital staff. The operations went very well but it was hard to see the 2 little stumps at the end of the operation. We will all be praying for a quick healing and recovery. I hope to see this little one walking with prostheses and a tiny walker when I return next year.

Historic Vote in Africa Today

2011-01-09T07:04:00.000-08:00

Sunday, January 9, 2011, Koutiali, Mali, West Africa

Our team worshiped at the church at the seminary in this city this morning. Although 98% of Malians are Muslim, there are about 600 Protestant churches in this region of Mali and several Catholic churches. The Protestant churches were started many years ago by Christian and Missionary Alliance missionaries dating back to 1935. Now the Protestant church is a completely independent with Malian leadership. It was good to see African friends I had met on previous trips.

We are in Africa at the time of a historic vote that is scheduled to occur over the next week starting today. The country of Sudan in North East Africa has been a war torn country for many decades. I worked in a hospital in southern Sudan for a month in 2001 during the civil war while my eldest son spent his summer working in a refugee camp for boys about 100 kilometers away. Since that time my son has been working in many ways to help the southern Sudanese as the move toward independence from the government of Sudan in Khartoum.

Starting today the voting is to begin to determine whether the southern half of the country will be separating from the north. Pray for safe and fair voting and for the new beginning for the southern Sudan.

We are resting today and will begin operating again tomorrow. I have a tonsillectomy, a mastectomy and an amputation scheduled for tomorrow.

Research at the Hospital for Women and Children, Koutiala, Mali, West Africa

2011-01-08T07:42:00.000-08:00

As I sit in the living room of the guest house in Koutiala, Mali I am listening to Joan reading the “Register d’ Accouchement” or birth registry to Shannon, (on her third visit here), who is placing the information in to a spreadsheet on Rosanna’s computer. These three nurses constitute the research team. Each year Rosanna, who has a Doctor of Nursing Practice in research and spent 20 years of her life as a medical missionary to another country in Africa, brings nurses with her each year to collect data from the hospital. She uses the info to publish articles in medical journals and find ways to improve the care of patients in this hospital and at other hospitals in Africa. There are several research projects continuing at this time.

The research here includes determining the results of deliveries at this hospital, the effectiveness of an intrauterine balloon to stop post-partum hemorrhage, frequency of Rh factor and risk factors for stillbirths.

Of the 1664 women delivered and 1708 babies delivered at this hospital in 2009:

8% of pregnant women have Hepatitis B (all babies of hepatitis B positive mothers now receive immunization for Hepatitis B)

4% of pregnant women are HIV positive (50% return for treatment)
Patients are very fatalistic about contracting AIDS (if Allah wills you will get it so prevention is avoided)

12.5% of births were low birth weight babies (Women often decrease their food intake near the regnancy to decrease the size of the baby)

20% of deliveries were first time mothers

Average birth weight is just 6.16 lbs.

42 sets of twins and one set of triplets were (this is 10 times the frequency in the USA)

69 stillbirth delivered

46% of pregnant women come for 3 or less prenatal visits

In addition a research project for the rural areas in this region supported by ECHO from North Fort Myers, Florida is studying the use of leaves of the Moringa plant to bring more protein and vitamins to malnourished African children.

There is so much that can be done to improve the lives of people here. The ongoing research is an important part of this effort.

Completing Our First Week of Operating in Africa

2011-01-07T13:21:00.000-08:00

January 7, 2011, Koutiala, Mali

After making rounds on the patients we had previously operated on we returned to the operating room. It is a privilege to work with Dr. June Lee, an anesthesiologist from Columbus, Ohio and Joan Silverstrand, a nurse anesthetist from Omaha, NE. Although neither have recent experience with children, they have been working together very well to provide excellent anesthesia for our patients.

We continued our operating schedule. Our first patient was to have a skin graft placed to her burn but the burn was infected and we cleaned it and will reconsider grafting in a few days. Our second patient was the 1 year old baby with the amputations. We examined the sites and most are healing well. However, the left foot is not going to make it so I need to consider completing the amputation of that foot next week. What a terrible thing to have to do. This has been very emotional for the hospital staff so I definitely want to complete whatever needs to be done before I leave so this responsibility is off of their shoulders.

The third patient had a malformed penis. I was delighted with the repair. This little guy will do just fine.

Our last patient was an 18 year old boy who was involved in a motorcycle accident 2 years ago. He fractured his right femur with bone protruding from the skin. Unfortunately the bone was not repaired properly at another hospital in Mali and his bone was infected and still protruding from the skin! I removed the infected bone and rotated a muscle flap over the exposed bone. This should be the best way to bring a long term solution to this young man’s serious problem.

Overall, it has been a good week and several little ones have been cared for.

A Much Better Day at the Hospital for Women and Children, Koutiala, Mali

2011-01-06T13:33:00.000-08:00

January 6, 2011, Koutiala, Mali, West Africa

This was a much better day. Removing debris from a burn in a 8 year old girl, cleaning a serious foot infection in a woman who stepped on a piece of wood 1 month ago and has lost much of her foot to the infection and removing a lymphatic tumor from the leg of a 6 year old boy and placing a skin graft from his thigh to his leg were all rewarding operations to do.

I was most pleased to teach Dan Nesselroade, an Ob/Gyn who has devoted his life to developing this African hospital, how to perform a colostomy on a 2 year old baby girl who was born without an anus but has a communication between her colon and her vagina She has been passing stool from her vagina since birth. This not only improves this baby’s life but will help Dan to save many children when they are born with this abnormality. Next year when I return I plan to repair this anomaly in this little girl.

It is great to work with the great group of people here who have come from the USA, Canada and Holland. They are so devoted to these people and treat each with so much love and tender care. It is also a privilege to work with so many Malians who have learned so much and are doing such a great job caring for so many of their fellow Malians during their time of need.

Yes. It was a much better day.

A Most Emotional Day

2011-01-05T13:17:00.000-08:00

January 5, 2011 Koutiala , Mali, West Africa

I have been communicating with the doctors here by email for about 6 weeks about a 13 month old baby girl who developed a severe case of malaria. She survived but developed severe ischemia of her hands and feet. By the time I arrived the baby had black mummified fingers and feet. This tissue was clearly dead and had to be removed.
Today our team took this little one to the operating room and I did the necessary amputations of the ends of all of her fingers at least half of both feet. It was very sad and each of us returned to the guest house emotionally and physically exhausted.

Next week we will look at the amputation sites and decide if more must be removed or if skin grafts can be placed to close the defects.

What a terrible operation to have to do. I am doing everything I can to preserve the length of this little girls legs.

We will all take the evening to recover so we can return tomorrow for another series of challenging cases.

Finally, We are Safely ln Koutiala

2011-01-04T13:54:00.000-08:00

January 4, 2011, Koutiala, Mali, West Africa

The trip from Bamako to Koutiala is always a little crazy. With ten of us in the van, Nelson, one of our team members at the wheel and what seemed like a ton or more of luggage we headed out on the narrow two lane asphalt road at about 100 kilometers, about sixty miles an hour, to contend with the fast moving grossly over loaded trucks, busses and bush taxis while dodging the goats, sheep and chickens that decided to cross at inopportune times. Thank goodness the brakes worked well. Do you know what happens when a chicken is too slow when crossing the road? Believe me it isn’t prett!. Occasionally cattle or a donkey decided to share the road and we gave them priority. Potholes, speed bumps and toll booths were too numerous to count but after 3 hours we were all tired and hungry as we entered the town of Segu on the Niger river for a late lunch of Hawian Pizza and Tonic water at a local restaurant.
After lunch it was my turn to drive and after another two hours we made it to the guest house in Koutiala to clean up before dinner with all the American, Dutch and Canadian workers and their families. Most of the kids were still home from school since it is still Christmas holiday for those that attend a boarding school in Dakar, Senagal so there was about forty of us all together. We had a great time becoming reacquainted and telling stories from times we were together during our yearly visits to the hospital over the last four years.

We are all glad to be here safely and we will rest well tonight before starting work tomorrow. If we are lucky maybe we will even be reacquainted with the delayed luggage Tomorrow as well.

Big day tomorrow as Dr. June Lee and I will begin to evaluate patients and add patients to the operation schedule.

Good night from Koutiala, Mali.

Ariving in Mali

2011-01-03T17:24:00.000-08:00

We arrived in Bamako, Mali about 9 pm West Africa time. The plane ride from Paris was smooth and pasport check took time but was without hassel. Five of our eleven checked luggage arrived with us but six bags did not. We spent until midnight filing the missing lugggage forms. Of course this is a hassel with halting french language skills at best. Hopfully the other bags will arrive tomorrow and be brought to us at the hospital.

It is after 1 AM and we are in the guest house. The clean sheets are beconing and it will be great to be able to lay supine instead of tryting to sleep while sitting in an airplane seat.

It was great to meet with Rossana and her husband, Nelson. They were with us last year doing research at the hospital. Shannon, a nurse from Omaha, NE met up with us in Paris and traveled with us with her sister and another nurse. It is great to see "old freinds" and meet new ones.

Got to get some sleep before we travel the 5 hour over land trip to Koutiala where the hospital is located.

Why Go to Africa?

2011-01-03T16:53:00.000-08:00

January 2, 2011

I am writing this from the airport in Cincinnati. Our flight has been delayed for “mechanical reasons”. We should be on our way in an hour or so.

I feel invigorated already. The on call coverage for the practice has been switched to Dr. Dominguez and as I tell my office staff, “They can’t hurt me know.” I have about 7 or 8 hours of uninterrupted reading and/or sleeping before we arrive in Paris for our next flight to Bamako, Mali.

We have been gathering last minute items such as anesthesia medicines, Xray dye and surgical instruments. The five of us loaded 11 pieces of luggage about 50 lbs. each and are carrying another 10 carryon bags. It is surprising how few clothes we have despite being in two climates but we have plenty of peanut butter, ketchup, spices and other food stuff to help with our meals.

We have reserved a room at the Paris airport to catch a short nap and shower. Then back on another plane for the next leg of the journey to Bamako.

It is an honor to be able to return to Africa for the ninth time. There are many reasons I do this. I so enjoy caring for those that would otherwise be without care, especially the children. It is also an encouragement to the staff working at the hospital and others involved in the work there. It resets my moral compass and helps me to know what is really important in life. Finally, I count this as part of my worship, doing what I believe is pleasing to the Lord I serve.

All in all, this is not a sacrifice. This is a privilege.

To Africa Again with Love

2010-12-31T21:01:00.000-08:00

As many of you know, my wife, Beth, and I spend the first two weeks each year working in the Hospital For Women and Children in Koutiala, Mali, West Africa Now that the Christmas holiday is over we have been focusing on Africa again. A few years ago I had a small part in the development of this hospital. It has been up and running for 5 years and we have had the privilege of traveling there each year for the last four years.

We are taking my daughter, Stephanie, a friend and pre-medical student, David Straka, and June Lee, MD an anesthesiologist. Everyone has their visas and we are off within the next 48 hours. (The last visa just arrived today!).

I have been in nearly constant communication with the doctors from the USA that live and work there. Even today they called with a surgical question about a small boy that that needed an emergency operation even before I will arrive just 4 days from now. They have several children that will need operations while I am at the hospital. They usually ask me to take care of some of the more complicated pediatric surgical problems while I am there.

I will need to correct a 2 year old child that was born without an anus, a little boy that has a congenitally malformed penis, an 18 year old that has the “thigh bone” out of the skin following a motorcycle accident 2 years ago and even do a tonsillectomy on a child. Unfortunately I will need to amputate parts of a 1 year old’s fingers and foot that are dying after a severe infection and will need to care for acute burns and release burn scar contractures in other children.

Food, clothes, medical instruments, passports and tickets are being packed. Luggage is being weighed and final arrangements confirmed.

We leave from Cincinnati, Ohio the day after tomorrow and fly to Paris. Later that day e will join a team of nurses from Omaha, Nebraska and leave Paris and arrive in Bamako, Mali about 11 PM that night. After a night’s sleep at the guest house in Bamako we will travel over land for about five hours to arrive at the hospital exhausted but excited to see our American, Canadian, Dutch and African friends at Koutiala.

We welcome your prayers especially for the health and safety of the children we operate on. I will continue posting from Africa.

To learn more about the hospital in Mali find it on the web at www.koutialahospital.org.

Laura England Loses 100 Pounds in Five Months!

2010-12-22T18:41:00.000-08:00

BEFORE

Laura England had a laparoscopic gastric bypass five months ago and was seen in my office for her five month follow up visit today. She has lost 109 since her operation and only has 68 more pounds to lose by the end of her first year.

She says she has 100% more energy and looks forward to exercising. She even went shopping on "Black Friday".

She no longer needs to sit down while singing in the church chior!

Recently others living in her comdominium suprised her by celebrating with this sign:

Robotic Surgery Update

2010-12-21T18:32:00.000-08:00

We have now completed our first 44 robotically assisted gastric bypass operations. I am pleased to report that our patients are doing well. We have had no leaks and no transfusions. Most patients are now going home the day after surgery. Surgical pain is much less and patients seems to be pain free on their first office visit after surgery at 1 week after the operation.

We have needed to dilate one patient who developed a narrowing between the gastric pouch and the Roux limb of the small intestine.

We now are completing the operations in 2 hours.

Call for Recipes

2010-12-18T12:00:00.000-08:00

Have a favorite recipe(s) that has helped you in your bariatric surgery journey? We would love to hear from you! Sharing with us can help others in their journey.Feel free to share about your weight loss or other items that might be helpful to others.

Appetizers
Drinks
Salads
Vegetables
Soups or Stews
Fish and Poultry
Meats
Pastas
Casseroles
Desserts

Just send them to Kristi, one of our dietitians, at Run4sanity@yahoo.com. Kristi will do the nutritional analysis and we will share the recipes with our patients.

We would especially like to know your ideas of how to improve protein intake and use of non-calorie sweeteners!

Anthem Medical Insurance Company Approves the Gastric Sleeve

2010-12-16T16:32:00.001-08:00

Today we noted Anthem changed their policy and will now approve a gastric sleeve for bariatric surgery patients who would prefer to choose this procedure.

Blue Cross/Blue Shield companies usually follow the recommendation of Anthem.

This ruling reverses the previous policy that stated a "Gastric Sleeve is an experimental procedure".

A gastric sleeve is now the second most frequently performed operation in my practice after a gastric bypass.

I have had the privilege of performing about 150 Gastric Sleeve operations. Our patients lose 78% of their excess weight at one year on the average and it is not medically necessary to take a multivitamin and calcium after this operation although it is still encouraged.

This operation is best considered for patients who do not have significant diabetes since a gastric bypass is more likely to improve or resolve diabetes.

A Bag of Calcium Chews Cost Grace $500!

2010-12-02T17:18:00.000-08:00

I saw Grace Sexton in the office today and was startled when she told me a bag of chocolate calcium chews cost her $500. This is the story she said I could share with you.

Grace recently bought a bag of chocolate chews for calcium supplementation and placed it in a drawer at home. The chews must have smelled irresistible to her dog since he opened the drawer and proceeded to eat all 50 of them, wrappers and all!

That amount of calcium is toxic and chocolate is dangerous to a dog as well so off to the veterinarian they went. The dog was hydrated with IV fluids and his stomach was pumped. Five hundred dollars later the dog recovered.

This could be the most costly bag of calcium chews ever.

A Heavy Load for a Little Boy

2010-11-19T15:25:00.000-08:00

Kimberly Foley was seen by me in the office this week for her 1 year visit. She has had an amazing result! She has lost 97% of her excess weight. In fact she lost even more if you count her weight loss before her operation. She said she was willing to share her information with you.

5/21/09 Intake visit 384 lbs
11/9/09 Pre-op visit 356 lbs
11/18/10 1 yr Post-op 166 lbs

Her Body Mass Index dropped from 59 to 25.

Even more important, Kim shared a story that nearly brought tears to my eyes. Kim has a son Trevor who is 8 years old and a sister, Barbara, who is a funeral director.

One day Trevor said to Kim, “Mommy, I’m so proud of you for getting “thinny” so we don’t have to call Auntie Barb to get your funeral ready”.

Whew! What a heavy load this little one was carrying without anyone knowing it. You never know what kids are thinking.

How did Kim get such a great result? She said she had positive support from friends and family, she exercises 4 days a week and gave up elevators for lent!

Gastric Band and Autosnacking

2010-11-15T16:55:00.000-08:00

"Autosnacking" is a word I invented to explain one of the reasons that patients who have a gastric band are not hungry for about 3 hours after eating. This term refers to the slow release of solid food from the gastric pouch as it passed through the area of narrowing created by the adjustable gastric band.

If the band is adjusted properly solid food will be held up by the band and allowed to reach the rest of the gastrointestinal track over the next couple of hours after eating. This suppresses the patients appetite just like snacking but without eating. after the food has passed the hormone, Ghrelin, will again begin to rise making the patient feel hungry about 3 hours after eating.

We use this time interval to determine whether someone needs a fill. If the patient is feeling hungry just an hour or so after eating a meal of solid food the band may need to be adjusted with more saline injected to make the band tighter and therefore narrowing the restriction slowing release of food from the pouch.

I emphasize solid food because the band is not designed to hold back liquids.

Other indicators for needing a fill include losing less than 1 pound a week and the ability to eat foods such as bread, chicken breast and / or steak.

Update on Robotic Bariatric Surgery at Fresh Start

2010-11-14T18:51:00.000-08:00

This is just a quick update on our robotic gastric bypass operations. We have now completed 23 Laparoscopic Roux en-Y Gastric Bypass operations with robotic assistance. We have had no complications from the robotic portion of the operation and the only complication was the infection from the non-robotic small intestinal connection that we reported in the previous update. The robotic portion has reduced in time from 2 hours to 45 minutes and most patients are now going home on the day after surgery. Overall I am delighted with our progress to date.

Gene Carey shares his success story - Pt. 1

2010-10-25T07:02:00.000-07:00

Gene Carey shares his success story - Pt. 2

2010-10-25T06:31:00.000-07:00

Diabetes May Double by 2050, Bariatric Surgery Can Help!

2010-10-23T14:14:00.000-07:00

Front page news in the USA Today and the Columbus Dispatch newspapers this week reported the most recent CDC prediction for diabetes in America.

1). Diabetes may increase from the present rate if 1 in 10 to 1 in 3 persons over the next 40 years.
2). Presently there is about 200,000 diabetics in central Ohio
3). It is estimated that the number of diabetics in central Ohio will increase by 13,000 every 2 years

Most of the increase will be in Type II diabetes. Why?

1). Improved diabetic care is allowing diabetics to live longer
2). Earlier diagnosis
3). Growing minority populations
4). Increasing frequency of obesity

How can bariatric surgery help?

For those persons of size who develop type II diabetes, their diabetes is resolved 84% of the time after bariatric surgery. For those who were diagnosed with diabetes within the last 5 years the results are even better: 95% of patients will resolve their diabetes.

Although all bariatric operations can help to prevent diabetes, the best operation to resolve diabetes is a Roux en-Y Gastric Bypass. A Roux en-Y Gastric Bypass is the only operation that changes to patients hormonal situation to increase the amount of insulin the pancrease produces in response to carbohydrates.

Learn more about diabetes and bariatric surgery on other posts on this blog.

Our practice is available to help as many persons of size with diabetes who want to be helped.

Bariatric Surgery Decreases the Risk of Breast Cancer

2010-10-19T18:56:00.000-07:00

A recent study showed that the risk of developing breast cancer over the 5 years after bariatric surgery is decreased by 80%.

Nicolas Christou at McGill University in Montreal, Quebec, Canada compared a group of bariatric surgery patients with a group of people of similar weight over a 5 year period of time.

Only 2% of those who chose bariatric surgery developed breast cancer over the subsequent 5 years compared to 8.5% of people of similar size that did not have bariatric surgery.

This is the first study that clearly shows the risk of developing breast cancer is decreased by 80% over the next 5 years after bariatric surgery.

Baraitric surgery could be the most important choice some women make.

Results of the First Eleven Robot Assisted Gastric Bypass Operations at Fresh Start

2010-10-14T16:59:00.000-07:00

Left: Dr. Myers, Right: Mike Palasek, CRNFA, Robot, named "Bow Tie" center

Over the last few weeks I have been privileged to several Robotic Assisted Laparoscopic Gastric Bypass operations. I am very pleased with the initial results and I would like to share them with those who follow this blog.

Number of operations performed 11

Converted to open operations 0

Number of incisions required 4, which is 1 or 2 incisions less (2 5 mm ports and 2 12 mm ports)

Total lentht of incisions decreased by 50%

Discharged day after operation 50%

The length of time required to perform the operation has improved from 3 hours 30 minutes to 2 hours 20 minutes.

In addition, we have noted the patients have much less pain in the hospital and denies any pain at the 1 week visit.

One patient was rehospitalized for an infection not related to the robotic assistanc and they are improving nicely.

Overall patients are doing very well. I will keep you informed of further progress.

Ramona Fleming and daughter Mellisa Hume share their success stories

2010-10-14T10:49:00.001-07:00

Brian & Christine Stinecipher share their success stories after gastric bypass! Part 1

2010-10-13T07:33:00.000-07:00

Brian & Christine Stinecipher share their success stories after gastric bypass! Part 2

2010-10-13T07:28:00.000-07:00

Consignment Clothing For Weightloss Wardrobe Changes

2010-09-28T14:12:00.000-07:00

During the stages of weight loss, it is hard to imagine purchasing a whole new wardrobe in the size that your weightloss takes you each month or so. My best suggestion is to go consignment shops that specialize in Plus Sizes. Also, Thrift stores are a great place to go hunting for a few pieces to get you by while you are loosing the weight. Here are a five in the Columbus, Ohio area.

Go Figure Consignment
988 N. High St.
Columbus, OH 43201
614.297.8070

One More Time – Grandview
(Men’s and Women’s Consignment)
One more time plus
614-486-3728
1515 West Fifth Avenue
Columbus, OH 43212

JustPlus
6042 E. Main St Columbus OH
614-759-PLUS (7587)
Monday - Saturday 10 - 8
Sunday 12 - 6

Miss Chrissy’s
3058 W Broad St
Columbus, OH 43204-1302
(614) 351-7253

And My personal favorite (which is my own happy hunting grounds) is
Gabriel Brothers in Mansfield or Zanesville

Where have you had success?

Early Results from Our First Robotic Gastric Bypass Operations

2010-09-28T13:54:00.000-07:00

“It’s amazing”, Robyn Blake told me in the office today. She is just one week from her robotically assisted laparoscopic Roux en-Y gastric bypass and she is thrilled with her results. ‘I only took one pain pill a day for the first 2 days after I was discharged from the hospital.”

“The results are not subtle,” Mike Palasek, CRNFA who assisted with each of these operations told me today. “The patients who had their operation robotically are having much less pain.”

We have now completed our first four robotically assisted gastric bypass operations. Both are doing very well. Two of these patients went home the day after their operation instead of two days later. The patients appear much more comfortable the day after the operation.

Overall I am very impressed with these very early results. There are only 4 incisions and these are smaller and healing well without a drain or staples.

I agree with Robyn, the results are amazing.

Great Message from My Patient, Wendy Hartman. Check Out Her Blog!

2010-09-25T20:21:00.000-07:00

My husband and I have been together for 26 years. Married, 19. He met me at about 180 pounds. I was about 250 when we married. I was at 395 when I had surgery.

Scott told me the other day something that had me in tears.

I knew he was worried about me, but we never talked about it. He said: "6-8 months ago, I was crying myself to sleep wondering what I would do when you were gone. How was I going to handle the kids? How was I going to pay the bills when I don't even know where the passwords are for the accounts? I had no idea that our lives could change so much in 6 months. Everything is so much better. You are a better person. We are better." Wow.

Thank you, Dr. Myers!!!

Wendie Hartman

http://margaretandelwood.blogspot.com/

Dressing for Excess Skin

2010-09-23T09:55:00.000-07:00

A posting from Stephanie Myers, Dr. Myers' daughter, on 3 problem areas that can be improved by focusing on appropriate wardrobing.

One of the major issues post bariatric surgery is the issue of excess skin. Although the fatty tissue will be gone soon because of the surgery, exercise, and nutrition adjustments, the skin which has been stretched to accommodate that fatty tissue will remain (some to a more severe degree than others, depending on an individual basis). Regardless if you choose to have bariatric surgery or not, I want to give you a few ideas to work around the excess skin in the mean time.

At a recent support group I shared about what clothing to look for in order to resolve the issues of discomfort and embarrassment. Those are both valid issues and the key to solving this issue is having the correct undergarments. Of course, all three can be used at the same time if necessary. Most likely these ideas are not foreign to women, such as Spanx, or control top hosiery. Now, I will explain the three main problem areas, the solutions, (what to look for to work with each area), and styling tips.

1). The problem area: The “Apron” - This is what is known for the the excess skin area of the stomach. Again, once the weight is lost, the skin can still remain.

The solution: A good solution here is to find a very fitted stretch tank top that will help to hold in excess skin. This tank can be a few sizes smaller than you would typically wear so that you get the supporting effect.

This picture is a great example. It is a Spanx for Plus sizes that can be found at Lane Bryant. You could even look for a longer version that will go just below the hips.

How to Style: The key with styling this is that it does not have to show, in fact it really shouldn't. The best idea is to layer and especially going into fall and winter this will be easy to do.

2). The problem area: The “Wings” - This area of excess skin is from any stretched skin that caused by the fatty tissue in the arms.
The Solution: A very fitted three quarters length fitted t-shirt will hold skin in place so you don’t have that 'flapping' feeling. This shirt needs to be more fitted than your usual clothing, again to support your arms.

How to Style this garment: The purpose of this garment is also to be an undergarment, and should be worn with other clothing that fit appropriately.

This example is a top that is on sale at Nordstrom.

3). The problem area: The Inner Thighs - The inner thighs are an area that can be an annoyance.
The solution: Very fitted bicycle shorts or spanx (apparently, these shorts to the left are lined with zebra print. Zebra print is optional when you do your shopping!
How to style: Another great trick is to wear bicycle shorts under your pants or dresses in order to give you a more controlled feeling and therefore, will be more comfortable. This pair is from Lane Bryant.

Again, I am here as a resource for your wardrobing issues now. I also will work with you to create a look that is uniquely yours. Please contact me at Stephanie.Myers1@gmail.com to arrange a meeting to begin!

Get Well Picture for Grandma

2010-09-20T17:02:00.000-07:00

Mikey Pyle drew this picture for his grandmother who had her bariatric operation last week and was seen in the office today. Look closely to find the following 4 details:

1). Grandmother's size before and after the operation

2). What is that in Dr. Myers hand?

3). Note the Gandmother + Surgery = Smaller Grandmother format

4). The facial expressions are terific

Great job! Thank you, Mikey, for cheering up your grandmother and bringing a smile to all of us.

Finding "New" Things after Bariatric Surgery

2010-09-19T18:44:00.000-07:00

Finding “New” Things after Bariatric Surgery

Last week one of my patients who had lost a lot of weight after her bariatric operation returned complaining of finding a new mass just below her breast bone. She was obviously very worried.

After I examined her I indeed noted a firm ½ inch hard rubbery mass just as she had described.

I explained that this finding is called the xiphoid process and is a normal anatomic structure. She was just now finding this for the first time because she had lost enough weight it was no longer hidden in the fatty tissue!

This is a very common occurrence. As a bariatric surgery patient loses a lot of weight, say 100 to even 200 lbs or more they are able to “find things” they did not even know they had such as hip bones, back bones, clavicles, tail bones and even ribs that they thought were breast masses!

Of course these patients are often embarrassed when they find out these structures were always there but could not be felt until they lost significant amount of weight but it is just part of discovering themselves anew.

Having bariatric surgery is truly a Fresh Start for many and a new discovery of the new you.

Update on the Use of the da Vinci Surgical Robot

2010-09-18T19:27:00.000-07:00

Last Tuesday, September 14, 2010, I was privilegded to perform 2 gastric bypass operations with the assistance of the da Vinci surgical robot. Although it is always challenging to begin to use new technology, both patients did well and one left the hospital after only one night stay.

The following is an exert from an email sent out by a representative of the company that makes the da Vinci robot to some of the Medical staff at our hospital. I thought you might be interested in this anouncement:

"OhioHealth has established itself as a leader in robotic surgery and Dr. Myers has established himself as a leader in bariatric surgery. This is another application where da Vinci is helping surgeons deliver minimally invasive surgery to a broader base of patients every day. Dr. Myers gave the following reasons for using the da Vinci for his gastric bypass procedures:

1. Stronger anastomosis
2. Patients are less likely to bleed
3. Less incisions - reduced from 5 to 4 with about 50% reduction in incisional "footprint"
4. Less pain at trochar sites
5. No need for largest incision to pass circular stapler

Dr. Erik Wilson from the University of Texas Medical School at Houston proctored Dr. Myers with the use of the dual console da Vinci Si system."

This important device will be able to help make this operation even safer and better. I will have the oportunity to use the robot to perform a gastric bypass for three more patients in the coming week.

Learn more about the da Vinci robot at www.IntuitiveSurgical.com

New Video! Dietitian explains Nutrition Facts Label

2010-09-16T06:37:00.000-07:00

In this video, You will see Dietitian, Kristi Highley sharing the importance of the Nutrition Facts Label. The photo on top is an image of the exact Label she is referring to, but enlarged. One more thing before we get started, Dr. Myers wants to know something about the beginning of the video, "What's up with the tongue Kristi?"

Brian Stinecipher shares his success story after gastric bypass! Part 1

2010-09-14T08:46:00.000-07:00

We begin this video with Janet Dearwester, a Fresh Start Bariatrics patient, who went from 200lbs to her current weight of 130 lbs. Then, Brian Stinecipher shares he and his wives' success stories as patients at Fresh Start Bariatrics. He shares before and after stories and pictures.

Brian Stinecipher shares his success story after gastric bypass! Pt. 2

2010-09-14T08:41:00.000-07:00

In this part of Brian's presentation, he concludes and then takes questions from perspective patients at a recent Informative Seminar that Fresh Start Bariatrics. and Questions are then answered by both Brian (a Fresh Start Bariatrics patient) and Dr. Myers. The free seminar is the first step in the Fresh Start Bariatric Patients journey.

Preparing to Perform Robotic Assisted Bariatric Surgery

2010-09-13T19:55:00.000-07:00

Preparing to Perform Robotic Assisted Bariatric Surgery

My wife and I were at my parent’s home last weekend. Our conversation included my plan to begin performing robot assisted bariatric surgery. They asked a great question, “How have you been training to use the robot?”

I thought you might be interested in my response.

First, it is important to remember that I have been performing the Laparoscopic Roux en-Y Gastric bypass for over 7 years and have performed nearly 800 of these operations.

Second, I plan to begin by performing only a part of the operation using the robot.

Third, using new advanced technology to perform this operation is much like an experienced professional pilot training to use a new airplane to fly a familiar air route.

As you might imagine Riverside Methodist Hospital has a pathway each surgeon is required to complete to become credentialed to perform operations with the assistance of a robot. I have exceeded the requirements and followed the following 10 steps in the path to preparation:

1). Observed two operations performed by Dr. Michelle Toder in Bangor Maine in July 2010 and was very excited by the capability of this remarkable instrument.

2). Informed the hospital of my interest in robotic surgery

3). Reviewed about at least 8 hours of video of the operation performed using the robot

4). Observed an operation with Dr. Burges at Riverside

5). Completed an all day training session performing several operations with a certified instructor

6). Logged at least 8 hours of independent practice on the robot

7). Choreographed each step of the operation with the operation room staff during a mock operation

8). Received temporary privileges to perform robotic surgery from Riverside credentials committee

9). Obtained consent from the first 2 patients to perform their operations using the robot

10). Arranged for Dr Erick Wilson, a very experienced robotic surgeon from Houston, Texas, to be present in the operating room during the first two operations using the robot as my “proctor” or supervisor tomorrow, (9/14/2010)

Now I am ready to get started! Maybe I should watch “Top Gun” once again before we start the operations!

Roller Coasters after Bariatric Surgery?

2010-09-10T20:48:00.000-07:00

Yesterday I saw Stephanie, a patient of mine, in the office one week after a laparoscopic gastric bypass operation. I was surprised when she asked if she could ride the roller coasters at Cedar Point amusement park just 11 days after her operation. She said she loved roller coasters and especially enjoyed the rides that make her hang upside down!

I said I was delighted she was doing so well she wanted to ride the rides at an amusement park a week or so after her operation. However, even if it does not injure you, hanging upside down is for bats not humans!

How to dress during dramatic weightloss - Dr. Myers' Daughter explains

2010-09-08T10:30:00.000-07:00

Dramatic weightloss requires dramatic wardrobe changes. I, Stephanie, (stylist and Dr. Myers' daughter) want to focus on finding a good dress first, because it can be very versatile while you are loosing weight (Sorry Guys! This one is for the Girls!). Especially after surgery, a dress can be a wonderful solution for you while your body is in this very dramatic transitional time period. Here is what to look for while shopping for this must-have fall wardrobe essential: The Dress. Here are five points to guide you to the perfect dress. Let's get started!

#1 What to look for in the perfect dress - Structure

A dress with structure is going to give your body shape, such as this dress from Nordstrom.

I love this dress! The denim is right on trend for this fall. This dress works because of the structure in the bodice which gives the rest of the body a perfect shape. The skirt is full and falls gracefully away from the waist. This is a wonderful solution and a great option for your fall wardrobe. And as the weather changes and cools down, you can switch out the white belt for a nice leather one and pair the dress with an adorable sweater or cropped jacket. Finish the look with a pair of cute boots.

Now, moving right along to the second aspect to look for...

#2 What to look for in the perfect dress - Visual Lines

First of all, can we all just agree that this is a gorgeous dress?! The idea behind a dress like this is that the lines in the garment create a visual trick and elongate the entire body. The draping is also a very current way to look effortlessly glamorous.
Look for these kind of detailing that can quickly update a wardrobe and making you look very modern at the same time.

#3 What to look for in the perfect dress - Necklines

Necklines are an important aspect to look for when you are shopping for the perfect dress this fall. This hot pink dress from Nordstrom is fabulous. It has the best two important key elements when looking at the neckline of a dress. The V-neck is wonderful and creates an illusion of length. Also, the faux-wrap on the bodice can also minimize the chest.

#4 What to look for in the perfect dress - Fit

This specific area of dressing yourself walks a fine line. It is very important to wear a size that is fitted, yet not too tight. However, leave enough room that you can breathe and move easily, and yet is not baggy. If ever you have a question as to if the fit is right on you or not, then try on three different sizes. One that is typically your size, then a size up and a size down from that. Also, because brands can size very differently.

The following two pictures gives two examples of dresses that fit just right.

And now for an ill fitting garment..

The reason why this garment doesn't work is because it hides a figure all together, and what begins as a good intention to hide unwanted weight, actually creates more surface area instead of the desired camouflaging.

#5 - What to look for in the perfect dress - Texture & Fabric

Fabrics are incredibly important aspects of finding a great dress for this season. Look for fabrics that have a certain stiff quality. These fabrics can be forgiving and can camouflage problem areas. Where as a thin jersey (or t-shirt fabric) can cause unwanted hugging. This dress is a fantastic example of almost all of the points we just discussed. I can just see it now with the perfect pair of boots and an adorable jacket for the fall...

And when you are ready to go shopping, Contact me! I would love to guide you through your fall wardrobe and give assistance during the transition time after surgery. We can go to Target or Saks Fifth Avenue and everywhere in between. Contact me at: Stephanie.Myers1@gmail.com

Gastric Sleeve Surgery Performed by Dr. Myers

2010-09-08T07:11:00.001-07:00

This video contains the Gastric Sleeve Surgery procedure. It is not for the weak stomached. However, the video will give you a good idea of what the procedure looks like.

Gastric Sleeve, Tara Burchett Explains Why She Chose This Operation

2010-09-07T13:33:00.000-07:00

NEWS RELEASE

2010-09-05T11:07:00.000-07:00

Columbus, Ohio, September 5, 2010

Free Interactive Bariatric Surgery Course Now Available Online

Prospective weight loss surgery patients can now learn more about bariatric surgery by accessing a new free interactive online course at www.freshstartbariatrics.com. Dr. Steve Myers, a bariatric surgeon in Columbus, Ohio has developed the online seminar in close collaboration with Riverside Methodist Hospital. “This course shares information in plain language for people of size that would like more detail about which bariatric operation would be best for them”, Dr. Myers explains.

This free progressive course includes many videos, drop and drag activities, pictures, information ‘dots’ on diagrams, interactive question and answer opportunities and click for definitions in user friendly terms. Myers says, “This is truly an interactive experience”. Prospective patients unable to attend the live Fresh Start Seminar can now obtain the same information online. For those interested in proceeding in the Fresh Start Bariatrics program, this course can be the first step in the process.

This new course provides clear, transparent information in an easy to learn format and will help persons of size choose the best approach possible when considering bariatric surgery.

Walk from Obesity!

2010-09-02T12:46:00.000-07:00

Walk from Obesity is happening again in Columbus, Ohio!

Columbus, OH
Walk from Obesity
Register today - Early registration for adults (12+) is only $25.00.

Children under the age of 12 are FREE!

Register online at: www.walkfromobesity.org

Walk Date: Saturday, October 30, 2010

Registration will open at 9:00AM
The Walk will begin at 10:00AM

Walk Location:
Fred Beekman Park / The Ohio State University
Southwest Corner of Lane Avenue and Kenny Road

Presented By: The Ohio State University Medical Center Bariatric Surgery Center, Dr. Bradley Needleman and Dr. Dean Mikami

Event Leaders: Shannon Hall and Andrea Hansen

Walkers: You may seek pledges using the online tools after registration. To collect pledges in person, a printable pledge form is available here.

Event Sponsors: Please contact Shannon Hall or Andrea Hansen directly for local Walk sponsorship information and opportunities.

For more information, or to volunteer your services for the Walk, please contact:

Shannon R. Hall
redheadedshannon@yahoo.com
614-595-1492
3555 Rangoon Drive
Westerville, OH 43081

Andrea Hansen
aniahansen@hotmail.com
614-451-6510
3558 Rangoon Drive
Westerville, OH 43081